John Hollander, DPM

Treating Cuts & Blisters While Camping & Hiking

Ah, the joy of getting out into nature, breathing in the fresh air, exploring the wide-open spaces, stomping through rivers, and sometimes treating the occasional cut or blister. Following the best practices for wound treatment and having the right medical supplies on hand for camping and hiking, will allow you to treat your injuries in a manner that will help you to get right back on your feet so you can enjoy the great outdoors.

Treating Foot Cuts

Sharp rocks, thorns, pointy sticks, etc. are the common culprits in a cut to the foot.  The first method of treatment should be to clean the wound.  You can use soap and water, or pour some hydrogen peroxide over it.  You can even use rubbing alcohol, but due note that it will cause stinging! After cleaning the wound, apply clean gauze with pressure to stop any bleeding.

Once the bleeding stops, apply bacitracin cream (first aid antibiotic) to the wound to help prevent an infection.  It’s always a good idea to squeeze the medication onto a clean cotton swab or bandage rather than directly onto the wound, for it could contaminate the container of medicine.

Next, apply your bandage.  Be sure to use a bandage that can flex with the motions of your foot, otherwise, the bandage may fail and come off.  For larger cuts, a gauze square and bandage tape work well.  If you are out of bandage tape, duck tape can do the trick, but keep in mind that the glue could cause skin irritation.

Keep your wound dry until it has healed.  Healing can take a few days or more depending on the severity of it.  Change your bandages daily or whenever they get wet.

If you end up getting a deep cut that may need stitches, or you step on a rusty nail, it’s best to have a friend drive you to the nearest doctor or urgent care.  Deep cuts need more than a daub of bacitracin to heal.  They will probably require stitches and a stronger antibiotic medication.  And rusty nail punctures should be thoroughly cleaned out and followed by a tetanus shot if you are not up to date on them.

Treating Foot Blisters

Poorly fitting shoes and prolonged shoe-wearing often cause painful blisters.  Blisters are small pockets of fluid that form under the upper layers of skin.  There are a few things you can do to treat them depending on the severity of the blister.   First and foremost, do not pop your blister! Doing so can quickly expose your body to bacteria which could lead to an infection.  Covering the blister with a cushion of gauze, waterproof bandage, or a hydrocolloid bandage can help reduce discomfort while it heals. Should the blister pop on its own, keep it clean and dry.  Medication is not needed to treat a blister, but it doesn’t hurt to apply an antibiotic should you wish to.

Cuts and blisters are common and often easily treatable. Be sure to pack a first aid kit for your next outing so that you can treat your foot wounds effectively while you are away from home.

Here is a list of items to keep in your first aid kit for treating cuts and blisters:

  • Fabric bandages
  • Waterproof bandages
  • Hydrocolloid bandages
  • Gauze squares
  • Roll of Bandage Tape
  • Bacitracin (first aid antibiotic) cream
  • Hydrogen peroxide or rubbing alcohol
  • Soap
  • Tweezers
  • Cotton Swabs

 

If you have a foot injury that is not healing, call Dr. John D. Hollander, DPM for care at (707) 578-1222 at our Santa Rosa, Ca office. We are here for you!

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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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Summer BBQs Lead to Painful Gout?

The Summer season brings out a variety of celebratory traditions, including, campouts, pool parties, and fireworks.  Another common one is the outdoor cookout.  Families and friends gather in backyards and on porches to enjoy grilling and eating together. However, for anyone with gout, this tradition could set them up a painful attack later.  You can still grill this summer, but you should keep in mind that certain foods can encourage a gout attack or flare up.

Foods that are high in purines can increase the production of uric acid in your body, making it more likely the crystals will collect in your joints—especially your feet—and cause pain.  By avoiding these foods and drinks, and eating other healthy choices, you can decrease your odds of developing an uncomfortable problem.

Reduce your intake of meat, including poultry and fish.  Watch your fat consumption, too, since saturated fats impair your ability to eliminate uric acid.  Instead, choose low-fat options, especially for dairy products and snack foods like potato chips.  Limit the snacks you consume with high-fructose corn syrup as well.  This may mean skipping the soda or sweetened juice.  You should also avoid alcohol, especially beer, since it seems to have a link to gout attacks.

Instead, get extra protein with beans or legumes.  Eat plenty of fruits and vegetables, and look for whole-grain and starch-rich carbohydrates.  Rice, potatoes, oats, barley, and other whole grains are good options.  Choose water or a 100% juice to drink over other drink alternatives.

Changing your diet now is better than waking up at night with a painful gout attack.  This may mean eating only one burger or hot dog, saying no to the beer, and looking for fruits and veggies to fill up your plate.  Pay attention to what you consume and watch for the foods to avoid that contribute to gout.  If you experience a gout flare-up, contact John D. Hollander, DPM, in Santa Rosa, CA. You can call (707) 578-1222 to reach us Monday-Friday or after-hours for urgent matters.

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7 Ways to Clean and Freshen Up Your Sandals

The moment the weather heats up our sandals are put into use.  Sandals are exposed to all sorts of conditions, sweat, sun, sand, oils, bacteria, and dirt. And with all that exposure to grit and grime, they can get dirty and smelly fast!  By cleaning your sandals you can help extend the life of them and keep them looking great!  Here are a few tips on ways to clean your sandals.

 

  1. Mild Soap and Water. For synthetic fiber shoes, a generous scrub of warm water and mild soap can quickly and easily clean up your favorite sandals.
  2. Clean magic eraser. This magic eraser can make quick work of cleaning up the dirtiest of shoes.  We don’t recommend using this tool on leather sandals as it may scratch the material.
  3. Baking soda. Mix together 2 tablespoons of baking soda to 1 tablespoon of water to create a paste.  Use an old toothbrush to scrub the paste onto the footbed of the sandals in a circular motion.  Wipe off the baking soda paste with a warm damp cloth and then allow your sandals to completely dry in a cool place (this is especially important for leather sandals, you don’t want to keep them in a hot place as this can damage the fibers).
  4. Sandpaper for suede. Using a 125 or 150 grit sandpaper sheet, gently scrub the suede sections of your sandals in a circular motion until the dirt and grime are gone.
  5. Vinegar is tough on grime but gentle enough for leather.  Mix equal parts vinegar to water and apply the solution to your sandals with a soft sponge or washcloth.  Allow the shoes to completely dry before wearing them again.
  6. Rubbing Alcohol. Wipe down the footbed of your sandals with a cotton ball soaked in rubbing alcohol.  This will not only remove dirt and grime, but it will also kill any bacteria on the sandal.  Be sure to rinse off the rubbing alcohol with a damp clean cloth and allow the shoes to dry.  This method is best for synthetic materials as it can have a drying effect on the leather.
  7. Footbed cleaner*. For a convenience factor, there are products available on the market that is made for cleaning sandals.  Sandal Rescue is a textured wipe that scrubs away dirt and oil build-up and comes in a convenient package you can take with you anywhere.  Vionic Footbed Cleaner is applied with a clean cloth, sponge, or brush and wiped off with a dry cloth.

By cleaning your sandals, you not only extend the look and life of your sandals, but you also will help keep your feet clean and odor-free.  If you are experiencing extreme foot odor or have thick or brittle nails, visit our website for more information on our successful methods of treatment. To schedule an appointment at our Santa Rosa office, you can reach us at (707) 578-1222.

 

*This is NOT a paid advertisement for Sandal Rescue or Vionic.  We only wish to provide our patients with effective solutions to their shoe care needs.

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Peripheral Arterial Disease

Have you ever noticed muscle pain or weakness in your legs or feet after you’ve started walking, but then stops within minutes after resting? You may have PAD (Peripheral Arterial Disease).

PAD is a condition in which the arteries in the legs become narrowed or blocked by the buildup of fatty deposits called plaque.  This narrowing or blocking of arteries reduces blood flow from the heart to the extremities which causes poor circulation and often pain.

PAD  has many risks factors including:

  • Family history and genetics
  • Age (you can develop PAD at any age, but most commonly found in those age 65 and older)
  • Lifestyle habits (smoking, stress, diets high in saturated fats, lack of physical activity)
  • Having certain medical conditions can increase your risk for PAD (diabetes, high blood pressure, obesity, chronic kidney disease)

Those with PAD may experience the following symptoms:

  • Foot or toe pain that makes it hard to sleep
  • Fatigue, tiredness or pain in your legs, thighs, or buttocks that happens when you walk but then goes away when you rest
  • Foot ulcers that are slow to heal (taking longer than 6 weeks to heal)
  • Pale, discolored or blue leg or foot
  • Lack of growth of your toenails and leg hair
  • One foot feeling colder than the other

Treatment for PAD really depends on the severity of your PAD and what complications may develop or may already have developed.

Your doctor will recommend making heart-healthy lifestyle changes such as, quit smoking, managing stress, aiming for regular physical activity, and encouraging you to get your weight into a healthier range.  Your doctor may also prescribe medications to treat and prevent complications related to PAD.

If lifestyle changes and medications do not work well enough to treat your PAD, your doctor may recommend an angioplasty procedure where they insert a small mesh tube called a stent, into the artery which is designed to reduce the artery from narrowing again.    In more severe cases, you may need bypass surgery which is where the doctor will use a healthier blood vessel or an artificial vessel to create a new path around the blocked artery in your leg.

 

PAD is a lifelong condition, but you can manage and minimize complications with lifestyle changes and keeping open communication with your doctor about your feet.

 

If you are experiencing pain in your legs or feet when you perform physical activity, ask to be seen by your doctor right away.  PAD is not a condition you want to put off.  Early care and maintenance are important.  If you would like to speak to a doctor about your feet call (707) 578-1222.

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Sports and Foot Pain in Children

Foot Pain in ChildrenFoot pain in children can be very common, especially when they are active in sports. Spring is here and that means baseball and soccer season. Some sports injuries can be avoided with a little extra care and knowledge. Other conditions just seem to be a part of growing up. Fortunately, your child should grow out of them over time.

One of the most commonly seen causes of foot pain in young people is Sever’s disease. This is when the growth plate in the heel becomes inflamed and swells, which results in pain and discomfort. The most common time for this problem to occur is during their growth spurt at the beginning of adolescence. Most children, by the age of 15, will have grown out of this condition because their feet will have reached their adult size. The fact that the growth plate grows faster than the leg muscles, along with the stress and pressure put on the feet during physical activity, leads to Sever’s disease.

Another common cause of pain in the feet is growing pains. This type of discomfort is typically felt more so at night than in the morning. This pain usually comes and goes and may last for weeks or months, but they will grow out of it. To ease growing pains you could try massaging your child’s legs and feet or help them to stretch the muscles themselves. Heating pads are also a good source of pain relief for your child’s sore muscles. A doctor may prescribe an anti-inflammatory, but always make sure the correct dosage is giving and that your child has no allergies.

For more information about foot pain in children call Dr. John Hollander at (707) 578-1222 to schedule an appointment in our Santa Rosa, CA office. We want your children’s feet to be pain-free so they can enjoy being young and staying active.


Podiatrists Treat Skin Conditions Too!

When we think of a podiatrist, we tend to think of a doctor that treats broken ankles, hangnails, neuroma, and performs foot surgery. But did you know, podiatrists can also treat several dermatology issues related to your feet?

Some of the common dermatology issues treated includes Psoriasis, Dermatitis, Athlete’s Foot, Melanomas, Warts, and Venous Stasis Dermatitis.

Psoriasis
What is it? Psoriasis typically causes a scaly, red rash that can appear almost anywhere on a person’s body, including the feet.

Causes/Symptoms: Psoriasis develops when the body replaces skin cells too fast. There are many different types of psoriasis and two of the most common are Plaque Psoriasis and Palmoplantar Pustulosis.

Plaque psoriasis can occur on almost any part of the body, including the feet. This type of psoriasis causes red, dry patches of skin known as plaques. These plaques are usually covered in silvery scales and can be itchy and sore. In more severe psoriasis, plaques may also crack open and bleed.

Palmoplantar Pustulosis creates many tiny, pus-filled blisters on their feet, hands, or both. Despite their appearance, these blisters are not infectious or contagious. They can cause itching or painful burning sensations.

Treatment: The three primary treatments are topical medications, light therapy, and systemic drugs.

Dermatitis
What is it? Dermatitis is a very common condition resulting in inflammation of the skin.

Causes/Symptoms: Dermatitis can occur when you have contact with a substance that causes an allergic reaction, such as, lotions, adhesives, nickel, poison ivy, and even medications.

Treatment: Treatment includes a prescription for topical steroids or moisturizers. Your doctor will also want to determine the cause for your allergic reaction and eliminate exposure.

Athlete’s Foot (tinea pedis)
What is it? Athlete’s Foot is a fungal infection that usually occurs between the toes but can also affect other areas of the foot.

Causes/Symptoms: Fungus thrives in warm, damp environments, which are commonly found inside your shoe, around pools and showers. Symptoms include dry skin, peeling skin, itching, burning, swelling, and blisters.

Treatment: Treatment includes a prescription for an anti-fungal, as well as, encouragement to keep your feet dry, and to wear proper footwear around pools and in public places like showers.

Melanomas of the Foot
What is it?  Melanoma is a cancer that begins in the cells of the skin that produce pigmentation (coloration).  It can occur on your skin but also be present in your fingernail or toenail bed.

Causes/Symptoms: Most cases are caused by too much exposure to ultraviolet rays from the sun or tanning beds, but can also come from exposure to radiation.

Signs to look for on your skinABCDs of melanoma:

Asymmetry- one half of the spot is different in shape than the other half.
Border- the border is irregular. The edge/ border is typically ragged, notched, or blurred
Color- Mix of colors or hues are present. It is not uniform in color.
Diameter- Melanoma grows, whereas moles will remain small. A spot larger than a pencil eraser is cause for concern.

Signs to look for on your nail bed:
A pigmented band, the length of your nail, that does not grow out with your nail. Over time it can become wider, the color can change throughout the band, development of a nodule can occur, or may even cause the nail to crack.

Treatment: Treatment begins with examining the area of concern and then taking a biopsy. If biopsy determines the area to be cancerous, your podiatrist will recommend the best course of treatment.

Warts
What is it? Warts are a viral infection caused by the human papilloma virus (HPV). They are often mistaken as corns or calluses. They occur when HPV enters the skin through a small cut or abrasion. Children and teenagers are more susceptible to getting warts than adults.

Causes/Symptoms: Warts are spread by touching, scratching, or contact with skin shed from another wart. If left untreated, wart clusters can form.  Warts look like small rough growths on your skin.
Treatment: If self-care approaches have not helped, your podiatrist can provide you with a few options: prescription-strength salicylic acid, Cryotherapy, minor surgery, or laser treatment.

Venous Stasis Dermatitis
What is it? Venous Stasis is when the veins in the leg are no longer properly carrying blood back to the heart. This also results in blood building up in the feet, ankles, and legs. 

Causes/Symptoms: Venous Stasis is when the veins in the leg are no longer properly carrying blood back to the heart. This also results in blood building up in the feet, ankles, and legs. The pigmentation from the red blood cells stains the skin from the inside, and a reddish-brown discoloration develops on the skin, which is called Venous Stasis Dermatitis (VSD).

Early symptoms of VSD include:
-heaviness or aching when you stand or walk for extended periods of time
-swelling at the ankle at the end of the day
-varicose veins
-skin is itchy, dry, red, or sore

Symptoms as VSD progresses include:
-swelling beyond the ankle
-dry cracked skin
-red to violet-colored open sores
-shiny skin

Treatment: Types of treatment include:
-compression socks
-mechanical compression to help move fluid away from the leg
-corticosteroid creams
-vein surgery to repair damaged veins (such as placement of a stint)

If you think you are experiencing a dermatological issue related to your feet, you don’t necessarily have to find a dermatologist. Your established podiatrist may be able to treat your condition.  Call Dr. Hollander today if you think you may have a skin issue that is causing you discomfort or concern at (707)578-1222.

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Tips for Keeping Your Feet Warm

As I’m sitting at my desk next to a window, I notice that my feet are starting to get quite cold!  This got me thinking, that others, maybe you, are experiencing cold feet right now too!?  What can be done to resolve the uncomfortable feeling of cold feet?  Well, here are a few suggestions I can recommend:

  1. Get moving. Blood circulation instantly warms the body up.   That’s why we get warmer after a workout, all the blood moving around our body. So try walking up and down your hallway a few times.
  2. Stretches. If you’re sitting at a desk like me, then try performing foot stretches.  Move your ankles in circular motions ten times in one direction, and then repeat ten times in the opposite direction.  You can also flex and relax your feet too!
  3. Socks. If you don’t have any on right now, then please, do so.  But when selecting what type of fiber to wear, some are more effective at keeping the cold away, then others.  Moreno wool would be my first choice for it has the ability to hold more moisture and keep it off your feet.  Moisture is was makes your feet feel cold.  Bamboo can be a great option if you find wool too itchy.  It is also eco-friendly!
  4. Slippers. Yes, not only will they keep your feet warm, they can protect your feet from bumps and cuts.  If you have a pair with orthotic support- even better.  If your slippers hurt your feet, call your podiatrist to talk about orthotic inserts.  Slippers should be supportive too!
  5. Shoes. While we encourage wearing shoes that allow airflow to help prevent foot fungus, it is counterproductive when it comes to warming your feet.  Wearing boots or shoes designed to minimize breathing will help keep air and moisture from touching your feet, thus keeping them warmer.
  6. Footbaths. A nice warm foot soak is an excellent way to warm your toes back up. But be sure to check the temperature with your hand or forearm, especially if you have neuropathy. We don’t want you to burn your feet!
  7. Floor mats. This idea may be overlooked, but worth a try.  If you have solid floors where your desk or chairs are, you could try adding a floor mat in that space.  This will create a barrier between you and the floor.  They even have heated floor mats on the market, if you want even more warmth.

I hope after following these tips you will find relief in your cold feet.  If cold feet just seem to be following you everywhere, then give Dr. Hollander a call.  There may be something else going on.  You can schedule a consultation by calling (707) 578-1222.

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When a Small Trip Can Turn into a Dangerous Fall

Whoops!  You tripped on that floor mat, again!  And this time you almost fell on the floor.  Falls are not just a ‘normal part of getting older’.  And while yes, as we age our chances for falling do increase, it doesn’t mean it has to happen! In fact, falls are caused by a number of risk factors for people of any age.  So what are the risks associated with trips and falls and what can be done to prevent them?

Types of Risk Factors For Falls

If you experience any, or a combination, of the following you could be at an increased risk for trips or falls:

  • weak muscles, especially in the legs
  • poor balance, causing unsteadiness on your feet
  • foot problemsincluding pain, gait, and deformities
  • vision and hearing problems
  • dizziness or lightheadedness
  • taking medication that makes you dizzy or drowsy
  • Vitamin D deficiency

Weak muscles

Our muscles gradually get weaker as we get older, affecting our strength and balance and making it more difficult to undertake daily activities.  As well as normal changes caused by ageing, there are a number of reasons why our muscles get weaker, including:

  • lack of physical activity and exercise
  • conditions like arthritis

Poor balance

A number of things can cause poor balance, including:

Do exercises that make your legs stronger and improve your balance. Tai Chi is a good example of this kind of exercise.

Foot problems

There are many conditions that can cause discomfort to the feet, which in turn can lead to an increased risk in falls.

Problems such as:

  • corns, calluses bunions,ingrown or thick nails and foot ulcers
  • Improper gait– over pronation or under pronation
  • Poorly fitted footwear; you wouldn’t want to wear flip flops to a construction site
  • Numbness in the feet such as neuropathy, sometimes linked to diabetes, can leave you unable to fully sense where your foot is on the floor, also leading to an increased risk of a fall

Scheduling a visit with your podiatrist can help address your foot problems and assist in eliminating the risk factor for falls.

Vision and hearing problems

Problems with your vision and hearing can make it more difficult to move around safely.

Eye problems can make it difficult to anticipate and spot slip or trip hazards in your home.  As we get older, changes to our depth perception and ability to adjust to changes in lighting can also contribute to the risk of falls.  If you wear bifocal or varifocal lenses in your glasses, you might sometimes find it difficult going down steps, stairs and curbs. If you wear bifocals, you may want to have a pair of distant only glasses for your outdoor activities.  Cataracts, glaucoma and vision-related problems linked to stroke or dementia can also increase your risk of falling.

We are finding more correlations in falls and loss of hearing from studies in the last 5-8 years.  Studies have found that when we lose our hearing, our brain is having to overwork with limited resources. So while you should get your eyes checked regularly, you should also have your ears checked too.

Dizziness or lightheadedness

There are a number of reasons why someone might be dizzy or lightheaded. It’s not normally a sign of anything serious, but should be checked out by a doctor.

Understanding why you become dizzy is important to counter the risk of falling. Some of the most common causes include:

  • a drop in blood pressure when getting up from lying or sitting
  • inner ear problemssuch as inner ear infections and wax blockages
  • problems with your heart rate or rhythm
  • dehydration

Medication

The side effects of some medicinessuch as dizziness, lightheadedness, unsteadiness, drowsiness, blurred or double vision, and difficulty thinking clearly, and taking more than 4 medicines at the same time, can increase your chance of falling.

Medications that most commonly cause these symptoms include:

  • psychotropics (tablets to treat low mood)
  • blood pressure-lowering medications
  • sleeping tablets and sedatives
  • anticonvulsants (medication for epilepsy)
  • over the counter medications

Side effects can vary from person to person depending on their age, weight, gender, ethnicity and general health, so it’s important that you know and understand how your medications can affect you to prevent falls from occurring.

Vitamin D Deficiency

Vitamin D improves muscle function and strength. The weaker your muscles, the more likely a fall is to occur.  Vitamin D can be obtained from a supplement or foods such as fish, red meat, eggs, and fortified foods like cereal.

Trips and falls can be caused by so many different factors.  By taking your specific situation into consideration and taking note of the fall risk factors that relate to you, falling can be preventable.  If you have noticed an increase in tripping or falling, contact your doctor, which also includes your podiatrist, to discuss your concerns.

We are here for you at Dr. Hollander, DPM to help you at any time, one step at a time.  Call today to speak with our friendly staff members at (707) 578-1222.

If you are in need of more information on fall prevention, the CDC has several helpful brochures you can download at any time for free.

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