DeLand Foot and Leg Center

DeLand Foot and Leg Center
Never Forget the Journey

Tuesday, January 24, 2017

Our Health Care Crisis

The  Senate voted along party lines 51 – 48, then the Republican House successfully used their majority to confirm the GOP plans to:
1. End coverage for preexisting conditions, veterans benefits, and aid to rural hospitals.
2. Remove discrimination protection for women in healthcare.
3. Against the provision allowing children to remain on their parent’s insurance till the age of 26.
4. Cut off funding for the Child Health Insurance Program (CHIP).
5. Against ACA contraceptive coverage and maternity care provision.
6. To direct committees to send budget legislation to defund and repeal the Affordable Care Act. (ACA aka Obamacare)
7. No more requirement for private insurance to accept people with preexisting conditions and they can now reinstate lifetime caps for coverage once again.

Senator Elizabeth Warren’s staff member said that what would help the most would be to call the five Republican senators who have broken away from the GOP to demand a slow down of the ACA repeal. Tell them how much you appreciate their efforts to stop the train wreck and share your story.
They are:
Senator Bob Corker – (202) 224-3344
Senator Lisa Murkowski – (202) 224-6665
Senator Rob Portman – (202) 224-3353
Senator Susan Collins – (202) 224-2523
Senator Bill Cassidy – (202) 224-5824

Call to Action

Saturday, December 10, 2016

OUR nature

Hello K****,
Photo by David Swoyer Dec 2014

Thank you for your inspiration. You have encouraged our team to talk about businesses that take a social and ethical position.  We were elated and inspired by the volume of companies with our like mind.  So during this week, we have made a decide to support other businesses that are positive stewards to our community, country, and planet.  We will join a  platform where we will evaluate our purchasing practices & business structure and move towards others that share our values:  Fair Trade, Global Sustainability,  and Human Equality.

As you do not want to spend your dollars with us because of our social stance, we want to spend our dollars supporting others who are ethically responsible.  Over the next several weeks we will re-build our companies purchasing directives. This will be an exciting change, and we hope inspire and educate others as we move through this process.

K****, we hope that you will understand that when businesses have these resolute social missions that are different from yours, it is unrealistic to presume you are being judged. Our goal is to improve the town we live in and ultimately be inclusive and welcoming to all patrons.  To this end, we will be intolerant of hate and focus on Fair Trade, Global Sustainability, and Human Equality in the next coming months and years, for it is in OUR nature.

Jenneffer & Hari Pulapaka

Saturday, December 3, 2016

Uphold equal humanity

For the last 11 years, I have lived in a community that is welcoming and divisive. 10 years ago, I moved into the realm of hospitality at night and I was exposed to the darker side of people’s essence. I have been adamant and will remain steadfast in my lack of tolerance from those demanding servitude or subjugation. You know who you are, and this is not about you.

It is however about being told to hush by other businesses, bloggers, and critics; to deceive the community and not publicize our moral commitments. Our businesses’ missions focus on product transparency and we vow to support producers with a pledge to quality, sustainable, fair trade products. If you do not like our dutiful position, don’t spend your money in our businesses; you will not cause us to waiver. For now is the time to counter deceitfulness and lies with facts that promote equal humanity.

This election has been the catalyst to talk about our country of hate. We have a President that is morally repugnant and lacks the respect of the populous.  It is time to ask why your neighbors, friends, colleagues, and adversaries voted for a demagogue; for he is a leader that exploits prejudice and ignorance. Why did you do this?
  • Why are we tiptoeing around historical references to Nazism?  History has given us both the context and warnings.
  • Why do we mask with the benign term “Alt-right”, when “White-supremacist” is more accurate?
  • Why is America behind many other countries in its representation of women in politics?
  • Why do we blame men for misogyny, when women are an offender as well? 
  • Why is there ignorance to accept climate change as a scientific fact? It is not an opinion.
  • Why our current political gridlock occurred under a Republican Congress's refusal to work with President Obama? Was it racism?
  • Why do we not see the actions of others as racist? Superficial politeness has given a platform to fester cultivated hate.
  • Finally, why did legions believe that an elitist would lead them to salvation and financial freedom? That answer is simple. It is the nature of a demagogue to exploit the ignorant.

With that said, we will continue to uphold equal humanity for it is in OUR nature. 

*1/24/2017. Correction made changing "President-elect" to "President". 

Friday, November 25, 2016

Toenail Fungus

Nail Fungus:  A fungus is an organism that lives in warm moist areas. Fungus of the toenails is a common problem that can affect people of all ages, although it most commonly affects individuals who are older. 
Toenail fungus often begins as an infection in the skin called tinea pedis (also known as athlete’s foot). The fungus often starts under the nail fold at the end of the nail. Over time it grows underneath the nail and causes changes to its appearance, such as a yellow or brownish discoloration. It can also cause thickening and deformity of the toenail. 
Many people have difficulty with their toenails and need assistance in caring for them. A foot and ankle surgeon can diagnose the cause of toenail problems and recommend treatments.
Treatment Options:
The most common treatment for nail fungus is debridement or nail trimming. This helps to prevent or monitor degeneration of the nail and decrease the onset of secondary infection under the nail plate due to the deformity and debris.  Sometimes the fungal infection has been left uncontrolled and has permanently damaged the cells that produce the nail plate called the matrix.   When this happens, neither topical nor oral medications will work, and debridement is the only treatment option.
Topical antifungals need to be applied around the cuticles and skin.  Before the application, clean under your nails with a toothbrush to loosen as much debris as possible.  Gently clean with Peroxide first if very thick and debris filled, then mild soap and water. There are 2 FDA approved topical medications; additionally, we have an affordable option, Formula 3, if the prescription is too expensive or not covered by insurance.
Oral antifungal treatments benefit from a daily clean routine. The most common medication is Lamisil. It is taken for 3 months once daily. Patient must have a healthy liver as demonstrated on the liver function blood test in the last 3 months. This test will be repeated after the first two doses are complete and before the third dose. No other drugs that are processed through the liver can be taken for the treatment time of 4 months, to list a few examples: Alcohol, Statins, Acetaminophen, Ibuprofen, Naproxen, Sleeping pills, Tranquilizers, Cholesterol Lowering Medications, some Supplements and Herbs.
Nail Care:
Discontinue harsh nail products; switch to gentle or children’s nail polish. We have several options in the Office to choose from by LVX.  Non-acetone nail polish removers should only be used, because they may dry the nails and surrounding tissue.
A daily supplement with Biotin, which you can purchase from the pharmacy separately or in a multi-vitamin, strengthens the nail once healed. Allow nine months to see results, because nails grow approximately 1 mm per month.
Like your skin, nails can get overly dry or “waterlogged.”  Use common sense as far as water exposure.  Moisturizers are beneficial as well as nail conditioners. 
Do not remove your cuticles - push them back.  
Make sure your nail instruments are sanitary.  Consider buying your own. Purchase cheap emery board for the infected nail and use ½ of the board, and then throw away. Do not infect your other nails with a dirty file.
After a manicure or pedicure, ask your salon to apply sunscreen to prevent sun damage and nail polish from fading.
Allow nails to rest one to three months per year from cosmetic procedures such as over-grooming, press-on nails, and adornments. Never use/apply gel coats, acrylic or nail sculptures.

Check out this episode!

Saturday, June 25, 2016

Annual Foot Screen

Your annual foot screen is a comprehensive exam in which Dr. Pulapaka and her team update/overhaul your chart, check your Medicare compliance, and perform simple & basic tests to the lower extremity as part of her Lower Extremity Amputation Prevention (LEAP) program.

Who might have an ANNUAL FOOT SCREEN?

Foot Screens should be performed annually on patients with at least one of these factors:

·       every diabetic patient
·       every patient over 60 years old
·       current or former smokers over 50 years old
·       history of foot  and/or leg ulcers
·       history of heart attack, stroke, TIAs, PAD
·       history of vascular surgery, angioplasty, open heart surgery
·       neuropathy, Hansen’s disease,  spinal trauma, polio, etc.
·       motor loss to the legs,

Why do it?
It is simple.  Our comprehensive program follows guidelines adopted by U.S. Department of Health and Human Services, to dramatically reduce lower extremity amputations in individuals with a loss of sensation or other diseases that can cause a breakdown in the feet.  Foot Screens also helps document qualifying criteria for medical necessity with Medicare in the treatment and maintenance of mycotic nails or callus care and diabetic shoe programs.

Check out this episode!

Saturday, May 21, 2016

Diabetic Foot Care

The importance of diabetic foot care and some Do’s & Don’ts.

Washing your feet with warm or tepid water and soap every day keeps them clean and gives you a good chance to do that daily inspection.

Applying a moisturizing lotion to your feet once or twice a day can also help keep your skin healthy and moist.

Even with the best foot care, it would be hard to go through life without developing a callus or corn on your feet. 

The drugstore is a good place to pick up two first-aid essentials: antibiotic ointment and adhesive bandages (such as Band-Aids).  If you see no appreciable improvement within 24 hours,  call your doctor immediately.

For many people, the regular toenail trimmers or clippers sold at the drugstore are safe for home use. Toenails should be cut straight across or following the natural curve of the toe.

You can do a lot to keep your feet healthy. In addition to protecting the skin on your feet by making smart drugstore purchases, you can extend their life by maintaining blood glucose control, following a heart-healthy diet, getting regular exercise, and wearing properly fitted diabetic shoes.

Check out this episode!

Sunday, April 24, 2016

Heel pain - plantar fasciitis

Anatomy - The plantar fascia is made up of 3 distinct parts: the medial, central, and lateral bands on the bottom of the foot.

There are many treatment options when patient experience heel pain.

  • Rest and activity modification, although helpful may not be practical, particularly for more active individuals and for those whose jobs require standing.
  • Physical Therapy or home stretching is the initial physical treatment for plantar fasciitis that emphasizes stretching of the calf and foot.
  • NSAIDs or Corticosteroids (anti-inflammatory medications) are frequently used to treat plantar fasciitis. Corticosteroids can be administered either orally or via injections.
  • Orthotics help support the arch and limit the motion the foot experiences.
  • A fasciotomy in some cases surgery may be required.  A plantar fascia release provides significantly improved outcomes for patients with severe symptoms.

Check out this episode!