Note: I had a broken foot. I am not a doctor. This was my experience. Discuss your concerns with your doctor. This article is NOT medical advice. It is a blog post.
Diagnosis: Clumsy! I mean, the Emergency Room report didn’t say that, but that’s what I felt like it should say. I missed the last step and fell. The diagnosis really said, Closed avulsion fracture navicular right foot.
Diagnosis: Closed avulsion fracture navicular right foot.
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Of course this x-ray was taken 10 days after I fell. I thought my ankle was very badly sprained so I had not gone to the ER right away. I was following the RICE method of treatment: Rest, Ice, Compression and Elevation. But my foot still hurt. I went in to the Emergency room and had an x-ray. Yep, broken. I was to keep up with the RICE plan. I could do that.
Three days after the x-ray I received a surprising phone call. The trauma surgeon wanted me to be put in a cast! A cast?!? Right before Thanksgiving? Right before I had a visiting family coming for Christmas? NOOOOO!
I fussed and fumed but I got a cast. The orthopedic doctor said that a cast was the best way to treat my fracture, keep my foot immobilized and would help to keep me active later.
This cast was very uncomfortable. My foot swelled easily and I had to keep my foot elevated (above my heart) often. Hours and hours every day. I did have good books to read and I spent extra time on my blog (which was fun.)
Even at night I kept my foot elevated on pillows under the covers. I found it difficult to get comfortable at night. I would wiggle a little this way and that way until finally I could go to sleep.
After 2 weeks, I was excited to go back. I was hopeful to get the cast off and get back to my active life. Unfortunately, there was not enough bone growth to get me out of another cast for 4 more weeks. The next cast was RED!
I needed to adjust my eating so I wouldn’t gain weight during this time. I was not going to have that to worry about as well. I really, really cut back on my eating and did not gain weight. I had to pass up a lot of good holiday food but I did sneak in a chocolate truffle here and there.
My Christmas company was extremely kind and helpful. I was on crutches when we were out and used a walker in the house. But mostly, I was sitting with my leg up. The second cast was a bit more comfortable. I had asked for some extra padding over my ankle bones. Note: In the picture above I am watching some business training by Lindsey Anderson.
Crutches are difficult to use. You are NOT supposed to lean on them under your armpits. You use your arms to keep your balance. This is difficult because you have a heavy cast on your foot that is throwing you off balance! I don’t know about you, but my arms are not very strong. My shoulders hurt and my hands hurt from the crutches. I even got callouses on my hands. Using the walker was a little easier because I could put my knee up on the seat and take some of the weight off of my wrists.
I went up and down stairs sitting down. Sometimes it was easier to crawl somewhere than to use my walker or the crutches.
Remember, you are putting extra weight on your opposite leg and hip, your wrists and shoulders, and your cast leg. It is not going to be comfortable. I took Ibuprofen regularly to keep up with the new aches and pains.
My instructions were to be completely non-weight bearing on my right foot. Easier said than done!
For showers, I found that I needed to use a rubber band to secure a hand towel around my foot. Another hand towel was secured at the top of my cast. Then a garbage bag went around the whole thing with rubber bands at the top. Because the cast material was rough, the extra towels were necessary. The cast would cut a hole even in a thicker garbage bag. Another problem: I was worried that water would get into my cast so I felt water getting into my cast! The extra towels assured me that my cast was okay.
2 Weeks with a Walking Boot
Another two weeks was spent slowing putting more weight on my foot. How do you start off only putting 10% of your weight down? One toe at a time?? I did the best I could to transition weight back onto my foot slowly.
I was not assigned to go to physical therapy but I was supposed to practice writing the alphabet in the air with my toes. The physician’s assistant said that those motions would provide the exercises that I needed. I think I could have used some additional physical therapy. My foot is still very stiff.
Two months and a pandemic later: I ended up doing my own physical therapy: playing with the grandkids helps your foot and leg move in all kinds of directions. I don’t know why, but it has taken me a LONG time to heal and get so my ankle does not hurt. Like 5 months after the cast was off long. And sometimes it still hurts, especially walking down stairs. I hope this is not the case for you but don’t be discouraged if it is. It is getting better – just slowly.
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Do I need a referral to see the doctor?
Generally speaking, if you have a “PPO” type health insurance, you do not need a referral. Most “HMO” patients do require a referral. Examples of HMO’s in Suffolk include HealthNet, Aetna, and others. BCBS HMO, however does not require a referral. Anthem HealthKeepers and TriCare Prime insurance plans require referrals. All patients with insurance that require referrals will need to obtain authorization prior to scheduling an appointment.
Can you take x-rays in your office?
Yes. Our offices are equipped with digital processors so that your x-ray images will display on a computer monitor. Your x-rays are stored in digital format on a computer and can be easily copied to a CD or JPEG file.
Will I be required to pay a copayment at your office?
That depends upon your particular insurance contract. Most PPO and HMO policies require the insured to pay a copayment each time they visit a physician’s office, whether it is a primary care physician or a specialist. It is best to check your benefit booklet prior to visiting our office. If you do have a copay per your insurance contract, then you will be expected to pay the copay prior to seeing the doctor. Our office accepts cash, checks, credit or debit cards.
Do you only treat adults?
Of course not. If you have feet, regardless of age, 1Foot 2Foot can help. We treat people of all ages who are in need of podiatric care. There are a wide range of problems that are specific to children which we can treat. In fact, our book Little Feet was written specifically to provide useful information to parents regarding the conditions that may impact their children’s feet.
When should I seek treatment by a podiatrist?
Many times this is determined by your primary care physician, if you have an HMO policy. Most PPO, indemnity and Medicare policies allow you to self refer to a specialist. If you are having any problems or concerns about the lower leg below the knee, then you should seek advice and treatment by a podiatrist.
What expectations should I have when I visit your office?
You can expect to be treated with respect and kindness. Our patients are important to us and we want them to feel welcome. You can expect us to work with your insurance company to resolve claims issues. Most importantly, you can expect to be treated with the best medical treatment that we can provide.
Is there anything you can do for toenail fungus?
Yes. There are oral and topical medications available to rid this unsightly condition. Additionally, there are surgical procedures that can be performed in the office to permanently remove part or all of a fungal nail should medications fail.
I have a heel spur. Do I need to have it removed?
No. Most people who have heel pain caused by a “heel spur” do not need surgery. The reason being that there is a ligament-like structure on the bottom of the foot that courses the arch and connects into the heel. At times, this tissue (which is termed the plantar fascia), becomes inflamed. As a result, there is an inflammatory process which the body calcifies creating a heel spur. The pain comes first, the spur comes later, and the spur generally does not cause the pain. It is important to remember that there are many people who have heel pain without a spur and plenty of people who have heel spurs, but no pain. Our 1Foot 2Foot podiatrists can show you how heel pain can be treated without surgery. You should know that heel pain is one of the most common foot ailments, and 95% of those who obtain treatment for plantar fasciitis go on to full recovery without the need for surgery.
My child has flat feet. Should he/she be treated?
Yes. Flat feet in children are common. In fact, all children have flat feet until the age of 5 or 6 when the arch develops. Many times “flat feet” are not painful. However, if your child is having pain, is clumsy when running, or chooses to sit on the side lines when others are playing, then that might be a sign of a problem. Also, if you see your child’s ankles “rolling in” (especially when viewed from behind), then you should have him/her examined. Often times, doctors will prescribe orthotic devices (custom made inserts) to be worn in the shoe to help realign the bones and joints of the foot. This allows the foot to mature in a good position. In rare instances, your child may need reconstructive surgery. Our 1Foot 2Foot podiatrists have extensive training in reconstructive flatfoot surgery.
What are orthotics?
Foot orthotics are custom-made devices that are worn in your shoes. Our 1Foot 2Foot podiatrists will either take a mold of your feet with plaster or use a computerized digital scanner to obtain “impressions” (identical pictures) of your feet. We then send the molds/scan to an orthotic laboratory for fabrication. Orthotics are more than arch support and are used for a variety of reasons. The orthotic devices control your foot and help realign the structures of your foot. Orthotics have influence on the spine, hip, knee, ankle, and foot. Orthotic devices are useful in treating a myriad of disorders that cause pain or dysfunction of the lower extremities.
What type of surgeries do you do?
The most common foot and ankle surgeries include fixing bunions, hammertoes, neuromas (pinched nerves between the toes), fractures, removal of bone spurs, and surgical care related to infections and ulcers.
Less common surgeries that 1Foot 2Foot podiatrists perform include flatfoot (pediatric and adult) and high- arched foot reconstructions, fusions or joint replacements for arthritic joints, Charcot reconstruction, tarsal tunnel and other nerve decompressions, ankle ligament repair, and tendon repair (i.e. Achilles ruptures).
1Foot 2Foot podiatrists have specialized training in revisional surgery and complicated reconstructive surgery. We serve as a referral source for other foot and ankle surgeons who do not perform these types of surgeries.
Podiatrist or Orthopedist? What’s the difference?
An orthopedic surgeon is a medical doctor who treats the entire musculoskeletal system, head to toe. A podiatrist has specialized training, and limits his/her practice, to treat disorders of the foot and ankle. Podiatrists have the ability to treat disorders in a conservative fashion in the office as well as perform reconstructive surgery at your local hospital if necessary.
What is peripheral vascular disease?
Peripheral vascular disease (PVD) also known as peripheral arterial disease (PAD) is a condition where there is diminished blood flow to your legs and feet caused by narrowing of the arteries (atherosclerosis). It has been estimated that 12 million people in the U.S. have PAD and more than half of those people are asymptomatic. This condition is seen more often in diabetic patients and those who smoke. Common symptoms may include cold feet, calf pain when walking short distances, and/or slow to heal wounds on your feet. Diagnosis usually involves testing your circulation with a doppler ultrasound and/or an angiogram. Treatments include certain medications, an exercise program, and sometimes surgical procedures. Our office can perform vascular testing that is non-invasive and coordinate a consultation with a specialty-trained peripheral vascular physician.
Is the doctor board certified?
Yes. Dr’s. Dairman and Dalrymple are board certified by the American Board of Podiatric Surgery. Dr. Dairman is also board certified in Wound Care.
I don’t have health insurance. Can I still see the doctor?
Yes. Our office is understanding that some people do not have insurance, have high deductibles (major medical only), or want to be seen even though 1Foot 2Foot may not be contracted with your insurance company. For this reason, 1Foot 2Foot does offer cash paying patients a 20% discount on services provided in the office along with flexible payment plans. Products are not subject to discount.
Do you accept credit cards?
Yes. We accept cash, checks, credit (MC, Visa, and AMEX) and debit cards.
I am diabetic. How often should I be seen by a podiatrist?
All diabetic patients should have a podiatrist. On your initial exam, your podiatrist will tell you if you are at low or high risk for complications in your feet. Generally speaking, a diabetic patient that has good circulation and no neurologic deficit (numbness/burning/tingling) can be seen on an annual basis. However, if one is at higher risk with poor circulation and/or numbness in the feet, then exams/treatments should be done every 2-3 months.