Fungal Toenails Treated with Laser and KeryFlex

Dr. Gary Prant

The problem with every treatment for fungus toenails is that you have to wait for the healthy toenail to grow out to have your nails look really decent. While it’s true that when we “debride” the toenail (a fancy medical word for thinning it down), it looks a lot better, it is not as smooth or attractive as we would like.  Many times the nail is so decayed it just breaks off. So even though the fungus in the nail is “killed” the nail can be ugly and deformed.

It can take about a year, and sometimes long as two years, for the new toenail to grow out. During that time there is a risk of reinfection from the fungus. That is why it is so important to kill the fungus in your shoes and take other precautions such as applying a topical antifungal on the nails and drying the feet well.

If you want your toenails to look good immediately after the laser treatment there is one other option. After the laser treatment a KeryFlex nail can be applied to the old nail, as long as there is about 20% of the old nail left. KeryFlex is a very unique product. It is composed of keratin which is the same material that real nail is made out of. It is not a gel nail and certainly not an acrylic nail. Acrylic nails are extremely damaging for the nail bed and the nail plate which is underneath it. They do not breathe and promote the growth of fungus and bacteria. While gel nails are somewhat better they are still not healthy for the nail bed.

A KeryFlex nail, on the other hand, is made of the same material as a natural nail, and so is not damaging to the existing toenail or the nail bed. Topical antifungal medicines penetrate the KeryFlex nail just as they would a normal nail. By providing a path for the new nail to grow out, many people who use the KeryFlex nail report that there is about a 10% improvement in the final results over the laser therapy alone.

We are proud to offer the KeryFlex nail procedure after laser treatment to both eradicate your nail fungus and give you normal, healthy-looking toenails right away!

To learn more about laser fungal nail treatment and KeryFlex, call the Arbor Foot Health Center at 512.335.1800.

Posted in Austin, Foot care, Foot Health, Nail Care, Nail Restoration, Podiatrist, Toenail Fungus | Tagged , , , , , | Leave a comment

An Ugly Laser for Beautiful Toenails

By Dr. Gary Prant

At Arbor Foot Health Center, we have three lasers in our office. Two are reasonably attractive pieces of equipment. The third, an ugly duckling laser, has a design that only an engineer could love. The machine has a gunmetal gray case with red LED indicator lights. Rather than a slick, thin fiber optic cable to carry the laser beam, it has a large laser head – heavy, awkward, and ugly! Ahhh! But, as any engineer will tell you, it’s what’s inside that counts!well-groomed female foot with a french pedicure

When I served on a local hospital laser committee I learned a few things about buying lasers. What makes the ugly duckling laser so special is the fact that it works remarkably better than the” pretty” lasers for certain things – most notably toenail fungus. The problem with the pretty diode lasers is that in order to be effective they must generate a certain level of heat which is quite uncomfortable. To kill fungus takes a relatively high power level to penetrate the nail and kill the fungus. In the diode laser with a long pulse this makes the nail quite hot and this is painful.  The ugly laser on the other hand works with extremely fast pulses. The pulses are in fact about eight billionths of a second long. The power is extremely high but since it is on for so short of a time you cannot even feel it most of the time. Not only does this particular type of power works exceptionally well killing fungus but it also causes a cavitation effect which also helps kill the fungus.

There is nothing wrong with the diode lasers; I use them for warts and ingrown toenails, but when it comes to fungus toenails, that ugly laser is a thing of beauty!

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I “Won” a Heart CT Scan

By Dr. Gary Prant

About five years ago in a silent auction for a charitable organization, I bid on and won a Heart Saver CT Scan. The test cost $100 – all of which went to the charitable organization. What a great deal I thought. How nice was it of this cardiology group to donate the test!

Dr. Gary Prant, Podiatrist

Dr. Gary Prant

Today I read of a new $40 million extensive study of the heart CT scan. The study reveals that people who were checked with the heart CT scan after seeing a doctor for chest pain had no less risk of heart attack, dying, or being hospitalized months later than those who took a simple treadmill test or other older types of examinations. Okay, so far no problem. At least the heart CT scan is not worse than the older tests, right?

This extensive new study notes that the heart CT scan is the equivalent of 500 to 700 regular x-rays – wow! This study claims that if more people were told the radiation dose before agreeing to the test more would end up with safer alternatives. I had no idea this test exposed me to that much radiation and I’ll bet most people don’t know that.

Radiation can raise the risk of developing cancer, yet few doctors are choosing heart tests that use no radiation, this $40 million study revealed. One independent expert, Dr. Eric Topol of the Scripps Clinic in La Jolla, California was quoted as saying, “It’s such a bad reflection on American medicine. Look at how much radiation they gave these poor people, that is despicable.”

Now I feel like a fool for having undergone this test having had no heart symptoms just because I “won” it into a silent auction. The moral of the story is not only can the information high-tech tests provide us sometimes be of questionable value– sometimes the test themselves can be potentially harmful.

Caveat emptor!

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A New Treatment for Stubborn Heel Pain

Most heel pain can be cured without surgery. Unfortunately, there is no magic bullet for heel pain. Many times heel pain treatment consists of many different types of treatments and each treatment contributes a little bit. Sometimes taping of the foot will relieve up to 40% of the heel pain. Using a nightsplint can often help about 20% of the heel pain. Injections, stretching and changing shoes, avoiding going barefoot, and custom or over-the-counter orthotics also relieve a significant amount of the heel pain. All these things together almost always cure heel pain.Heel Pain

But what about those cases where all the conventional, simple, noninvasive treatments don’t get rid of heel pain – or where it is taking a really long time to see any results?

Specialized injections of PRP (platelet rich plasma) can help. However, those injections can be very expensive. I’ve had patients complain of $1,400 bills for those injections and they didn’t work! There are treatments that are simpler and less expensive, though.

Shockwave therapy has had a good track record in curing resistant heel pain. Initially there was high-energy shock wave which required the foot to be put to sleep and the use of a very expensive machine. When insurances reduced payments for those machines they all but disappeared.

Today, we are using a low energy shock wave in our office which requires four treatments at weekly intervals followed by four treatments at biweekly intervals. This treatment is inexpensive and doesn’t require anesthesia. It works by increasing the blood supply to the plantar fascia and helping nature repair the plantar fascia.

What is exciting is the combination of the shockwave therapy with laser therapy. We are using a class IV diode laser which serves to increase the ATP (adenosine triphosphate) of the cell. ATP is the energy of the cell. By using the shockwave therapy to increase the blood supply to the plantar fascia then followed by the laser which increases the energy within the cells we are seeing remarkable results using a noninvasive, pain free treatment modality.

The shockwave and laser combination along with our comprehensive plantar fasciitis protocol has tremendously increased our success in curing the most stubborn heel pain!

Call Dr. Gary Prant at Arbor Foot Health Center to make an appointment for your heel pain.  512-335-1800.

Posted in Austin, Foot care, Foot Health, Heel Pain, Laser Treatment, Non-surgical solutions, Plantar Fasciitis, Podiatrist, Shockwave therapy | Tagged , , , , , , , , , , , | Leave a comment

Too Much of a Good Thing?

Adorable ten month old baby wearing a graduation mortar board.There was an interesting article recently in the New York Times entitled “Big Baby, Smart Kid.” The article notes that about half of all births in the United States are hastened by either drugs or surgery which is approximately double the amount in 1990.

The article goes on to note that a huge new set of data based on every child born in Florida over an 11 year span is calling into question some of the most basic assumptions of our “ medicalized”  approach to childbirth. The authors note that the results also play into a larger issue. There is a growing sense among many doctors and other health experts that Americans would actually be healthier if our healthcare system were sometimes less aggressive.

Everyone from CBS News, to Kaiser Health News and Harvard have published articles about the dangers of excessive testing.  Excessive testing can result in invasive procedures which can carry a greater risk than the original condition and there is also in some cases risk from the test itself.  Think about this though – the expense and risks of testing are a statistical thing that experts say apply to the population as a whole.   When it comes to ourselves — we want to know more and fix anything that could hurt us.  We want to know exactly all of our diagnoses.  We want to be able to do something about our diagnosis – even if that is not always the best course of action.

What about common surgical procedures?   I see in my practice people who have a bunion and even if it is causing minimal or even no pain they want to have it fixed.  Why, because we are Americans and we see a problem we address it and solve it!

The bias towards medical intervention is not just seen in practice, it is also in the medical journals.  When people who have undergone surgery are asked if they would do it again, invariably almost all of them say yes.  To my mind this is one of the most bogus statistics ever used.  Think about it.  If you go through a painful and expensive procedure which may require long recovery — are you ever going to say that it was not worth it?  Besides after a person has recovered from surgery they often don’t exactly remember the level of pain they had before the surgery.  Now, of course most people that have surgery derive great benefit and great relief of pain from surgical procedures.  What I’m saying is that sometimes these procedures are overused and even if a person does not get a great benefit from these procedures they will not usually admit to it.

The takeaway is that sometimes it is best to not test everything or medically intervene in every biological process.  Sometimes babies do better if left to mature as nature intended and not everything on a foot or anywhere else should be corrected.

Dr. Gary Prant

Arbor Foot Health Center

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The Blow Dryer-Athlete’s Foot Connection

When you have been in practice for some time you start getting feedback from your patients.  It is very interesting to hear what sticks with patients and also to hear what advice you offer is actually useful for your patients.Black Hair Dryer

Last week this was driven home to me by a patient telling me that the most valuable thing he had learned from me was to blow dry your feet when you get out of the shower.  I have been saying this for many years because I have found it to do be a simple and fairly effective way to prevent recurrent athlete’s foot.

Fungus on the foot is particularly difficult to solve because the feet are in a dark, warm, moist environment, (a shoe), for most of the time.  In fact there was a recent study looking at fungus on the skin of different parts of the body.  In most areas and of the body there were between four and five different species of fungus.  On the foot however, there were vastly more numbers of different types of foot fungus species.  The heel of the foot had approximately 80 different species of fungus and the toes had between 40 and 60 different species of fungus.  The experts who did this study were at a loss to explain why the foot has so many more different species of fungus than anywhere else on the body.

To my mind, anyone with common sense would realize that there are vastly more types of fungus on the feet simply because of the aforementioned dark, warm, and moist environment of the shoe.bigstock-Itchy-Feet--45520456

So what does blow drying the feet after a shower do?  Blow drying the feet removes the residual moisture on the skin from the shower and it seems to help inhibit the growth of fungus.  The nice thing is blow drying the feet only takes a second, doesn’t involve an expensive medicine, and seems to be fairly effective in preventing recurrent athlete’s foot.  Many patients have told me that since they started blow drying their feet, they no longer have recurrent athlete’s foot infections.

To find our more about Dr. Gary Prant, visit our website at www.arborfoot.com.

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High Deductibles Are Not The Answer!

Dr. Gary Prant

Insurance companies are promoting high deductible insurance plans as a way to slow the growth of healthcare costs. The theory is that people’s healthcare decisions will be better if they have some “skin in the game.” Certainly for insurance companies this has been a bonanza. In an insurance plan with a $3000 deductible, the first $3000 of expenses are paid by the insured. Many people don’t have $3000 of medical expenses in a year and so get little or no benefits paid by their insurance company. The main benefit for all expenses below $3000 is that the insurance company will re-price the doctor’s bill and hopefully give the patient who is paying the fee a discount for the service which is less than the original price the doctor billed to the insurance company. But many doctors and hospitals have a lower price for services paid in full at time of service – a cash price.Healthcare In The Unted States Of America

There is a problem with the high deductible logic that I have always suspected, and only recently seen confirmed. In the June 2014 issue of Money magazine there is an article entitled “High Deductibles Create Real Pain for Thrifty Men.” This article quotes a study from the Employee Benefit Research Institute which notes that people in high deductible plans cut spending not only by rejecting name brand drugs that treat chronic conditions but also by failing to even use the generics. That finding corroborates a 2013 study showing that “men in high deductible plans avoid treatment for serious issues, at times with adverse consequences.” Other research has shown that large deductibles discouraged emergency room visits for minor ailments such as sore throats but last year’s study also found that men in particular pinch pennies by not going to the ER for even potentially serious problems such as irregular heartbeat or kidney stones. In a chart accompanying the Money magazine article there is the startling statistic that men in high deductible plans are 34% less likely to visit an emergency room for a serious health problem than men in low deductible health plans!

The Money magazine article concludes by suggesting that consumers increased their utilization of 24 hour advice hotlines sponsored by insurance companies and large employers.

Don’t get me started about the American healthcare system! Americans spend $2.5 trillion on health care a year. Meanwhile the United States ranks 45th in life expectancy behind Bosnia and Jordan: near last in infant mortality compared with other developed countries: and last in healthcare quality, access, and efficiency among major industrialized countries, according to the Commonwealth Fund, a healthcare research group. There are many things that can be done to improve the American healthcare system; high insurance deductibles are not one of them.

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