Searching For Answers In The Measurement And Treatment Of Pain

Stephen Barrett DPM FACFAS
8/10/12 | 2030 reads | 0 comments
I was so excited the other day when the package finally arrived at my doorstep. I had ordered it months ago and was expecting a really large box filled with the latest in fantastic gadgetry. I love gadgets probably like no other person but when they can give me a leg up on clinical management, this love escalates to a level that would render most folks to sedatives and restraints. Read More.

Slicing A Patient's Complaints Down One Layer At A Time

Stephen Barrett DPM FACFAS
7/10/12 | 2305 reads | 5 comments
The “onion” is more common than rare and every practice is filled with them. Onions are easy to identify most of the time as Ms. Tuber, our fictitious representative of the onion phyla, always presents with a list of multiple complaints. (By definition, a patient can still be an onion with only one chief complaint. We will get to that later.) Read More.

Rethinking The Role Of The 5.07 Semmes-Weinstein Monofilament

Stephen Barrett DPM FACFAS
6/12/12 | 3445 reads | 1 comments
As a deputized epidermal protector, I was overcome by sadness as I read the report from Ferreira and colleagues.1 How could this be? I had always believed in this sacred agent, this bodyguard of all bodyguards. Surely, the report must be mistaken. Could this be a rogue report? Read More.

Why Focusing On Tidbits Of Information Can Lead You Down The Wrong Diagnostic Path

Stephen Barrett DPM FACFAS
5/11/12 | 2776 reads | 0 comments
I had a very interesting patient come in last month. Sadly, she was in an automobile accident about four years ago, which resulted in an intracranial bleed. She ended up with severe vertigo and loss of strength on her left side. The car hit her from the left side, causing trauma to the entire aspect of her left side, including an ulna fracture as well as a tibial plateau fracture of the left knee. Read More.

Should We Run Barefoot?

Stephen Barrett DPM FACFAS
4/13/12 | 3579 reads | 0 comments
A few weeks ago while on a flight to some forgotten city from another forgotten city, the gentleman next to me started up a conversation. As I recall, it was one of those deals where I wanted to sleep as it was an early morning flight. Unfortunately, the conversant was not of high enough social IQ to discern this so he pressed on. “What do you do?” he asked. Still trying to scratch the sand out of my eyes, I replied, “I’m a podiatric surgeon.” Read More.

Ramping Up Our Knowledge Of Pain Management

Stephen Barrett DPM FACFAS
3/13/12 | 2635 reads | 1 comments
No matter what surgical procedure or even rudimentary treatment you offer, the patient outcome is only as good as what the patient “thinks” about the result. You know what I’m talking about. You just did an incredible piece of work, the foot looks great and you’re ready to send off the X-rays for inclusion in the next edition of McGlamry’s Comprehensive Textbook of Foot Surgery. Suddenly, the air gets sucked out of your chest faster than it takes to blink and the patient says: “I don’t think it looks that good, Doctor!” Read More.

When Will We Start Calling Morton’s Neuroma What It Is: Morton’s Entrapment?

Stephen Barrett DPM FACFAS
2/9/12 | 4136 reads | 0 comments
In the December 2011 issue of Foot and Ankle Specialist, there is an interesting article titled “Long-Term Results of Neurectomy in the Treatment of Morton’s Neuroma: More Than 10 Years’ Follow-Up.”1 What is interesting about this article? There are several things really. First, in an inset sidebar on the first page of the article, it says: “… the cause of Morton’s neuroma remains unclear, and its etiology and treatment remain matters of controversy.” Read More.

Can Sesamoiditis And Hallux Valgus Be A Nerve Entrapment?

Stephen Barrett DPM FACFAS
1/11/12 | 3102 reads | 0 comments
Several weeks ago in the pre-op area, I greeted a patient and started going over the planned surgical procedures we had listed on her informed consent. She was here for her second extremity surgery. We had performed peripheral nerve decompressions for her six weeks previously. She did well and wanted to have the other side done. Read More.

Breaking Out Of Our Apathy About Plantar Fasciopathy

Stephen Barrett DPM FACFAS
12/16/11 | 5122 reads | 1 comments
As I wrote in last month’s blog, I want to know more about human plantar fascia (see http://bit.ly/vDJesC ). I know you do as well because of the overwhelming response I had to the upcoming largest paper ever published on the subject of plantar fasciopathy. My goal is to have data on 1,000 plantar fascia, which come to the office cloaked in the simple costume of heel pain. I want to know what these fascia look like with high-resolution diagnostic ultrasound. Read More.