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  1. John Spina
    Post

    Shear stress and diabetic foot ulcers

    Shear lesions are underdiagnosed by many in the podiatric community.I was at the recent wound care seminar at Columbia University and the speakers...
    Post by: John Spina, Dec 20, 2007 in forum: Diabetic Foot & Wound Management
  2. John Spina
    Thread

    Workman's comp

    I have a patient who is on workman's comp.I treat her for ankle pain related to her job.Obviously,I bill workman's comp for any medically...
    Thread by: John Spina, Dec 20, 2007, 0 replies, in forum: Practice Management
  3. John Spina
    Post

    Painful Leg Ulcer

    Try an unna boot also.That would milk out some swelling there.
    Post by: John Spina, Nov 27, 2007 in forum: Diabetic Foot & Wound Management
  4. John Spina
    Post

    Listerine mouthwash for onychomycosis

    I have not seen anything,evidence wise,to correlate clinical success with this treatment.That being said,it cannot hurt.
    Post by: John Spina, Oct 5, 2007 in forum: General Issues and Discussion Forum
  5. John Spina
    Post

    Foot pain in Renal Transplant Patient

    Neuropathy is also common in renal/dialysis patients.Think of this also.
    Post by: John Spina, Oct 5, 2007 in forum: General Issues and Discussion Forum
  6. John Spina
    Post

    'Inflammatory' vs 'mechanical' plantar fasciitis

    I am with you.I see a lot of plain old PF and little of the latter.Inflammatory PF will respond to the newer drugs so I use them.
    Post by: John Spina, Oct 2, 2007 in forum: Biomechanics, Sports and Foot orthoses
  7. John Spina
    Post

    Methotrexate and infection

    Why is this patient on methotrexate?And yes,it is an immunosuppressant.
    Post by: John Spina, Sep 5, 2007 in forum: Diabetic Foot & Wound Management
  8. John Spina
    Post

    Restless Leg Syndrome

    For such cases,a blood test can rule out systemic causes.Also try to limit caffeine intake.
    Post by: John Spina, Sep 1, 2007 in forum: General Issues and Discussion Forum
  9. John Spina
    Post

    The latest on gout

    That would make sense.A lot of gout patients do have such maladies as HTN,DM and the like.Plus the pain there-and the unpredictability of...
    Post by: John Spina, Aug 21, 2007 in forum: General Issues and Discussion Forum
  10. John Spina
    Post

    Itchy toe

    It can be a deer tic,check for lyme disease.If you see no bite,ask her if she has changed soaps or fabric softeners/detergents recently.
    Post by: John Spina, Aug 20, 2007 in forum: General Issues and Discussion Forum
  11. John Spina
    Post

    Itchy toe

    Ask her if she has gone overseas or in the country-this can be a bite.
    Post by: John Spina, Aug 20, 2007 in forum: General Issues and Discussion Forum
  12. John Spina
    Post

    5th digit bleeding....

    I have had a few like that.A good coagulant is the nick-be-gone that is used at barber shops.Believe me,it works.It comes in a powder form and...
    Post by: John Spina, Aug 18, 2007 in forum: General Issues and Discussion Forum
  13. John Spina
    Post

    Macerated feet

    Re: Macerated feet........ What these folks need is a cheap and easy way to solve this problem.A solution is have them soak their foot in warm...
    Post by: John Spina, Aug 18, 2007 in forum: General Issues and Discussion Forum
  14. John Spina
    Post

    Onychomycosis and Pregnancy

    I have frankly never tried any garlic preps on a patient with onychomycosis but this sounds like a good idea.
    Post by: John Spina, Aug 9, 2007 in forum: General Issues and Discussion Forum
  15. John Spina
    Post

    Onychomycosis and Pregnancy

    Carmol 40 is good.It contains urea which is an emollient.I use it a lot and I think it is safe in pregnancy as I am very reluctant to give oral...
    Post by: John Spina, Aug 8, 2007 in forum: General Issues and Discussion Forum
  16. John Spina
    Post

    Diagnosis for all heel pain "plantar fasciitis"?

    Some heel pain can be a stress fracture of the calcaneus.The key:squeeze the sides and if pain is elicited,you may have a stress fracture. Had a...
    Post by: John Spina, Aug 3, 2007 in forum: Biomechanics, Sports and Foot orthoses
  17. John Spina
    Post

    Exercise for intermittent claudication

    An exercise regimen can help with this because collateral circulation is formed.
    Post by: John Spina, Aug 2, 2007 in forum: General Issues and Discussion Forum
  18. John Spina
    Post

    Onychomycosis and Pregnancy

    That is a good query.My advice would be to try a topical such as Carmol 40 as that thins out the nail plate.
    Post by: John Spina, Aug 2, 2007 in forum: General Issues and Discussion Forum
  19. John Spina
    Post

    Cryosurgery in the treatment of verrucae on toes

    I see no harm in this,however,be careful on whom you use it on.
    Post by: John Spina, May 14, 2007 in forum: General Issues and Discussion Forum
  20. John Spina
    Post

    Cryotherapy to treat verrucae in young children

    Be careful with that.That is an aggressive procedure to do on such a young child. For me,duct tape works well without the trauma.
    Post by: John Spina, Apr 23, 2007 in forum: General Issues and Discussion Forum
  21. John Spina
    Post

    Falanga - foot pain following torture

    Re: Foot pain following torture This is a topic that has never really been discussed and I thank you for bringing this up.
    Post by: John Spina, Apr 16, 2007 in forum: General Issues and Discussion Forum
  22. John Spina
    Post

    Cracked heels

    For mild cases of heel fissuring,what say you to Crazy glue?
    Post by: John Spina, Mar 31, 2007 in forum: General Issues and Discussion Forum
  23. John Spina
    Post

    Podiatrist charged with insurance fraud

    As a wiser man than me once said,bulls make money,bears make money and pigs get slaughtered.
    Post by: John Spina, Mar 27, 2007 in forum: USA
  24. John Spina
    Post

    Clanging tuning fork test

    I prefer the monofilament as it is a better test,however that does not preclude use of tuning fork.
    Post by: John Spina, Mar 26, 2007 in forum: Diabetic Foot & Wound Management
  25. John Spina
    Post

    A 'burning' issue...

    That makes a lot of sense.If only in the boots,then she should get rid of the boots.
    Post by: John Spina, Mar 26, 2007 in forum: General Issues and Discussion Forum
  26. John Spina
    Post

    Work shoes and plantar fasciitis

    I have patients who wear work boots and that exacerbates the symptoms.My query:Since they must wear the boots to work,is this not a catch-22?Think...
    Post by: John Spina, Mar 19, 2007 in forum: General Issues and Discussion Forum
  27. John Spina
    Post

    Tea Soaks for macerated feet?

    Tea is a drying agent and can be used for IM.
    Post by: John Spina, Feb 28, 2007 in forum: General Issues and Discussion Forum
  28. John Spina
    Post

    Lyrica vs neurontin for diabetic neuropathy

    I would guess that they nondiabetic causes of neuropathy give the same set of symptoms.There are differences,for insance sciatid nerve pain would...
    Post by: John Spina, Feb 14, 2007 in forum: Diabetic Foot & Wound Management
  29. John Spina
    Post

    Lyrica vs neurontin for diabetic neuropathy

    Empirically I do not see why not.
    Post by: John Spina, Feb 14, 2007 in forum: Diabetic Foot & Wound Management
  30. John Spina
    Post

    Lyrica vs neurontin for diabetic neuropathy

    The only thing that is a pain in the neck re Lyrica is the authorization and Medicare part D or insurance issues.Neurontin does not give me the...
    Post by: John Spina, Feb 12, 2007 in forum: Diabetic Foot & Wound Management
  31. John Spina
    Post

    T-Acid and Nail surgery

    I do not know about that.I will google it.
    Post by: John Spina, Feb 11, 2007 in forum: General Issues and Discussion Forum
  32. John Spina
    Post

    Metatarsal pads and metatarsalgia

    Logically we knew that they worked,we just were not sure of the mechanism.
    Post by: John Spina, Feb 11, 2007 in forum: General Issues and Discussion Forum
  33. John Spina
    Post

    Lyrica vs neurontin for diabetic neuropathy

    I agree that if the patients are doing well with neurontin,then why change?On the other hand,I do prefer to start them on Lyrica.
    Post by: John Spina, Feb 9, 2007 in forum: Diabetic Foot & Wound Management
  34. John Spina
    Post

    Haglunds in an elite marathon runner

    I have a lady,early 60s who is seeking non surgical management of this.I injected-NOT IN ACHILLES TENDON,OF COURSE,only in Haglund's and it gave...
    Post by: John Spina, Feb 3, 2007 in forum: Foot Surgery
  35. John Spina
    Post

    Cold pink foot with palpable pulses and good capillary refill

    That is a good question.I am honestly not sure.
    Post by: John Spina, Feb 3, 2007 in forum: General Issues and Discussion Forum
  36. John Spina
    Post

    Haglunds in an elite marathon runner

    I am not sure of the difference between Haglunds and pump bump myself,in fact I think that they are one and the same.
    Post by: John Spina, Feb 3, 2007 in forum: Foot Surgery
  37. John Spina
    Post

    Patient with painful hallux rigidus

    I think that felt would help.I'd put 1/4 inch felt Morton's extension there as I do not think that 1/8 inch will be good.
    Post by: John Spina, Jan 30, 2007 in forum: Biomechanics, Sports and Foot orthoses
  38. John Spina
    Post

    5th nail as marker of onychomycosis success

    Honestly,I never gave this much thought,but now that I think of it,yes,that makes sense.
    Post by: John Spina, Jan 29, 2007 in forum: General Issues and Discussion Forum
  39. John Spina
    Post

    Location of foot pain in pes cavus

    In cavus foot,I usually see pain sub 1 and 5 mts plus under the heel.
    Post by: John Spina, Jan 29, 2007 in forum: Biomechanics, Sports and Foot orthoses
  40. John Spina
    Post

    Reimbursement for palliative foot care

    Here in the USA,pallative foot care is reimbursed if certain criteria are met.For callus debridement,the patient should have PVD and for...
    Post by: John Spina, Jan 18, 2007 in forum: Diabetic Foot & Wound Management
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