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Mountain West Foot & Ankle Institute Mountain West Foot & Ankle Institute
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What Questions Do You Have?

  • Page 5
  • Can Gastric Bypass Surgery Cause Neuropathy?

    Yes.  Malnutrition has been shown to cause peripheral neuropathy and has been associated with alcoholism, gastric bypass surgery, intestinal disease, improper diet and will often present with a painful neuropathy.  Symptoms will present as "burning feet" and is often very painful.  In the case of Gastric Bypass Surgery, it is a problem of poor absorption of nutrients necessary for normal nerve function including B vitamins (specially thiamin, B12, folic acid and B6), copper and other important nutrients.   Since gastric bypass surgery is also associated with decreased caloric intake, it increases the probability of malnutrition.

    If you will be undergoing (or have undergone) gastric bypass surgery, discuss this possibility with your surgeon.  There may be supplements you can add to your daily intake to decrease the chances of peripheral neuropathy.

  • What Is Peripheral Neuropathy?

    Neuropathy by definition is the malfunctioning of nerves, and can occur in any nerve of the body whether sensory nerve, autonomic nerves or even muscle nerves.  Sensory neuropathy (malfunctioning of nerves that provide sensation or sensory nerves) often presents as numbness, tingling, electrical shocks or shooting pains.

    Peripheral Neuropathy specifies involvement of nerves away from the brain and spinal cord (peripheral) and usually indicates the nerves to the legs and feet or arms and hands.  Peripheral Neuropathy usually presents in the feet first, but may progress to the hands.  The causes of neuropathy may vary but are becoming more understood.

    The Neuropathy Doctor discusses this unique entity through a regular blog and free information.

  • Should I be Worried if, I Jammed my Toe and the Base of the Nail is Swollen and Puffy?

    What Happens When you Stub/Jam Your Toe?

    "Jamming" or "Stubbing" a toe is a very common injury and although it is often nothing to worry about, there are several things to keep in mind in the days that follow an injury.

    Jamming your toe, by hitting it against a hard object, kicks the body’s immune system into high gear. Blood is rushed to the site of the injury and the toe becomes enflamed. This inflammation can temporarily make the toe difficult to move. This effect is referred to as “function laesa”, which just means loss of function. If your toe continues to swell, try taking a NSAID (non-steroidal anti-inflammatory drug) like Ibuprofen to both help with the pain and take down inflammation. Also, remember to RICE: rest, ice, compress and elevate.

    Common Injuries after Stubbing Your Toe:

    Ingrown Toenail: Ingrown toenails are easily diagnosed by curving of the edge of the nail into the skin and causing inflammation, redness and significant pain. Ingrowns are caused by a variety of things- including incorrect nail trimming, tight shoes or just an inherited tendency for the nails to curve.  However, if the toenail was broken during the impact of hitting your toe, it becomes much more likely that you develop an ingrown toenail. If you start to experience these symptoms, it often helps to soak your foot in warm water and Epsom salt. If your pain continues to increase it is a good idea to have these ingrowns removed by a doctor.

    Bruising to the toenail:  A hematoma, or bruising to the nail, can cause pressure and pain.  If the pressure is bothering you, we recommend you come in to have it drained by puncturing the nail.  As the blood and fluids drain out, the pressure will be alleviated and the pain will often resolve in a day (full healing may take up to two weeks).   If the pain is minimal, however, treatment is not necessary. The toenail will be stained, and it may take several months for the bruise to grow out (Nails just grow that slowly!) For most individuals, the nail becomes pain free in a short period of time and becomes less problematic. 

    Puffy base of toenail:  This is caused when the base of the toenail is damaged after it was jammed into the nail bed.  Usually no treatment (except protection from further injury) is necessary.  Sometimes the nail will fall off over the next couple of weeks.  However, if the pain and swelling are severe, come in to get your toe drained to alleviate the pressure and allow healing with minimal pain.  Patience is the key to this injury. If your toenail falls off, try wearing Crocs, diabetic shoes, or shoes with a protective toe box to prevent further painful injury.

    Fractured toe:  Sometimes when you hit your toe really hard, it’s not just jammed, it’s broken.  If you think you may have a broken toe, the best option is to have a doctor look at it and test for fractures.  

     

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  • What is this

    When a nerve is inflammed or swollen, the bones in the ball of the foot (metatarsals) will put increased pressure on a nerve and you will feel the nerve pop up and down in the foot.  This "clicking" is called a Mulder's Click and will often be confirmation of a neuroma in that area.  A neuroma is a common cause of ball of foot pain.

  • How Do We Find The Office?

    Hey Everyone!  Here is another great tip for making your experience at our office the best possible!

    We have received a lot of feedback from our wonderful patients that most of them had a hard time finding our office. So here is a few easy things to remember when trying to find our office for the first time. 

    Our office is located at 36 North 1100 East Suite B in American Fork.

    We are south of the American Fork Hospital, we are also right night door to Excel Eye Center on the east side of 1100 East.  The front of our building says, “Forum, College of Cosmology”. Just go around to the back and you will find us.

    Also remember you can call us anytime and one of our friendly staff would be happy to guide you in. We look forward to serving you!

  • Is it normal that my child walks like a duck?

    The way your child walks is often concerning to you as you see them roll in, flatten out or even "walk like a duck". You may have some questions we commonly hear about this condition in our office, such as:
     

    Is this normal?  
    Should we do something early to ensure the child doesn't have pain later?
    Why does he/she walk this way?

     

    First of all, parents want to know if it's normal for their child's feet to be developing the way they are. While there is no one perfectly normal way to develop (many patterns lead to healthy feet) it may help to know that children's feet often rotate from infancy through the teen years as they continue to grow. So, a child's feet may point more outward than appears "normal," but that's not really a cause for concern.

     

    What should be a red flag for concern is if the child is having problems such as frequent tripping/falling, complaining about not liking running/getting tired if they are in otherwise good physical condition. If this is occurring, it may be that the child needs some assistance from a podiatrist. The best thing to do would be to bring the child in for a podiatric gait analysis. During this exam, the podiatrist will examine the way your child walks and carries herself, and look at the structure of the feet looking for things like arch height, pronation and supination, and leg length discrepancies. Usually inexpensive orthotics are prescribed based on the unique abnormalities of your child's feet. If orthotics do not solve the problem, other treatments and even surgery are available. 

     

    Second, parents want to know if this abnormal foot shape will cause their child pain later in life. The answer depends a lot on how the child deals with the abnormal shape. If the gait is affected, it's likely that there will be problems. Abnormal gait causes abnormal stress on parts of the body that aren't supposed to be stressed that way. So, it can lead to foot problems, and knee, hip and back problems also become more likely. 

    Third, parents want to know why their child walks this way in the first place. The answer is right under their nose: their own feet. Foot shape is usually inherited, which means, barring any abnormality, your child has the same foot shape as either you or your spouse, or a combination of the two. This can be troubling to parents with foot conditions, but it doesn't have to be. In fact, it can be beneficial to know what conditions kids may be prone to so that we can give preventative treatment to avoid certain conditions progressing to painful problems. 

  • Why Did My Shoe Size Change During Pregnancy?

    It is not your imagination, nor is the swelling after pregnancy the reason for shoe size changes.  In fact, the same hormone changes that occur to allow birth of a child (loosening of the ligaments in the pelvis) can also cause lengthening of the feet usually upto 1 shoe size.  As the ligaments of the feet relax from the hormone, the foot will flatten out and lengthen slightly.   This increased length causes a change in shoe size that usually doesn't return to previous size.  Sorry, but this change is usually permanent. 

    Good news is, however, that the shoe size doesn't continue to change every pregnancy, so additional births usually don't cause additional size change.

  • In Treating Neuropathy, Can I Take Too Many Vitamins?

    Before providing a more complete answer, it should be understood that anything in "excess" can be problematic.  With that understood, most vitamins are eliminated from the body without difficulty (especially the water soluble vitamins) and don't cause many problems.  With that understood, there are some noticable exceptions:

    • Vitamin B6 - Is a well known essential vitamin that can cause peripheral neuropathy in deficiency or excess.  This should be limited to less than 200milligrams per day.
      Vitamin A - Overdose occurs at 100,000 units/day and can present with fatigue, insomnia, painful bones and joints, bone growth abnormalities, hair loss, itchy skin, loss of appetite (anorexia), decreased blood clotting time, and risks of birth defects or abortions during pregnancy.
      Vitmain D - Overdose occurs at 4000-10,000IU /day and can present with muscle weakness, joint pain, resorption of bone, calcification of soft tissues, loss of appetite, nausea and diarrhea.
      Vitamin E & K - Have some studies that exhibit overdose, but with unknown upper limits are associated symptoms.

    • Supplementation is an important adjuctive treatment for peripheral neuropathy.  However, care should be exercised in supplementing (even for neuropathy) and should be done under careful direction of your physician.

  • What causes hammertoes?

    Studies have long discussed multiple causes of hammertoes, some state the primary cause of hammertoes are poor fitting shoes, others state the cause is how the foot functions or how an individual walks, and others state the primary cause is genetic. The truth is, however, that all these causes can influence the presentation or progression of hammertoes.

  • Can Ankle Pain Be Caused By Sever's Disease (Calcaneal Apophysitis)?

    Sever's Disease is an inflammation of the growth plate (physis) at the back of then foot where the Achilles tendon attaches.  The pain from this problem can present on the bottom of the foot, in the back of the heel or even in the ankle.  Although it is not true ankle pain, the motion of the ankle causes the pain (since the Achilles tendon crosses the ankle and the knee joints).

    Therefore, pain can even present at the ankle from Sever's Disease or Calcaneal Apophysitis.

  • Can a child get Plantar Fasciitis?

    Sometimes parents worry when they find out that their heel pain is caused by Plantar Fasciitis, that their children are going to develop the same symptoms in the future. If the child's then starts to also have pain in their heel, the worry of the parents only increases. However, Plantar Fasciitis is rarely (if ever) seen in children, due to the increased elasticity of the tissues.  As we get older, the tissue lose elasticity and sprains, strains (as in plantar fasciitis) or breaks are more common. Heel pain in children is actually usually caused by Sever's Disease or Calcaneal Apophysitis. Sever's Disease is most often seen in children that are very active and occurs as the growth plate in the foot is put under extra stress and becomes inflammed. Preventative measures can be taken to make sure this inflammation doesn't occur.

  • My feet are numb. Does that mean I have diabetes?

    Although diabetes is still the most common cause of numbness (neuropathy) to the feet, it is not the only cause.  There are actually close to 100 causes of neuropathy with diabetes only being one.  Diabetes is one of the causes that should always be evalauted.  For more information on numbness, see our Neuropathy page.

  • What insurance does Mountain West Foot Ankle Instiitute accept?

    Here at Mountain West Foot and Ankle Institute, we want to make it easy for you to have your foot and ankle concerns treated. Therefore, as a service to you we accept almost any insurance. We are also constantly negotiating and updating our status with many of the plans in the area.  Here is a list of the most common insurance plans we accept.
     

    • AARP
    • Aetna
    • Altius
    • Assurant Health
    • Bankers
    • BCBS
    • Beech Street
    • Car Insurance (In cases of car accident injury)
    • Care Credit
    • Caremark
    • Champva
    • CHIP
    • Cigna
    • DMBA
    • Educators Mutual
    • Eighth District Electrical
    • Everest Administrators
    • Great West Healthcare
    • HIP Utah
    • Humana
    • Mail Handlers
    • Medicare
    • Medicaid/Select Access/Molina
    • Mutual of Omaha
    • PEHP
    • Select Health/IHC
    • Starmark
    • Tall Tree Administrators
    • Tricare
    • United Healthcare

     
    It is recommended, however, that you confirm personally with your insurance plan coverage (and a list of in-network providers) prior to being seen.  We similarly will confirm your coverage with your insurance providers so that we can provide the highest quality care and you understand any costs or committments at the time of service.

    At this time, we are not able to accept Select Value.  Triwest memebers on active duty must see a doctor on base unless special permission is given.

  • What is a copay?

    As part of your contract, either as an individual or as part of an employee group through your employer, you agree to pay a co-pay.  A copay is an agreed upon amount that you as the insured pay at the time of an event, either a doctors visit or prescription purchase.  Your insurance requires that it be collected and paid at the time of service, and the doctor's office or pharmacy has no control of this amount.  The doctor's office or pharmacy are usually under contract to collect this amount and are not permitted to waive these fees.

  • I don't have a copay. Why do I owe money at the visit?

    As part of your insurance plan, whether individual or employer provided, you as the insured will have commitments to pay portions of benefits or bills.  This may be a simple copay, coinsurance or deductible.  Often you will have an  out-of-pocket limit or maximum that is the most you will pay prior to the plan paying 100% during a calendar or benefit year. Copays do not always count toward the out-of-pocket limit and with some plans will need to be paid even after reaching this maximum.


    For additional information about your benefits, please contact your insurance plan or beneftis administrator.

  • What is coinsurance?

    Some insurance plans require a copayment (copay), but others require coinsurance.  Coinsurance is similar to a copay, but consists of a percentage, such as 20% or 30%, that is paid by the insured after reaching any applicable deductible.  This percentage is usually calculated on the insurance approved amounts and should be paid at the time of service.  Similar to copays, the doctor's office or pharmacy are usually under contract to collect this amount and are not permitted to waive these fees.

  • What is a deductible?

    A deductible is an amount, determined by an insurance plan contract, that needs to be paid for a particular service prior to plan benefits being paid.  This amount is a yearly amount and is based on a calendar year or insurance plan year.  A patient may also have more than one type of deductible on their plan (in-network deductable, an out-of-network deductable, a DME deductable, a prescription deductible, a hospitalization deductable, etc)   The doctor's office or pharmacy are usually under contract to collect this amount and are not permitted to waive these fees. 

    Please contact your insurance company or benefits manager for additional information about your deductible.

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