John Hollander, DPM

You Need to Wash Your Hands Better

Do you wash your hands after going to the bathroom, blowing your nose, handling raw meat, playing at the park or before you eat a meal?  Chances are you do, or at least I’d like to think you do.  But are you washing your hands well enough?  Chances are, you’re not!

This week is Hands Washing Awareness Week and we want to make sure you are doing your best at washing your hands.  It is important to spend at least 20 seconds washing your hands with soap and clean water.  Cleaning between your fingers, around your nails, and the tops and bottoms of your hands is necessary in the prevention of illness and spreading of disease.  But what about hand sanitizers you may ask?  According to the CDC, hand sanitizer with at least 60% alcohol can help to eliminate most unwanted germs, but not all.  “Soap and water are more effective than hand sanitizers at removing certain kinds of germs, like Cryptosporidiumnorovirus, and Clostridium difficile1-5.  Although alcohol-based hand sanitizers can inactivate many types of microbes very effectively when used correctly 1-15, people may not use a large enough volume of the sanitizers or may wipe it off before it has dried 14.”  

You can keep track of how long to wash your hands by singing or humming “Happy Birthday” twice.  Use the infographic below for a visual on how to properly wash- it’s also great for showing your kids how to wash their hands too.

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Shoe Shopping for Wide Feet

Shopping for shoes that are both cute and comfortable can be a daunting task in itself; but if you have wide feet, it can be even more challenging.  Finding shoes that fit your feet properly is crucial in preventing discomfort and the development of other foot conditions.  Having a poorly fitting shoe can lead to issues like: painful arches, bunions, ingrown toenails, blisters, poor circulation of the feet, poor walking gait & foot alignment and tight muscles!  Take a look at the following tips to helping you select the best shoes for wide feet.

What to look for in a wide shoe

Once you have determined your shoe size, you will want to start looking at shoes that will suit your needs best. Those of us with wide feet will need to look for size widths that start at D to 2E for women and 2E to 4E for men.  You will want to find a shoe that has a wide toe box. Avoid shoes that tapper to a point, these tend to squish your toes.  And it is best to try on shoes with a thick sock. This will allow for room in your shoe on days that your feet may swell. If the shoe feels too tight now, put it back, it’s not going to stretch enough to suit your needs!

Measure your feet yearly

As we age, our feet can get longer and wider.  Get a proper size measurement by having your podiatrist or shoe provider measure the length and width of your feet. There are methods of measuring at home, but having a professional help is best.

Where to shop for wide shoes

Focus your efforts on shoe brands and retailers that cater to the wider foot.  In bigger cities you can usually find at least one retailer in the mall, but if you don’t have one in town, the internet is an amazing resource as well.  While it may be a hassle, you can always return the shoes if they don’t fit the way you want them to.  You can find all kinds of wide and extra wide shoes, from running shoes, to casual shoes and even dress shoes.

There are many shoe brands and styles that have received the American Podiatric Medical Association’s Seal of Approval and you can view the list here.

If you would like help to determine your shoe size or have any foot-related questions or concerns, please give our office a call at (707) 578-1222- we would love to help you!

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5 Natural Exfoliants for Dry Skin- Holiday Edition

Cold weather has arrived and that can often lead us to experience dry, flaky, and itchy skin.  You can combat the effects of winter with simple exfoliants found right in your kitchen!

Dry skin can occur for several reasons and often becomes most prevalent during the summer and winter months where the air is most dry.  Removing dead skin cells helps to relieve the appearance of dry skin, encourage new cell production, as well as, prime the skin for moisturizers which help lock in moisture.

Try these simple exfoliants, that are typically found in your kitchen, the next time you experience dry skin on your hands, arms or legs.

Make a Peppermint Coffee Scrub.  Coffee is an excellent exfoliant for dry skin.  You can use fresh coffee grounds or used coffee grounds.  Add a few drops of peppermint extract for a festive scent! If you want more of a paste consistency, mix in a tablespoon of warmed coconut oil and 2 tablespoons of hot water.

Baking Soda.  There is nothing easier than mixing baking soda and water to make an exfoliant.  Baking soda is great for sensitive skin and delicate areas such as your face and neck.  Simply mix water into a handful of baking soda to make a paste consistency. Apply with circular motions and rinse off with warm water.

Take a Milk Bath.  Milk contains lactic acid which acts as an exfoliant and may also increase your skin’s ability to hold in moisture.  If one specific area is dry, soak a washcloth in cold milk and place the washcloth on the dry area for five minutes. Gently wash off the milk to allow for some of the lactic acid to remain behind.  If you are feeling dry all over, add a quart of milk to your bath. For additional benefits, you could even add a few tablespoons of honey or oatmeal to the water. Don’t have milk, try plain yogurt- though we don’t recommend using it in your bath.

Take a Salt Bath. Yes, you heard that right. Add two cups of Epsom salt to your warm bath and soak.  Take a small handful of additional Epsom salt and use it to scrub the areas of skin that are dry.  For a softening effect, add dried seaweed to your bath.

Make a Sugar Scrub. Perfect for showers, a sugar scrub can be applied quickly to your legs, arms, and belly.  Take a cup of sugar and mix in a ¼ cup of coconut oil.  Add your favorite essence if you’d like (such as a combination of vanilla, orange, and peppermint).  Apply the scrub to your skin in a circular motion and rinse off with warm water.

Immediately after exfoliating your skin, be sure to apply your favorite moisturizer.  Coconut oil with lavender and orange essence is a lovely combination but do note that it can leave the skin feeling a tad bit greasy.

If you are not seeing relief in your dry skin after a week or two of self-care, you may need to see a doctor.  Chronic dry skin can be a sign of something more serious.

Happy exfoliating!

*If you are a diabetic, please consult with your doctor prior to using at-home remedies for your dry skin.

If you are not finding relief for your dry skin, please call Dr. Hollander at (707) 578-1222 to schedule an appointment today.

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What you need to know about Raynaud’s Disease- the disease that turns your fingers and toes blue

The minute your body is exposed to cold temperatures, or you touch something cold, your extremities start to turn blue!  Have you experienced this, or know someone that has?  It could be a case of Raynaud’s Disease.  Fingers and/or toes that become numb, prickly or sting and also change color, such as white or blue when exposed to cold temperatures, are often the result of vasoconstriction (extreme narrowing of the blood vessels).

The disease causes an interruption of blood flow to the fingers, toes, nose, lips and/or ears when a spasm occurs in the blood vessels of these areas. Spasms are caused by exposure to cold or emotional stress.  Typically, the affected area turns white, then blue, then bright red over the course of the attack.  There may be associated tingling, swelling, or painful throbbing.  The attacks may last from minutes to hours.  In severe cases, the area may develop ulcerations and infections, which can lead to gangrene.

Here are some tips on avoiding a Raynaud’s attack:

  1. Manage stress.
  2. Dress warmly and in layers.
  3. Limit your consumption of alcohol and caffeine.
  4. In cold weather or when exposed to air conditioning or cold temperatures wear gloves. Mittens are even better protection. Use these even when handling frozen or refrigerated foods.
  5. Carry hand and foot warmers.
  6. Use insulated drinking glasses or mugs. Place a napkin or insulating material around them to protect your fingers from becoming cold.
  7. Place hands under warm (not hot) water to warm them up quickly.
  8. Don’t smoke. Smoking narrows blood vessels and makes Raynaud’s worse.
  9. Swing arms around in a windmill fashion to get the circulation going quickly.

If you believe you are suffering from Raynaud’s or have any concerns call Dr. Hollander today for an evaluation, 707-578-1222.

For further reading: http://www.raynauds.org/

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6 Signs It’s Time to Replace or Refurbish Your Orthotics

Do you have a pair of orthotics that are worn down, flat and no longer provide any support? If so, chances are it is time to refurbish or replace your orthotics.

Orthotic refurbishing helps extend the life of your orthotics.  Refurbishing can include replacing top covers or the addition of extra soft cushioning under the heel or the ball of the foot. Everything can be replaced to add more cushion and modifications to address specific foot pain.  If there is a new problem, Dr. Hollander can recommend additional modifications.

Signs that may indicated it is time to refurbish or replace your orthotics include:

-Worn out top cover, which provides comfort to the surface of your foot

-Pain in your feet, ankles, legs or back- even when wearing your orthotics

-Orthotic is flat and no longer holding shape

-Age. Most orthotics last between one to five years, depending upon the frequency of use and material type

-Damage, signs of cracking or breakage to the orthotic

-Shoe wear is not even. Orthotics are designed to keep you balanced, so if your shoes are wearing unevenly, that could be a sign it’s time to refurbish or replace them.

Before you go to put on your shoes for the day, take out your orthotics and examine them. See if one of these signs pertain to your orthotics.  If they do, then you know it’s time to see Dr. Hollander.

What a better way to start off this new season than having a pair of comfortable orthotics and healthy feet.

Call or stop by our office today to schedule an appointment with Dr. Hollander to have your orthotics evaluated. Make your feet happy!  You can reach our office Monday- Friday at (707) 578-1222 or schedule online through our online scheduler.

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CBD Rapid Cooling Cream- Now Available!

At Dr. Hollander, DPM we are always looking for advanced methods and the newest technology in podiatric care.  Dr. Hollander is especially adamant about NOT prescribing opioids because he knows the risks associated with the drug and that there are so many other effective methods to pain management.

Introducing MEDTERRA’s CBD Rapid Cooling Cream, now available in our office for purchase, no prescription needed.

MEDTERRA’s CBD Rapid Cooling Cream is a powerhouse combination of CBD and certified organic ingredients. This topical cream provides a rapid cooling effect, perfect for sore muscles and tight joints. Use at the end of the day, after a workout or hitting the links for quick comfort.

Tested in the USA, MEDTERRA’s high quality, hemp-derived CBD is fully compliant under the Kentucky Department of Agricultural Industrial Hemp Pilot Program and is certified by the U.S. Hemp Authority.

Their whole-plant, CO2 extraction process allows for them to draw CBD from the plant material and filter out unnatural and undesired substances, maximizing the pure CBD concentration for you. The CBD is 99.6% pure!  MEDTERRA states that their CBD products are third-party tested, completely legal and contain 0% THC.

Each 3.4 fl oz. bottle contains 100mls of cream, allowing for ample applications of soothing, long-lasting comfort.  Bottles are available in 250mg and 750mg strengths depending upon your specific needs.

The next time you’re feeling that ache or pain, consider MEDTERRA CBD Rapid Cooling Cream to temporarily resolve your discomforts.   Stop by our office Monday-Friday 8am-4pm at 95 Montgomery Dr. Ste 114, Santa Rosa, CA 95404.  For any questions about this product please call our office at (707) 578-1222.

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Why Use a Spiky Ball?

Have you ever tried to give yourself a foot massage when your feet are unbearably achy?  If so, you’ll know that it’s difficult because the angle that your feet and hands meet is quite limiting and often the strength of our fingers is minimal.  So, what do you do?  Many people have found success by using a spiky ball to massage their achy feet.  This blog post will tell you what you need to know about spiky balls, why you need to start using them and how to use them.

What is a spiky ball?

Spiky balls are beneficial tools most often used by physical therapists and now more frequently by athletes, to perform self-therapy on varying muscles of the body and to shorten recovery time.  Often spiky balls will be used on the feet to help treat tight arches, achy heels and plantar fasciitis.  Spiky balls are balls that come in varying sizes from lacrosse size to golf ball size, covered in small rounded spikes.  The firmness of the balls also varies depending upon the location of where the ball is to be used.

Why use a spiky ball? 

Using a spiky ball to address your aches and pains is very convenient, can be used just about any where and they are great at getting to those tough to reach muscles!  The spikes on the ball trigger pressure points on the feet that send a message to the pain receptors in the brain, thus resulting in temporary relief.  Massaging your feet with the spiky ball encourages blood flow to the area, which in turn breaks down painful adhesions (tears) in the plantar fasciitis and helps to speed up the healing process.  They are also great at reducing muscle tension in your calves, reducing edema in pregnant women and providing some relief to those with flat feet.

How to use a spiky ball?

When addressing plantar fasciitis, stand or sit with the ball under your arch. Roll the ball from your heel up to your toes with medium pressure. Repeat this motion back and forth several times.  This is a great technique for runners to use as well!  When the pad of your feet or your heel are particularly sore, use firm pressure and make small side to side motions with the ball.

Remember, self-massage with a spiky ball isn’t a permanent pain relief solution but rather an effective temporary solution. Use it as part of a healing regimen in combination with icing, stretching and orthotic inserts (if needed) for long-term results.  If you are still experiencing foot pain when practicing these methods at home, schedule an appointment with your podiatrist today!

While we don’t carry spiky balls in office, you can purchase them locally at Fleet Feet Santa Rosa or on Amazon!

Important Note: If you start to experience pain that does not subside or increases following use of the Spiky Ball please do not continue with these exercises until you have spoken with your podiatrist.

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Is Diabetic Burnout a Real Thing?

Whether you’ve lived with diabetes for most of your life or have just recently been diagnosed, diabetes burnout is real and it could happen to you!  By learning how to recognize the symptoms of burnout and tricks to putting a halt to them, you can prevent getting yourself  into risky life-threatening situations.

What is Diabetes Burnout?

Every day you have a routine you need to follow-  check your sugar levels, count your carbs,  take your medicine, visit your doctor and more.  That is a lot that you have to do in your day-everyday.  When you suddenly don’t want to do these “chores” anymore, the routine gets old, you slack on taking your insulin, you cancel your doctor appointments, or you stop self-care, that is diabetes burnout.  Experiencing diabetes burnout can also cause anxiety and stress and lead to life threatening situations.

What does diabetes burnout look like?

There are many ways to experience diabetes burnout including: feeling isolated or alone with diabetes, strong negative feelings towards diabetes,  avoiding some or all of your diabetes management tasks and self-care, feeling controlled by diabetes or, feeling like you have lost control of your diabetes.

What are the tools that one can use to combat diabetes burnout?

Don’t be perfect:  Everyone wants to have the exact “perfect” number for them and while it is good to strive for “happy” numbers, it’s just not practical to be perfect.  It is OK to be a little above or a little below your target numbers once in a while.  Try to stay within your healthy range but recognize that life happens and just try to do your best.

Set mini goals: If it all just seems to feel like it is too much, take one step at a time. Set yourself mini goals or tasks such as, checking your blood sugar after every meal or going for a short walk at the end of your day.

Tell your doctor you’re burned out:   Reaching out to your doctor about feeling burned out is a good thing. By doing so, the two of you can set up a new plan of action and new goals that are attainable for YOU!

Ask friends and family for help: They may not fully understand what it is like to be diabetic, unless they are diabetic themselves, but by including your family and friends in your struggles and achievements with diabetes, they can then be able to help cheer you on and provide emotional support when days are tough.  Also, educate your friends and family by making them aware of the comments they say to you. Their comments may have been said with good intentions, but in all reality, they can make you feel discouraged or isolated- let them know!

Relate through support: Reach out to fellow diabetics for tips and tricks and as a safe place to speak your frustrations.  Many others have been in the same boat and they will have ideas to help you get back on track. It is also a great way to support others like you.

To read or not to read, that is the question: If you are lacking motivation, try reading a book or article or support page for encouragement and to help you bust out of feeling burned out.  If you find yourself reading too much on the topic of diabetes take a break from it- disconnect from reading on the topic- instead, focus on activities that make you feel good like crafts, outdoor adventures or volunteering.

As Scott Coulter, writer for Diabetes Self Management said, “Diabetes is a tricky thing. It will always have the capacity to frustrate us, irritate us, scare us, and make us mad, but if we know how to work with our feelings we can avoid serious burnout, or at least catch it early and reverse it.”

If you think you may be experiencing diabetes burnout, talk to your doctor. Don’t put it off, you are worth the time and you deserve to be happy!

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Accessory Bones of the Foot

When you hear the word accessory, we tend to think of using pretty necklaces, rings or belts to enhance our outfits. But with accessory bones, they aren’t enhancing anything, but rather showing up in our x-rays as extra bones.

What is an accessory bone?

When we are born, most of our bones are cartilage that fuses and hardens over time.  In some cases, pieces of cartilage do not fuse together, but continue to harden into bone.  This lack of fusion and hardening is what causes an accessory bone.  Accessory bones are considered normal skeletal variations. In fact, there are up to 24 variations of accessory bones in the foot alone!

How do I know if I have an accessory bone?

Most people do not know that they have an accessory bone until it shows up on an MRI or X-ray, or foot pain is presence after a fracture, dislocation or more pressing conditions like osteoarthritis or tumors.   Unless the accessory bone itself is damaged, it will most likely be just be noted in your chart as an incidental finding.

How do you treat an accessory bone?

Unless the bone is injured or causing pain, there is no need to treat or remove it.  If there is pain, your doctor may prescribe an anti-inflammatory medication, rest, ice, steroid injections or physical therapy.  In some cases, surgical removal of the bone may be needed.

The next time you have an x-ray of your foot and discover an accessory bone there is no need to worry. Instead, embrace that little extra piece that makes you, you!

If you ever experience foot pain, contact your doctor if pain persists. Foot pain is not normal, and you don’t have to suffer through it. Call our office Monday through Friday at (707) 578-1222.

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Mirror, Mirror on the Floor: I See Diabetic Foot Checks in Store

Proper foot care for diabetics is crucial. Diabetic patients are more prone to foot problems such as:

  • Loss of feeling in their feet
  • Changes in the shape of their feet
  • Foot ulcers and sores that do not heal

Simple daily foot checkups can prevent serious problems in the long run. It is always better to catch them early rather than later.

Follow these simple everyday steps that will help prevent serious complications with your feet:

  1. Take care of your Diabetes.
  2. Check your feet every day. If you have trouble bending over use a plastic mirror to see your feet.
  3. Protect your feet from the elements by wearing proper shoes and socks. If you are unsure of what types of shoes and socks to wear, contact your podiatrist. Your questions are important and we want to help!
  4. Wash your feet every day. Be sure to keep the area between your toes dry, as that is an area fungus likes to live!
  5. Keep skin soft and smooth.
  6. Keep the blood flowing through your feet with light activities.

A simple search online for plastic mirrors will get you on your way to healthier feet. Start your diabetic foot checks today!!

At Doctor Hollander’s office, our staff is highly trained and sensitive to diabetic patient’s needs. If you feel you are in need of care, please call our office today at (707) 578-1222.

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