Many treatment options are available for fungal toenail infections. However, not all are equal in effectiveness. When selecting the proper treatment for fungal toenails, the nature and duration of the toenail fungus must be explored. There are different types of fungal infections, which can be important to rule out certain types in order to get the most effective treatment. Issaquah Foot and Ankle Specialists has extensive experience in treating discolored nails and fungal nails. We have established treatment protocols which we have implemented for years with great success. Oftentimes we are able to treat this without using oral medications. One of the latest technologies is a FDA approved laser for clearing of the toenails. It is important to know that not all lasers of the same and not everyone has an FDA approved laser. If you or someone you know is suffering from fungal nails, give us a call to explore treatment options and preventing toenail infections from getting worse.

Here at Issaquah Foot & Ankle Specialists, we see patients for various reasons. However, one big reason patients come to us is for plantar fasciitis. Plantar fasciitis is the most common cause of heel pain. Over two million people seek treatment for plantar fasciitis per year, according to the latest medical statistics. Most of our patients come in with sores, irritations, or discomfort. We offer many conservative treatments for plantar fasciitis, including cortisone injections and shockwave therapy. In addition, we teach patients stretches and exercises that help relieve their symptoms. We only resort to surgery in the most severe cases. We have over 20 years of experience in treating plantar fasciitis. It’s important that you see a foot and ankle specialist if you are experiencing heel pain, because the pain usually worsens over time. It doesn’t get better on its own. 

The majority of bunion surgery requires some type of bone healing.  We typically do an osteotomy (bone cut similar to a fracture) that would require bone healing.  Or, we may consider a fusion of the joints to realign the first metatarsal, in this case we are removing the cartilage and preparing the joint to be fused.  These procedures will require screw or plate fixation to allow for the bone healing.  It is also important for the body to be in its best nutritional and physiological condition for bone healing.  This means it is important to have the proper amount of calcium, vitamin D, magnesium and vitamin K 2.  There are other nutritional elements that also help with this.  It is surprising to me how many people, especially here in the Northwest that are vitamin D deficient.  This means that when they do have bunion surgery (that requires bone healing) there will be a delay or challenge with bone healing.  If you have not had your vitamin D levels checked previously, then it may be helpful to have this checked.  And vitamin D is a fat soluble vitamin so it can take some time to build up her proper level and it is possible to get too much.  But that is rarely the problem.  We routinely recommend that our patient's take "Ortho Pro Bono" bone healing supplement during the postoperative phase.  It is even a good idea to take the vitamin D well before the surgery is planned.  If there is any doubt or question about potential low vitamin D please let us know and we can order a blood test.  If you would like to discuss potential bunion surgery or have questions about the process or nutrition involved with this, please feel free to set up a consultation with either Dr. Brandon Nelson or Dr. Timothy Young (myself).

Fungal toenail treatments are now more effective than ever.  This is usually a combination approach.  It is rare to just treat and resolve fungal toenails with one treatment or modality by itself.  For example, just an oral pill, laser treatments, or topical treatments .  These treatments by themselves are rarely effective.  One adjunctive treatment that we utilize that has made all of our treatment approaches more effective is the use of oral nutritional supplements.  We strongly recommend supplements that contain biotin.  We carry and recommend "DR'S REMEDY, enriched nail supplement".  This helps the nails grow faster and stronger.  It is important to consider this along with the other treatments in a combination approach.  With more involved nail fungus or for multiple toenails involved, I recommend a combination of laser treatment with topical antifungal and a possible low dose oral antifungal medication.  But as I mentioned in addition I recommend nutritional supplements to help augment the other treatments.  No matter what nail treatments that we provide, the goal is to kill the nail fungus.  However, if the new pink and healthy (fungal free) toenail grows back very slowly, this complicates the whole treatment process.  The faster the new nail growth is, the quicker that the new healthy nail will replace and displace the old fungal portion of the nail.  This removes some of the "fungal load", so there is less fungus or potential fungus to treat.  If you do have questions about treatment of fungal toenails or like a consultation, Dr. Brandon Nelson, and Dr. Timothy Young (myself) would be happy to see you.

Bunion surgery in Seattle, Bellevue, Issaquah can be an important undertaking. It is highly recommended that you see a bunion surgery specialist because outcomes are directly related to the number of bunion procedures performed. At the Washington Bunion Center we perform 4-6 bunions every single Monday and are highly specialized with the most advanced bunion care available. We have an on-site surgery center, which helps limit cost, speeds up recovery and creates the best outcome. Proper procedure selection is very important when it comes to bunion surgery and only through performing lots of bunionectomies can a surgeon obtain the necessary judgments. At, the Washington Bunion Center we have the most advanced treatment protocol for both surgery and recovery available in Seattle, Bellevue, Issaquah and Renton.

Foot and ankle surgery in Bellevue and Seattle is best done at a certified foot and ankle surgery center. At Washington Foot and Ankle Surgery Center we perform only foot and ankle surgery. Our center is highly specialized and provides the best location to have foot and ankle surgery for Issaquah, Bellevue, Seattle, Kirkland and Renton. We perform hundreds of procedures a year and have serviced thousands of patients. The majority of our cases can be performed with just IV sedation which is much safer than general sedation and provides a great experience with much less positive nausea and pain. We have specialized pain blocks that can be used to numb the entire foot and ankle creating much less postoperative pain. In addition, there is a huge cost saving advantage by having it done at the Washington Foot and Ankle Surgery Center as opposed to another outpatient surgery procedure or hospital. Often patients that we have save thousands of dollars as compared to other facilities. If you are contemplating foot and ankle surgery, have a second opinion at the Washington Foot and Ankle Surgery Center. We will save you time and money.

Every Monday we perform multiple bunion repair procedures at our certified surgical Center here at Foot Surgical Center of Issaquah.  There is always the question from our patients whether or not this is going to be a procedure done under general anesthesia.  We do virtually all of our procedures with local anesthetic combined with IV sedation.  This would be similar to the sedation that you would have during colonoscopy.  The IV sedation allows for the patient to essentially sleep through the procedure, however they are still conscious.  They are still breathing on their own.  With a general anesthetic you are unconscious and require outside help for mechanical ventilation and breathing.  We find that our patients are very comfortable with this because they do not hear or feel anything (or remember anything) during the procedure.  Our patients also recover very quickly from the IV sedation type anesthesia.  Our patient's also appreciate the fact that they do not have to have general anesthetic for these procedures.  Once the procedure is done and the patient "wakes up" then because there is already local anesthetic in the foot, they have no initial postoperative pain.  There are some procedures we can do with local anesthetic only also.  If you have questions about bunion surgery or the anesthesia associated with the procedure please let us know.  We would be happy to schedule a consultation with either Dr. Brandon Nelson or Dr. Timothy Young (myself).  For the vast majority of these procedures we work together as a team to perform the bunion surgery.  Our anesthesia services for our certified surgery Center are provided by Evergreen Anesthesia.  

Fungal nails can be an unsightly and embarrassing condition that can only get worse with time. It is important to seek treatment early in the process and seek treatment from someone who sees a lot of fungal nails. At Issaquah Foot and Ankle Specialists we have advanced treatment protocol for fungal nails. Our treatment regime has an extremely high success rate utilizing an approach at this taking years to develop. Oftentimes with our treatment regime we are able to provide an alternative to the oral pill which can be hard on your liver. If you suffer from unsightly nails and have tried other treatments and failed we can help you succeed.

Here at the Washington Bunion Center, Dr. Brandon Nelson and Dr. Timothy Young, one of our biggest goals during the postoperative healing phase is to do everything possible to speed-up the healing process, and especially the bone healing process. This starts out by effective protection for the foot and ankle and leg during this timeframe. Initially the patient is in a splint. Then we placed the patient in the special fiberglass cast. The fiberglass cast typically will have a walking heel as far back as possible. This allows for full weightbearing on the heel without any pressure in the forefoot. To make this more comfortable for the patient we will split the fiberglass cast (bivalve) and tape the seems. This allows for better access for physical therapy and for bathing. This special fiberglass cast has been fine-tuned in our clinic to make our patient’s as comfortable as possible and to help maximize healing. Another component for healing is the bone healing itself. It is critical to take supplements to help maximize bone healing. This includes calcium and vitamin D magnesium and vitamin K 2. We recommend Orthotic Pro Bono supplement and it is available at our clinic for our patients. In addition to the supplements, there is some studies the taking arginine supplements can be beneficial. Some of our patient’s may require a bone stimulation unit also. There are several different technologies available. One utilizes a pulsed ultrasound unit (Exogen), and the other major technology utilizes a pulsed electronegative magnetic field (PEMF). To summarize, proper bone healing during the postoperative phase of bunion surgery includes proper immobilization, nutrition, and even physiology such as bone stimulation units. Here at the Washington Bunion Center, for both Dr. Brandon Nelson and Dr. Timothy Young, our goal is to speed up the postoperative bone healing so that our patients can fully and quickly recover from bunion surgery.