San Francisco Podiatry Video

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Thursday, June 24, 2010

What If I Have a Stress Fracture and Keep Running on My Sore Aching Foot?


I was heading to Kezar stadium to run intervals when I got a call on my San Francisco Sports Medicine Podiatry practice phone from a runner with a typical question. He explained he was having a mild aching sensation in the foot when walking around, but it has been getting worse when running. He said he thought it was slightly bruised on the top of the foot, but couldn't remember dropping anything on it. He had been trying to figure out whether or not it might be a stress fracture. Because he has ben ramping up his training for a marathon, his main question (of course) was "Well what if it is a stress fracture....what is the worse thing that can happen if I keep running on the foot?"

To help him understand what could happen if he does have a stress fracture and keeps running on it, I told him he could read all about the SF podiatrist point of view on "Can I run with a stress fracture in my foot?"

I also sent him the link for the video on "What If I Run On a Stress Fracture - By San Francisco Sports Medicine Podiatrist."


Dr. Christopher Segler is an award winning foot surgeon and podiatric sports medicine specialists in San Francisco. He developed a house calls based practice to serve active athlete, marathon runners and triathletes who can't waste their free time driving around town or sitting in a doctor's waiting room. If you have a question about a possible stress fracture, you can call him directly at 415-308-0833. You can also learn more at stress fractures at San Francisco's Best Running Related Podiatry Site or MyRunningDoc.com.

Wednesday, June 16, 2010

What Should I Do If I Sprain My Ankle?

San Francisco Podiatrist Explains How To Stop The Ankle Pain and Swelling When You Twist Your Ankle

Ankle sprains are the most common sports-related musculoskeletal injury. Unfortunately many patients who roll their ankles head to the Emergency Room to treat the pain, swelling and bruising. The reality is, you can often get ankle pain relief much faster if you don't go to the ER. When deciding which doctor is best for your ankle sprain, you should see a specialist: an ankle expert called a podiatrist (not a Jack-of-all-Trades in the ER).

The best ankle sprain treatment right after the sprain is P.R.I.C.E.

P=Protection
You have to prevent any further injury to the sprained ligaments. An ankle brace or fracture walking boot can let most ankle injuries heal without having to worry about hobbling around on crutches.

R=rest
If you get sick and rest, you get well faster. If you tear your ankle ligaments and rest, they heal faster. Try to get some rest and take it easy for the first 48 hours after a bad ankle sprain.

I=ice
Ice is one of the cheapest and most effective home remedies for an acute ankle sprain. Apply ice to your injured ankle for 10 minutes out of every hour during the first 24 hours after you roll your ankle.

C=compression
Use the elastic bandage given to you by Dr. Segler a your House Call visit. By keeping your ankle wrapped the way he showed you, the swelling will stop and go down as fast as possibly. Your ankle ligaments won't start to heal until the swelling goes away.

E=elevation
Use gravity to your advantage! Prop the injured ankle way up on a pile of pillows. It has to be above your heart to really work well. Keep it elevated for the first 24 hours and the throbbing ankle pain will start to go away. Remember, your ankle ligaments won't start to heal until the swelling goes away.

By following the PRICE method, you can help stop all of the inflammation that causes ankle pain and leads to prolonged healing of the ankle sprain.

You can also view the Ankle Sprain First Aid Video here.

Dr. Christopher Segler is a podiatrist and a true ankle expert. He published the largest research study every conducted on subtle ankle fractures that are often misdiagnosed as ankle sprains. The fact is, ankle injuries often don't get the best treatment in the Emergency Room. Dr. Segler won an award from the American College of Foot and Ankle Surgeons for his ankle injury research which showed that lateral process fractures are 10 times more common than previously thought. These ankle fractures often don't heal properly because they are incorrectly diagnosed by busy ER physicians. Dr. Segler now has a podiatry practice in San Francisco that offers same-day house calls for people in the San Francisco Bay Area who have ankle sprains or other sports medicine -related foot and ankle injuries.

If you rolled your ankle and have a question, you can actually call him directly at 415-308-0833. And yes, you will actually get to speak with an award-winning ankle surgeon. No nurses, students or residents... direct access to a true ankle expert.


Learn More about ankle injuries at the best podiatry site in San Francisco: AnkleCenter.com

Friday, June 4, 2010

July is Most Dangerous Time for Surgery: San Francisco Foot Surgeon Explains


Your chances of dying in a hospital are highest in July. A new study published yesterday in the Journal of General Internal Medicine exposes one of medicine’s dirty little secrets. It has long been known that all medical internships, surgery residencies, and fellowships begin on July 1st every year. Because of this, July may be the riskiest month for you to have foot surgery or any other procedure that might be associated with hospitalization.

This is not complicated. After eight years of sitting in college classrooms and medical school lecture halls, the wet-behind-the-ears medical intern is just plain itching to practice all of those skills he or she has read about. The problem is, they have a lot of learning left to do.

You don’t really want to be the first person when a new foot doctor tries to make a surgical incision on your foot. You don’t want to be a new ankle surgeon’s very first ankle ligament repair surgery. You also don’t want to that new, nervous, over-worked and sleep deprived intern fumbling through a Pharmacy handbook while writing your medication orders at 4:00 a.m.

It is this combination of pressure and inexperience on new doctors in training that produces the “July Effect.” This new study conducted at large teaching hospitals in California (but not in the San Francisco Bay Area) found that fatal medication errors spiked by 10% during the month of July in counties that had teaching hospitals. By contrast there was no increase in medication errors in counties that did not have doctor’s in training. The study concluded that the spike in hospital deaths was in large part associated with the influx of new medical resident doctors in the month of July.

Whether you are considering bunion surgery or back surgery, there are some simple steps you can take to avoid the risks associated with new medical residents.

1) Have surgery in June or August instead of July. The most change in staff happens in July. This is when the medical residents are newest and more likely to make errors. They are also more likely to get in over their heads in surgery.

2) Avoid the teaching hospitals in July. If you have an elective procedure (such as bunion surgery, ankle stabilization surgery, or heel spur surgery) request that the procedure be performed at an outpatient ambulatory surgery center. There will be fewer residents and less chance of a newbie bungling your case.

3) Ask questions! You have a right to understand all of the procedures that will be done, and by whom. Ask if a resident will scrub in your foot surgery. You do have the right to refuse to have doctors-in-training involved in your care. By asking questions about your surgery, postoperative care, rehabilitation and medications, you will force the attending doctor to stop and think. This may decrease your risk of an error that could occur if the doc is hurried.

4) Have an advocate on your side. If you have a concierge type physician caring for you and overseeing your care, it is far more likely that any mistakes will be caught in time. Docs that report to other docs will be more focused and paying closer attention. If you don’t have a concierge-type physician, at least bring a family member who can ask lots of questions and take notes.

5) Choose an “Out-of-Network” Surgeon. Don’t expect concierge care if you have Medicare. This is just math. On June 1, 2010 doctor’s who accept Medicare got a 21% pay cut. They will be moving faster and working harder to pay the light bill. This will quickly trickle down to all “In-Network” Insurance Policies. Most insurance contracts with “In-Network” doctors are based on a percentage of Medicare pay rates. By choosing a doctor who is “Out-of-Network” you will get a doctor who has more time to spend with you, answer your questions, and guard against resident-associated errors.

The more you know about the dangers of medication errors and inexperience associated with the annual medical trainee change-over in July, the more empowered you will be to enter the hospital or operating room and have a successful surgery. But if you have to check into a University Teaching Hospital in July, stay low and keep moving!

Dr. Christopher Segler is a San Francisco based foot surgeon and an award-winning podiatrist. His new patient appointments with foot surgery patients generally take 1-2 hours. He thinks the best medical care is personalized convenient care. He makes house calls and does not allow residents to perform surgery for him. He also takes his patients to reputable outpatient surgery centers. If you have a question about foot surgery, you can call him directly at 415-308-0833. Learn more at San Francisco's Foot Surgery Info Site.