dpmkirk

"I can't afford that!"

2012-01-23T20:51:00.000-07:00

Everyone is complaining about "Obama-Care". I don't have any answers for you on that, but I can tell you that the system that we have today is very broken. Just today I had a patient that would have had to pay $700 out of pocket for Physical therapy, but I know that if she had the Physical therapy, she would be better by now. I had another patient that was unable to get an MRI because her deductible is $1500 and she was told that she needed to come up with every bit of it in cash before she could have the procedure done. Another patient had to pay $800 up front before she could get her vascular studies. And lastly, I had a patient that has MRSA, you know that awful, antibiotic resistant staph infection that we all hear about. Two of the antibiotics that would cover this infection, she is allergic to. One is Tetracycline, which is cheap, but they have pulled it off the market. Another one is not too inexpensive, but she would have to come in for shots everyday for two weeks and may lose her hearing. The last one her infection is sensitive to and the pharmacist worked with me to get the co-pay down to $200, as the medication is $1500. So the patient had to tell me "I can't afford it!" I long for the day when I can provide treatment that is good for the patient that they can afford! I don't know if I will every see it, but it is a good pipe dream for now!

Oh my aching feet

2012-01-15T22:07:00.000-07:00

There are few things that can bring a person down as quickly as a problem with their foot can. What can you do to prevent this?
1. Wear shoes that fit well. Before you go shopping for shoes, make a tracing of your foot, place that on each pair of shoes that you would like to try on. If your foot is wider then the shoe, that is NOT the shoe for you!!
2. Shop for your shoes at the end of the day. This is when your feet will be most swollen.
3. Get more then one pair of shoes. This will allow your shoes dry out in-between wearing.
4. Check your feet daily, if you notice any rashes, red spots, swelling or other problems, get to your Podiatrist immediately.
5. Ingrown-toenails, warts, ulcers, infections and other problems, require immediate attention.

More about PA's "Prior Authorization"

2012-01-14T13:25:00.000-07:00

For many patients and doctors offices this is a very difficult area! Patients and doctors assume that if they A. Evaluated you B. Come up with a diagnosis C. Come up with a treatment plan, then this will all occur. This could not be further from the truth. Every insurance company is different. Even if you and another person have blue/cross or united health care. They many have very different benefits. Even if you work for the same company as another patient, they may have selected a "lesser" plan. At times an MRI will be approved that day with no more then a list of diagnoses. Other times they may want office notes. Still others the doctor may need to have a physician to physician peer review. This may all take a day or a week, depending upon schedules and when this can be accomplished between other patients. Prior authorizations are required for some x-rays, MRI's, cat scans, durable medical equipment, medications and any other services that your insurance deems necessary. It is important for each person to check their coverage and work with the doctors to get these approvals. Although it may be very stressful for patients, remember that the doctor does want you to have this service and they are working on prior authorizations for other patients as well!

Prior Authorization is not a guarantee of payment!

2012-01-12T22:35:00.000-07:00

If you work in a doctors office, these words can strike fear into the hearts of all personnel. Whether it is for surgery, braces, newer medications, physical therapy, MRIs, CT scans and other medical tests, many require prior authorization. This can cost the office staff an entire day in trying to track this down. We as doctors are trained to know what is going on with our patients and what they need. Unfortunately, we spend a large part of our day being told that we are not able to get what we feel is necessary for the best care of our patients. This leads to a large amount of dissatisfaction among doctors. There has to be a better way to treat our patients well and not spend time fighting with "Peggy" to get their treatment plan instituted!!

Cost for the doctor to see you!

2011-06-29T10:56:00.000-07:00

Recently Shopdme posted a great article breaking down how much your doctor actually makes when you go in.
The approximate breakdown of a $100 new-patient appointment:
$9 for malpractice insurance
$4 for equipment and maintenance
$8 for supplies
$6 for rent and utilities
$10 for office expenses such as telephones, accounting fees, advertising, medical journals, licenses, and taxes
$28 for staff salaries and benefits
$35 for the doctor
This does not include billing costs, legal fees if needed, the cost of implementing electronic health records or the cost of new equipment to keep up with the changes in medicine.
Most doctors graduate with large student loans.
I personally pay $2400 a month in student loans and have been for over 11 years. This means that I must see 69 patients a month just to cover my student loans. Then I can start earning money to cover food, housing, clothing, car costs, health insurance, and other expenses. If this cost $3000/month, it would take another 90 patients a month to see. That's 159 total. Reimbursement is lower for established patients. This doesn't include day care if the doctor has children or the cost of repairing equipment or their car.
The next time that you come in to your doctor. Please don't say, well, you're a doctor you can afford it. They have sacrificed many years of their lives and are usually in serious debt, to take care of people!

Your Leg Is a Mirror Of Your Body - ModernGhana.com

2011-05-07T22:50:00.000-07:00

Your Leg Is a Mirror Of Your Body - ModernGhana.com

This a very good article to discuss the many complications that may occur with diabetes.

The best way to deal with a diagnosis of diabetes is this:

1. Educate yourself. The more you know, the better you can protect yourself.

2. Check your feet every day!

3. If you have any small wounds or sores, contact your doctor immediately!

4. Educated yourself. Yes I am repeating myself!! Things change regularly in treatments and how to manage your diabetes, if you keep up to date, you won't miss anything.

5. Make sure to wear shoes with a wide toe box and good cushioning. If you draw a picture of your foot on a white piece of paper and put your shoe on top of it.... if the drawing is wider then your shoe. You need a new shoe! It will be much cheaper to throw away a shoe that is too small and rubs your foot, then to deal with the cost of an ulcer and possible amputation.

There will be more on foot care coming up.

Children's Feet

2011-04-11T11:37:00.000-07:00

Heel Pain Plantar Fasciitis Part 3

2011-02-28T12:30:00.000-07:00

Heel Pain Plantar Fasciitis Part 3

Arizona cuts Podiatric Coverage to Medicaid Patients

2011-02-27T22:43:00.002-07:00

http://diabeticfootonline.blogspot.com/2011/02/lack-of-podiatric-coverage-on-medicaid.html

Heel Pain Plantar Fasciitis Part 4

2011-02-27T13:47:00.000-07:00

Heel Pain Plantar Fasciitis Part 4

How to prevent heel pain or plantar fasciitis:

Make sure that you have properly fitted shoes. Many patients come into my office with shoes that are too big or too small. If you need help, call shoe stores or your Podiatrist to get your feet measured. Unfortunately for many people, their feet do not stay the same size throughout their lifetime.
Replace your shoes regularly. Although shoes can get expensive, it is usually cheaper then visits to your doctor or time off from work due to foot pain. Check the bottom of your shoes; if you see that there is a lot of wear in the heels or soles of the shoes, it is time to get new shoes!
Make sure that you get shoes that are supportive and have cushioning! A good way to check both of these is to bend the shoe from the heel to the toe, if you can fold the shoe in half, it doesn’t have the support that you need. If you can press down on the inside of the shoe at the heel and there is no cushioning then that is not the shoe for you unless you can remove the innersole and put your orthotics in for your cushioning.
Prepare yourself before exercise; make sure that you stretch before and after exercise as well as getting warmed up.
Although exercise is important, it is also very important to pace yourself. Many people want to start out by running or walking 10 miles the first day. If you have not been exercising start out with 5 minutes. Always remember no matter how far you go, say 5 minutes from home; you still have 5 minutes to go back, unless you have just gone around the block that leads back to your home!
Make sure that you are taking care of your total body when exercising, if you do not have proper nutrition and support for the rest of your body, you will not be able to sustain any activity properly.
Although no one wants to talk about this, if you are overweight, you need to lose weight. Multiply your weight by gravity: g = 9.8 m/s² and 32 ft/s²^and that will be the force that is hitting your feet when you walk.
Remember if you are overweight, you didn’t put it on in a day or a week or even a month, so you want to take it off at the same pace that you put it on! Small changes can make a huge impact, such as swapping out a soda or pop for a glass of water. Only eating half of the bag of M & M’s, and leaving at least a small portion of food on your plate at every meal!

Next: we will discuss what your doctor can do for you if you have heel pain plantar fasciitis

Plantar Fasciitis Heel Pain Part 3

2011-02-27T13:46:00.000-07:00

Heel Pain Plantar Fasciitis Part 3

Other Causes of Heel Pain:

Excessive Pronation:

Pronation is what allows the foot to absorb shock as it hits the ground in walking. When you have too much of this flexible motion and flattening of the arch, it is called excessive pronation.

If you will notice, when you are walking, your heel will hit the ground first, then the foot rolls toward the big toe before it lifts up for your next step. As the foot rolls toward the big toe, it becomes rigid and lifts the arch up. If you have excess pronation, you get excessive inward motion which puts extra stress on all of the ligaments and tendons that attach to your heel bone. This can also lead to extra stress and injury on your lower back, hips and knees.

There are some other conditions that can lead to heel pain:

1. Bone Bruise: this can occur as the result of trauma.

2. Haglund’s Deformity or Pump Bump, this is an enlargement of bone where the Achilles tendon attaches to bone. As your shoe presses on this area, you develop increased pain in this area.

3. Arthritis: Psoriatic Arthritis, Reiters Syndrome or Rheumatoid Arthritis can create pain in this area.

4. Bursitis: This is similar to tennis elbow where a small sack of fluid fills up and creates pressure in this area.

So, as you can see so far there are many different causes of heel pain. Which will lead to the next portion of our discussion: treatment. With so many different causes of heel pain, there are many different treatments for heel pain.

Even though your neighbor, or cousin or friend had heel pain and received a certain type of treatment for their heel pain, your treatment plan may be very different.

Diabetic Foot Ulcers

2011-02-25T10:27:00.002-07:00

Foot Ulcers Independently Linked to Mortality in Diabetes Patients

Over the years as a Podiatrist I have seen many patients with Diabetic Foot Ulcers. I have also been fortunate enough to see many patients with Diabetes that have never had an ulcer. There are many things that you can do to prevent Diabetic Foot Ulcers.
1. Monitor your diet. Spikes in Blood sugar have been shown to predispose patients to neuropathy and diabetic foot ulcers.
2. Have your Hemoglobin A1C checked! This gives you a recording of how your sugars have been running for the past 3 months.
3. Check your feet daily. If you notice any sores or wounds come in to see your Podiatrist or Primary Care Physician Immediately!!

Dermagraft is one of the ways that we treat Diabetic Foot Ulcers here at Surprise Foot and Ankle Specialists.
If you are having any foot problems come in to see us at:

dpmkirk.vpweb.com

Plantar Fasciitis Part 2

2011-02-25T08:43:00.000-07:00

What are heel spurs?

This is a bony growth on your heel bone. We all think of bone as the skeleton in the
corner of the classroom in high school biology. Bone is actually a dynamic living tissue. When bone is put under stress at the site of
a tendon or ligament, such as the Achilles Tendon or the Plantar Fascia, it can
make the bone bleed. When bone bleeds,
it forms new bone to heal. These spurs can be seen
on X-rays and can extend out as far as half an inch. Fortunately, the spur is not the actual
source of the problem.

What is plantar fasciitis?

The band of tissue that runs on the bottom (plantar
surface) of the foot is called the plantar fascia. If you add an itis onto a word it means
inflammation, so this is inflammation of the plantar fascia. This is very common in athletes that need to
do a lot of jumping. This can be
devastating for basketball players and is quite painful!

The plantar fascia can become stretched over time beyond
where it normally should go. This can
lead to small tears in the fascia which leads to inflammation. This in turn may lead to a heel spur.

Improper shoes with no support may aggravate this condition. I must say that the majority of patients that
come into my office, are sporting a pair of cute flip flops or other shoes with
no support.

With plantar fasciitis the first step after a period of
rest is often the most painful. This is
due to the plantar fascia elongating or stretching out suddenly. Most people find with walking that the pain
decreases or lessens, but will return after a period of rest.

Stay tuned to learn more about plantar fasciitis!!

Plantar Fasciitis Heel Spur Syndrome Part 1

2011-02-24T20:47:00.002-07:00

Heel Pain/Plantar Fasciitis: What is it?
This is part one in a series of articles about heel pain. Why do I have this? I like to tell patients that it is caused by telling lies, but they quickly realize that this will not help their foot. So on to the real causes of foot pain. And why you should go to see your Podiatrist and not your neighbor for this problem.

There are a number of different causes of heel pain that we will go over. These will include: Bone bruises, heel spurs, plantar fasciitis, excessive pronation and other diseases of the heels.

Heel pain is usually caused by a problem with your walking gait or biomechanics. This will put excess stress and pressure on the soft tissues that attach to the heel bone and the bone itself. The causes of this stress can vary from wearing improper shoes, being overweight, or a bruising that occurred while walking, jumping or running on hard surfaces.

There are 26 bones in each of your feet and the heel bone or calcaneus is the largest one. There are over 100 tendons, muscles and ligaments in the foot and 33 joints. All of these are exposed to outside influences such as your shoes and the ground we walk on. So our choices of where we work, what surface of floor we have in our homes and what type of shoes we wear will all influence whether or not we have pain in our heels.

One of the main reasons to see your Podiatrist about your heel pain is that you can have some arthritic conditions such as rheumatoid arthritis, infectious problems such as osteomyelitis or a bone tumor. A quick set of x-rays and sometimes blood work can rule this out!! And hopefully, although you had to go to your Podiatrist, take time out of your day, and pay your co-pay or deductible, you will be lucky enough to just have your regular old heel pain that can be treated simply. Continue to follow along and I will go over more causes, and treatment options for your heel pain!

Diabetic Amputation

2011-02-24T11:42:00.001-07:00

Patriot Guard Rider looks beyond amputation wfaa.com Dallas - Fort Worth Local News

Many patients over the years will experience an amputation associated with diabetes. There are some things that you can do to prevent this.
1. Watch your diet. Limiting the amount of sugar you take in will help.
2. Get moving, even if you exercise for 10 minutes at a time, it will add up to your 30 minutes a day!
3. Check your feet daily. If you notice any open wounds or sores, come in to see your Podiatrist or your Primary Care Physician immediately.

For all of your Foot Care Needs: Come on in to:
Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Extending Article Diabetes Foot and Wound Care Part 3

2011-02-24T10:28:00.002-07:00

http://www.articlesbase.com/medicine-articles/diabetes-foot-and-wound-care-part-3-4294375.html

Hammertoes - Causes And Cures

2011-02-23T12:29:00.002-07:00

Hammertoes - Causes And Cures

Hammertoes are when the toe bends at the first joint of the digit. This usually occurs in the smaller toes 2-5 and is more common in women then men.

Some hammertoes are flexible and some are rigid. This can be seen when you can no longer straighten out the toe with your hand.

Hammertoes are caused by a muscle imbalance that causes increased pressure in the joints and tendons of the toe leading to the toe bending. They can also be caused by trauma or it can be hereditary. Wearing tight shoes can also contribute to the pain associated with hammertoes.

What you can do:
1. Wear shoes that have a deep-wide toe box that allow your toes to wiggle a little bit.
2. Apply non-medicated padding to the toe.
3. Visit your Podiatrist
4. Avoid shoes with a heel greater then 2 inches.

Your Podiatrist May:
Tape or Pad your toes
Make Custom Orthotics
Perform Surgery

It is important to see your Podiatrist early to avoid surgical treatment if possible.

www.ati.es/blog/
francis-drake-photos-0/
?hammertoe-photos

Come on in to:
Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Extended Article and Diabetes Foot and Wound Care Part 2

2011-02-23T11:09:00.000-07:00

http://www.articlesbase.com/medicine-articles/diabetes-foot-and-wound-care-part-2-4287132.html

Extended Article Diabetes Foot and Wound Care Part I

2011-02-23T11:03:00.000-07:00

http://www.articlesbase.com/medicine-articles/diabetes-foot-and-wound-care-part-i-4278304.html

Diabetic Foot and Wound Care Part 3

2011-02-22T11:33:00.004-07:00

Amputations: This is by far the worst part of my job!! As I frequently tell patients: "Keeping your feet and toes, is job security for me."
No one wants to prevent an amputations more then your Podiatrist!
The things that you can do to help out:
1. Check inside your shoes before putting them on!
2. Wear properly fitted shoes at all times, many people with Diabetes and Neuropathy can step on things and not know it.
3. Check your feet everyday! You can use a mirror on the floor, or a mechanics mirror, or ask a loved one to look for you!
4. If you notice any open areas or wounds, come in and see your Podiatrist or Primary Care Physician immediately.

medicalmonofilament.com/
store
product-i...id78.html

For all of your footcare needs, come in and see us at:

Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Diabetic Foot and Wound Care Part 2

2011-02-21T11:13:00.002-07:00

More scary statistics here:
In 2007 we had 18.2 million Americans with Diabetes. Now the CDC estimates that we have 23.6 million!! That is 7% of the US population!!
The cost of Diabetic Amputations are increasing as well. In 2002 one out of every ten health care dollars or $132 Billion was spent on Diabetes treatment.

Here are some things that you can do to help!
1. Watch your blood sugars, the more of an up and down you get with your sugars, the increase in complications you will have.
2. Make sure your doctor is ordering your Hemoglobin A1C. This measures how your sugars have been over the past 3 months.
3. Make sure that you are checking your feet every day!! If you notice any open areas or sores, come in immediately to your Podiatrist or Primary Care Physician!!
4. Early detection and treatment are the keys to healing.
5. Prevention is the number one thing we can do to save limbs!!

This is demonstration of the Semmes Weinstein Monofilament Testing that can be done to check your feet for Neuropathy!

www.aafp.org/afp/
2005/0601/
p2123.html

Come on in to:
Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Diabetes Resources in Arizona

2011-02-20T09:00:00.001-07:00

Arizona - American Diabetes Association

There are many resources available for Diabetes, you don't have to do this alone!! A support group may not sound like what you want to do, but can really help you to see that you are not alone. People living with Diabetes that educate themselves about the conditions, complications and what they can do to help usually cope better with their condition. The things that you can do to help are:
1. Check your feet every day!!
2. No bare feet
3. If you see a wound or sore, come in to see your Podiatrist or Primary Care Physician immediately!

We are here to help you! Put your feet in good hands.

Surprise Foot and Ankle Specialists

14800 West Mountain View Blvd

Ste 160

Surprise, AZ 85374

623-584-5556

623-584-0755: Fax

dpmkirk.vpweb.com

fixingfeet.com

Diabetes, Heart Disease and Stroke!!

2011-02-20T08:38:00.000-07:00

Diet Drinks Linked to Heart Problems, Stroke

Here is another concern for our patients with Diabetes! Many patients switch to Diet drinks to help with the sugar. Unfortunately, this rarely works and can frequently make the problems worse. So what do you do? Start by swapping out one diet drink for a glass of water. Do this every week until you are down to one or less per week! You will feel better.
Other things that you can do with diabetes:
1. Check your feet every day!!
2. No bare feet!!
3. If you notice any foot sores or wounds come in to see your Podiatrist or Primary Care Physician Immediately!

Put your feet in good hands. For all of your foot care needs. Come in to:
Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd
Suite 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Diabetes Peripheral Neuopathy

2011-02-19T09:58:00.001-07:00

NeuRemedy, "The Neuropathy Vitamin", is used to nutritionally manage the pain, burning, numbness and tingling associated with peripheral neuropathy.

Foot injuries occur more frequently with the decreased levels of sensation often

associated with peripheral neuropathy. Take care of your feet with these ten tips for better foot health!

"Ten Tips for Better Foot Care for People with Peripheral Neuropathy"

1. Examine your feet once a day. Your ability to feel injuries or sores on your feet may be diminished by the effects of peripheral neuropathy. Do not forget to inspect between the toes! Use a mirror if necessary.

2. Notify your doctor if you find a problem. Receiving treatment immediately following an injury will likely decrease long-term consequences. See your podiatrist for help.

3. Get your feet checked professionally and frequently. Your podiatrist or physician may recognize problems with your feet that you may miss.

4. Keep your feet clean. Wash your feet with soap and water and dry them well once a day. Be certain to wash and dry between your toes. If you have an open sore consult your physician before washing.

5. No operating on yourself! Do not trim corns, calluses or toenails on your own. Seek the assistance of a medical professional.

6. Avoid ill fitting shoes. Make certain that shoes fit properly to prevent rubs or sores. Have your shoes fitted by a professional.

7. Wear the right socks. Select socks that are soft and do not cut off circulation to your feet. Put a pair of clean and dry socks on every time you put on your shoes.

8. Wear the right shoe for the activity. Wear athletic shoes when exercising. This will help you to avoid injuries.

9. Don't walk barefoot. Insensitive unprotected feet are prone to cuts and puncture wounds.

10. Stop smoking immediately. Now is a better time than ever. Avoid second hand smoke and smokeless tobacco. Smoking interferes with your body's ability to heal injuries and may cause non-healing sores, gangrene and amputations.

It is our goal to continue to be a resource for answers to your questions about peripheral neuropathy and to help you make educated decisions about how to manage your peripheral neuropathy symptoms.

NeuRemedy is a medical food which is specifically formulated for the nutritional management of people suffering from peripheral neuropathy. The active ingredient in NeuRemedy has been extensively and successfully used in Europe and Asia for decades. It has been studied in the scientific literature and shown to be safe and very often effective. Realm Labs, LLC has recently made NeuRemedy available to people suffering from peripheral neuropathy in the U.S.A.

For all of your foot care needs, come on down to:

Surprise Foot and Ankle Specialists

14800 West Mountain View Blvd

Ste 160

Surprise, AZ 85374

623-584-5556

623-584-0755: Fax

dpmkirk.vpweb.com

fixingfeet.com

Diabetes and Neuropathy

2011-02-19T09:45:00.000-07:00

Feel The Difference : Metanx® Feel the Difference

We have many patients that have Diabetic Peripheral Neuropathy. We frequently use Metanx to help with the symptoms. We have had a lot of good success with metanx. Ask your doctor about it today!!
Come on in to:
Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd
Ste 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Diabetic Foot and Wound Care: Part One

2011-02-18T11:06:00.000-07:00

Do you or a loved one have Diabetes? There are 25.8 million children and adults in the US with Diabetes.
There are 7 million people that have not been diagnosed. 79 million people have prediabetes.
In 2007 diabetes contributed to 231,404 deaths!!!
The complications associated with Diabetes are:
Amputation, Blindness, Heart Disease and Stroke, High Blood Pressure, Neuropathy and Kidney Disease.
There aer many things that you can do to help reduce your risk of these complications. Checking your feet everyday is one of the biggest things you can do. If you cannot see your feet, have a loved one check your feet everyday. If you notice a sore on your foot, get in to see you Podiatrist or Primary Care Physician immediately.
If you already have a wound, here at Suprise Foot and Ankle Clinics: we can use:

KCI- V.A.C.® GranuFoam™ Bridge XG Dressing

The Vac System is one of the ways that we here at Surprise Foot and Ankle Specialists take care of open wounds.
Many patients develop wounds from Diabetes, Pressure Ulcers and Venous Stasis. Here at Surprise Foot And Ankle Specialists we are here to heal your wounds!!

Suprise Foot and Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Night Splints

2011-02-15T15:08:00.000-07:00

Many patients with Plantar Fasciits or Heel Pain need a night splint. Here at Surprise Foot and Ankle Specialists we have night splints to help.

Purpose of the Night Splint: To place a light streatch on the plantar fascia while you sleep. Many people experience pain with the first step our of bed in the morning. The best night splints are the dorsal types which go on top of the foot and leg.

If you or a friend or family member are experiencing plantar fasciitis. Come in to:

Surprise Foot And Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85376
623-584-5556
623-584-0755
dpmkirk.vpweb.com

fixingfeet.com

This is just one part of our comprehensive approach to treating your plantar fascia pain!!

Blue Shine Laser

2011-02-15T12:22:00.000-07:00

I have a few new machines that we have in the office to report about!

We now have the Blue Shine Laser. We have been having good success and we are having good feedback from our patients.

If you are having foot and ankle pain, come on down to:
Surprise Foot And Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85376
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Custom Diabetic Shoes

2011-02-15T10:15:00.000-07:00

Some Patients with Diabetes may have other conditions that make it necessary for them to wear custom Diabetic shoes. Charcot Foot is one of the reasons to make this important. At our office we are able to cast patients that are in need of custom molded shoes and get them the type of shoes in the colors that they request! Our goal is to decrease wounds, ulcers and amputations, while giving the patients choices in what they wear!
If you have any foot or ankle problems, come on down to:
Surprise Foot And Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85376
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Amerigel Home Page Consumer

2011-02-14T09:49:00.001-07:00

Amerigel Home Page Consumer

This is another way that we treat diabetic foot ulcers here at Surprise Foot and Ankle Specialists. This is also very good after an ingrown toenail removal!!

If you have any foot pain or problems, come on in to:
Surprise Foot And Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85376
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Organogenesis Inc. Home—the world leading tissue regeneration company

2011-02-14T09:46:00.001-07:00

Organogenesis Inc. Home—the world leading tissue regeneration company

Diabetic Wound Care. This is one of the ways that Surprise Foot and Ankle Specialists help to heal foot wounds.
We see a lot of patients with Diabetic Foot Wounds and Uclers in our office and this is part of how we treat them.
Our goal is to close these wounds as quickly as possible!
Put your feet in Good hands!
Come to:
Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85374
623-584-5556
623-584-0755
dpmkirk.vpweb.com
fixingfeet.com

Heel Pain

2011-02-12T16:17:00.000-07:00

Heel Pain

Here is some additional information about heel pain. This is a very common problem. Please come in to see us for all of your footcare needs at:

Surprise Foot and Ankle Specialists
14800 West Mountain View Blvd.
Suite 160
Surprise, AZ 85374
623-584-5556
623-584-0755
fixingfeet.com
dpmkirk@vpweb.com

heel pain causes: is it plantar fasciitis or fasciosis?

2011-02-12T13:11:00.000-07:00

heel pain causes: is it plantar fasciitis or fasciosis?

Here is some additional information about heel pain.
At Surprise Foot and Ankle Centers we have all of the lastest diagnostic tools and treatments for heel pain, including x-rays, ultrasound, night splints, custom orthotics, EPAT and laser!!!

Come on in and find out what you can do for your heel pain!!!

Surprise Foot and Ankle Centers
14800 West Mountain View Blvd 160
Surprise, Arizona 85374
623-584-5556
623-584-0755 fax

We want you to be able to get back on your feet and get the most out of life!!

Help! My Toes Are Numb! - Peripheral Neuropathy

2011-02-10T14:17:00.000-07:00

Help! My Toes Are Numb! - Peripheral Neuropathy

Here at Surprise Foot and Ankle Center we strive to help people with Neuropathy.

We use a combination of therapys including medications, surgery, bracing, and physical therapy.

Are doctors are here and ready to help. Give us a call:

Surprise Foot And Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85376
623-584-5556
623-584-0755
fixingfeet.com

When to Refer to a Podiatrist | Today's Podiatrist

2011-02-08T12:00:00.001-07:00

When to Refer to a Podiatrist Today's Podiatrist

Here at Surprise Foot and Ankle Specialists we have 3 doctors and can treat all aspects of foot care. We are a caring group of Doctors that are here to serve all of your Podiatric Needs!!

We have in office x-rays, vascular studies, ultrasound, neurosensory testing, laser, EPAT. We do diabetic shoes, custom and non-custom. We construct orthotics, arizona afo's, richie braces and many other braces!

So if your feet hurt!! Come on down and we will fix your feet!!

How Long-Term Primary Podiatric Care Can Reduce Diabetic Pedal Complications | Podiatry Today

2011-02-08T10:11:00.000-07:00

How Long-Term Primary Podiatric Care Can Reduce Diabetic Pedal Complications Podiatry Today

Here at Surprise Foot and Ankle Specialists we offer a wide variety of services for your feet. We take care of many patients with Diabetes and our goal is to protect the feet!!

Come on by and let us take care of your feet

Surprise Foot And Ankle Specialists
14800 West Mountain View Blvd. Ste 160
Surprise, AZ 85376
623-584-5556
623-584-0755
fixingfeet.com

Bucks' Gooden out 4-6 weeks - Basketball Wires - MiamiHerald.com

2011-02-03T11:47:00.000-07:00

Bucks' Gooden out 4-6 weeks - Basketball Wires - MiamiHerald.com

This is a great intro into heel pain/ plantar fasciitis. Over the next few days, I will go over what causes heel pain, what it feels like and what can be done to treat it.
The calcaneus (heel bone) is the largest of the 26 bones in the human foot.
Causes: Heel pain is usually a result of abnormal biomehcanics (the way you walk, being abnormal). This abnormality will cause stress on the soft tissues that attach to the heel bone and to the heel bone itself. Stress on the heel bone may also be a result of a bruise or injury that occured while, jumping on hard surfaces, wearing poorly constructed footwear, running and walking and of course weight gain.

There are other conditions that can affect the heel bone that require a visit to the doctor and usually x-rays: these include, fracture or break of the heel bone, torn tendons, bone tumors and some types of arthtitis can attack the heel bone.

So it is always better to get this condition checked out no matter what friends and family have had.

We will next go over what you can do about this.

More on Diabetic Wound Care and Insurance Payments

2011-02-01T14:35:00.000-07:00

http://www.podiatrytoday.com/will-reimbursement-changes-adversely-affect-preventative-wound-care?page=1

Will Reimbursement Changes Adversely Affect Preventative Wound Care?

Volume 24 - Issue 2 - February 2011

Author(s):

Lee C. Rogers, DPM

This author details recent changes to the CMS physician fee schedule and what lower reimbursement may mean for wound care centers and the high-risk patients they treat.

The 2011 update in the Centers for Medicare and Medicaid Services (CMS) physician fee schedule can be projected to reduce reimbursement for wound care services in facilities by 22 percent. While Congress called for a 0 percent update in the fee schedule for 2011, the CMS cut the conversion factor from $36.8729 to $33.9764, which is an approximate -7.8 percent reduction. The conversion factor cut is designed to help keep the relative value unit (RVU) changes budget neutral.

Physicians who specialize in wound healing have a unique practice and represent a heterogeneous group of physician specialties, including general surgery, podiatry, vascular surgery, plastic surgery, infectious diseases, endocrinology, pulmonology and general surgery. Some practice in private offices but given the nature of the work, many practice in hospital-based wound centers.

Updates in the 2011 fee schedule particularly impact codes that are used by wound specialists. Wound debridement codes were completely revised both in definition and value, and some common skin substitute application codes were drastically reduced. Changes in RVU and fee schedule for common codes from 2010 to 2011 for facility sites are illustrated in the tables below.

A Closer Look At The Coding Changes

Debridement reimbursement (1104x) is no longer based on the number of wounds debrided but rather on the total area of the debridement in increments of 20 cm². Partial (11040) and full thickness (11041) skin debridement codes were deleted and replaced with removal of devitalized tissue (97597). There are now add-on codes to report additional increments of 20 cm². The add-on codes are inherently reduced in value and should not by modified by -59.

Why the drastic impact in wound services? It is all about the requirement to bill by surface area and not number of wounds. Under 2010 guidelines, if there were two wounds that each measured 9 cm² and were debrided into the subcutaneous tissue, one would bill 11042 and 11042-59. The -59 modifier results in a 50 percent reduction of reimbursement for the second code.

In the 2011 guidelines, one only bills 11042, adding the surface areas together to total <20 cm². Even if adding the surface areas together is sufficient to bill another unit, the RVU of the add-on code is 40 percent of the value of the first code.

The debridement of subcutaneous tissue (11042) code was the only frequently used wound care code that increased in value from 1.17 RVU to 1.4 RVU. This increase is offset by the requirement to code by area and not number of wounds. If this were debridement of muscle, the reduction would be even greater. The RVU of the parent code for muscle debridement (11043) dropped 42 percent and the add-on code for muscle debridement (11046) is 31 percent of the parent code. It is difficult to directly calculate the impact on reimbursement since it depends on the 2011 square area scenarios and the number of wounds debrided in the 2010 scenarios.

In our wound center, 67 percent of the patients have more than one wound. The average number of wounds in those patients is 2.35.

Author(s):

Lee C. Rogers, DPM

The skin substitute policy has also undergone drastic changes. Both Apligraf (15340) and Dermagraft (15365) were replaced by a CMS G code (G0440). The service was also revalued. In 2010, Apligraf had an RVU of 7.00 and Dermagraft had a RVU of 7.72. In 2011, G0440 is valued at 3.51. While the products are still reimbursed, the reimbursement for the physician service dropped by more than $150 in all scenarios.

Understanding The Impact Of The CMS Changes On Wound Care Clinics

To determine how this will affect physician revenue in the clinic, we sampled two consecutive days of patients (55) and calculated the reimbursement for the services delivered under the 2010 guidelines compared with the 2011 guidelines. The 55 patients in 2010 would have generated $5,643.87 and now the same services coded in 2011 would generate $4,419.61, a reduction of 22 percent.

Our calculations were based on a doctor delivering services in a facility with the 2010 and 2011 fee schedules from CMS Palmetto, Los Angeles County.

Final Notes

Every year in the United States, there are nearly 100,000 amputations, a majority of which are on those with diabetes.¹ There are 25.8 million people in the U.S. with diabetes and 79 million adults over age 20 with pre-diabetes.² Amputations are a dreaded complication of diabetes. A chronic wound is present on nearly 85 percent of limbs that are amputated, making it the one of most common reasons for amputation.³

During the 2008 presidential election, many candidates campaigned on increasing revenue and access to preventative services, and used the “diabetes-related amputation” as an example to illustrate their point.⁴ This update in the CMS fee schedule for wound care is the antithesis of that ideology. The substantial reduction creates a disincentive for physicians to treat patients with chronic wounds. As a result, this may leave Medicare patients experiencing delays in treatment or cause them to seek treatment by non-specialists. Just as the epidemic of diabetes continues to get worse, we may see an increase in the rate of amputations.

Dr. Rogers is the Associate Medical Director for the Amputation Prevention Center at Valley Presbyterian Hospital in Los Angeles. He is the Medical Director for the Amputation Prevention Centers of America, a national network of wound centers and limb salvage centers.

References

1.Centers for Disease Control and Prevention. Hospital discharge rates for nontraumatic lower extremity amputations by diabetes status - United States, 1997. MMWR Morb Mortal Wkly Rep. 2001;50(43):954–958.

2. Centers for Disease Control and Prevention. National Diabetes Fact Sheet 2011. http://www.cdc.gov/diabetes/pubs/factsheet11.htm .

3. Pecoraro RE, Reiber GE, Burgess EM. Pathways to diabetic limb amputation: basis for prevention. Diabetes Care. 1990;13(5):513–521.

4. American Podiatric Medical Association. Presidential candidates stump podiatry reimbursement plight to make a case for health reform. Available at: http://bit.ly/h7tZvx .

eTalk : Medicaid Cut for Podiatry in AZ

2011-01-31T16:28:00.000-07:00

eTalk : Medicaid Cut for Podiatry in AZ

More states are looking to cut Podiatry from their Medicaid programs. Unfortunately for many people this will end in disaster.
The long story short on this matter is that education, access to healthcare and early detection are the keys to decreasing the amputation rate in patients with Diabetes!! Yet, we are still cutting Podiatry from Medicaid programs!!

Diabetes is the leading cause (more than 50%) of nontraumatic lower extremity amputation in the United States. Significant risk factors for amputation are hyperglycemia, a longer duration of diabetes, older age, and the presence of neuropathy, peripheral vascular disease, or foot ulcer. Foot ulcers alone precede about 85% of these amputations.11–13 Peripheral neuropathy can occur in both types of diabetes (60% to 70%), but more severe cases are found in patients with type 1 diabetes.10 It was the most common complication found in this study (68%).

The higher percentage of ulcer and amputation observed in our study may be attributed to the lower levels of education, low socioeconomic status, high rates of obesity, and high rates of non-adherence as compared with national levels. According to recently published data, intensive multidisciplinary team management can reduce up to 50% of neuropathic foot ulceration.14 Early detection and proper management of foot ulcer will further reduce the risk of amputation. Recently, the US Department of Health and Human Services called for a 40% overall reduction in lower extremity amputations, including a reduction in the amputation rate for African-Americans from 10.2 per 1,000 to 6.1 per 1,000 by the year 2010 http://www.jarcet.com/articles/Vol2Iss2/Siddhiquispr02.htm

Feet

2011-01-27T22:49:00.000-07:00

From the beginning of time, people had issues with their feet. From Achilles in need of a Podiatrist to save him from his poisionous arrow, people needing foot washing for rituals and patients needing help after foot bindings. Podiatrists have been needed to care for wounded feet for centuries. Over the next few weeks I am going to discuss some of the more common foot problems,causes and treatments available! I will welcome questions to help make sure that we hit all of th foot problems out there. Thank you. Patricia Kirk 623-584-5556

Does your heel hurt??

2011-01-25T14:43:00.001-07:00

Is the first step out of bed in the morning painful? Have you tried other treatments and they just don't work? Have you tried stretching, injections, icing and physicial therapy? Are you considering surgery? Then you are the person that we are looking for!!
We have just started using the Extracorporeal Pulse Activation Treatment.
So far our patients have all said that they feel a lot better immediately after treatment!!
Just give our office a call to schedule your appointment today! 623-584-5556
I will be posting more information on this topic shortly!

26

2011-01-25T13:33:00.001-07:00

This is the number of bones in the human foot!! The foot is a very complex portion of our body. We have 206 bones in the entire body. This doesn't include all of the muscles, tendons, ligaments, arteries, veins and nerves we have in our feet.
The APMA has estimated that 75% of the population will experience foot and ankle problems of varying degrees at some point in their life.
The APMA states that for a 150 pound person, walking one mile exerts the equvalent of 63-1/2 tons-127,000 pounds in each foot!!
Due to the complex nature of our feet, they are designed to handle this stress, but certain problems if left untreated can lead to serious foot problems if left undectected and or untreated!
So make your appointment with Surprise Foot and Ankle Clinic 623-584-5556 to take care of those foot problems!!

The Wound Healing Process | Dermagraft Â®

2010-10-30T21:18:00.000-07:00

Do you have an ulcer (wound, sore) that is having difficulty healing on the bottom of your foot? Do you have diabetes?
Our doctors here at Surprise Foot and Ankle Specialists we have many treatments available to help your foot wounds
We current perform Dermagraft in our office. This is a cultured human dermis. A cover for your ulcer that has substances in it that help to heal your wound faster.
Come to Surprise Foot and Ankle Specialists to have your foot wound (ulcer, sore), evaluated with inspection, wound culture, x-rays, vascular studies all in the office.
We have many treatments available to heal you!

The Wound Healing Process Dermagraft Â®

Ritchie Brace

2010-10-30T13:44:00.000-07:00

Do you have flat feet? I mean severe flat feet? Are you one of those people who have to rest after just a few minutes at the mall? Do your feet roll in towards one another? Then you might be a candidate for a Ritchie Brace.

Come visit us at Surprise Foot and Ankle and we'll evaluate your feet. We'll take x-rays, look at how your feet look when you are standing, when you are walking and talk about how much pain you are in. We may want to start with Physical Therapy, we may do that along with prescribing a Ritchie Brace, or we may decide that surgery is the answer to your pain.

Don't live in pain, don't cancel trips to the mall or museum, come visit us at Surprise Foot and Ankle and let's work together to get you back walking and enjoying yourself!

Resources | Today's Podiatrist

2010-10-25T22:00:00.000-07:00

Resources Today's Podiatrist

APMA's Podiatrists Keep America Walking Campaign Appears on National Tel...

2010-10-23T21:59:00.000-07:00

Foot Pain

2010-10-23T20:03:00.001-07:00

Many people have foot pain! The first thing to do is to see your doctor. The largest problem that we see in our office is patients waiting too long to get care. We all worry about what could be wrong with us. There is nothing more stress relieving then finding out exactly what is wrong, and that it can be fixed!

Our office offers a variety of services! We do on site x-rays, diagnositic ultrasound, neruosensory testing, vascular testing and have a great staff!

We offer wound care, surgical care, custom orthtoics, custom braces and shoes, diabetic shoes, diabetic foot care, and care of all conditions of the feet.