Fungus Nails is an unsightly infection of the nails, causing thickened, brittle, yellow, discolored and sometimes painful nails. It is very difficult to cure. It is caused by one of several microscopic organisms, similar to those that cause Athlete’s Foot (dermatophytosis) These are plant like organisms that thrive in a dark, warm, moist environment, such as within shoes and stockings. They grow in the nail bed, beneath your nails, and live off Keratin, the protein in the nail.

What Causes Nail Fungus?

• Bruised or damaged nails
• Exposing nail to contaminated areas- locker rooms, bathtubs, swimming pools
• Sweaty shoes or socks
• Sharing contaminated nail instruments- nails cutters, nail polishes, cuticle cutters

What Does It Look Like?

Toenail fungus can look very different. Some fungus are black, some are dark white and some are even yellow or greenish. In addition, cracked, dry, brittle or broken nails can be a sign of nail fungus. To be properly diagnosed and determine the best treatment, make an appointment with your podiatrist!

Ditch the Pain.

Did you know six out of 10 teens just ignore foot pain? That’s crazy! You’re busy with schools, sports, and prom, so don’t let foot pain slow you down. Sometimes foot pain can be caused by something as simple as the wrong size shoe. And in case you didn’t know, your feet are still growing during your teen years. Whether you’re dealing with blisters, athlete’s foot, or ingrown toenails, you can ditch it all! A podiatrist, the foot and ankle expert, can help. Today’s podiatrists are uniquely qualified among medical professionals to treat the foot and ankle. In fact, they are the only doctors who study the foot and ankle exclusively for four years while attending podiatric medical school.

If you or a friend want to ditch foot pain and stay healthy, check out the info below!

The myFEET foot health awareness campaign, created just for teens, gives YOU to the tools to take control of foot pain and ditch it for good!

True/False Foot Health Quiz Think you know it all when it comes to your feet? Find out now by taking this quiz.		Dos and Don’ts For A Fabulous Pedicure Everyone needs a little foot pampering from time to time!
Foot Care 101 Keeping your feet healthy can help you avoid embarrassing problems.		How to Choose the Right Shoe You wouldn’t wear flip flops to play soccer! Find out how to select the right footwear.
Common Foot Problems (and What to Do About Them!) Wonder why your feet always stink? Find a fix for this problem and more.		Avoid Pain & Raise Your Game: Shoes for Sports Sport-specific shoes can really affect the way you play.

Find a Podiatrist

Ditch the pain with the help of today’s podiatrist – a foot and ankle specialist. Find one near you now!

Thank you Spenco Medical Corporation for sponsoring the myFEET Foot Health Awareness Campaign!

Nail fungus is a common disorder that leads to yellow or chalky white, brittle, cracked, and thick nails. Fungal nail infections, called onchomycosis, most often affect toenails. Nail fungus is more common in men and those with weakened immune systems, including people with diabetes: typically, the toenail is traumatized by trimming, or dropping something upon it, or repetitive trauma as in running or playing tennis.

Once the fungus enters the nail, it eats away the nail keratin (protein) causing it to thicken and discolor. With shoe pressure, pain can occur or the nail may become ingrown.

Laser treatment of the nail may reduce thickness, improve appearance, and make trimming easier. However, treatment is not generally considered medically necessary unless other factors are present such as diabetes, poor circulation, excessive pressure, pain or lack of normal sensation. Additional treatment options include the use of liquid antifungals such as Penlac (which reports a 7% cure rate and 44% improvement rate), the use of prescription oral Lamisil (which reports up to 66% success rate with need for blood test to monitor for liver damage) or laser treatment. Many patients whom have failed using topical and oral treatments, are turning to the laser for a safe, effective option.

Dr. Dave Kirlin and his partners, Dr. Ryan Meredith and Dr. Wagner Santiago, utilize a Q-Switched NdYAG laser, which is one of the most advanced dermatologic lasers currently available. In 3-10 billionths of a second, impulses of high power laser energy pass through the nail to the nail bed and nail growth area with typically no damage to the nail or surrounding skin. At the time of the procedure no visible change is seen until the nail begins to grow out. In a few months, a more normal nail is expected to appear with complete regrowth of the nail taking 9-12 months.

No post treatment side effects have been reported. One may resume all normal activities immediately. Most people do not feel any pain. Some patients may experience slight warmth or occasional snapping sensation during the procedure, No anesthesia is needed.

Laser treatment is considered cosmetic and is not covered by health insurance. Treatment cost varies depending on the number of nails and the severity of the infection.

The chance for the recurrence of nail fungus can be reduced by controlling excessive foot perspiration with antiperspirants, frequent sock and shoe changes and by using nail polish with an anti-fungal additive.

For more information on laser treatment and other podiatric foot problems, contact Dr. Kirlin’s office at (704) 861.0425 or visit the Gaston Foot & Ankle Associates website at www.gastonfoot.com.

(Gastonia, NC – March 2011) Toes and feet can take a beating, especially from sports.

Foot and ankle surgeon Dr. Wagner Santiago and his partners Doctors Dave Kirlin and Ryan Meredith treat many soccer-playing children for ingrown toenails. Santiago blames improper toenail trimming, snug soccer cleats and repetitive kicking for creating this painful problem.

“Many kids wear hand-me-down cleats that don’t fit,” says Santiago. “Older children like tighter cleats. They believe it gives them a better feel for the ball and the field.”

Santiago, whose office is in Gastonia, is board certified by the American Board of Podiatric Surgery. He says there are steps soccer moms and dads can take to prevent their children from suffering a painful ingrown toenail. First, teach children how to trim their toenails properly. Trim toenails in a fairly straight line, and don’t cut them too short. Second, make sure cleats fit properly.

“A child’s shoe size can change within a single soccer season,” Santiago reminds parents.

If a child develops a painful ingrown toenail, soaking their foot in room-temperature water and gently massaging the side of the nail fold can reduce the inflammation. But Santiago warns parents against home treatments, which can be dangerous. The American College of Foot and Ankle Surgeons lists myths about ingrown toenail home treatments on its Web site, FootHealthFacts.org.

“If your son’s or daughter’s ingrown toenails show signs of infection, it’s definitely time to seek medical care,” says Santiago.

A foot and ankle surgeon like Santiago can remove a child’s ingrown toenail, and prevent it from returning, with a simple, 10-minute surgical procedure. During the short procedure, the doctor numbs the toe and removes the ingrown portion of the nail. Various techniques can permanently remove part of a nail’s root too, preventing it from growing back.

“Most children experience very little pain afterwards,” says Santiago, “and can resume normal activity the next day.”

Other soccer-related injuries Santiago often treats include ankle sprains, foots sprains and broken bones.

For more information on ingrown toenails and other pediatric foot problems, contact Dr. Santiago’s office at (704) 964-6466, or visit the Gaston Foot & Ankle Associates website at www.gastonfoot.com

Treatment is available for a variety of foot wounds such as severe infections, diabetic foot ulcers, serious cuts, burns, and snake or spider bites. Services available include in-office debridement of wounds, skin grafts, Peripheral Arterial Disease (PAD) testing, off-loading devices, custom-molded and fitted shoes, custom-molded shoe inserts and reconstruction.

The primary goals of the Center for Wound Healing at Gaston Foot & Ankle Associates are:

• Prevention: encouraging at-risk patients with wounds to have regular visits with a wound specialist
• Healing: provision of coordinated, comprehensive care to heal wounds
• Maintenance: education of patients on day-to-day care of wounds and the importance of regular follow-up visits

Gaston Foot & Ankle Associates uses a multidisciplinary approach which includes a thorough diagnostic examination to identify the type of wound and to determine the underlying complications prolonging the healing process. Once examined, a personalized treatment plan is developed to accommodate each patient’s individual needs.

“We are pleased to offer an affordable option for patients by providing these services all in one place with no extra fees,” said Wagner Santiago, DPM. “Our objective is to save limbs and prevent unnecessary amputations.”

Along with their wound care services, Gaston Foot & Ankle Associates also has treats general podiatric conditions such as Achilles tendons, ankle sprains, athlete’s foot, bunions, corns, calluses, sports injuries, diabetic foot complications, fungus toenails, hammertoes, foot and ankle fractures, flat feet and fallen arches.

For more information about the Center for Wound Healing and Gaston Foot & Ankle Associates, visit www.gastonfoot.com or call the office at (704) 964-6466

“Hikers, hunters and others who love the outdoors often don’t realize how strenuous it can be to withstand constant, vigorous walking on uneven terrain,” said Ryan Meredith, DPM, a member of the American College of Foot and Ankle Surgeons (ACFAS) located in Gastonia, NC. “Lax physical conditioning and inappropriate footwear bring scores of outdoor enthusiasts into our office each fall for treatment of foot and ankle problems such as chronic heel pain, ankle sprains, Achilles tendonitis, fungal infections and severe blisters.”

“Walking up and down steep hillsides and tramping through wet, slippery fields and wooded areas puts stress on the muscles and tendons in the feet and ankles, especially if you haven’t conditioned properly before hitting the trail,” said Meredith. “Also, many don’t realize that cross-training athletic shoes aren’t the best choice for extended hiking and hunting. Had some of my patients worn sturdy, well constructed hiking boots, they wouldn’t have suffered sprained ankles or strained Achilles tendons.”

Meredith advises hikers and hunters to make the investment in top-quality hiking boots. He said strong, well insulated and moisture-proof boots with steel or graphite shanks offer excellent ankle and foot support that helps lessen stress and muscle fatigue to reduce injury risk. “The supportive shank decreases strain on the arch by allowing the boot to distribute impact as the foot moves forward. So if a boot bends in the middle, don’t buy it.”

In wet and cold weather, wearing the right socks can help prevent blisters, fungal infections and frostbite. Meredith, along with partners Dave Kirlin, DPM and Wagner Santiago, DPM, recommends synthetic socks as the first layer to keep the feet dry and reduce blister-causing friction. For the second layer, wool socks add warmth, absorb moisture away from the skin, and help make the hiking boot more comfortable. “Wool lets moisture evaporate more readily than cotton, so fewer blisters develop,” he added.

What happens if your feet or ankles hurt during a hike or hunt? Meredith said pain usually occurs from overuse, even from just walking. “If you’re not accustomed to walking on sloped or uneven ground, your legs and feet will get tired and cause muscles and tendons to ache,” he explained. “To avoid a serious injury, such as a severe ankle sprain or an Achilles tendon rupture, rest for awhile if you start hurting.”

According to the ACFAS consumer website, FootHealthFacts.org, pain is a warning sign that something is wrong. “Serious injury risk escalates significantly if you continue hiking in pain.” He likened hiking to skiing, in that beginners should take on less difficult trails until they become better conditioned and more confident.

Evaluation by a foot and ankle surgeon is recommended if there is persistent pain following a hiking or hunting outing. “I’m most concerned about ankle instability and strained Achilles tendons. Inattention to these problems at their early stages may lead to a serious injury that will keep you off the trails for a long time,” Meredith said.

Hikers and hunters seeking further information about ankle sprains, Achilles tendon injuries and other foot and ankle problems may contact Dr. Meredith at Gaston Foot & Ankle Associates’ office at (704) 964-6466 or visit the practice’s website at www.gastonfoot.com.

“We’re seeing more heel pain than ever in patients 15 to 25 years old, a group that usually doesn’t have this problem,” says Santiago, who has an office in Gastonia with partners Dave Kirlin, DPM and Ryan Meredith, DPM. “A major contributor is wearing flip-flop sandals with paper-thin soles everyday to school. Flip-flops have no arch support and can accentuate any abnormal biomechanics
in foot motion, and this eventually brings pain and inflammation.”

Santiago recommends wearing sandals with reasonably strong soles and arch support.

“Especially for girls and young women, thicker soled sandals with supportive arches might not be considered stylish, but if you want to wear sandals most of the time, you’ll avoid heel pain if you choose sturdier, perhaps less fashionable styles,” he says.

It is estimated that 15 percent of all adult foot complaints involve plantar fasciitis, the type of heel pain caused by chronic inflammation of the connective tissue extending from the heel bone to the toes. Being overweight and wearing inappropriate footwear are common contributing factors.

The pain is most noticeable after getting out of bed in the morning, and it tends to decrease after a few minutes and returns during the day as time on the feet increases.  Not all heel pain, however, is caused by plantar fasciitis. It also can occur from inflammation of the Achilles tendon, bursitis, arthritis, gout, stress fractures, or irritation of one or more of the nerves in the region. Therefore, diagnosis by a foot and ankle surgeon to rule out other causes is advised.

Initial treatment options for heel pain caused by plantar fasciitis should include anti-inflammatory medications, padding and strapping of the foot and physical therapy. Patients also should stretch their calf muscles regularly, avoid wearing flat shoes and walking barefoot, use over-the-counter arch supports and heel cushions, and limit the frequency of extended physical activities.

Most patients with plantar fasciitis respond to non-surgical treatment within six weeks. However, surgery is sometimes necessary to relieve severe, persistent pain.

For further information about heel pain, contact Dr. Santiago at (704) 964-6466 or visit practice website at www.gastonfoot.com. You may also visit the ACFAS consumer Web site, www.FootHealthFacts.org.

~ Dave Kirlin

(Gastonia, NC) Spring is sports season for many amateur athletes and weekend warriors in the Gaston area. It’s also ankle sprain season for one area foot and ankle surgeon.

Dave Kirlin, DPM, FACFAS, a foot and ankle surgeon with an office in Gastonia says ankle sprains are one of the most common sports injuries he treats this time of year.

“As people emerge from their winter hibernation and start to get active again, they can injure their ankles playing sports such as basketball, baseball, tennis and soccer,” he says.

Anyone who injures an ankle requires prompt medical treatment, whether it’s their first sprain or their fifth. Rest, ice, compression and elevation (R.I.C.E.) can reduce swelling and pain until the ankle can be evaluated and treated by a foot and ankle surgeon. A sprain may not always be a sprain; the ankle could be fractured.

Kirlin, who practices at Gaston Foot & Ankle Associates with partners Ryan Meredith, DPM and Wagner Santiago, DPM, notes that many athletes develop chronic ankle instability from repeated ankle sprains, causing their ankle to frequently “give way.” In some cases these players may require surgery. Proper rehabilitation of an ankle sprain reduces the likelihood of developing chronic ankle instability.

Kirlin shares three spring ankle sprain prevention tips from FootHealthFacts.org:

1. Perform warm-up stretches and exercises before playing sports.
2. Wear the right shoes for the sport. For example, don’t wear running shoes for sports that involve a lot of side-to-side movement, such as tennis and basketball.
3. Wear an ankle brace if you’re recovering from an injury or have repeatedly sprained your ankle.

Dr. Kirlin, as well as Drs. Meredith and Santiago, are members of the American College of Foot and Ankle Surgeons (ACFAS) and all are board certified in foot and ankle surgery. Kirlin has been practicing in Gastonia since 1984.

For more information about ankle fractures and sprains or other foot and ankle problems, contact Gaston Foot & Ankle Associates’ office at (704) 964-6466 or visit FootHealthFacts.org.