Monday, February 6, 2012

Effectively Treating Toenail Fungus Requires Treatment of Shoes...

Proper Treatment of 
Fungal Infections of the Feet, 
Whether Skin or Toenails, 
Requires Proper Treatment of Your Shoes. 

This is a bit off my usual topic of reviewing shoes but
I thought - as long as I am encouraging you to invest in proper shoes - it would be appropriate to spend some time on discussing the proper care and treatment for your shoes if you are trying to rid yourself of a fungal toenail or skin infection.

If you do have a fungal toenail infection or suffer from a chronic athelete's foot infection 
(also fungal) - it is impossible to clear up the toenails if you do not clear up the skin infection and vice versa. 
More importantly,  
even if you do clear up those infections, if the shoes are not properly treated also, 
there are fungal spores that have been shed in your shoes and threaten to "break open" and re-infect your skin and toenails months after the infection has cleared. 

Scary Mary. 
What to do?? 

Well, here are my comprehensive recommendations for clearing toenail and skin fungal infections permenantly:

1. 
Stop walking barefoot! 
This will greatly decrease the chance of picking up fungal as well as viral infections such as warts. Not to mention foreign bodies, ect. 
Wear Croc Rx clogs around the house with the strap to the back for more biomechanical control.

2. 
When you do wear shoes - follow the
four rules of proper shoegear: 
thick-rigid sole, 
arch support, 
wide, soft square toebox 
and firm rearfoot control. 

A wide toebox is important because a tight toebox applies pressure to the toenails, which causes injury to the toenail (onychauxis) which is what sets out the "welcome mat" for setting up fungal infections of the toenails. 
Injury
even if it is constant repetitive micro-trauma to the toenails from a tight toebox or a flimsy sole on the shoe that allows too much motion through the forefoot area - will cause the onychauxis that sets up a perfect environment for a fungal infection to start. 
The typical presentation for a patient with fungal toenails is, 
"I dropped something on my toe and now it's thick and discolored." 
Injury = Fungal Infection. 
Protect the toenails!

3. 
Spray your shoes every morning before putting them on with an 
over-the-counter topical anti-fungal spray 
such as Lamisil or Tinactin. 
You don't have to break the bank - 
a good spray may cost anywhere from 
four to ten dollars.
Bowling Alleys use Lysol spray, which is also effective. 
You can also use over-the-counter anti-fungal powders but I have been informed by several of my patients who are Shoe Repair Professionals that powders will decrease the lifespan of your shoes as they tend to "build up" within the shoe and break down the sole quicker. 

4.
Avoid wearing the same shoes every day. 
Try to switch off shoes every other day to allow the shoes a full twenty-four hours to dry out. Fungus loves a moist, dark, warm environment, which is basically inside a shoe after a long day's wear.

5. 
Cedar Shoe trees that you place within a shoe helps to absorb the moisture and keep the shoes dry. There are other over-the-counter ultra-violet products that help to treat shoes while you are not wearing them and for a severe infection, they may prove useful.



6.
If you have a chronic infection of your feet and/or toenails and nothing clears it up - 
if you've tried everything and nothing works - 
it's probably not a fungal infection! 

 Follow up with your Podiatrist. 
In the worst case scenario, we can take a biopsy and send it out to a Pathologist to look at under a microscope and tell us what it is so that it can be properly treated. I rarely have to do this but it is always an option. 
It could be Psoriasis, Eczema, Dermatitis and any number of other skin conditions that are commonly mistaken for 
an athelete's foot infection. 
The same thing goes for the toenails - it is very easy to trim off a piece of the toenail and send it to a pathologist for what is called a KOH and PAS test to confirm the diagnosis of a fungal infection. There are many conditions that mimic a toenail fungal infection and, unless it is properly identified, it is hard to properly treat it. 


7.
Talk to your Podiatrist about treating your toenail and skin fungal infections. 
Whether you choose to use oral antifungal prescription medication (i.e. Lamisil), topical antifungal prescription medications (i.e. Penlac), over-the-counter antifungal medications (Formula-Three) or homeopathic remedies such as white vinnegar, tea tree oil or Vick's Vapor rub - 
use something!
Your Podiatrist will be able to discuss the pros and cons of each type of treatment and together you can decide what is best for you.




8.
The "Golden Rule" with fungal foot infections: 
If you don't treat it, it won't get better. 
If you do treat it, it probably will get better." 

So...

Go to your Podiatrist or Dermatologist and get an accurate diagnosis of your foot infection - 
this will greatly skyrocket your chances of successful treatment!

Once you do start treatment, you must be "consistent and persistent" with any treatment plan and it should resolve. 




Hope this has been helpful!

Dr. Cathleen A. McCarthy


:)







Monday, January 23, 2012

Comfortable Women's Wedge Sandal - Earthies Salerno

EARTHIES SALERNO

love it...


This is a gorgeous shoe!

I love the Earthie shoe line - 
they are pretty and, in a world full of poorly constructed shoes, Earthies has consistently offered exceptional quality. 
This shoe is wonderful because of the rigid protective sole that offers more protection and comfort for the foot structures. 
What really wins me over is the contoured foot-bed with soft material and excellent arch support.
The strapping provides forefoot, midfoot and rearfoot control, which increases biomechanical control of the foot and allows for 
more comfort as well as less chance of injury and mechanical strain. 

This Shoe is Recommended For Patients with:
*Mild Bunions
*Mild Hammertoes
*Mild Tailor's Bunions
*Plantar Fasciitis (Heel Pain)
*Achilles Tendonitis


This Shoe is NOT Recommended For Patients with:
*Hallux Limitus/Hallux Rigidus (Limited or No Range of Motion across the 1st Toe Joint)
*Osteoarthritis or Degenerative Joint Disease of any of the Toe Joints (especially the 1st Toe Joint)
*Metatarsalgia
*Morton's Neuroma
*Capsulitis of the Toe Joints
*Ankle Instability/Hypermobility
*Diabetes
*Peripheral Neuropathy (Nerve Damage)
*Peripheral Arterial Disease (Poor Circulation)
*Charcot Foot
*History of Ulcerations
*Dropfoot


If you are one of my patients or in 
the Scottsdale area, 
J. Stephens Shoes 
located in Kierland Commons carries 
the Earthie shoes. 

Check out their website at:

www.shoesjs.com

(I have no financial interests with them!)


***


Have a great evening!


Dr. Cathleen A. McCarthy


:)





Saturday, January 21, 2012

Comfortable & Stylish Man's Dress Shoe - The Dansko Theo

DANSKO THEO

Comfort & Style for Men.


Of course there is a story behind this shoe!

One of the Podiatry Students from Midwestern University School of Podiatric Medicine who has been shadowing me this month was wearing a lovely looking Echo dress shoe but I noticed that by the end of the day he was shifting around like his feet hurt. 
Although I recommended on several occasions for him to sit down and rest - he declined and continued standing for the entire day while we saw patients.

Foot pain is a common problem for third year medical students because they spend the first two years of school sitting and in the third year they are thrown into hospitals and expected to stand for long hours on hard surfaces.

When I was a third year Podiatry student, 
I spent a month shadowing a Podiatrist and my feet and legs were killing me! 
At one point, I was so desperate I asked the doctor if I could sit during his patient exams and he refused to let me! 
He advised me it was more professional if I remained standing - even though he was sitting!
 
I remember thinking that it was very odd that a Podiatrist - a person who has devoted his career  to foot care - would refuse to let me sit and I promised myself  that I would never do that to any students.

Anyway, the student shadowing me this month didn't want to sit - 
even when I encouraged him to do so  -
(am I that scary??)
He is an excellent student and I respect his tenacity but I hate to see him suffering.

So, he's had to listen to me talk biomechanics all day long to practically every patient for the past month and he showed up on Friday with the Dansko Theos. 

I am ashamed to say that I didn't notice at first but one of the office staff (my mother!) admired his new shoes and we checked them and they proved to have excellent biomechanical control. 

At the end of the day, the student said they felt fantastic and finally admitted that his feet had been killing him by the end of each day 
(I knew it! I have a sixth sense when it comes to foot pain...) 
and (yea!) he loved his new Danskos. 

He was surprised because he had spent significantly more money on the Echo dress shoes than on the Danskos but I reminded him that it is not how much money you spend - it is knowing what you are looking for in a shoe. 

The Echo was a great looking shoe but the 
forefoot sole on this particular shoe was thinner and far too flexible.

The Dansko Theo has a thick, rigid sole that does not bend, which allows for much more biomechanical control and therefore - less pain. 
It also has a good insert with decent arch support (it can be removed to accommodate a custom-molded orthotic if needed) as well as a wide toebox and great rearfoot control.

Echo is a wonderful shoe line and has many excellent shoes but, like every shoe line, it also has some stinkers. 

Hence, the whole purpose of this blog - 

finding good looking comfortable shoes that are pathology specific! 



Dansko Theo's are Recommended for Patients with:
*Mild to possibly Moderate Bunions
*Mild to possibly Moderate Tailor's Bunions 
*Mild to Moderate Hammertoes
*Metatarsalgia
*Mild Morton's Neuroma
*Hallux Limitus/Hallux Rigidus (Limited to No Range of Motion across the 1st Toe Joint)
*Recovery from any Injuries to the Foot - especially the forefoot or the metatarsals
*Mild to Moderate Tendonitis
*Maybe Mild Achilles Tendonitis (It will feel better with a Heel Cup in the shoe if you have Achilles Tendonitis)
*Mild Ankle Instability
*Hypermobility or Ligament Laxity
*Tired Leg Syndrone
*Mechanical Strain
*Mild Knee, Hip or Lower Back Pain


This Shoe is NOT Recommended for Patients with:
*Diabetes with history of Ulcerations
*Neuropathic Feet (Nerve Damage)
*Peripheral Arterial Disease (Poor Circulation)
*Charcot Foot
*Prominent "bumps" on the foot or an excessively high arch (Pes Cavus) - especially if you have an exostosis (bone spur) on the top of your midfoot area. This shoe may rub that area, which will cause irritation. 


Overall, I give this shoe a rating of 9
on a scale of zero to ten with ten being the best. 


Enjoy your day!

Dr. Cathleen A. McCarthy

:)

A special thank you to the student 
(you know who you are little grasshopper!) 
for providing me with the information that allowed me to do the review on the Dansko Theo! 



 


Tuesday, January 17, 2012

Comfortable Women's Casual Dress Shoe - Wolky Cloggy...

 
The Wolky Cloggy 




The Wolky Cloggy is an excellent shoe and I highly recommend it!

It has a thick and protective sole with good arch support and "memory foam" that molds to your foot for extra comfort. 
The wide toebox, midfoot and rearfoot strap biomechanically control the foot, which allows for more comfort and less chance of injury.

This shoe is Recommended for Patients with:
*Bunions
*Hammertoes
*Tailor's Bunions
*Metatarsalgia
*Corns & Calluses
*Morton's Neuroma
*Sesmoiditis
*Tendonitis
*Hallux Limitus/Hallux Rigidus (Limited Range of Motion or no range of motion across the 1st Toe Joint) 
*Osteoarthritis 
*Rheumatoid Arthritis
*Fibromyalgia


This shoe is NOT Recommended for Patients with:
*Diabetes with a history of Ulcerations
*Peripheral Neuropathy (Nerve Damage)
*Peripheral Arterial Disease (Poor Circulation) 
*Charcot Foot

Overall, the Wolky Cloggy is an excellent shoe for a multitude of foot types...
Have a Great Evening!

Dr. Cathleen A. McCarthy

:)


Monday, January 16, 2012

Comfortable Women's Dress Shoes - Dansko.

Dansko
Comfortable Women's Dress Shoes...
Dansko Bett
$160
 Dansko Reeny
$155



More comfortable Dansko shoes! 
It's hard to go wrong with Dansko and these two shoes are no exception. 

Both have a thick, rigid sole which allows for maximum biomechanical control of the foot structures 
(Joints, Muscles, Tendons, and Ligaments) 
and therefore allows for 
more protection and comfort. 

Both shoes also offer a wide toebox, 
excellent rearfoot control and a strap for midfoot control. The combination of the rigid sole and these three thing also allows for more biomechanical control and therefore more comfort and protection of the foot, ankle as well as the knees, hips and lower back.

Dansko shoes typically do not accommodate any arch support whether it is over-the-counter or custom-molded but that is usually not an issue because there is adequate arch support built into the shoe. 

Patients sometimes have trouble with proper fitting if they are half sizes and, 
if this is the case with you, I recommend trying the shoes on in a store. 
It is also a heavier shoe than some other brands, which works well for people who are on their feet on hard surfaces for long hours but this can be a problem for patients who are elderly, have muscle weakness or have a history of some neurological problems such as "drop foot".

In general, Dansko shoes offer hard-core biomechanical control but...
they are not for everyone! 

If you work on concrete floors and your feet hurt, give Dansko shoes a try. 

If you continue to have foot or ankle pain even with good shoes, 
I recommend that you follow up 
with a Podiatrist for 
a proper evaluation including x-rays
as you may be walking around on a stress fracture or some other problem that can be treated successfully doing some simple things.


These Shoes are Recommended for Patients with:
*Mild Bunions
*Mild Hammertoes
*Mild Tailor's Bunions
*Mild Morton's Neuromas
*Mild Metatarsalgia
*Mild Halluc Limitus (Limited Range of Motion across the 1st Toe Joint) 
*Mild Tendonitis
*Mild Achilles Tendonitis
*Mild Plantar Fasciitis (Heel Pain)
*Mild Osteoarthritis
*Mild Plantar Plate Injuries (of the Forefoot Joints) 
*Mild Forefoot Joint Capsulitis


These Shoes are NOT Recommended For Patients with:
*Diabetes
*Peripheral Arterial Disease (Poor Circulation)
*Neuropathy (Nerve Damage)
*Drop Foot 
*Charcot Foot
*History of Foot Ulcerations 
*Excessive Swelling
*Hallux Rigidus (No Motion across the 1st Toe Joint)
*Moderate to Severe Hallux Limitus (Limited Range of Motion across the 1st Toe Joint) 
*Moderate to Severe Bunions
*Moderate to Severe Hammertoes
*Moderate to Severe Tailor's Bunions 
*Severe Morton's Neuroma's 
*Severe Degenerative Joint Disease or Rheumatoid Arthritis across any of the Forefoot Joints



I hope all is well!
Dr. Cathleen A. McCarthy 

:)





Sunday, January 15, 2012

Comfortable Women's Shoe - Dansko Riki...

Dansko Riki 

 I own this shoe and I love it!
It's my "go to" shoe for work as it is super-comfortable for all day wear and it looks great with black slacks and jeans. 
There are some limitations to this shoe and if you have any "bumps" on the top of your mid-foot area or you have a high instep and tend to get irritation from shoes across the top of your midfoot - this shoe will probably not work for you.

The Dansko Riki has a thick rigid sole that is very protective of the foot, which also makes it very comfortable. 
It has a wide toebox as well as excellent rearfoot control that allows for more comfort. 
The Dansko Riki will not accommodate an insert or custom-molded insert but it does not necessarily need one as it has decent arch support built into the shoe. 

Dansko shoes are not for everyone. 
Dansko offers pretty hard-core biomechanical control, which works wonders for people who need to be on concrete floors for long hours. 
Dansko does not tend to work for elderly people who cannot tolerate a "heavy" shoe and it does not accommodate large "bumps" that certain people might have on their feet such as bunions or bone spurs that protrude. 

The Dansko Riki is Recommended for Patients with:
*Mild Bunions 
*Mild Hallux Limitus (Limited Range of Motion across the 1st Toe Joint) 
*Mild Osteoarthritis of any of the forefoot or midfoot joints
*Mild Hammertoes
*Mild Tailor's Bunions 
*Mild Morton's Neuroma
*Mild Metatarsalgia
*Mild Tendonitis
*Mild Plantar Fasciitis (Heel Pain)
*Mild Achilles Tendonitis
*Mild Knee, Hip and Lower Back Pain


The Dansko Riki is NOT Recommended for Patients with:
*Moderate to Sever Bunions (May have too much pressure on the "bump")
*People with "high insteps" or "bumps" on the top of their mid-foot areas (the strap causes too much pressure in this area)
*Moderate to Severe Tailor's Bunions
*Moderate to Severe Hammertoes
*Moderate to Sever Morton's Neuromas
*Hallux Rigidus (No motion across the 1st toe joint) - caused by biomechanics, degenerative joint disease, osteoarthritis or previous injury
*Diabetes
*Charcot Foot
*Neurpathy (Nerve Damage)
*Peripheral Arterial Disease (Poor Circulation)
*History of Foot Ulcerations 
*Muscle Weakness in Lower Extremities
*Drop foot
*Pes Cavus Foot Type (High Arch Foot Type)
*Wide Feet
*Geriatrics



Overall, a great shoe! 

I purchased mine from Paradise Valley Mall in Phoenix for $160 and they are worth every cent. 



Have a great day!


Dr. Cathleen A, McCarthy


:)









Wednesday, January 11, 2012

"Top Comfortable Shoe Lists" that are Podiatrist Recommended.

For Lists of my Podiatrist recommended 
"Top Shoes" -
Please use the search box to the right (within the blog) to look up:


Top Twenty Comfortable Dress Shoes
Top Twenty Comfortable Boot
Top Ten Comfortable Sandals
Top Five Comfortable Walking Shoes



Hope these are helpful!

Sincerely,

Dr. Cathleen A. McCarthy