Top Docs Radio

Common Foot Injuries This week our friend, Dr. Shamir Bhikha, DPM with Ankle & Foot Centers of Georgia stopped by to talk about common foot injuries often seen as the weather begins to warm and people decide to get out and start running/walking.  He talked about the fact that after the New Year as folks […]

Common Foot Injuries

This week our friend, Dr. Shamir Bhikha, DPM with Ankle & Foot Centers of Georgia stopped by to talk about common foot injuries often seen as the weather begins to warm and people decide to get out and start running/walking.  He talked about the fact that after the New Year as folks set goals to lose weight and especially during spring, folks tend to go out and jump into a training regimen that doesn’t allow for adaptation to occur in the connective tissues, muscles, and bones of the lower legs and feet.

This leads to several common injuries that can derail our ability to continue training for months (or even longer).  We talked about plantar fasciitis, which causes often-debilitating heel pain that is particularly painful after having been at rest or in bed for a period of time, Morton’s neuroma, an injury to the nerve between the toes that makes affected toes feel like they’re broken, Achilles tendonitis, which is a painful aggravation of the tendon behind the heel bone, and issues that can occur with poorly-fitted shoes.

Shamir talked about the importance of having a running pro help you choose a training shoe that is appropriate for your gait as well as properly fitted for the activities you plan to use them for.  Not doing this can result in toenail injury (including loss of the nail), toenail fungus, toe deformities, stress fractures, and other painful problems.

Before you head out to the trail you need to take a few minutes and listen to this foot/ankle expert who focuses his clinical practice on sports-related injuries through a conservative approach to helping his clients recover and ideally prevent further problems.  We readily recommend Dr. Bhikha as an expert for foot/ankle-related problems.

Special Guest:

Dr. Shamir Bhikha, DPM  of Ankle & Foot Centers of Georgia        

* Doctorate with Honors, Podiatric Medicine, Barry University School of Podiatric Medicine

* Residency, Inova Fairfax Hospital 2010-13 & Limb Salvage Center at Georgetown University Hospital 2013

* Skilled in Sports Medicine/Trauma to the foot/ankle, Podopediatrics and Reconstructive foot/ankle surgery

* Comprehensive training in diabetic limb salvage, plastic surgery and wound care

  Mindfulness This week I sat down with Peter Vajda.  He’s a Certified Professional Coach and PhD in Education and Cognitive Psychology.  We talked about how we can apply the practice of meditation and mindfulness to bring about a more centered “You”, becoming better able to handle conflict and reduce one’s over-all level of anxiety.  […]

Peter North talks Mindfulness on Top Docs Radio

 

Mindfulness

This week I sat down with Peter Vajda.  He’s a Certified Professional Coach and PhD in Education and Cognitive Psychology.  We talked about how we can apply the practice of meditation and mindfulness to bring about a more centered “You”, becoming better able to handle conflict and reduce one’s over-all level of anxiety.  Peter is an astute observer of the human condition and is a passionate pioneer in the field of mind-body-spirit integrative functioning and development. Dr. Vajda is dedicated to supporting individuals and groups to enhance their understanding of how to live consciously – from the inside out – which deeply supports an individual’s ability to change, grow and evolve.

Peter brings a diversified base of professional expertise – as an entrepreneur, an educator, a facilitator, and a manager. He is sensitive to the diverse perspectives,  demands and dynamics of relationships. Since 1981, he has facilitated individuals, couples, groups and organizations.

His life and the orientation he brings to coaching, consulting, facilitating and writing are deeply influenced by his understanding of, and his experience in, the psychology of personal growth and development.

For over thirty years, Peter’s has been committed to his own personal and spiritual development. His experience in working with the “whole body” is based on his studies of psychodynamics, ego development, bioenergetics as well as energy healing.

Peter earned his Ph.D. in Education and Cognitive Psychology from Fordham University. His post-graduate work is in organizational behavior at NYU’s Stern School of Business.

For six years, Dr. Vajda has written a weekly column – “Know Thyself” – for the widely-acclaimed international Management-Issues website.

His book– Becoming a Better You, Who You Are vs. Who You Think You Are – was published in October, 2013.

Special Guest:

Peter Vajda, Phd, CPC, True North Partnering    

* PhD, Education-Cognitive Psychology, Fordham University

* Former Director, Academic Services, Information Technology Institute, New York University

* Previous Manager, Instructional Design Dept. , Gulliver Ritchie Associates

* Published Author

 

 

  Start Exercise Fitness Training Without Injury This week, our new monthly partner, Dr. Andrew Pugliese stopped by to introduce us to Randy Nicholson, of Fitness Firm Studio.  He’s a certified trainer who shared some very helpful information on how folks who have not previously trained or former athletes who haven’t trained in a while […]

 

Start Exercise Fitness Training Without Injury

This week, our new monthly partner, Dr. Andrew Pugliese stopped by to introduce us to Randy Nicholson, of Fitness Firm Studio.  He’s a certified trainer who shared some very helpful information on how folks who have not previously trained or former athletes who haven’t trained in a while start exercise fitness training without injury.

As a former athlete who has experience in high intensity and high volume cardiovascular and weight/resistance training, I know too well what it’s like to resume working out after a prolonged layoff and experience overuse injuries.  These come from a burst of activity with or without heavy weight/resistance.  Too much exercise too soon can easily result in a incapacitating measure of pain or even injury that prevents continuing without another break to recover.

Randy shared what a person who’s motivated to start or resume training should ask a prospective personal trainer to determine what their philosophy is regarding the initial training phase.  He also shared the value of using a roller to help facilitate muscle recovery as well as releasing trigger points that can cause muscle spasm.

We talked about the best way to approach beginning training in a step-wise fashion to insure that muscular imbalances, postural weaknesses, and flexibility have been improved upon before moving on to more intense training moves/activities.  If you or someone you care about is thinking about resuming or wants to start exercise fitness training without injury they need to check out this week’s episode.

Special Guests:

Randy Nicholson  Fitness Firm Studio    

* NASM

* EGOUSE

* 4th Degree Black Belt in Tae Kwon Do

* BS Engineering, University of Chattanooga

Andrew Pugliese, MD, Infectious Disease Consultants      

* Doctorate in Medicine, St. George University School of Medicine

* Fellowship, Infectious Disease, Winthrop University Hospital

* Triple Board Certified in Internal Medicine and Infectious Disease

* Pioneer in non-surgical treatment of acute and chronic sinusitis

* President of Sinus Solutions

Medical Reserve Corps The U.S. Department of Health and Human Services (HHS) has approved MAG’s request to form the nation’s first medical society-sponsored statewide volunteer medical reserve corps (MRC). MAG and the Georgia Department of Public Health would oversee MAG’s MRC. MAG is now eligible for limited federal capacity building funds and has in fact […]

Medical Reserve Corps

The U.S. Department of Health and Human Services (HHS) has approved MAG’s request to form the nation’s first medical society-sponsored statewide volunteer medical reserve corps (MRC). MAG and the Georgia Department of Public Health would oversee MAG’s MRC. MAG is now eligible for limited federal capacity building funds and has in fact received a 2015 grant for $2,500 – though the MAG MRC will require funding from private sources to fully maximize its vision.

The MAG MRC will train physicians to respond to declared emergencies in Georgia, and it will establish a system to coordinate the deployment of those physicians during any such emergencies. The MAG MRC will supplement the official medical and public health and emergency services resources that are available in the state. MAG MRC units will be capable of setting up mobile hospital systems. And under extreme circumstances (e.g., a shortage of health care providers in a given area), MAG MRC units can be called upon to perform some of the functions that would otherwise be performed by the full-time emergency medical response personnel in the state. MAG formed the MRC as a result of 2013 House of Delegates meeting action.

The MRC is a national network of volunteers, organized locally to improve the health and safety of their communities. The MRC network comprises 993 community-based units and 207,783 volunteers located throughout the United States and its territories. Georgia has 19 approved MRCs.

MRC volunteers include medical and public health professionals, as well as other community members without healthcare backgrounds. MRC units engage these volunteers to strengthen public health, improve emergency response capabilities and build community resiliency. They prepare for and respond to natural disasters, such as wildfires, hurricanes, tornados, blizzards, and floods, as well as other emergencies affecting public health, such as disease outbreaks. They frequently contribute to community health activities that promote healthy habits.

The designated point of contact is the Director of Health Protection with DPH. The MAG MRC may also be activated by MAG MRC leadership team as necessary. The MAG MRC Unit will supplement the State of Georgia Public Health Emergency Preparedness’ and Response Unit. The unit will not replace or supplant the existing emergency medical response system or its resources including locally based MRC units.

Special Guests:

John S. Harvey, M.D.

* Chief of Surgery, Gwinnett Medical Center

* Acting Colonel and Command Surgeon, Georgia State Defense Force

* MAG’s President-elect.

* Missions have included the Katrina/Rita hurricane and Haiti earthquake victim airlifts. He dealt with the Centennial Park bombing that took place during the 1996 Olympics as a medical command officer.

* Doctor of Medicine, Medical College of Georgia

Susan Moore

Susan Moore has been MAG’s Director of Health Policy and Third Party Payer Advocacy since 2013. She helps MAG members resolve third party payer claim disputes and grievances. She has spent 30 years in the health care industry – more than half of those focused on patient safety and health care quality. Moore has a degree in nursing from the Emory University School of Nursing and a Master’s Degree in Public Health from the Yale School of Public Health at Yale University.

Paul Hildreth

Paul Hildreth is the emergency management coordinator/grant coordinator for REMS for the Fulton County School District. He has 14 years of experience in emergency response and crisis management. He is a certified emergency manager and master certified emergency manager.

Peripheral Arterial Disease As many as 12 million Americans are dealing with peripheral arterial disease (PAD), a progressive blockage of the blood vessels that carry blood to the lower extremities.  For many of these patients, amputation is the outcome, leaving them without a foot, or in others, half or more of their leg.  Medical literature […]

Peripheral Arterial Disease

As many as 12 million Americans are dealing with peripheral arterial disease (PAD), a progressive blockage of the blood vessels that carry blood to the lower extremities.  For many of these patients, amputation is the outcome, leaving them without a foot, or in others, half or more of their leg.  Medical literature has shown that in these patients, their risk of death within 1 to 5 years of their amputation they have a 40% likelihood of amputation of the remaining leg and a significant risk of death.  It’s clearly a serious problem.

But we can reduce the rate of amputation among these patients and we can also reduce the severity of intervention required to address the problem if we catch it early.  Dr. Joseph Ricotta, vascular surgeon and director of the Northside Hearth & Vascular program, stopped by the studio to talk about what can be done to improve patient outcomes for those with PAD.  We talked about the troublesome statistics around peripheral arterial disease, including the fact that among diabetics with PAD who develop a non-healing wound resulting in amputation, as many as 50% of them never receive a non-invasive study that could prevent the loss of their leg.

That means we need our partners in primary care and foot/ankle surgery to take an aggressive stance when presented with patients who are at risk for PAD or who have a poorly-healing wound on their leg or foot.  There are numerous non-invasive studies that take only minutes in the vascular surgeon’s office that can readily identify patients who have blockage affecting blood flow to their feet.  In these cases, if caught early, surgeons like Dr. Ricotta have more options and greater probability they can reestablish adequate blood flow that helps a wound to heal, preventing or mitigating extent of amputation.

We talked about the fact that Northside offers access to 2 of the country’s 10 robotic devices that significantly improves the effectiveness of minimally-invasive procedures by allowing the vascular surgeons to access and treat previously-inaccessible locations.  Additionally, with the assistance of the robot, the surgeons are able to reduce damage that can occur on the inside of the vessel being treated, which reduces the likelihood that scarring after the procedure will block the vessel off again (a leading cause of reocclusion in PAD lesions).

I also spoke with foot and ankle surgeon, Dr. Michael Bednarz of Ankle & Foot Centers of Georgia, whose office is located in Woodstock, just north of Marietta.  He talked about treating PAD patients with wounds from the perspective of the specialist who is tasked with managing the wound and ultimately, treating it surgically as necessary (including amputation when efforts to heal the wound fail and serious infection is a risk).

We talked about the fact that amputation should be viewed as a last-ditch option.  And Mike shared that no patient should face amputation without having had a vascular study to determine if poor flow is contributing to the wound not healing.  He talked about the fact that when he’s presented with a poorly-healing wound, particularly in a patient with PAD risk factors such as diabetes, one of the first things he does is request a vascular study to assess blood flow.  He also utilizes Transcutaneous Oximetry, a non-invasive test that shows how well the tissue at the surface where a wound is located is getting oxygen.

With the results of those studies, he is able to address poor blow flow by referral to a vascular surgeon and/or to hyperbaric medicine (readily available in Atlanta and surrounding suburbs) to address poor oxygen levels in the skin.  He also evaluates other risk factors such as glucose levels and presence of infection, often resulting in consults with infectious disease and/or endocrine specialists to help heal the limb-threatening wound.