How To Pick Out Baby's First Shoes

Seems like yesterday that you were getting your first ultrasound and dreaming about taking your new baby home. Now your little one is crawling all over the place and getting ready to take their first steps. How did it happen so quickly? You've seen all of the cute options for first shoes, but how do you know what's good and what's not? Here are some tips in picking out baby's first shoes:
1. Don't Rush! Most new walkers don't need shoes right away when they first start to walk, unless it is outside. Barefoot is actually the best way for children to learn to walk. Children do not need shoes until they are actually walking.

2. Know Where To Go. And that does not mean Walmart or Kmart unfortunately. It is also not the time to hone your skill of shopping online. Your baby's first pair of shoes should be fitted by a professional, along which each pair thereafter. When shoes do not properly fit, it affects your child's gait and foot development. Go to a shoe store that will have a fitter on hand.
3. Get A Shoe With Sole. For walking shoes, babies need shoes with soles that are stiff because flexible ones don't offer any support. Do the bend test- if the shoe bends in half or twists, then try another pair. Don't worry about finding shoes with arch support as arches do not develop on children until they are three years old.
4. If The Shoe Fits, Wear It! The salesperson should do a thorough check for the proper fit, all around the baby's foot. There should be room for the foot to move in the shoe, along with a quarter to half inch space between the front of the shoe and the big toe.
5. Check and Re-check Those Little Piggies. Check your child's feet often after purchasing the shoes, especially after a growth spurt. Children are not typically good at expressing pain or what hurts where, so check your child's feet for redness and blisters. Imagine if you had a blister on your feet and couldn't tell anyone and had to wear those shoes every day?
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How To Give Yourself A Pedicure

In light of how dirty and unsanitary most nail salons and pedicure stations are, we recommend you try to do your own pedicure at home. Not only will you save your feet from fungus and Athlete's Foot, among other things, but you'll save a few dollars as well.
1. Soak your feet in warm and soapy water. We suggest five minutes- in the meantime chill and relax! Make sure to clean and dry off your feet thoroughly before proceeding.

2. Use a pumice stone to remove any calluses or dead skin. Don't forget to remove scaly skin and dry skin from your heels and balls of your feet.
3. Rub your cuticles with cuticle oil, olive oil, or baby oil. Afterwards, use an orange stick, which you can find at any drugstore, to push back the dead skin near the cuticles. You can also use the orange stick to clean under your toenails.
4. Now you can clip your toenails. We recommend getting specific toenail clippers with a straight blade to prevent ingrown toenails. Remember to cut your toenails straight across and trim them so you can see a little bit of skin past the nail.
5. Massage lotion or cream all over the skin of your feet.
6. Using nail polish remover, remove the lotion from your toenails. Now it's time for the fun part! Using your desired polish, start with a stroke down the center of your nail.
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Avoiding P.A.D. Complications, Part 4

Getting regular foot exams- as well as seeking immediate help when you notice changes in the feet- can keep small problems from worsening. P.A.D. requires ongoing attention.
To avoid complications, people with this disease should follow these precautions:

• Wash your feet daily. Use warm (not hot) water and a mild soap. Dry your feet- including between the toes- gently and well. 
• Keep the skin soft. For dry skin apply a thin coat of lotion that does not contain alcohol. Apply over the top and bottom of your feet, but not between the toes. 
• Trim toenails straight across and file the edges. Keep edges rounded to avoid ingrown toenails, which can cause infections. 
• Always wear shoes and socks. To avoid cuts and abrasions, never go barefoot- even indoors. 
• Choose the right shoes and socks. When buying new shoes, have an expert make sure they fit well. At first, wear them just for a few hours daily to help prevent blisters and examine the feet afterward to check for areas of irritation. Wear seamless socks to avoid getting sores.
• Check your feet- every day. Check all over for sores, cuts, bruises, breaks in the skin, rashes, corns, calluses, blisters, red spots, swelling, ingrown toenails, toenail infections, or pain.
• Call your foot and ankle surgeon. If you develop any of the above problems, seek professional help immediately. Do not try to take care of cuts, sores, or infections yourself. 

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PADnet Testing Part 3

A PADnet Arterial Test can provide early detection of P.A.D. when treatment options are broadest (incorporating both lifestyle modification, and non-invasive and invasive therapeutic options). The PADnet detects blockage in arteries and the quality of blood flow using pulse-volume recordings and segmental blood pressure measurements. Given appropriate signs and symptoms, a PADnet + Post-Exercise test may be necessary.
Before Your Test
Getting ready for your test requires little effort. You will be asked to remove clothing that covers your arms and legs, keeping your underwear on. You may be asked to remove your shoes and socks as well. A gown may be provided, or you may bring shorts to wear. This test often takes 15-20 minutes. Be sure to allow extra time to check-in.

• Do not smoke or use tobacco 30 minutes prior to your PADnet+ exam. Smoking constricts the peripheral arteries and can interfere with the results.
• If you think you cannot tolerate lying flat on the exam table, please let us know. 

During Your Test

You will lie down on the exam table. Pressure cuffs will be wrapped snugly around your arms, above your knees, calves, and ankles. The technician will inflate the cuffs, and the sensors in the machine will record the pulse waves that correspond to each beat of your heart.
Blood pressure will be recorded at your arms and ankles also. The ABI (Ankle-Brachial Index) is measured by the ratio between these pressures. P.A.D. is diagnosed if your ankle pressure is 99% or lower than your arm pressure. With severe narrowing, the ABI may be less than 50%.
You may be asked to perform toe-ups or to walk on a treadmill until symptoms are induced. After exercise, you will lie down on the exam table and repeat the arm and ankle tests.
If the ABI and/or waveforms are abnormal, your doctor may recommend additional diagnostic tests.
After Your Test
You may return to your normal routine right after the test. Your doctor will let you know when the results are ready.
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Am I At Risk For P.A.D.? Part 2

Answers to these questions will determine if you are at risk for Peripheral Arterial Disease (P.A.D.) and if a vascular exam will help us better assess your vascular health status.
1. Do you have foot, calf, buttock, hip, or thigh discomfort (aching, fatigue, tingling, cramping, or pain) when you walk which is relieved by rest?
2. Do you experience any pain at rest in your lower leg(s) or feet?
3. Do you experience foot or toe pain that disturbs your sleep?
4. Are your toes pale, discolored, or bluish?
5. Do you have skin wounds or ulcers on your feet or toes that are slow to heal?
6. Has your doctor ever told you that you have diminished or absent pedal (foot) pulses?
7. Have you suffered a severe injury to the leg(s) or feet?
8. Do you have an infection of the leg(s) or feet that may be gangrenous (black skin tissue)?
Next Time: A test that can detect P.A.D.
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Partying To Excess: Alcoholic Neuropathy

When we're young, we think nothing bad will ever happen to us. We drink to excess, never thinking of the potential ramifications of our partying lifestyle. Alcoholism is a serious condition and addiction which millions of Americans deal with every day.

Besides the liver problems alcoholics have, they also have problems with their feet. Alcoholic neuropathy is a nerve loss condition in the foot caused by the prolonged use of alcoholic beverages. Ethanol, the alcoholic component of these beverages, is toxic to nerve tissue. Over time, the nerves in the hands and feet can become damaged resulting in the same loss of sensation that is seen in diabetic peripheral neuropathy. The damage to these nerve is permanent. A person with this condition is at the same risk, and should take the same precautions as people with diabetic peripheral neuropathy. Another form of peripheral neuropathy is caused by exposure to toxins, such as pesticides and heavy metals, and is equally detrimental to health.
Symptoms for alcoholic neuropathy include a feeling of tingling, prickling, or needles and pins, general achiness or cramping, nausea, incontinence, or difficulty urinating.
Treatment for alcoholic neuropathy may include Vitamin B-12 injections, certain oral medications to ease any burning pain, topical ointments, magnetic therapy, and galvanic stimulation (which is the therapeutic use of electric current, particularly for stimulation of nerves and muscle.
If you have alcoholic neuropathy and currently do not see a podiatrist, call one of our six offices to make an appointment.
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What is Peripheral Arterial Disease? Part 1

Peripheral Arterial Disease (P.A.D.) is a serious circulatory problem in which the blood vessels that carry blood to your arms, legs, brain, or kidneys become clogged or narrowed. It affects 8 million Americans, most over the age of 50. It may result in leg discomfort with walking, poor healing or leg sores/ulcers, difficult to control blood pressure, or symptoms of stroke. People with P.A.D. are at significantly increased risk for stroke and heart attack.
Because only half of those who have P.A.D. actually experience symptoms, it is important that people with known risk factors be screened or tested for P.A.D.
The risk factors include:

• Being over age 50
• Smoking (currently or previously) 
• Diabetes
• High blood pressure
• High cholesterol
• Personal or family history of P.A.D., heart disease, heart attack, or stroke. 
• Sedentary lifestyle (infrequent or no exercise)

Signs and symptoms include:

• Pain in the legs brought on by walking and relieved by rest.
• Pain in the legs at rest due to poor circulation.
• Poorly healing wound on lower extremity.
• Injury to lower limb or foot involving blood vessels.
• Discoloration of toes and feet.

Simple foot deformities (hammertoes, bunions, bony prominences) or dermatologic conditions such as ingrown or thickened fungal toenails often become more serious concerns when P.A.D. is present. Because the feet and legs of someone with P.A.D. do not have normal blood flow- and because blood is necessary for healing- seemingly small problems such as cuts, blisters, or sores can result in serious complications.
Having both diabetes and P.A.D. further increases the potential for foot complications. People with diabetes often have neuropathy (nerve damage that can cause numbness in the feet), so they don't feel pain when foot problems occur. When neuropathy occurs in people with P.A.D., ulcers can develop over foot deformities and may never heal. For this reason, P.A.D. and diabetes are common causes of foot or leg amputations in the United States.
Once detected, P.A.D. may be corrected or at least improved. The foot and ankle surgeon can then correct the underlying foot deformity to prevent any future problems should the circulation become seriously restricted again.
Next Time: Questions to ask if you think you are at risk for P.A.D.
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