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Podiatrist - Houston
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Houston, TX 77043
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By Jeffrey N. Bowman
August 28, 2014
Category: Heel Pain
Tags: Plantar Fasciitis   Foot   heel  

Plantar fasciitis is very common problem.  As Podiatrist’s it is one of the most common problems we treat on a daily basis.  The majority of conditions are successfully treated conservatively.  Very few cases require surgical intervention.  The standard conservative methods for treating plantar fasciitis are:

  • Stretching
  • Icing
  • Supportive shoes
  • Orthotics
  • NSAIDs

However, there are other modalities that can be employed in the treatment of this often debilitating condition.  Once such method is Extracorporeal Shockwave Therapy (ESWT) and it’s hard to get in Texas.  I know it’s a mouthful and I’m also sure the extremely puzzled look just crossed your face.  No, I did not just make up these words to impress you, although if you are impressed then I will say I did make these up.  Anyways, this is a conservative method that can be done in the office of your local Podiatrist granted they have the equipment.

What is it and how does it work?

            ESWT uses shockwaves to create micro-trauma to the area in which the body will respond by increasing blood flow.  As mentioned before, increased blood flow brings healing cells and nutrients to the area of interest.  There are 3 methods by which the shockwave is generated, none of which I will go into depth.

  1. Electrohydraulic
  2. Electromagnetic
  3. Piezoelectric

There are low pulse waves AND high pulse waves depending on how aggressive your physician feels is needed.  The low pulse waves do not typical cause pain during the procedure.  The higher wave pulses tend to cause pain and so your physician may inject some local anesthetic around the area prior to treatment.  The typical treatment requires 3 sessions. 

This is just another weapon in the battle over plantar fasciitis.  As mentioned in prior blogs this is not only method OR “Holy Grail”. 

If you are in need of care for plantar fasciitis, please contact Dr. Bowman at 713-467-8886 or visit www.houstonfootspecialists.com.

Photo Credit: Alexis VIA pixabay.com

By Jeffrey N. Bowman
August 27, 2014
Category: Diabetes

There are many things in life that are just not meant to go through alone. Haunted houses are much easier (and more fun) with a group of friends, a cooking class is a blast when you are creating next to others, and healing through a difficult time is much sweeter with encouraging and supportive friends by your side. Having diabetes can be a scary, and even daunting, disease to live with, especially at the start when you don’t know what to do or what to expect. This is why joining a support group can not only boost your spirits but also give you a place to learn the best ways to keep you and your feet safe and healthy.

The expert doctors and staff at Houston Foot Specialists help diabetics stay on top of their foot health on a regular basis. If you have this condition, we encourage you to visit Dr. Jeffrey N. Bowman on a regular basis so we can catch any potential problems and treat injuries in your feet. In addition to visits at our Houston, TX, office, there are several other groups in the Houston area that will provide you with the extra support you may need:

  • Harris County Hospital District Diabetes Support Group at the Quentin Meese Hospital. They meet the second Tuesday of every month.
  • Lyndon B Johnson Hospital. They meet every Tuesday and Spanish is also spoken here.
  • Memorial Hermann Memorial City Hospital. They meet the second Thursday in January, March, April, June, July, September, October, December and is right across the street from our office.
  • St. Luke's Diabetes Support Group. They meet the first Wednesday of every month.
  • Bayshore Medical Center. They meet the second Wednesday of every month.
  • West Houston Medical Center. They meet the second Thursday of each month.

We encourage you to find a group near you, whether you’re new to having this condition or have lived with it for years. There is much advice, encouragement, and support you can give to someone who has just found out their life has been changed by this disease. If you have any concerns about your foot health or require treatment, contact Houston Foot Specialists at (713) 467-8886 to make an appointment with Dr. Jeffrey N. Bowman.

Photo credit: David Castillo Dominici via freedigitalphotos.net

By Jeffrey N. Bowman
August 25, 2014
Category: Heel Pain

If I were to tell you there were a procedure called the Topaz would you think it involved the use of a glittery precious stone?  I would hope not, but wouldn’t it be amazing if that were truly the case.

The Topaz procedure is used as a possible treatment option for plantar fasciitis and heel pain.  I know we have discussed in prior blogs what plantar fasciitis is so I will not spend any time reviewing.  The Topaz is another weapon used in the war against plantar fasciitis.  Please know it is not the only available option for treatment and as many treatments it does not come with a 100% guarantee that it will cure your problem. 

What is it and how does it work?

 The Topaz procedure is a minimally invasive surgical technique used NOT just for plantar fasciitis, but it is a very common indication for its use.  It involves making a dotted grid pattern on the bottom of your heel with a marker.  This grid is made overlying the origin of the plantar fascia.  After the grid is made, the dots are punctured penetrating the skin BUT not the fascia.  A metal tipped wand is then inserted into each individual hole where the actual Topaz procedure now begins.  A bipolar radiofrequency is transmitted through the wand that debrides the fascia.  The idea is to create an angiogenic response and increase vascularity.  Increased vascularity brings necessary cells for healing.

The biggest plus that has most people looking at this procedure is that it is minimally invasive.  Again, this is not the only option for treatment. 

If you suffer from plantar fasciitis and are in need of TLC for your feet, please contact Dr. Bowman at 713-467-8886 or visit www.houstonfootspecialists.com

By Jeffrey N. Bowman
August 21, 2014
Category: Foot Health
Tags: Blisters   Burns   Feet  

Burns are not an uncommon occurrence.  With BBQs, popularity of outdoor activities, and many occupations surrounding hot objects, you probably know of someone who has experienced some form of burn; if not yourself.  I’m also fairly certain you have heard various terminologies in regards to burns.  The question is if you truly understand the terminology.  Thermal injuries can come from chemicals and electricity, not just from fire OR the sun.

Burns are typically classified into 3 categories depending on severity and what the skin looks like: First degree, Second Degree, and Third Degree.  However, there is a 4th degree. 

Classification:1-4

1st Degree Burns:

This is more of your basic mild sunburn.  The skin is red (erythematous) with no blister formation noted.  These are termed partial thickness burns meaning the damage to the skin does not go beyond the superficial layers of the epidermis (outer most layer of skin).

Treatment:1

  • Aloe Vera topical ointment for soothing
  • Benadryl (other antihistamine) for itching
  • NSAIDs for pain control if needed

2nd Degree Burns:

Still considered a partial thickness but may vary in depth of injury and so it can be further categorized into superficial and deep.  Hair follicles and sweat glands are spared but blisters are most likely present.  The blisters are a key difference between this and 1st degree.

  • Superficial – erythema with some blister formation.  The area may weep and these injuries are painful.1  Blanches with pressure
  • Deep – does not blanche with pressure.  Area is white with red patches.  The injury may be wet OR dry.  Some times these are painless.4

Treatment:

  • Aloe Vera
  • As mention in prior blogs, leave blisters alone if not rupture and cover with a nonadherent dressing that will not irritate.  If blisters have rupture then remove loose tissue and cover with dressing.
  • NSAIDs for pain as needed.

3rd Degree Burns:

These are full thickness burns.  This means the injury has extended past the epidermis into the dermis and subcutaneous tissues.  Dermal structures such as hair follicles and sweat glands are destroyed.  These are usually painless due to the destruction of the cutaneous nerves.  These injuries do not blanche with pressure and appear white OR charred.

  • These are most likely to become infected.4
  • Clinical signs of infection following a burn:  discoloration of the wound (from darkening to a green hue), erythema surrounding and spreading from the wound, spreading necrosis into adjacent areas of the injury, and breakdown of the eschar.  The most common organisms found are Staph and Strep, although Pseudomonas is often cited as the most common which would explain any green hue within the wound.

Treatment:

  • Cleansing the injured area and removing all loose non-viable tissue
  • Applying topical antibiotic OR a silvadene cream with a nonadherent dressing.
  • Possible oral antibiotics for further coverage against bacterial infection
  • Daily wound care by a professional team

4th Degree Burns:1,3

  • This is very similar to 3rd degree except now the injury has extended past the subcutaneous tissue and muscle, fat, and bone are destroyed.
  • The same risks of infection are present
  • Treatment is the same as for 3rd degree burns
  • Risk of amputation is extremely high.

Other things to consider about burns besides depth of injury are:3

  1. Percentage of body surface involved
  2. Internal injuries from inhalation of hot and toxic fumes
  3. Promptness in managing infection, fluids, and electrolyte levels.

The Rule of 9s:  this is the classic method of determining total surface area injured.1

Segmental body parts are in multiples of 9:

  • Each arm is 9%
  • The head is 9%
  • Each leg is 18%
  • The torso, both front and back, are each 18%
    • The palm is 1%
  • Helps measure/estimate injured area
  • Each foot is 3.5%
  • NOTE: only used for adults. The percentages are slightly different in children.

A major burn is classified as follows:

  • <10 y/o or >50 y/o and covering >10% of the body
  • 10-50 y/o >20% of the body

A minor burn is classified as follows:

  • <10 y/o or >50 y/o covering less than 10% of the body
  • 10-50 y/o covering <20% of the body

Treatment can be summarized by the 5 C’s:1

  1. Cut – cut away clothing that is burned.  Adhered clothing may need to be surgically removed
  2. Cool – cooled, sterile saline soaked gauze.  Ice can be used but one need be aware of potential frostbite.  The purpose of this step is to stop cellular death and decrease pain/hyperthermia.
  3. Clean – remove any and all loose tissue.  This can be done gently with a soft towel or washcloth, mild soaps, chlorhexidine.  A whirlpool may be used.  Blisters are debrided completely.  Anesthesia may be needed.
  4. Chemoprophylaxis – application of antibacterial ointments/creams such as silvadene
  5. Cover – nonadherent, occlusive dressing followed by loose application of a gauze wrap.

Severe burns that are left untreated can lead to extreme disability and loss of function.  Severe burns require hospitalization until the individual is stabilized.  Further treatment involves daily wound care and the possibility of skin grafting OR amputation.

If you or someone you know has recently suffered a burn to their lower extremity and are in need of care, please contact Dr. Bowman at 713-467-8886 or visit www.houstonfootspecialists.com

References:

  1. Banks et al.  McGlamry’s Comprehensive Textbook of Foot and Ankle Surgery.  3rd Edition, Volume 2.
  2. Coughlin et al.  Surgery of the Foot and Ankle.  8th Edition, Volume 2.
  3. Kumar et al.  Robbins Basic Pathology.  8th Edition.
  4. Warren Joseph.  Handbook of Lower Extremity Infections.  3rd Edition.
By Dr. Jeffrey N. Bowman
August 20, 2014
Category: Foot Health
Tags: Feet   conditioning   Houston Color Run  

Ready for the craziest and most colorful 5K you’ll ever do? The Houston Color Run is taking off on Saturday, August 23! If you haven’t experienced this kind of race before, it is time to get your running shoes ready and prep for an event to remember. You may start the race gleaming white, but you will show every color of the rainbow when you finish. The right preparation before a race is important and your feet may need a bit of conditioning.

All of the balance and forward propulsion that you get while running is in large part due to your feet. They are incredibly designed to withstand a great amount of stress and pressure. However, when they’re not in great working order, you are at risk for pain and injury. We often don’t think much about them until they hurt. If you are going to be doing a lot of running or racing, be proactive to make sure your feet are healthy to prevent looming injuries at the finish line.  

Your feet can make around 15,000 strikes on the ground during a 10-mile run and Dr. Jeffrey N. Bowman can make sure they’re up to the challenge. He can assess your gait to see how they make contact with the ground and distribute weight and can even check the wear and tear on your current shoes to see if there is a pronation problem.

He also can identify the exact type of shoe you should be wearing, determined by your foot structure, so you can be safe and comfortable on race day. A helpful tool to keep feet fit and conditioned is to use orthotics inside your shoes. They not only offer extra cushioning, but additionally act as little beds of support to keep your feet stable and in proper alignment while you run.

If you love to run and race, we want you to feel confident and finish strong. Your foot health plays a big role in that. If you have any pain or concerns right now, do not hesitate to contact Houston Foot Specialists for a thorough evaluation and treatment. You can reach Dr. Jeffrey N. Bowman at our Houston, TX, office by calling (713) 467-8886 or www.houstonfootspecialists.com.

Photo Credit: Sura Nualpradid VIA freedigitalphotos.net





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1140 Business Center Drive
Houston, TX 77043

Podiatrist - Houston, Houston Foot Specialists, 1140 Business Center Drive, Houston TX, 77043 713-467-8886