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DR. K's BLOG

By drkurlanski
January 08, 2012
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When Feet Smell

Feet perspire more than most parts of the body.  With each foot potentially producing over a pint of sweat on a daily basis, foot odor does not seem unlikely. Sweat is composed of water and salt, it doesn’t have an odor. However, sweat in conjunction with bacteria can produce a “waste” product that bears a pungent odor. If you are experiencing foot odor., see your podiatrists. Medication that is applied to the feet at night may be prescribed. Feet should be bathed daily in lukewarm water with a mild soap and dried thoroughly. Wear natural fiber socks that wick away moisture. Finally, allow your shoes to dry out by not wearing the same pair two days in a row.

Sweaty feet don’t have to be a problem that someone has to suffer from all their lives. There are ways that they can control it. Excessive sweating doesn’t have to be a curse, it’s a problem that can be livable and that doesn’t have to control a person’s life. You will receive the highest quality medical care coupled with the personal attention you expect and deserve.

We’re located at 15 Sewall Street, Portland and welcome you to call 207-774-0028 for family foot care. We provide personalized, friendly, caring and complete foot and ankle care. Specializing in custom-molded orthotics to treat foot and ankle pain and diabetic wound care.

By drkurlanski
December 31, 2011
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Foot Issues for the Elderly

Disabilities in the elderly are often caused by foot problems. Ingrown toenails, calluses, corns, fungal infections,and other problems can cause pain and result in foot deformities. Many of the foot problems experienced by seniors are the result of inadequate foot care, which can result in an improper gait and increase the chances of falling. Foot health for the elderly can be promoted by diligent daily care. Feet should be cleaned and thoroughly dried. Toenails should be trimmed straight across, and lotion should be applied to the feet and massaged in order to prevent dryness. Proper footwear should be worn to avoid slipping and foot injuries. Seniors should maintain regularly scheduled visits with their podiatrists.

Hint: Examining the feet of an elderly person is an important part of a geriatric evaluation.

For comprehensive foot care for everyone in your family, we welcome you to call us today. Foot problems come from many sources–improper shoes, muscular imbalances, disease, neglect, trauma, heredity, too much physical exertion, even too little movement. If your feet are cramping your lifestyle, professional care is in order. We know that good foot health can enhance your daily existence andimprove your quality of life. Our approach is conservative, gentle, and caring at 15 Sewall Street, Portland. We welcome your call for family foot care at 207-774-0028.  We provide personalized, friendly, caring and complete foot and ankle care. Specializing in custom-molded orthotics to treat foot and ankle pain. 

By drkurlanski
December 31, 2011
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Healing a wound can be like solving a puzzle and very challenging.  It is up to me to figure out why a wound won't heal or why it is present in the first place.  There are several reasons a wound won't heal, infection, poor circulation, uncontrolled diabetes, foot deformity, trauma and patient compliance.   I love wound care because it calls into play all of my training  in biomechanics, dermatology, infectious disease, primary care, medicine and radiology.  I feel that I am using the full scope of my education.  It is very rewarding to watch a wound evolve into "normal" skin.

In order to figure out what needs to be corrected to allow the wound to heal, I look at the wound from all angles.  I evaluate the circulation to see if there is vascular compromise.  If there is no flow, I refer to a vascular surgeon for intervention.  I test for peripheral neuropathy and loss of protective sensation. I look the nutritional status of the patient to see if the diabetes is under control or if there are any protein deficiencies that would delay healing.  I take x-rays and order MRI to evaluate for bone infection or abscess.  I look at structural deformities such as bunions and hammertoes.  Surgically correcting a hammertoe may relieve the pressure causing an ulcer.  I look at shoe gear to see if it is appropriate and may prescribe diabetic shoes and multidensity inserts.  Modifications such as a rocker bottom  may prevent ulcerations.  If there is a infection present I prescribe oral antibiotics or may have a patient admitted to the hospital for IV antibiotics. I consult with the infectious disease doctor to find the best antibiotic to treat the infection.   I must be acutely aware when a diabetic foot infection requires immediate surgical debridement or amputation.  It can make the difference between losing a toe or losing a leg.  Sometimes a patient may be in denial about their wound or diabetes.  Maybe a patient needs to make better eating choices, help monitoring their blood sugar or smoking cessation.  I can help refer them back to their primary care doctor for management.  Patients come in weekly for wound debridement.  It is also a good opportunity to ask how they are doing will their blood sugar and offer encouragement.  Chronic wounds may develop into a form of cancer and may need to be biopsied and surgically excised. If a wound has stalled I will use advanced therapy such as biologic grafts to faciliate the wound closure.    After a wound has healed I provide diabetic foot care to prevent future problems.     

 

 

 

By drkurlanski
November 13, 2011
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There are several risk factors for developing a diabetic foot ulcer....

  • Absence of protective sensation due to peripheral neuropathy
  • Arterial insufficiency, poor circulation
  • Foot deformity (hammertoes, bunions) and callus formation resulting in focal areas of high pressure
  • Autonomic neuropathy causing decreased sweating and dry, fissured skin
  • Limited joint mobility
  • Obesity
  • Impaired vision
  • Poor glucose control leading to impaired wound healing
  • Poor footwear that causes skin breakdown or inadequately protects the skin from high pressure and shear forces
  • Kidney disease

What can you do to decrease your risk of a diabetic ulcer?

  • Have your feet checked yearly by your podiatrist for signs of poor circulation or peripheral neuropathy, or more frequently if you already have these symptoms.
  • Quit smoking
  • Monitor blood sugar levels
  • Exercise, stretch, lose weight
  • Wear extra depth diabetic shoes with diabetic inserts prescribed by a podiatrist
  • Hydrate skin daily with a moisturizing lotion
  • Treat athlete's foot with an over the counter antifungal
  • Check your feet daily, if you cannot reach your feet, use a hand mirror or ask a loved one to check them
  • Call your podiatrist at the first sign of an ulcer, redness, drainage, swelling, foul odor.
  • Don't be afraid to call a podiatrist if you don't have an established relationship with one.  Podiatrists consider ulcers to a "heart attack of the foot" and patients can be seen immediately.
  • The sooner an ulcer is detected the easier it is to treat and heal.

 

 

By drkurlanski
November 13, 2011
Category: Uncategorized
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Rheumatoid Arthritis

Most people with rheumatoid arthritis (RA) develop issues related to the foot or ankle. This inflammatory condition produces substances that inflame joints throughout the body. When RA affects the feet, it results in pain, stiffness, and swelling. Corns or bunions may develop, and toes can curl and assume a claw or hammer toe position. Foot bones may shift and cause the collapse of the long arch, resulting in flatfoot. Some of these issues can be addressed with surgery. Among the most successful surgeries is fusion, in which the cartilage is removed and the bones fused in place. A bone graft may be implanted to unite the bones.  Although loss of motion results, the patient achieves freedom from chronic pain.

HINT: Medication, exercise, and surgery can alleviate the eff ects of RA and may slow its progress.

Without proper early management of the feet, rheumatoid arthritis will slowly deteriorate the range of motion and flexibility of your foot. Take the road to happy, healthy feet and call us today. We treat all members of your family, from kids to grandparents, for all kinds of foot problems. Our phone number is 207-774-0028 We are a multi-faceted podiatric practice, offering conservative and surgical treatment of the foot and ankle. We are located at 15 Sewall Street, Portland, Maine. We provide personalized, friendly, caring and complete foot and ankle care. Specializing in custom molded orthotics to treat foot and ankle pain. 





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