On Wednesday June 20 2012 I boarded a plane in Toronto (and paid way too much in taxes) to fly to Cleveland Ohio for an international meeting of the Academy of Ambulatory Foot Surgery, where we teach surgeons to perform  minimally invasive foot surgery for bunions and other foot problems using local anesthetic .The conference was held at the Emabssy Suites in Independence, Ohio, a suburb of Cleveland, home of the Rock and Roll Hall of Fame and the Ohio College of Podiatric Medicine. 

This was exciting for me on many levels.

For one thing, I hadn't been to Cleveland in many years (decades). I was born and raised in Toronto and graduated from the University of Toronto in 1975 with an Honours Bachelor of Science degree in 1975 (I was very young at the time). I then moved to  Cleveland to attend the Ohio College of Podiatric Medicine in September 1975. (To become a podiatrist you first must have a Bachelor of Science degree which is followed by four years at a college of podiatric medicine). After four years of hard work (and some fun with my mostly American class mates), I received my Doctor of Podiatric Medicine degree or D.P.M. in May of 1979 (I was still very young). I then did a one year hospital based residency in foot surgery at the Broad Street (do you remeber the Broad Street bullies?) Hospital and Medical Center in Philadelphia which I completed in July 1980. (Current graduates are doing three year surgerey programs - unfortunately the Ontario government, in its finite wisdom, will not allow these graduates to practice in Ontario as podiatrists). I then stayed in Philadelphia to study minimal incision surgerey, also known as ambulatory foot surgery, and more recently, minimally invasive surgery, under one of the pioneers of the techniques, the late Dr. Abram Plon.

Getting back to Cleveland, this was a chance for me to see the new facilities at the new Ohio College of Podiatric Medicine in Independence Ohio as well as some of my old friends from school.

As I mentioned, it takes four years to get the Doctor of Podiatric Medicine degree. My class spent our first year (freshman year as they say in the U.S.) at a very small, old facility on Cornell Road on the campus of Case Western Reserve University.

In second (sophomore) year we moved into a new, modern, larger, renovated facility at 105 and Carnegie Rd. It was very exciting to be in a facility that was second to none in the podiatric world. My class graduated from that facility in 1979.

Approximately five years ago, the school building was sold to the Cleveland clinic, apparently for a lot of money and the school moved to its new, fabulous facility, in Independence. I was finally going to see it! (This is actually very exciting for a podiatrist). The conference was taking place in the new school, the students were invited to attend at no cost, podiatrists and orthopedic surgeons would be attending from all over Canada, United States, Latin America and even Australia and I had the honour of being invited to present  two surgery lectures to this distinguished group.

I arrived at the hotel Wednesday afternoon (how can you beat the Embassy Suites? $98.00 per night includes breakfast - thank you omlette guy - and afternoon snacks. This is what makes The U.S. great!) and immediately walked next door to the O.C.P.M. I couldn't wait to see it!

The new school is a very short walk from the hotel so I parked my bags and walked over.

I was fortunate to be able to get a short tour of the facilities. The rather large building featured modern, roomy classrooms with the latest computerized display boards, an up to date anattomy lab, a large library with row after row of computers where students can supplement their classes with online tutorials, a nice lunchroom and plenty of administration offices. While I was there, I managed to pick up some O.C.P.M. jerseys, since, as of July 1 2012 my alma mater was becoming part of Kent State University (I wonder what Neil Young would think about that) so the Ohio College of Podiatric Medicine was becoming the Kent State University of Podiatric Medicine. Those jerseys will undoubtedly become collectors items.

That evening, as one of the trustees of the Academy of Ambulatory Foot and Ankle Surgery, I attended our board meeting where we elected my good friend, Dr. Ed Cohen, as the new president of the academy. I had the honour of being asked to be a trustee for another year. I accepted.

Later that evening, after the meeting, I had the pleasure of having dinner with my best friend in podiatry school, Dr. Rustom Khoury, and his lovely wife Mary, at their home in a nearby suburb. It was great to see them.

In a future blog I will tell you a little bit about the seminar.

New president, Dr. Cohen on the left. That's me on the right.

According to reports, Seattle Mariners centre fielder Franklin Gutierrez is suffering with heel pain due to  plantar fasciitis. If not treated appropriately, plantar fasciitis can be devestating to a professional athlete since they need their feet to be free of pain in order to run quickly and efficiently. If not treated properly, palntar fasciitis can become a nagging problem.

The plantar fascia is a broad, dense ligament that begins at the plantar (bottom) surface of the calcaneus (heel bone), runs along the arch, giving it support, and ends at the toe bones.

Classically, someone with planatar fasciitis will experience sharp or dull pain in their heel or arch with the first few steps in the morning and following a period of rest. This is called post kinetic dyskinesia. The foot tends to feel betterwith stretching and a little bit of walking. It the person with plantar fasciitis spends a lot of time on his/her feet during the day and sits for a while (watching T.V. or eating dinner), it tends to be very painful when he or she gets up to walk again. It may not be terribly painful during exercise but usually will hurt later or the next morning.

In my Toronto podiatry office, I encourage patients with plantar fasciitis to replace their shoes if they are showing signs of wear, in order to support and protect the foot. I may recommend off the shelf arch supports to give cushioning or made to measure orthotics fabricated from plaster casts of their feet in order to improve the biomechanics and relieve excessive stretching of the plantar fascia.

In my Toronto foot clinic, I may recommend a non-steroidal anti-inlammatory medication (or N.S.A.I.D.) to releve the associated pain and inflammation, such as Aspirin (A.S.A.), Motrin (Ibuprofen), or Naprosyn (Naproxen). Another good medication is Celebrex (Celecoxib). I will also consider a cortisone injection.

However, many people do not wish to take anti-inlanmmatory pills because they are not good for their blood pressure, heart, stomach and bowels. Many also do not want cortisone injections because they can cause discomfort and also weaken the connective tissue. For those people, I offer sound wave and laser treatments.

If you or a loved one is suffering from heel pain or arch pain due to plantar fasciitis, or other foot problems, please call my Toronto podiatry office today at 416-486-9917 for a private consultation. My staff and I will do everything we can to get you back on your feet.

I believe it is essential for the modern podiatrist to attend medical conferences on a regular basis in order to stay current so that I can provide the most up to date care for my patients in my Toronto podiatry clinic. The Chicago conference was the third meeting I have been to in 2012. I previously attnede a seminar in Pittsbugh in February and a surgical conference in Barcelona Spain in January 2012.

I had the pleasure of attending several lectures on wound care, bunion surgery and laser treatments for toe nail fungus. Most of the laser companies were represented, including CoolBreeze laser (made by CoolTouch or Cool Touch), Cutera Genesis laser (Cutera),  Pinpointe or Pinpoint laser (Cynosure),  ClearSense laser or Clear Sense (Sciton),  Q-clear Q-switched laser (Light Age)  and the Fox diode laser. I discussed protocols with the company reps and other podiatrists and compared them to how I treat fungal nails using my long pulsed laser in my Toronto podiatry office.

I learned about the latest in digital X-ray technology including Reina 20/20 P-DR (20/20 Imaging), Simon Marathon (SimonDR), iCR3600 (iCRco) and ScanX (AllPro Imaging).

While I was there, I ordered some inexpensive soft insoles to provide  cushioning for patients who do not need custom orthotics, as well as some surgical instruments for use when I perform minimally invasive surgery to treat bunions (hallux valgus) hammer toes (crooked or contracted toes), bone spurs, corns and calluses (osteotomies) with local anesthetic in my office.

I also ordered some textbooks on antibiotics, diseases of toe nails and a textbook called Minimally Invasive Surgery of the Foot and Ankle for which I had the honour of writing a  chapter called "The modified Wilson osteotomy for the correction of hallux valgus" which is a technique  I use for treating bunions in my office with local anaesthetic. This type of foot surgery involves specialized instruments and reduces soft tissue trauma which can mean less pain and swelling and quicker return to normal activities following foot surgery.

For more information on minimally invasive foot surgery and laser treatment for thick yellow fungal toenails , or onychomycosis, please call my office today at 416-486-9917. My friendly staff will be happy to answer your questions and arrange a private consultation with me.

All work and no play makes Sheldon a dull boy, so I managed to go out for dinner and I caught the Chicago production of Jersey Boys, one of my all time favourite musicals about the life and times of Frankie Valli and the Four Seasons. After the show, I said hello to Joseph Leo Bwarie who plays Frankie Valli. I told him that I liked the show so much even after seeing it twice in Toronto that I couldn't turn down a chance to see it again  in Chicago. He was very personable and asked me lf I remembered which cast I saw in Toronto. I told him that I remembered him and several others of the Chicago cast from Toronto. I picked up an Jersey Boys poster autographed by the cast. I will get it framed and put it up in my Toronto podiatry office beside my Beatles and Elvis posters. If the show comes to your area, see it. You will enjoy it.