What Is an Ingrown Toenail?

When a toenail is ingrown, it is curved and grows into the skin, usually at the nail borders (the sides of the nail). This “digging in” of the nail irritates the skin, often creating pain, redness, swelling, and warmth in the toe.
If an ingrown nail causes a break in the skin, bacteria may enter and cause an infection in the area, which is often marked by drainage and a foul odor. However, even if the toe isn’t painful, red, swollen, or warm, a nail that curves downward into the skin can progress to an infection.

Causes
Causes of ingrown toenails include:
Heredity. In many people, the tendency for ingrown toenails is inherited.
Trauma. Sometimes an ingrown toenail is the result of trauma, such as stubbing your toe, having an object fall on your toe, or engaging in activities that involve repeated pressure on the toes, such as kicking or running.
Improper trimming. The most common cause of ingrown toenails is cutting your nails too short. This encourages the skin next to the nail to fold over the nail.
Improperly sized footwear. Ingrown toenails can result from wearing socks and shoes that are tight or short.
Nail Conditions. Ingrown toenails can be caused by nail problems, such as fungal infections or losing a nail due to trauma.
treatment
Sometimes initial treatment for ingrown toenails can be safely performed at home. However, home treatment is strongly discouraged if an infection is suspected, or for those who have medical conditions that put feet at high risk, such as diabetes, nerve damage in the foot, or poor circulation.
Home care:
If you don’t have an infection or any of the above medical conditions, you can soak your foot in room-temperature water (adding Epsom’s salt may be recommended by your doctor), and gently massage the side of the nail fold to help reduce the inflammation.
Avoid attempting “bathroom surgery.” Repeated cutting of the nail can cause the condition to worsen over time. If your symptoms fail to improve, it’s time to see a foot and ankle surgeon.
Physician care:
After examining the toe, the foot and ankle surgeon will select the treatment best suited for you. If an infection is present, an oral antibiotic may be prescribed.
Sometimes a minor surgical procedure, often performed in the office, will ease the pain and remove the offending nail. After applying a local anesthetic, the doctor removes part of the nail’s side border. Some nails may become ingrown again, requiring removal of the nail root.
Following the nail procedure, a light bandage will be applied. Most people experience very little pain after surgery and may resume normal activity the next day. If your surgeon has prescribed an oral antibiotic, be sure to take all the medication, even if your symptoms have improved.

Aching feet:

But these days, we see a whole soccer teams of 16-year-old girls" complaining of the sort of foot pain when we used to see mostly in "older, fatter" people.

The culprits aren't the girls' soccer cleats or even the high heels they break out on prom night. Instead, it's their flip-flops — the flimsy, slip-on, toe-thonged sandals that girls and young women nationwide have adopted as their warm-weather, everyday shoe uniform.

"Flip-flops were never meant to be everyday shoes," "They were meant to wear from the locker room to the pool and back."

The problem, is that flip-flops offer little cushioning and no arch support, and they force their wearers into an unnatural, toe-gripping, foot-slapping gait.

Among the possible consequences:

•Sore arches and heels, which can progress to chronic conditions, including inflamed Achilles tendons and plantar fasciitis, inflammation of the connective tissue between the heel bone and the toes. Heel calluses (from the pounding). Hammer toes (from the gripping). •Irritation between the toes (from the toe thongs), which can lead to nasty fungal infections.

Of course, flip-flops aren't the only popular shoes that can hurt your feet. Pretty little ballet flats and sky-high wedges, if worn too often or in the wrong circumstances, can cause just as much pain as classic trouble-makers such as stiletto heels, experts say. Even sensible, low-heeled, wide-strapped sandals can harm your feet if you wear the same pair every day from June to September.

A few tips for making it through the summer with feet that look good and feel good, too:

•Spend most of your time in sturdy shoes that offer heel and arch support. "If you can take the sandal or ballet flat and twist it into a little ball, that's a sign that they can't take everyday wear and tear," Crane says.

•Stick to heels — or wedges — of 2 inches or less, except on special occasions. A wedge may feel more stable than a heel of the same height, but it can put just as much pressure on your feet, knees and hips.

•Wear the right shoes at the right time. "If you are going to be involved in a sport or walking all day, wear shoes that are made for that.

•Switch shoes daily, if possible, especially if you live in a humid climate. Even very comfortable, sensible shoes can grow fungus if they don't get a chance to dry.

•Buy shoes that fit and feel comfortable the first time you put them on. "The concept that you just have to break in a shoe is a fallacy. If the shoe is not comfortable, don't buy it," Anderson says.

•Put some sunscreen between those sandal straps. "People put it on their legs, completely forget their feet" and end up with badly burned feet..

1 in 5 Health Insurance Claims Mishandled

It may come as a surprise to few to learn that one in five health insurance claims aren't handled properly. According to a new report by the American Medical Association (AMA), one-fifth of all claims are handled incorrectly by health insurance companies. In their annual "National Health Insurer Report Card," the AMA graded the eight largest health insurers in the U.S. on how claims are handled. The AMA concluded that the system would save $15.5 billion each year in administrative costs if the problems were corrected. In addition to unnecessary administrative costs, wrongly handled claims delay payment to medical providers and frustrate many patients. According to the AMA, the health care system spends as much as $210 billion annually on claims processing.

Pregnant Women Should Avoid High Heels

High heels, Uggs and flip flops should be avoided by moms-to-be as they may cause foot and back problems, according to a survey from the British Society of Chiropodists and Podiatrists. Of 1000 pregnant women surveyed, seven in 10 who wore high heels reported foot problems including swollen ankles and heel pain. High heels "place extra pressure on your joints when they are already under strain, which can result in a host of foot, leg and back problems and could increase the likelihood of falls," said podiatrist Lorraine Jones. Sixty-six percent of the women surveyed said they regularly wore flip flops, 53% wore ballet pumps, 30% wore Uggs and 32% wore high heels. The American Podiatric Medical Association recommends "comfortable footwear that provides extra support and shock absorption."

Anyone for new shoes?

Romanian shoe designer Mihai Albu has created a shoe that will raise you up an entire foot. What woman wants to be a whole foot taller? And talk about hard to walk in – they’re a lesser version of stilts (albeit much better looking)!The tall shoes seem to come at a tall price, as well: $1,525, which is approximately three times the monthly wage in Albu’s homeland of Romania

Recovery, yea sure, tell that to my patients!
Las Vegas has been hit with the worst recession in the nation. Unemployment is in the double digits, the visitor count is at a ten year low, construction has been nonexistent for 2 years. Driving to work this morning, I noticed that the usual billboards that in the past displayed enormous “ busted” women as an inducement to have augmentation surgery by cosmetic surgeons were replaced by bankruptcy attorneys. There were a plethora of “ discount buffets” advertisements at the local hotels and the bail bondsman were everywhere! What does this have to do with podiatry you ask? Simple. People are out of work, Insurance coverage has dried up for many and Colbra coverage is just not affordable. As many of my readers know, I left a very successful practice in the northeast 20 years ago to become Director of a Community Health Care Center in Las Vegas. I had the opportunity to oversee the operation of a clinic that treated over 35,000 patient visit’s a year. Of these visits 95% represented uninsured, Medicaid, homeless and AIDS patients all. If this type of experience does not instill humility nothing will! I have seen the return of this type of despair and hopelessness again during this recession. Patients are waiting weeks if not months longer then they should to receive foot care. Patients whose Ingrown nails could have been treated with just antibiotics now must undergo extensive surgeries to save their feet. Many have no to little health care coverage. Some have a local HMO who refuses to see patients for weeks because they say “ we are backlogged” and you just have a “ toe” problem. The current situation has become troubling, but, it also has given me the opportunity to once again pay back the community for the success it has given me. We are now (until this economic mess ends) are discounting ALL our fees to uninsured and to those whose plans we do not accept to the lowest fees we can possible accept. Examples: Permanent correction of ingrown nails (includes the visit, surgical procedure and follow up) $150.00. Custom orthotics (depending on type) for $199.00. These fees I feel are fair and more importantly needed during the worst economic times many of us have and ever will suffer from. I may not be able to make my car payment as easy nor my house payments, but I will be able to put my head on the pillow at night and know that I am making a difference to my patients, their families and all who are in need of foot health care.
Wishing you all a safe, healthy and joyful summer,
Dr. Ted

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