EP 612: Treat Your Feet This Holiday Season: Why Podiatrists Ask for Slippers in their Stockings, and You Should Toe!

In this segment, Dr. Mistry and Donna Lee are joined by guest Dr. Ana Urukalo of Elite Foot and Ankle Associates. As a podiatrist specializing in the surgical treatment of painful conditions like plantar fasciitis, bunions, and hammer toes, Dr. Urukalo knows how to give foot pain the boot. Learn what steps you can take to treat your feet, from house slippers all the way to corrective surgery. Dr. Urukalo also explains how quarantine and new work-from-home arrangements have affected our feet, and why sometimes you have to break a few toes to set your feet straight! Visit Elite Foot and Ankle Associates online or call 512-907-3100 today.

Voted top Men's Health Podcast, Sex Therapy Podcast, and Prostate Cancer Podcast by FeedSpot

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Speaker 1: 0:07

Welcome to the Armor Men's Health Show with Dr. Mystery and Donna Lee.

Speaker 2: 0:12

Hello and welcome to the Armor Men's Health Show. This is Dr. Mystery, your host, board certified urologist. Joined by my co-host, Donnel Donnelly. Uh, this show is brought to you by the urology group that I started in 2007 N A u urology specialists. We're blessed to have four physicians, four advanced practice providers. We have two pelvic floor physical therapists, a health coach. We have sleep medicine and sex therapy. We are here for your urologic needs. You

Speaker 3: 0:39

Know, we have two sex therapists on site now.

Speaker 2: 0:41

That's amazing. Yeah.

Speaker 3: 0:42

We didn't need need some more patients though, but yeah,<laugh>,

Speaker 2: 0:45

<laugh>,

Speaker 3: 0:46

Get'em a little busier.

Speaker 2: 0:46

And, you know, uh, a lot of people don't know that there's a big psychological component to your erectile dysfunction issues, but they don't know. Uh, but sex therapy also affects a lot of our, um, uh, fertility patients, not mm-hmm.<affirmative>. That's right. So, um, uh, we are blessed to have guests on our show often. We have a wonderful friend of the show, a wonderful friend of our practice, Dr. Anna Ulo joining us today. Thank you so much for joining us today, Dr. Ulo. Welcome.

Speaker 4: 1:11

Good morning and thank you for having me here. It's a pleasure.

Speaker 2: 1:15

So, uh, this a

Speaker 3: 1:15

Chipper, unlike some of the other guests we've had. Yeah. Sometimes. Yay. Thanks

Speaker 2: 1:18

For having, thanks for coming there.

Speaker 3: 1:20

I love the female energy. Good.

Speaker 2: 1:22

Yeah. So, um, uh, foot uh, issues and ankle issues and p podiatrist issues are something that afflicts a lot of people, uh, as, especially as people age. Uh, why don't you tell us a little bit about what, uh, it takes to become a podiatrist?

Speaker 4: 1:38

So, um, you know, it's a, it's a long road, but it's a fun road. Uh, I really enjoyed it. Um, so, you know, undergrad, um, I went pre-med and, uh, then, um, took the mcat, uh, went to pod school, which is very similar to the M D D O program. So the first two years are pretty much identical. And then in the second two years, we kind of do a little bit of more focus on the foot, on the lower extremities. Uh, but we also continue with the general. And then after that there's residency postgraduate training. I did three years of residency, uh, and then practice. Some people do fellowships. There's varieties. It's, it's odd how much variety really there is in the foot and ankle cuz you think, well, what all can you do? But there's sports medicine, there's pediatrics, there's limb salvage, uh, there's trauma reconstruction. So there's a whole lot of variety there.

Speaker 2: 2:25

And, uh, al although there are like hundreds of medical schools, there are not hundreds of pod podiatrist schools are there? Is that right?

Speaker 4: 2:32

No, we're very few and exclusive<laugh>. Uh, so there's about seven in the country, uhhuh. Wow.

Speaker 2: 2:37

That is so few like seven. It's, it's amazing. There's,

Speaker 3: 2:41

Should we start one? Like

Speaker 2: 2:42

We're gonna start one.

Speaker 4: 2:44

We're gonna start. I like it. The

Speaker 3: 2:45

Urology podiatry department

Speaker 2: 2:46

Is there one in Texas.

Speaker 4: 2:48

Um, you know, there's one in the Rio Grande Valley that, uh, Dr. Larry Harks, my previous, uh, residence director was trying to, working on starting up. So yes. Wow,

Speaker 2: 2:57

That's

Speaker 4: 2:57

Fascinating. That's in a works. Yeah. How many

Speaker 3: 2:59

Urology programs

Speaker 2: 2:59

Are there? I mean, there's uh, really less than 350 urologists that graduate every, um, every year. Year. Oh, that's right. But, uh, they're, you know, dispersed over, you know, probably a good hundred programs, uh, around the, around the country and there's hundreds and hundreds of medical schools. So, uh, it's very, it's very elite to become a, a podiatrist. Do you think most podiatrists, uh, like seek out that specialty or, uh, what got you interested?

Speaker 4: 3:26

You know, it's, it's really interesting cuz uh, some do, uh, I, I think it just kind of comes different for everybody. Um, I always wanted to be in medicine. I grew up in a family of doctors and I always could hear'em talk about medical cases and it fascinated me. So I knew that that was my path. My mom was a dentist and I originally wanted to be a dentist and she talked me out of it really quick<laugh> and said if she was to do it again, she would do podiatry. And I remember my response being, mom feet are dirty,

Speaker 3: 3:52

<laugh> they are.

Speaker 4: 3:53

And she looked at me and she said, no honey, mouth

Speaker 2: 3:56

Mouths are dirty, dirty, dirty,

Speaker 3: 3:57

Dirty.

Speaker 4: 3:58

Um, so anyway,

Speaker 2: 3:59

Some mouths

Speaker 4: 4:00

<laugh>. So I'm very happy that I took this route. She said, trust me, sit down, you know, enjoy it and uh, I get to do surgery, I get to do conservative care. So it's really a great mix of things. Sports, medicine. I love it.

Speaker 2: 4:11

So as men age, where, you know, is a men's health show, um, what are some of the more common men's health, uh, or, uh, men's foot and ankle type things that, that you're gonna see?

Speaker 4: 4:22

You know, it really depends on the type of a patient. So we have men that are very active and then men that are a little more sedentary. So those are kind of the two dichotomies in the active ones. And, and men usually kinda like to wear this badge of honor of I don't need to see the doctor, I'm doing fine. Um,

Speaker 3: 4:40

<laugh>, no,

Speaker 2: 4:40

She does a good man in Virginia,

Speaker 4: 4:41

A good man in, and you know, a lot of times when I, you know, say what brings your wife sent me here<laugh>. So

Speaker 3: 4:46

We get that a lot too. Yes,

Speaker 4: 4:48

That's right. That's right. So, you know, it's, it's great. But, um, I think as we age, you know, just wear and tear on the body, putting miles on the wheels kind of thing. Um, and men I think tend to not care as much about their feet. It's cuz kinda like, ah, it's way there at the end of your body. We don't really care about it. Whereas women, you know, your body's like petties and, you know, pretty feet and

Speaker 2: 5:06

Not for the waist, we really stop caring.<laugh>

Speaker 3: 5:09

<laugh>. Yeah,<laugh>. It's the dangly parts we're

Speaker 2: 5:12

About the, the dangly parts we're more worried about

Speaker 3: 5:14

Not exactly

Speaker 2: 5:14

The foot. So, um, so heel pain, uh, foot pain are probably big reasons why people are gonna seek, uh, a podiatrist. Uh, what are the most common causes of heel and foot pain?

Speaker 4: 5:25

So, heel pain, most people are very familiar with plantar fasciitis. Uh, so that's a very, very common one. Typically overuse injury with falling of the arches, not wearing enough support, doing too much. The other type of heel pain is Achilles tendonitis, which is at the back of the heel, whereas plantar fasciitis is on the bottom. Um, so those are some of the more common ones. Uh, we see a lot of tendonitis, um, you know, um, neuros nails are a big thing, you know, ingrow nails, nail fungus, that kind of thing. Uh, but a lot of times just the, the wear and tear on the body.

Speaker 2: 5:58

So plantar fasciitis is something that I suffer from. And um, and, uh, and I've suffered from it for a few years now. And so,

Speaker 4: 6:06

Uh, I suffered in silence.

Speaker 2: 6:07

Suffered not, no, I complain about it constantly. Okay. He's

Speaker 3: 6:10

Never, he's never in

Speaker 2: 6:11

Silence.<laugh>, I'm never, I'm never quiet.<laugh>. Uh, in, in our, in our house, the joke is, I always say it with a whiny voice, it's my plant to our faciitis. Uh,

Speaker 3: 6:19

Oh,

Speaker 4: 6:19

Maybe you should see a podiatrist.

Speaker 3: 6:20

<laugh>

Speaker 2: 6:21

<laugh>. And so, um, uh, walking around your house without shoes has been something that like, you know, talk to me about shoe wearing and, and podiatry and kind of, uh, you know, what you carry around as, uh, comments to people.

Speaker 4: 6:35

Oh, sure. So shoe thing is a huge thing, especially how shoes, so once Covid hit and, uh, people started spending a lot more time at home, there were barefoot running around. A lot of the homes are now less carpeted and more hard floors, so that's not good for your feet. So what started to develop, seeing a whole bunch of these covid related foot and ankle injuries, mostly plantar fasciitis and things like that. So wearing house slippers is huge and not all house slippers are created equal. I usually like something with support. Uh, so people like those memory foam cushy, god forbid, crocs, um, that are just not good for your feet. You need support. Um, so that, that's a huge part. And again, not all are created equal. I usually recommend get a good pair of house slippers that you have. Uh, there's a place called Instep over at the Gateway Shopping Center that have

Speaker 2: 7:22

A amazing in Austin. Amazing Austin, that's right.

Speaker 4: 7:23

Yes. Yes. And they have great house slippers. There's a lot of other places as well. But what I like is going somewhere where they can really show you and, and kind of narrow you down to what you need, rather than you just buying something off the Amazon. Mm-hmm.<affirmative>, once you know what you have, what you need, then you can get it, but get something good cuz being at home is a huge part. And then being outside. Sure.

Speaker 2: 7:43

Having good shoes for, for sure. With, with walking around the house, one of the biggest differences, difference makers for me and my feet has been wearing shoes or something in the house. Mm-hmm.<affirmative>. Yes. Now this is interesting because, you know, my wife doesn't want me walking on the carpet with shoes, so you really have to have shoes that haven't been in the operating room. Mm-hmm.<affirmative><laugh> that you're walking around your house.

Speaker 3: 8:02

Yeah. Mm. Walking around in the dirty

Speaker 2: 8:04

Hospital floors. That's right.

Speaker 3: 8:05

I gotcha. Yeah. Thesing

Speaker 2: 8:07

House shoes really takes care of that. Let's,

Speaker 4: 8:08

You definitely wanna have something for a house that's not worn outside.

Speaker 3: 8:11

Right. And let's thank the in step people. They're very nice. And we told them we would give them a little shout out, but, um, you told me before when I first met you stop being barefoot in the house mm-hmm.<affirmative> and I've stopped that and I wear really supportive shoes. And then the other day I like left my supportive shoes at some part of the house and I was on the couch or something. I walked around for like 10 feet in my house on my bare feet and it was like totally awful. Like it was a whole different world. I was like, where are my shoes? Like I, I get, I get it now that, now it makes sense because there was no support whatsoever and it was not comfortable. But

Speaker 4: 8:38

You didn't know different from before. Right. Now that, you know, different. Yeah. Yeah.

Speaker 3: 8:41

Totally.

Speaker 2: 8:42

So when people with plantar fasciitis or Achilles heel pain are looking for shoes that they're gonna wear outta the house, what are some of the characteristics that you, that, that you recommend?

Speaker 4: 8:51

So, great question. Um, it all depends on your foot type, right? So different foot types require different shoes. Um, and here in Texas, you know, usually, by the way, let me backtrack for a second. Um, it's usually better to wear shoes that have lace up support. You know, tho those are the more comfortable ones. The problem in Texas, it's a hundred degrees six months a year or a hundred degrees plus. So people don't like to wear close those shoes. So there's a lot of sandal offers, but o o options, but therapeutic sandals, uh, not the, you know, so again, places like in step caravel, that kind of thing, uh, go in, get something good that you can wear and then replace'em frequently. But usually tennis shoes and lace up shoes are going to be your most supportive shoes. Now some people also require inserts in addition to the an orthotics and things like that. And these come in different flavors. There's over the counter, there's custom made that you can get to support to add additional support to your shoes.

Speaker 2: 9:43

Mm-hmm. And, uh, for a lot of these conditions, calf tightness and uh, and something above the ankle and foot can be really causative, right?

Speaker 4: 9:50

Oh, absolutely. So it's all connected. I usually kind of say, you know, my, your, your feet are made 26 bones in a foot, two in a leg thigh hit back and it's all connected. It's one big pulley system. So when you don't

Speaker 2: 10:00

Have, it's weird that you stop at the waist because that's where we started<laugh>,

Speaker 4: 10:03

You know, that's why you take off from there. So

Speaker 3: 10:05

<laugh>, that's why y'all work so well together. That's right. Yeah.<laugh>.

Speaker 2: 10:08

And so, uh, because things are connected, a lot of times people that have plantar fasciitis or achilles heel pain, they need to do stretches of their upper extra, uh, their, their their the higher up of their leg.

Speaker 4: 10:19

Right? Absolutely. Absolutely. A lot of times stretching the Achilles tendon, um, is what's going to help with your plantar fasciitis because it's connected. Um, so an achilles tendon is one of the biggest tendons. The important thing that I always want to pass on is you want to stretch it with the knee straight and the knee bent, because there's two muscles that make up the achilles tendon. Gastric is above the knee soleus below the knee. So you should feel two stretches, one kinda right below the knee in a calf region, and then one right above the ankle

Speaker 2: 10:44

For your, per your recommendations. I bought a slant board, slant board off of Amazon<laugh> and uh, because my, uh, my 15 year old daughter who plays volleyball also has plantar fasciitis and we've been using this slant board. It's a beautiful thing and it works better than just kind of like putting your foot up on a curb or something like that. Yes. Because it sticks there.

Speaker 4: 11:06

Yes. Great recommendation. Mm-hmm.

Speaker 2: 11:07

<affirmative>. Well, uh, Anna, we're gonna be right back after this message. Uh, how do people get a hold of you? What's the number of your new practice?

Speaker 4: 11:13

Yes, A new practice. Practice Elite Foot and Ankle Associates with my partner Dr. Alaska Soos number is 5 1 12 9 0 7 3 1 0 0.

Speaker 2: 11:23

We'll be right back. Thank you. Hello and welcome back to the Arma Men's Health Show. This is Dr. Mystery, your host joined by my co-host Donnelly. Hey

Speaker 3: 11:40

Everybody, welcome back. Thanks for listening,

Speaker 2: 11:41

Donna. There's a lot of options of how to listen to this show, huh? Mm You can listen. Could listen to us podcast, uh, right here on News News Radio. News

Speaker 3: 11:47

Radio,

Speaker 2: 11:48

Kj uh, five 90 am 99.7 fm.

Speaker 3: 11:52

You never know. Yes, that is correct. And there's also a free app. So if you don't wanna sit in your car and listen to our amazing po guests and podcasts, you can get the app, the k o BJ

Speaker 2: 12:00

App. And you can also listen to this as a podcast. Mm-hmm.<affirmative>, wherever you get your podcast. That's right for Armor A R M O r Men's Health.

Speaker 3: 12:06

That's right cuz you spelled it wrong,

Speaker 2: 12:08

<laugh>. I did spell it wrong.

Speaker 3: 12:09

Don't look for a R M O U R. Just look for a ar m o

Speaker 2: 12:13

R. I think we bought the link for the other one too, right?

Speaker 3: 12:15

Yeah, I have the Gmail

Speaker 2: 12:16

Link. Yeah. Very nice.<laugh>, this is a men's health show. This is brought to you by the urology group that I started in 2007 N a u Urology Specialist. And we're joined again by our wonderful guest, doctor Anna Ulu, with Elite Foot and Ankle Associates. Thank you so much for joining us again, Anna.

Speaker 4: 12:32

Thank you for having me here. It's an honor.

Speaker 2: 12:34

So the previous segment, we talked a lot about, uh, foot and ankle pain, uh, related to um, uh, plantar fasciitis and Achilles tendonitis. Uh, I wanna talk a little bit about things that happen with our toes. Uh, namely hammer toes and callouses and bunions and all these kinds of things. Ingram

Speaker 4: 12:50

Toenails

Speaker 2: 12:51

In, don't forget toenails that we deal with. So, um, let's talk about bunions first. What, what is a bunion?

Speaker 4: 12:56

So bunion is a deformity at the big toe joint where there's a movement of the big toe towards the second toe. So there's a bump that's prominent, what we call medial side of the foot, kind of closer to the inside of the body. So it's not really the, the bone that grows there, it's really the angle of the metatarsal and the, the toone, the failings that creates it to be more prominent rather than the growth of the

Speaker 2: 13:18

Bone. So it's not really a callous. Correct. So a callous would be like a buildup of skin. Yes. So, so that's not skin. There's an actual bone there.

Speaker 4: 13:26

Yes. Mm-hmm.<affirmative>, there's bone there, but sometimes you do get some skin callous formation because it's irritated in the tissue. It's

Speaker 2: 13:31

Rubbing. Yeah, it's rubbing. And so and so that's interesting. It's not really that there's an extra bone that's being built there, it's really the angle of the toe that's making that bone more prominent is

Speaker 4: 13:41

What you're saying. Exactly. Exactly. Why

Speaker 2: 13:42

Does that

Speaker 4: 13:43

Form, you know, uh, uh, genetics a lot of times. So it's the foot structure that you're born with Now, certain things like shoes can slow it down or speed it up. So all

Speaker 3: 13:53

The, the shoes I've been wearing in my twenties and thirties cause me to have my bunion named Paul

Speaker 2: 13:59

Paulina. Yes, yes.

Speaker 3: 14:00

No shoes, ladies. There you go. There

Speaker 2: 14:01

You go. You think it's wrong that I think that bunions are really sexy.

Speaker 3: 14:04

I was gonna make an only fann page about my bunion and just slide her up against things up and down slowly.<laugh> like a cucumber.<laugh>.

Speaker 2: 14:10

Do you find that a lot, Anna, that people are attracted to bunions?

Speaker 4: 14:14

I don't know. We'll see. I need to look out for that. Yeah.

Speaker 2: 14:17

When, when do people decide to get their bunions fixed?

Speaker 4: 14:21

Ooh, that's a really good question. Um, as a surgeon and someone who loves to do surgery, I will start off with that. This, um,

Speaker 2: 14:28

Trust me, you're in good company,<laugh>. We all love to operator on here.

Speaker 3: 14:31

<laugh>.

Speaker 4: 14:31

Think long and hard before you have surgery because, uh, because it, it does involve quite a bit. Uh, you know, there's a lot of recuperation, there's a lot of pain associated with it in my book. When it starts interfering with your activities of daily

Speaker 2: 14:45

Living, what kind of symptoms are people gonna have? Are they gonna have pain right there? Oh yeah. Right at the

Speaker 4: 14:50

Bunion. Right at the bunion. Pain in the shoes. You know, I get people that say, hey, or I'll get women that come in and say, yeah, it feels great in my tennis shoe. The the reality is I can't wear that day in and day out. I can't wear any other shoes. Mm-hmm.<affirmative>. So that, that's a problem. Right.

Speaker 2: 15:04

So if they're having pain right where the bunion is, uh, you might wanna operate on, are there non-surgical corrective kind of things that people can do if they're starting to get a bunion or starting to have minimal pain?

Speaker 4: 15:14

Absolutely. There's so much more we can do. There's so much we can do conservatively, but if you come to me at the end where there's nothing else to do, then there's not many options. Conservatively though, uh, good shoes, um, orthotics or arch supports. There's various, um, like bunion splints that you can use to kind of help stretch it out. Um, can be of benefit exercises

Speaker 2: 15:34

All. So those splints will be like to to separate your big toe and the one next to it so that

Speaker 4: 15:38

The angle, yeah. It's almost like yoga for your toes so to speak.<laugh>.

Speaker 3: 15:41

Oh, a little toga therapy. Toga. Yeah, I like it. Oh,

Speaker 2: 15:44

Toga.

Speaker 3: 15:44

Isn't that a thing? A toga party? No. Well that's a wrapping in cheese toga. Nevermind.

Speaker 2: 15:49

Okay. And so, and so those are some, some more conservative options now when you're gonna operate. Let's talk about the fun stuff. Yeah. What do you do? Do you go in there and like you get to cut like that little bone part off? Or do you like break the toe? Like what do you do?

Speaker 4: 16:00

Well, depends on the severity of it. Right? Okay. Sometimes you can just quote, shave off the bone. That's the least aggressive way. Oh. Um, not as common. Uh, usually a little more is needed. So we typically break the bone Oh. And shift it over and depends where you break it. If you for less for moderate deformities at the metatarsal neck and then it's screw fixation usually, or um, it can be at the base or sometimes you need a fusion of the metatarsal formm joint for really severe bunions. Now there's also things like fusion at the mp, the metatarsal joint plate and screws kind of fixation or implants. We do all sorts of

Speaker 2: 16:32

Things. Wow. So you're gonna get like some screws and some metal in you when you get your bunion fixed. Oh

Speaker 4: 16:36

Yeah.

Speaker 2: 16:36

<laugh> And, and and how long does the surgery take?

Speaker 4: 16:39

Depends on the severity of it. You know, anywhere from under an hour till it can take a couple hours depending what you're

Speaker 2: 16:44

Doing. And then do you have to like not walk for a while?

Speaker 4: 16:47

Yeah. Like

Speaker 2: 16:48

How long? Like,

Speaker 4: 16:49

Um, eight weeks. You know, some are we, you know, some of them are able to walk right away in like a surgical shoe or a ca boot and others require six four to six eight weeks of non-weight bearing, depending if there's grafting, bone grafting and things.

Speaker 2: 17:03

Is that when you get to walk around with that little scooter thing where your knees

Speaker 4: 17:05

On it? Yeah. Yeah. You can run people over in it. Yeah.

Speaker 3: 17:08

Thing my husband always wants one of those and he has no foot problem.

Speaker 2: 17:11

He's no foot problem.

Speaker 3: 17:12

He just wants to scoot around on that. Just wants scoot

Speaker 2: 17:14

Around. I don't know why people think it looks so cool. So

Speaker 3: 17:16

It

Speaker 2: 17:17

Does not. So, uh, so if you have a bunion that's interfering with your life or making you not be able to wear shoes, does it affect like your ability to run and do physical activity also? Oh

Speaker 4: 17:26

Absolutely. Mm-hmm.<affirmative>? Absolutely. No, it's really hard when it's on your right side. Like if you have surgery on the right, you can't drive, you

Speaker 2: 17:32

Can't drive, huh? Oh yeah. Yes. Yeah. Yeah. So, um, if people are uh, looking to make sure that their insurance covers it, does insurance usually cover bunion surgery?

Speaker 4: 17:41

Oh, usually yes because it's medically necessary now cuz medic bunion surgery, I haven't seen mu much of that, but if you're just kinda like, eh, it doesn't hurt, I just wanna make you look, look pretty, then that's a different

Speaker 2: 17:50

Situation. Especially since so many people are attracted to bunions,<laugh>

Speaker 3: 17:52

<laugh>. Check out my only fan

Speaker 2: 17:54

Page, check out my only fan page. Don Lee foot. So, uh, then, then what is a hammer toe?

Speaker 4: 17:58

Hammer toe is a contract contracture of the toe, usually kind of up and down. So sagittal plane, right? Um, but it can be at the um, metar, sophal alge joint. It can be at the um, proximal larygeal. Does

Speaker 2: 18:11

It make your toast curl? Yes. Curl in

Speaker 3: 18:14

Like a little

Speaker 4: 18:14

Hammer. Yes. Curl down. Yes. Like literally like a hammer. So they can be flexible or they can be rigid. So there's,

Speaker 2: 18:20

I don't think I've ever seen it like, but I don't have it and I don't look at people's toes that often. Like Yeah. Does it, does Is it pretty, is it pretty

Speaker 4: 18:28

Obvious? It's common. Yes. So they look like that.

Speaker 2: 18:30

So they look we're on the radio so you can't see Yes. But, but but, but but<laugh> so so the tor the toes curl in and does it hurt?

Speaker 4: 18:38

Yes, they can be very painful cuz think about it if it's, if you're walking at the very tip of the toe where the nail is right? Right. Instead of walking on the pad of the tip of the toe where the padding is. So number one, you're gonna get pain cuz there's not much padding there at the tip of the toe. But then also the part that's sticking up, um,

Speaker 2: 18:55

Rubs against your shoes.

Speaker 4: 18:56

Yes.

Speaker 2: 18:57

Yes. Oh, and so, uh, like does this come on all of a sudden? Like, don't people come to the doctor really early when they notice their toes look funny? Oh

Speaker 4: 19:06

No, some do, some don't. Some are in denial for a long time.

Speaker 3: 19:08

Kidding. The diabetic patients, they walk in on their toes, fall

Speaker 2: 19:11

Off. Oh my gosh. You know, that was gradual. It's the longest river in the world. Denial, you know,<laugh>. So

Speaker 4: 19:16

It usually takes a while to develop, but um, sometimes you can have the traumatic onset and then it'll happen a little quicker.

Speaker 2: 19:22

So, uh, what, what causes hammer toe? Is that, is that genetic? Is that, was that

Speaker 4: 19:27

Shoes, the structure of the foot shoes kind of similar as with the bunions. You know, they, they used to say shoes cause it, but they've done these studies in African tribes to run around barefoot. They still have bunions and hammer toes. Oh. Oh, okay. Interesting. Right about that.

Speaker 2: 19:38

Yeah. Okay. Well that, that's fascinating. And so, uh, again, uh, you're gonna choose to fix it when it interferes with your life and causes pain.

Speaker 4: 19:45

Right. And you failed conservative treatment options.

Speaker 2: 19:47

It's, it's a common mantra amongst all the surgeons we have on the show. You fix it when it's affecting your lifestyle and your Absolutely. And your activities of living. So, uh, conservative therapies for bunions were shoes and inserts and things like that and splints. What about for hammer toes?

Speaker 4: 20:02

Uh, kind of similar. There's hammer toe pads, usually also good shoes that are gonna have a large toe box so you're not rubbing on top of the shoe. Right. The, you're not scraping the roof of the shoe, so to speak. Um, also inserts, uh, stretching exercises. Yeah.

Speaker 2: 20:15

Can you reverse hammer toe or are these just like crutches that you're doing so you don't have to like deal with camera toe,

Speaker 4: 20:21

Eh Yeah, kind of, kind of the ladder. Um, if they're flexible and they're not super severe, yes, you can get a little bit of a give in them to where it's not a problem, uh, to where you can sort of live with it, so to speak. Um, but if they become rigid, then yeah, there's, there's no,

Speaker 2: 20:35

How do you fix it? Do you like open'em up and like straighten their toes out?

Speaker 4: 20:38

We actually, um, break the joint. Oh my god, God take out the mear, the, the, uh, head of the proximal failings. I can't talk. Yeah,

Speaker 2: 20:46

Everything about you is about breaking the

Speaker 3: 20:48

Foot, breaking something over there.

Speaker 2: 20:50

Everything she does breaks the

Speaker 4: 20:51

Foot. Yeah. But then we'll fix it. We'll put it back together in a nice way.<laugh>,

Speaker 2: 20:55

Is it usually one toe or is it like all five toes?

Speaker 4: 20:57

You know, it can be a, it, it, I don't usually see it. Yeah. Sometimes it's five toes. It's not as common. Usually one or two. Okay. It's more common. Yeah. So

Speaker 2: 21:05

You'll see one or two hammer toes and then, and then you'll operate on it. And that's another like hour, two hour surgery sometimes covered by insurance and then

Speaker 4: 21:13

Most of the time's covered by insurance. Okay. Usually covered by insurance? Yes. Okay.

Speaker 2: 21:16

And then, uh, similarly, they can't walk around for like eight weeks?

Speaker 4: 21:20

Uh, no, no, no. Those are a lot easier to recuperate from. Um, so they usually you can walk them, uh, unless there's pins sticking out of them.<laugh>? Yeah. Um, yeah.

Speaker 3: 21:29

Franken toe,

Speaker 4: 21:30

Frank and toe. Yeah. Usually

Speaker 2: 21:31

You can

Speaker 4: 21:32

Frank and toe, you can, you can walk them, uh, pretty soon, like within a few days. And uh,

Speaker 2: 21:36

And most of these are outpatient surgeries that are done? Yes. Kind of. Yes. Yes, yes. Uh, in a lot of different places. Yes. Well, that is fascinating. Uh, Anna, you just broke out on your own after leaving Austin Diagnostic Clinic after 23 years to start your own place. What's it called?

Speaker 4: 21:50

Elite Foot and Ankle Associates.

Speaker 2: 21:52

What's the website?

Speaker 4: 21:54

Um, elite foot austin.com.

Speaker 2: 21:56

And what's your phone number?

Speaker 4: 21:59

[inaudible] nine zero seven three one zero zero.

Speaker 2: 22:01

And if you are a, uh, regular listener and you want to get their information, we really believe in them. My wife Donna, you, yourself? Mm-hmm.<affirmative> me, my daughter and patient. We, we all, we, we all, we all trust you with our foot care, so thank you so much. How do people get ahold of

Speaker 3: 22:16

Us? That's right. If you wanna learn more about PEs of the toes, you can reach out to us at 5 1 2 2 3 8 0 7 6 2. If you have a question for Dr. A Cola, you can send us a question to armor men's health.com and you can listen to our podcast wherever you listen to podcasts.

Speaker 4: 22:31

Thank you. Thank you for having me here.

Speaker 1: 22:32

The Armor Men's Health Show is brought to you by N a U Urology Specialist. For questions or to schedule an appointment, please call 5 1 2 2 3 8 0 7 6 2 or online at armor men's health.com.