John Hollander, DPM

How to Finally Get Rid of a Plantar Wart!

How to deal with Plantar WartsYou’ve tried the old duct tape method and over the counter wart remover products, and yet that pesky wart is still there causing discomfort to your feet. So, what can you do? When at home remedies fail then it is time to visit a podiatrist. Podiatrists have access to more aggressive solutions and methods to get rid of your pesky plantar wart.

First and foremost, prevent your warts from spreading by keeping them covered with a bandage until you begin treatment. And remember, do not touch them and always use good hygiene practices.

The first line of defense a podiatrist will use in treating your plantar wart is either a stronger salicylic acid medicine or a freezing medicine.

Salicylic Acid: Similar to the products you purchase at the store, but at a prescription strength. The Salicylic Acid is designed to remove layers of the skin a little at a time. This topical method is applied on a regular basis until the wart is gone.
Cryotherapy: If your podiatrist suggests freezing your wart, also known as cryotherapy, this procedure will be done during your office visit. Cryotherapy is the method of applying a liquid nitrogen to the wart. The chemical reaction causes a blister to form around the wart, which will later slough off. This method can be painful, so often the doctor will apply a numbing solution prior to the procedure.

If your plantar wart does not respond to salicylic acid or cryotherapy, the next step would be to consider other wart removing alternatives.

Alternative Acids: When your wart doesn’t respond to salicylic acid, your doctor will scrap off the surface of the wart and apply trichloroacetic acid with a wooden toothpick. This method will require a few visits back to the office for each application.
Laser Treatment: A laser is used to cauterize tiny blood vessels inside the wart. This will then cause the wart to die. This method can also be helpful if a patient is unable to comply with regular applications of other medications.
Immune Therapy: A combination of medications or solutions are used to stimulate your immune system so that it can fight off the viral warts. Surgical Removal: This method is often used as a last resort due to the possibility of leaving a scar.  The wart tissue is either cut off with a scalpel or a needle carrying an electrical current will be inserted into the wart killing it.

Your feet are vital to everything you do, so take time to inspect them daily—including the soles. This condition is common in children, so parents should look at their children’s feet often. Those with compromised immune systems may also be more susceptible to this common condition.

Whether you have one or a cluster, we’re here to help you put the spring back in your step. For more information on plantar wart treatments, call Dr. John Hollander today at (707) 578-1222. You can also schedule an appointment at our Santa Rosa, CA office by requesting an appointment online. We want your feet to stay wart free so that you can feel confident and comfortable, so go ahead and put away your duct tape and give us a call!

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How To Stay In The Race When You Have Heel Pain- Extracorporeal Shockwave Therapy

Are you preparing for the upcoming Annadel Half Marathon in Santa Rosa, California next month? Wouldn’t it be devastating to have a chronic condition like plantar fasciitis or have an Achilles tendinitis flare up right before the big event?! If the unthinkable happens, extracorporeal shockwave therapy might be necessary to promote healing to your feet so that you can still run the day of the race.

Extracorporeal shockwave therapy, or ECSWT for short, is a therapy in which shockwaves are sent directly to the site of pain. It’s used when other more conservative treatments have failed, but before opting for surgical methods. There are different levels of shockwaves; some that require a local anesthetic and others that don’t. This therapy offers many of the same results as surgery, but with less down time and a much faster rate of recovery.

Podiatrists and patients alike prefer ECSWT to surgery, because of reduced healing times. You will probably notice, even after the first day of treatment, that the pain does not worsen. As the damaged cells begin to repair and new cells grow, you will notice that your pain is subsiding even more. After a session of this therapy, you will most likely notice soreness or possibly some bruising at the site of treatment. However, these effects are mild compared to those of a surgical intervention.

If you want to learn more about ECSWT, call Dr. John Hollander, DPM today at 707-578-1222 or schedule an appointment online. We want your feet to be as healthy as they can be. Faster, more effective healing means you’ll be ready for your next big race.

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Spring into Support With Orthotics for your Sandals

Spring has finally arrived! As the weather begins to get hotter, spring sandals become the shoes of choice. This year’s trends are varied. You might try an oil-rubbed leather, or maybe you prefer color blocking and wide straps. Whatever your favorite sandal style, comfort is key.

Custom Orthotics

If you wear orthotics in your shoes, you might feel like your footwear choices are restricted. There’s good news–most orthotics can be customized to fit any pair of shoes. Custom orthotics are made specifically for your feet from molds taken in our office. The materials used to construct these devices vary depending on your needs. However, the results are the same—feet that are free of pain.

Keep in mind that orthotics for sandals and dress shoes are smaller and regulate your foot less than those you use in your running shoes. A foot bed that can be removed is a must for orthotic use in sandals. Remember that heel height also impacts the effectiveness of these inserts—as heel height goes up, helpfulness decreases. Bring in your favorite pair of sandals or dress shoes, and our expert staff will explain your options.

Orthotics are used for many different conditions. The functional type control range of motion, while the accommodative type offer more support or cushioning. Both are used to control pain and address poor foot mechanics at the same time. Orthotics are commonly used to treat foot conditions including plantar fasciitis, tendinitis, and bunions. Custom-made orthotics are a good investment toward avoiding long-term complications brought on by a foot condition.

Remember, only a podiatrist will be able to tell you which kind of orthotic will best treat your condition.  Call Dr. John Hollander at (707) 578-1222 to schedule an appointment at our Santa Rosa, CA office. Let us help you get the right orthotics for your feet. Also, let us pamper your spring feet with a medical pedicure, because when your feet are cared for, you feel rejuvenated.

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What to look for in a walking shoe

Are you in search of a new pair of walking shoes, but you just aren’t sure what features to look for?  With a plethora of options, shopping for a new pair of shoes can be overwhelming.  To help you find the right walking shoe for your feet, we’ve put together a guide to assist you in your search.

  • Wear the same socks you will wear when walking and use them to when trying on your shoes.
  • Shop for shoes later in the day or after you’ve been walking for a while. Our feet tend to swell at the end of the day and that can affect how a shoe may fit.
  • Measure your feet (length and width) before trying on shoes- as we age our feet sizes can change. Stand while your foot is measured to get the most accurate measurement. Ask the salesperson to help measure your feet or, you can measure them yourself.
  • If one foot is larger than the other, try on a pair that fits your larger foot.
  • Try on both shoes at the same time and check the fit by wiggling your toes. If you don’t have at least a half-inch between your longest toe and the end of the shoe — approximately the width of your finger — try on a larger size.
  • Check the width of your shoe. The side-to-side fit of the shoe should be snug, not tight. If you’re a woman with wide feet, consider trying on a men’s shoe, which are cut a bit larger through the heel and the ball of the foot. If you feel like the shoe is too tight, move on to another shoe. Don’t expect it to get wider over time as you wear the shoe.
  • Walk in the shoes before buying them. They should feel comfortable right away. Make sure your heel fits snugly in each shoe and doesn’t slip as you walk. If the heel is a bit loose, there is a shoelace technique you can try before ruling out a pair of shoes. See photos below.
  • Look for a shoe with cushioning in the ball and heel of the foot. The more cushion a shoe has the more comfortable your feet will be as you walk.
  • Select a shoe that has ventilation points or made of a mesh material to allow for air to circulate around your feet and keep them cool.
  • If possible, buy shoes at an athletic shoe store with professional fitters or at a store where you have several options.  We like to send our patients to Fleet Feet in Santa Rosa because we know they have had the proper training needed to get you fitted in the right shoe.

    If your heels are slipping out of your shoes, try the butterfly lacing technique.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Remember, there is no one walking shoe for all. They each have a unique set of features, designs and pricing.  Take the time to try on different brands and sizes and really pay attention to how your feet feel in that pair of shoes. If something feels off, move on to another pair.  If you feel like you aren’t getting enough arch support in your shoes, call Dr. Hollander today to see if you are a candidate for orthotics.

We hope you find this guide helpful in your search for an awesome pair of walking shoes.  If you have any questions, please do not hesitate to give us a call. (707) 578-1222.

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How to Prevent and Treat and Ingrown Toenail

California is known for our never-ending summers, but an unsightly and painful ingrown toenail can put a damper your plans. While it is only March, summer will be here before you know it.   This common foot condition is easy to prevent and easy to treat, so you can stop wasting your time in pain and get back to enjoying your life!

An ingrown toenail occurs when the nail grows into the skin instead of upward. You will notice pain, redness, and swelling. It can even result in an infection if not taken care of right away.

You can usually treat an ingrown toenail at home by soaking it in warm, clean water and gently pushing back the skin where the nail has pierced through.

To prevent a nail from growing into the skin, make sure you trim them straight across, and wear shoes that give your toes plenty of wiggle room.

In certain cases, a podiatrist’s attention will be needed. One of the ways a foot specialist can help is by lifting the nail so that it grows the right way. In other cases, you may need to have your nail partially or fully removed, and some of the surrounding tissue may need to be detached as well. If you see signs of puss in the area, it could be a sign of infection and you might need a course of antibiotics to treat it.

If you are suffering from a painful ingrown toenail, call Dr. John Hollander today at (707) 578-1222 to schedule an appointment in our Santa Rosa, CA office. We can help get your feet back to feeling good and ready for your next outdoor adventure!

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A Caregiver’s Guide to Caring for Feet

While you do your best to care for your clients and improve the quality of their lives, sometimes there are areas of care which may be overlooked.  Among all the tasks that can be required of a caregiver an important one is keeping your client’s feet happy and healthy. Caring for your client’s feet is more than just washing and dressing them daily.  There are other aspects you need to be aware of while providing excellent care to their feet which includes, how to wash their feet, how to trim their nails properly, how to recognize signs of infection and how to recognize signs of discomfort.  Below you will find helpful tips on ways that you can provide excellent care to your client’s feet.

How to Properly Clean Your Client’s Feet

Wash their feet daily with warm water and soap. If your client has dry skin, try adding baby oil or mineral oil to their bath water.  You can also use non-scented moisturizers if your client’s skin is dry.  Be sure to thoroughly dry their feet especially between their toes. If moisture is left behind it can create a breeding ground for fungus.

How to Correctly Trim Your Client’s Toenails

Along with keeping their feet clean, maintaining toenails is also very important! Depending upon which state you live in some caregivers are not allowed to trim their client’s nails.  If you live in a state that allows you to trim nails, be sure to trim the nail straight across. Trimming the nail at an angle or around the nail bed can encourage the nail to grow down and inward, often resulting in a painful ingrown toenail.  If you ever feel overwhelmed by your patients nails, take them to a podiatrist. They have special tools to combat thick and overgrown nails.

If you live in a state where caregivers are not allowed to trim a client’s nails, you will then need to have them visit a podiatrist or a nail salon regularly.  In California, if your patient is elderly and has vascular disease (which diminishes blood flow), neuropathy (lack of feeling in their feet), or diabetes their insurance should allow them to be seen on a regular basis with a podiatrist to have their nails trimmed and their calluses debrided.  It is especially important for a client with diabetes and neuropathy to have regular visits with a podiatrist because sometimes under their callus build-up could be an open sore. An untreated open sore can lead to pain, discomfort and even amputation or death! So keep a close eye on them!  If your client’s nails are too thick for them to trim on their own, they can become overgrown and penetrate the skin, leading to pain and infection.

All podiatry offices offer services called ‘palliative foot care’ to patients who do not qualify for regular podiatry care, according to their insurance rules. With palliative foot care the patient/client can pay cash to have their nails cut and their calluses debrided in order to keep their feet healthy. Remember, when their feet are healthy, they can then keep the rest of their body healthy.

How to Identify Undesirable Foot Conditions

While it is not expected of you to diagnose foot conditions (that’s the doctor’s job), you should still be able to tell when there is a condition that needs the attention of a podiatrist.

Common foot conditions include:

Athlete’s Foot: A scaly, itchy rash around the toes and sides of the feet.

Fungal Nails: Thick, brittle, yellow nails.

Ingrown Toenails: Nails pushing into the skin, causing it to be red and swollen and sometimes oozing pus if infection is present.

Open sores: Keep a close eye on any signs of an open sore. Keep the area clean and dry.  If your client is a diabetic or has neuropathy, visit a podiatrist immediately!

Dry and Cracked Skin: cracked skin can be an invitation to an infection and is very uncomfortable.

Other signs of discomfort:

Tight fitting shoes: leave seam indentations on the client’s foot, promotes blisters and ingrown toenails.

Remember, examining your patient’s feet daily should be a part of your regular care routine. Look for pressure points caused by shoes, overgrown nails, thick nails, callus build up, dry skin, open sores and signs of infection.  If you are not able to care for your client’s feet, feel overwhelmed at the condition of their feet or just aren’t sure the correct method of treatment, reach out to your local podiatrist. They will be able to guide you in the right direction and help you to help keep your client’s feet happy and healthy.

If you are in the Sonoma County area and are in need of a podiatrist for you or your client, please call us today at (707) 578-1222 to schedule an appointment.

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Diabetic Care Team

Although your primary-care physician may have been the one to order a blood-glucose test, you need a team of professionals to guide you through all of diabetes’ medical details. Ideally your team will include your primary-care physician, an endocrinologist (a hormone specialist who understands the intricacies of insulin), a registered dietitian to help you fine-tune your eating plan, an ophthalmologist (an eye specialist who can look for diabetes-related signs of damage to the retina), a podiatrist (a foot-care specialist who can help prevent complications from diabetes-related nerve damage and skin sores), and a dentist to keep periodontal disease and other infections under control.

 “Understanding your diabetes numbers can help you feel better and have more control over the disease. Learn which numbers to watch and why.”

It is very important to properly manage your diabetes. Good health, foot care, exercise and a healthy diet are not only important in everybody’s life but are especially important in the life of a diabetic.

Call Dr. Hollander to schedule your diabetic foot check at (707) 578-1222.

For further reading on numbers to know with diabetes:  http://www.everydayhealth.com/health-report/cs-phototgallery-diabetes-numbers-to-know.aspx#/slide-7

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Toenail repair- Acrylics vs. Keryflex

Important factors for you to consider before heading to the nail salon!

If you have a bruised or damaged toenail, are experiencing yellow brittle nails, or have nails that just don’t grow “normally”, chances are you have been searching for a cosmetic option to fix them.  If you search for toenail repair, you have probably come across the options of using acrylics at the nail salon or a cosmetic application called Keryflex, which is only available to medical professionals.  While acrylics may seem like a quick and easy solution to your nail concerns, there are some important factors you need to consider before heading to your local nail salon.

Acrylics can seem like a great solution to covering up an ugly toenail, but they could be perpetuating an existing condition. For example, if you have Onychomycosis (toenail fungus), an acrylic nail application could cause further damage to your nail. Acrylics are not flexible and the toenail experiences lots of flexibility during the use of your foot (i.e. walking, running).   This lack of flexibility can cause the acrylic to pull on your nail bed and cause damage to it. In addition, acrylics are applied using harsh chemicals which can further irritate and damage the nail. If you are not seeking medical treatment for your onychomycosis the application of the acrylic could further perpetuate the condition. Acrylics are porous which means water can get under the acrylic and cause even more fugus to grow! Another factor to consider is that often the chemicals used to apply acrylics are in a communal container.  While we would like to think that a salon technician has the training and safety to know not to share containers with those that have a fungal infection, there is still the possibility that the condition could go unnoticed thus, leading to a contaminated jar of polymer!

An alternative to using acrylics is a product called the Keryflex Nail Restoration System. Its application process is similar to that of gel nail polish but without the damaging effects. Keryflex is a medical grade cosmetic resin- not a gel- that is impregnated with Piroctone, a hydroxypyridone antifungal ingredient. Keryflex does not treat onychomycosis, but it can prevent new fungal growth and can conceal the effects of it while your nail is healing. Keryflex was designed specifically for toenails with the need to be durable and flexible. This flexibility makes it an excellent option for runners and athletes that may have experienced black or severely broken toenails.  It is a non-porous resin, thus allowing nail polish to be removed with acetone without affecting the cosmetic nail.  Once applied, it is permanently bonded! No need to worry about lifting or chipping.  Because this product can only be applied by a medical professional, you won’t find it in your local beauty supply store.   You also won’t have to wonder whether your kit was used on someone else. Each person gets a kit specifically for them.

When looking for a cosmetic option to treat your nail condition, please take these points into consideration. Acrylic can be a quick, inexpensive and easy way to hide a problem, but depending upon your situation, it could make things worse.  With that being said, we recommend you speak with your doctor or podiatrist about your nail concerns before visiting your local nail salon.

If you would like more information on the Keryflex Nail Restoration system, you can visit our website, schedule a consultation or read more about Keryflex here.

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January 20th through the 27th is Healthy Weight Week. The idea behind Healthy Weight Week is to not focus on dieting or what the number on the scale says, but rather to practice mindful eating, moving your body in ways that make you feel good during and after the movements and practicing true self care.  These are all things that we can do for ourselves on a regular basis. Here are just a few ways that you can celebrate Healthy Weight Week and continue throughout the year.

Snacking is OK! There is nothing wrong with snacking, but the nutritious values of what you are snacking on, is what counts. Ask yourself, before you snack, “does this provide any nutritional value to me?” If no, opt for something else.

Moving your body! Explore a new trail, try a new sport, tidy up the house.  The CDC is recommending at least 2.5 hours of exercise per week! That’s nothing! 30 minutes a day of actively moving your body is easy to do. Think you don’t have time- read our blog post on how to incorporate more walking into your day.

Take a breath! Stress can prevent you from maintaining or losing weight. Take a few moments to practice mindful breathing.

Drink more water. Water helps the body remove excess waste and helps provide one with a clearer mind.

Sign up for a race! Signing up for a race automatically provides you with a goal and a timeline to reach it. Run, ski, bike, row, chop wood-any kind of race will do.

Talk to loved ones. Having someone that you can talk to about your daily ups and downs has shown to reduce stress levels.  It is also helpful in keeping you accountable in your goals when you have a support group ready to cheer you on.  In addition, face to face or talking on the phone are much more beneficial than sending an email or a few text messages. So, when you have the option to meet in person, video chat or telephone- take it!

Cook a nutritious balanced meal. The tip that says having a colorful plate is a balanced plate, is quite helpful.  A plate full of beige food is likely to be low in nutrients and higher in carbohydrates.

Be thankful. Before you let negative talk get the best of you, practice saying what you are thankful for. Positive talk leads to lower stress levels, higher self esteem and can produce better productivity in yourself.

Make time for sleep. Aim for 7-8 hours of sleep each night.  Turn off your electronics a minimum of 30 minutes before you close your eyes. Rather than watching a YouTube video, opt for reading a book or magazine instead.  And avoid alcohol before bed- while it may help you fall asleep faster, it has been shown to cause restless sleeping patterns.

Make one small change. Rather than grabbing a soda, drink a glass of water instead. Instead of an entire pint of B&J ice cream, only eat half. You don’t have to drop everything you love to eat, cold turkey (no pun intended). One swap here and another swap there, all add up over time and can lead to positive habits and a healthier self.

Cheers to a happier, healthier, more mindful YOU!

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Survival Tips for Keeping your Feet Warm

Whether you’re an avid winter sports enthusiast or one that prefers to stay indoors at any sign of cold or wet weather, it is important to know how to keep your feet warm and dry.  When venturing out into the elements you may need something more than just a rain boot or a fancy knee-high. Here are some easy survival tips to effectively keep your feet warm and dry this winter season.

 

  1. Wear a warmer shoe. Give your feet a head-start by keeping your shoes indoors where it is warmer.
  2. Wear shoes designed for your activity and weather. Avoid mesh running shoes. Instead, wear a hiking boot or trail shoe and something with a thicker sole, is water resistant or has water-proof features, especially around the toes and lower sides of the shoe.
  3. Wear a thicker sock. Aim for wool or synthetic fiber socks rather than cotton, which can absorb moisture quickly, dry slowly and pull heat away from your skin, making it a fabric to avoid when there might be snow involved.
  4. Waterproof clothing. If you’re going to be in cold conditions for an extended period of time, consider adding a liner between your sock layers, or even using plastic bags.
  5. Move your body. Starting to feel cold, walk faster, ski faster, run faster, do a few jumping jacks.  Physical activity increases body heat and helps to get the blood moving faster to your extremities which alleviates that cold feeling.

‘…On cold days, I grab a paper towel or Starbucks napkin and fold it over the top of my foot, toes, and under the toes. Then I put on my shoe. This provides a thin layer of insulation that is usually just enough for comfort…”

Remember that if you use toe warmers or do warm water soaks, then you’ll want to make sure the toe warmer or water is not too hot as you can easily burn yourself. If you have neuropathy then you need to check the temperature with your hand or forearm first, as you cannot rely on your feet to tell you if it is too hot.

“Don’t let cold feet keep you indoors during the winter. There is more to winter walking than just the treadmill. But your toes can get painfully cold, and you may even risk frostbite in bitter weather. You want to avoid getting sweaty feet, as that puts you at risk of developing a blister. You can protect your feet in cold weather with these tips.”

For further tips on keeping your feet dry and warm while outside in the cold, check out this article.

 

If you are experiencing cold feet with little to no relief, contact our office for an evaluation.  You may have a more serious condition. (707) 578-1222.

Stay active this winter and have fun enjoying the outdoors!

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