Questions & Answers
My toenails have changed color, what could be causing this?There are several reasons that toenails may change, the most common are trauma and infection. If trauma is the cause then the nail will usually "grow out" on its own and medical intervention is usually not required. If the cause is a infectious agent, medical treatment is needed. To appropriate the cause of the changes, a simple and painless nail culture is done to determine the results.
If the cause is an infection, what are my options and how effective/safe are they?There are several effective treatment options for fungal toenails. Topical agents may be somewhat effective, but take atleast a year of regular use and rely of strict care, from my experience the effectiveness is about 25%-35%. Oral(tablets) are another option, are very effective with the combat of fungal toenails. The medication must be taken for 3 consecutive months and stays in your system for an additional 6 months. In my experience the effectiveness is about 75-80%. The drawbacks are that the medicine is very strong and may be contraindicated to some (based on medical history or lifestyle). A series of blood tests may determine your candidacy. The ultimate option is Fotona Laser Therapy. This revolutionary laser is FDA Approved and has a success rate of over 90%. There are no sideffects, and no changes in lifestyle for the procedure to be a success.
How does Fotona Laser work?The Fotona Laser is a YAG 1064 run Wavelength, which is ideal penetration and affinity. 11 goes deep enough, without getting held up at the skin and it targets the hemoglobin (nol melanin), without over-heating it. It has the cleanest and most uniform beam profile in the world. No "hot spot" or uneven fall -off typical of other lasers, which exhibit a " Gaussian" beam profile, leading to burns and unpredictable results. It also has patentented variable square pulse (VSP) technology and variable spot size and pulse duration.
When I get up in the morning, my heel/arch is sore, after a few steps the pain improves, but has been gradually worsening, what may be causing this?Heel/Arch pain is one of the most common complaints that I treat in my practice. It is called Plantar Fasciitis.
What causes Plantar Fasciitis?Plantar Fasciitis is the inflammatory process that starts in the ligaments of our arch due to changes in activities, weight, age, and shoe gear. The plantar fascia is a tough ligamentous structure at the bottom of our foot which supports our body. With time and lifestyle changes, our arch begins to change, and mat places additional tension on the ligament. As the ligament fatigues, it becomes tighter and hence pulls/traumatizes at its attachment of the heel bone, sometimes creating a heel spur. An in office painless and quick diagnostic study may determine at which stage you may be in.
I have developed a bunion deformity, how do I treat it?A bunion deformity is usually due to our hereditary orthopedic compensation. We walk the same as do our parents and grandparents, hence we compensate as them. So if your mother, grandfather, etc. has a foot deformity, you may develop a similar condition. A bunion deformity is usually a compensation due to the flattening of our foot. As our foot becomes flatter, it equally becomes wider, our body tries to stabilize us and therefore the great toe joint shifts out of its correct position.
What are my options in treating my bunion?There are several options in treating a bunion deformity, based on the stage of the deformity and the condition of your joint. A quick in office X-Ray may determine this. The conservative care includes stretching devices, injections, change of shoewear, etc. Surgical options are considered for non-responsive, progressive bunion deformities.