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By Affiliated Foot & Ankle Care
December 02, 2016
Tags: Untagged

With winter fast approaching, you may think cold feet are just the norm for the season. Digging out your fur-lined boots or wearing an extra pair of socks may help, but feet that are constantly cold can be a sign of a bigger problem. Most often, chronically cold feet are an indication of poor circulation. At Affiliated Foot & Ankle Care our podiatrists, Dr. Varun Gujral or Dr. Nrupa Shah will be on the lookout for potentially serious causes of cold feet, including:

  • Peripheral Artery Disease—this is a narrowing of the peripheral arteries that bring blood to your legs and feet (as well as other parts of your body). It is similar to coronary artery disease and has the same risk factors: smoking, heart disease, high blood pressure and history of stroke. Your podiatrist can evaluate the circulation to your feet by checking for pulses.
  • Diabetes—poor circulation is often associated with this disease.
  • Raynaud’s Phenomenon—cold feet accompanied by changes in skin color from normal to a bluish white can be a sign of Raynaud’s Phenomenon. This condition mostly affects women and stress, smoking (which has a negative impact on circulation) and certain medications can all trigger symptoms.
  • Hormonal abnormalities
  • Nerve issues, such as peripheral neuropathy or fibromyalgia
  • Autoimmune disorders, including scleroderma lupus

Get Checked

Due to the wide range of reasons that feet can be constantly cold, it’s important to make an appointment at our Monroe, Monmouth Junction or Edison office to have your feet examined. The foot doctor has a number of different ways of evaluating your feet and will also take a detailed medical history that can reveal inherited tendencies toward foot problems. Treatment will, of course, depend on the final diagnosis but may include medication, lifestyle changes and referrals to other physicians. If you suffer from chronically cold feet, contact us today at: 732-662-3050.

By Affiliated Foot & Ankle Care
November 22, 2016
Category: Foot Surgery
Tags: Untagged

At Affiliated Foot & Ankle Care we know that telling a patient he or she needs podiatric surgery usually brings a stressful reaction. While no one looks forward to a surgical procedure, for many toe, foot and ankle conditions, surgery can provide correction of a problem that will be mean relief from pain and much greater mobility. Some conditions that can be addressed successfully through surgery include: toe deformities, tumors, flatfeet, heel spurs, fractures, joint disease, Neuromas and bunions.

Know What to Expect

Our podiatrists, Dr. Varun Gujral or Dr. Nrupa Shah want to be sure you feel 100% comfortable and confident in your surgical procedure. The key to reassurance is asking questions that will prepare you for what is to come. Here are some issues you may want clarification on:

Where will the surgery be performed? In many cases today surgeries can be performed in the doctor’s office or at an outpatient surgical center.

What type of anesthesia will be used? You’ll want to know if you will have local anesthesia, be completely knocked out or have some combination of local anesthesia and sedation. Most likely, you’ll need someone to drive you home after the surgery, but be sure to confirm this with the foot doctor.

How long will my foot have to be immobilized? It’s important to protect the area operated on after surgery and most patients will need one or more of the following: bandage, splints, cast, surgical or open shoes.

What will my recovery be like? The type of pain relief you’ll require, how long you’ll have to stay off your foot or limit weight bearing, when you’ll be able to return to work and other activities and other post-operative information will help you plan for the days and weeks after your surgery.

Will I need additional therapy? Most likely the foot and ankle surgeon will recommend some post-surgery exercise to help with the recovery process. This may include physical therapy or physiotherapy as well. Ask whether you’ll require special shoes or orthotic devices for the short or long term following surgery.

Getting answers to these and any other questions you have before surgery will set you mind at ease and help you anticipate what the days after the procedure will bring. If you have additional questions about a particular upcoming surgery, don’t hesitate to contact our Edison, Monroe or Monmouth Junction office at: 732-662-3050.

By Affiliated Foot & Ankle Care
November 15, 2016
Category: Diabetic Foot Care
Tags: Untagged

November is National Diabetes Month and here at Affiliated Foot & Ankle Care we work with many patients who have this disease. Good foot health is essential for controlling diabetes and preventing some of the more serious conditions that can occur, such as ulcers and wounds on the feet and Charcot Foot. We believe in a total body approach to diabetes. This includes regular examinations by our podiatrists, Dr. Varun Gujral or Dr. Nrupa Shah, taking medications and following the treatment plan of your other physicians, and exercising and watching your diet. Below are some nutrition do’s and don’ts that can help make it easier to maintain proper blood sugar levels:

Do: just eat when you’re eating. Doing other activities while you eat can result in eating larger quantities.

Do: eat a wide variety of foods. Picking different foods each day from each of the food groups will help ensure that you get the vitamins and nutrients you need and also ward off boredom with eating healthy foods.

Don’t: fry foods. Look for lean cuts of meat and poultry and fish and try grilling, broiling or baking them without adding oil, butter or other fats.

Don’t: swear off carbohydrates but instead choose whole grains for at least 50% of the carbs you consume. These include oatmeal and whole grain cereals, brown rice and whole wheat bread.

Do: plan what goes on your plate. Fill at least half your plate with vegetables and fruits. Also, switch to a smaller size plate to help with portion control.

Do: look for flavorful ways to season your food instead of salt. Peppers, citrus juices, herbs and salt-free seasoning blends can all help punch up the taste of food without salt, which can increase blood pressure.

Don’t: skip meals. This can lead to drops in blood sugar levels that can leave you moody, unable to focus and so hungry that you overeat at your next meal. Regular meals and snacks that add up to a balanced diet are a better strategy.

If you have additional questions about managing your diabetes and maintaining a diabetic foot health regimen, contact our Edison, Monroe or Monmouth Junction office at: 732-662-3050.

By Affiliated Foot & Ankle Care
November 08, 2016
Category: Uncategorized
Tags: Untagged

At Affiliated Foot & Ankle Care we find that many times patients are uneasy when told they need to have an MRI or Computed tomography to help find the cause of foot pain. Sometimes the physical examination that our podiatrists, Dr. Varun Gujral or Dr. Nrupa Shah  conduct does not provide a comprehensive view of what’s going on with your foot or ankle. Fractures, joint issues, heel pain and other conditions may require advanced imaging studies to diagnose and evaluate. Here are some that are commonly used in our Edison, Monroe and Monmouth Junction offices:

X-rays—This is probably the best known and most familiar diagnostic imaging tool. X-rays use radiation to take a picture of the structures inside your foot and ankle. X-rays can show fractures, foreign objects (such as glass or metal), reveal whether a child’s bones are developing properly, how far arthritis has progressed or how a bone is healing. If you are pregnant, it’s important to let the podiatrist know. Women who are expecting should not have x-rays.

Computed tomography (CT)—Also known as a CAT scan, this test is a type of x-ray imaging that shows a cross sectional image of the foot or ankle, giving the podiatrist a 3D image. Although CAT scans can be used to view some of the same things as x-rays, they can more specifically pinpoint a suspected abnormality. This test should also not be done on pregnant women.

Ultrasound—Using sound waves to produce an image, ultrasound is a safe, painless way to diagnose a wide variety of ankle and foot problems and is particularly good for soft tissue evaluation. Some conditions that ultrasound can help evaluate include: bursitis, tarsal tunnel syndrome, Neuromas, heel spurs and injuries to tendons, ligaments or cartilage.

Magnetic resonance imaging (MRI)—the device that is used to produce an MRI uses a large magnet and radio waves to produce 3D images of both soft tissues and bones. It is useful in assessing injuries, infections, tumors and arthritis. This test is time consuming—usually 60-90 minutes to do the whole foot—and people with implants such as pacemakers, artificial heart valves, inner ear implants, etc. may not be good candidates for this type of test.

It’s important to give the foot doctor a complete medical history in order to avoid having an imaging test that is inappropriate for you. If you have questions about a diagnostic or other procedure that the podiatrist has recommended, contact us at: 732-662-3050. We want our patients to feel comfortable and confident about all foot health procedures.

By Affiliated Foot & Ankle Care
November 02, 2016
Category: Diabetic Foot Care
Tags: neuropathy  

According to the American Diabetes Association, about 29 million Americans have diabetes. At Affiliated Foot & Ankle Care one of the areas of major podiatric concern that we work with our diabetic patients to identify and treat is neuropathy. Nervous system damage affects well over half of patients with diabetes, causing a loss of sensation in the feet and hands. Your nerves are what relay messages to your brain about pain, touch and temperature. When these pathways are damaged, patients are less likely to perceive injuries, which in the case of diabetic patients, can lead to dangerous ulcers and even amputation.  Because another condition associated with diabetes is reduced circulation, healing of an injury can take a very long time and lead to serious infections. There are ways to help minimize nerve damage if neuropathy is caught in its initial stages. That’s why it’s important to recognize the symptoms of nerve damage. These include:

  • Tingling or pins and needles sensation in the feet
  • Unsteady on your feet; difficulty feeling your feet when you walk
  • Stabbing or shooting pain in your feet
  • You have gotten a blister or cut on your foot and have not felt it
  • Your feet get very cold or very hot
  • Numbness
  • Feet and legs hurt at night
  • Muscle weakness in feet and legs
  • Feet appear to have changed shape

Be Proactive in Preventing Nerve Damage

If you have noticed any of the above symptoms, you need to make an appointment with one of our board certified foot and ankle surgeons, Dr. Varun Gujral or Dr. Nrupa Shah as soon as possible. The podiatrist will examine your feet and has a number of ways of testing and assessing the nerve pathways to and from your feet.

As a patient with diabetes, and particularly if you are having trouble with lack of feeling in your feet, you should check your feet daily for signs of injuries or changes. Regularly scheduled visits with your podiatrist should also be part of your care regimen. If you haven’t already discussed regular podiatric care with the foot doctor or you have questions about your feet and diabetes, contact our Edison, Monroe or Monmouth Junction office today.





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