A membership and active participation in the American Podiatric Medical Association and the Indiana Podiatric Medical Association offers multi level support for your doctors.

Through these associations, particularly the Indiana Podiatric Medical Association, we have access to the expertise of other doctors. We also have the encouragement of a group that promotes education for members in new technologies and treatments. We are trained and encourage to educate patients on proper foot care and how that is related to the patient’s overall health.

The Indiana association was organized in 1928 according to the IPMA website with the intention of improving professional standards, arts and sciences of podiatric medicine, and encouraging continued, lifelong education and learning for podiatric professionals.

I am proud to be president of the board of trustees for the Indiana Podiatric Medicine Association. I believe that networking and offering connection between Doctors of Podiatric Medicine brings benefits to the doctors and their patients.

A patient who endures other health issues such as diabetes, will need podiatric expertise to be able to live a full life with as much use of his or her feet as possible. At Hoosier Foot and Ankle, the doctors are all dedicated to providing foot health care which can prevent unnecessary amputation at the furthest chance.

For further diabetic care, through our podiatric networking, we’ve observed that diabetic patients who have foot pain may be suffering from equinus. To add an uncomfortable, sleep disturbing brace to the burdens already borne by the diabetic is not our best practice. This year, because of a personal foot injury which resulted in equinus in my own foot, I developed an adjustable brace that can provide intelligent treatment to equinus. I am proud to make this brace available for sale to other doctors who see the same conditions.

We’re ready to treat emergency sports injuries with the skills we have because of our strong association. We’re dedicated to treating pediatric foot conditions such as club foot with our experience and skill.

As members of the state and national association, we and our patients gain because we are now in a position to learn more. As the example of the brace illustrates, we also are in a position to share information and technology with others for the benefit of their patients.

The organizations that bring podiatrists together are more than a medical political statement, they are useful and practical for both doctors and patients. As president of the board of trustees for the Indiana Podiatric Medicine Association, I want to encourage Indiana podiatrists to join us in our mission to serve the foot care needs of Indiana. Make the decision and contact the association today. If you have questions or reservations, please contact us.

Indiana Podiatric Medical Association
101 W. Ohio Street Suite 780
Indianapolis, IN 46204
317.222.3847 (phone)
317.222.3849 (fax)
inpma@indianapodiatric.org (email)

That discomfort led to research on equinus treatment and several questions. Is it necessary to wear the stretching braces at night and to wear them all night?  Is there no way to make a brace more compatible with the patient’s body.

As a result of the research, I designed and invented a brace that treats equinus in an intelligent manner.  We even named it the EQ/IQ brace.

To answer one of those questions, the EQ/IQ brace, intelligent management for equinus, does not need to be slept in. I recommend using it 30 minutes in the morning and 30 minutes in the evening with 15 minutes spent stretching the Gastroc-Soleus complex and 15 minutes spent stretching the Soleus.

 As we look at features of the EQ/IQ brace from proximal to distal —

Yes, the EQ/IQ brace can be personalized for the patient’s needs. There is an above-the-knee extension with a hinge at the knee. The extension allows the knee to be locked into extension to stretch the Glastrocnemius muscle. The hinge can be released to allow for ease of application and isolated stretching of the Soleus. There is also a hinge at the ankle joint which allows the treating physician to set exactly the amount of dorsiflexion desired based on the patient’s biomechanical exam. I estimate 5 degrees the first month increasing to 10 degrees the second month, then if needed, 15 degrees the third month. The hinge goes from -30 degrees to +30 degrees, in 5 degree increments.

 More about the EQ/IQ

Rocker Soles:

I designed the EQ/IQ brace to be ambulatory with a negative heel rocker sole, which allows ambulation with a fixed dorsiflexed position.

The rocker soles can be removed. Three different sizes (5, 10, and 15 degrees) are included with the brace to match the amount of ankle joint dorsiflexion.

Adjustable Wedges:

There is an adjustable wedge that goes under the hallux to engage the Windlass Mechanism. These wedges come in 35, 50, and 65 degree sizes and Velcro to the foot bed.

I designed varying degrees for the wedges to allow for patients with hallux limitus or rigidus.

Adjustable Uprights:

The femoral and tibial uprights are adjustable for leg and should be set by the physician

 Foot Bed Sizes:

The standard foot beds will fit a small/medium size. However, the foot bed can be replaced by an extended version that will fit a large/extra large size.

Using the EQ/IQ Brace:

I am recommending time periods for wearing the EQ/IQ based upon recommendations for manual stretching, but doubled. Most manual stretching recommendations have the stretches done about 30 minutes per day. I think an hour a day is reasonable from a compliance stand point compared to 6-8 hours at night while disturbing the patient’s sleep.

The ambulatory component of the brace is an important factor. Patients can wear the brace during ther preparations for the day – after dressing the brace is working while they perform typical morning rituals. A similar scenario would play out for the evening stretching.

How to Get the EQ/IQ Brace:

The EQ/IQ brace is being prepared for production in the next few weeks. Treating professionals such as podiatrists, orthopedic surgeons, chiropractors, physical therapists, athletic trainers may pre-order the brace at an introductory discount of $170.00 per brace plus free shipping. Later the price will increase to $200.00 per brace.

To pre-order or get additional information, contact me at 317-660-2115 or you may use the contact/comment form at the Hoosier Foot and Ankle website, available 24/7 for your convenience.

The crux of that article was about the salvage gain that can come from a decision to amputate. So often, amputation of a limb or part of it seems like a defeat in the treatment plan.

But, the incidence of some catastrophic accidents or infections due to peripheral arterial disease is a very real issue. Being able to make the treatment plan and amputate part of a foot such as occurred for the patient in the video means the patient can survive, can recover and possibly be mobile in the future.

Comments at our YouTube channel indicate that after the dreaded amputation has been accomplished, the future for a patient who recovers from the amputation has promise and comfort.

Granted, we choose amputation after making other attempts to accomplish a successful healing of foot conditions. But, sometimes, when pre-emergency efforts fail, then we can see a different type of success for the patient.

Avoid accidents when you can. Pay attention to peripheral arterial conditions before gangrene can set in. These efforts can help more than anything to prevent amputation.

When you have an emergency injury, call 800-315-1363 for help with your needs. Call for a consultation if you are fighting peripheral arterial issues. I am, with the new associate, Dr. Catoire, ready to help you at any of our five podiatry clinics in the Indianapolis area.

Remember, Our Passion – Your Solution – Innovative Podiatric Care is the tag line for Hoosier Foot and Ankle.

1. Should you treat it yourself?
2. Should you seek treatment from a podiatrist?

When considering self-treatment, you can start with RICE therapy (Rest, Ice, Compression, Elevation). Anti-inflammatory medications can help with pain and swelling; just be sure to take them according to package directions. Proper shoe gear, fitted by a professional, is helpful for several painful conditions. Another consideration for self-treatment is an over-the-counter arch support to relieve pressure and support the foot.

Here are some situations where you should seek podiatric care:

1. If you experience pain that increases with activity. This could be a stress fracture or tendon injury. Both of these conditions require immediate care to prevent more serious problems.

2. Injuries that prevent you from putting weight on your foot due to significant swelling and pain require attention as soon as you can be seen by a podiatrist. This may mean going to the emergency room to be seen by the podiatrist on call.

3. Severe pain that lasts more than 24 hours can be the result of several conditions, therefore professional care is vital for diagnosis and treatment.

4. Open wounds or sores that are slow to heal on the foot should be seen by a podiatrist. If you have diabetes or poor circulation, you should seek immediate care within 24 hours of noticing the wound. The longer a wound is present, the higher the risk of infection.

5. If you have moles or other skin lesions on your feet that are irregular in shape or color, are painful, become open sores, or have changed appearance, you should see a professional as soon as possible to have a biopsy taken of the lesion. Your podiatrist will confirm a diagnosis and help generate a treatment plan once those results have been obtained.

6. Growths on the foot are not uncommon, but when they change or become painful, they should be examined.

7. Pain that wakes you up at night or when your legs are elevated, and is relieved by walking or dangling your feet is a common sign of poor circulation. Seeing a podiatrist is a good place to start your search for relief. After an examination and possibly some simple vascular testing, your podiatrist can make recommendations for further treatment and referrals as needed.

8. If you notice flattening of one arch, which may or may not be painful, you should seek care to determine the cause and plan subsequent treatment.

9. Changes in color of your foot or lower leg compared to the other side can indicate poor circulation (white discoloration), venous conditions (purple or blue discoloration), infection or gout (red discoloration). These conditions vary in severity, but should be evaluated.

10. An ingrown toenail that is causing pain or becomes red and swollen requires a simple in-office procedure to permanently remove the ingrown portion of the toenail.

11. Thickening and discoloration of your toenail which becomes painful or spreads to other nails can be treated by either topical or oral medications or laser treatment.

12. A foot deformity that is progressively getting worse should be evaluated and your treatment options reviewed.

The internet is a helpful option to make connection with other people dealing with like conditions. You can use free resources such as Blogger.com or WordPress.com, MyBlogSite.com and many others to journal about the ways you are making your path toward tomorrow.

Your journals can be helpful to you as a way to express your trials and blessing, Your experience is valuable and now while you’ve got this down time, creating the activity can make that time seem less burdensome and can make that time pass faster for you.

Or share tips with other people just beginning the journey. Many times being able to share treatment updates and other condition updates provides a healing outlet that helps people feel better.

Reading the experiences of others and joining them in comment can help you find solutions as well.

The blogs that are already active will also reveal how people write about other everyday things besides their medical conditions.

Journal-ling about activities with friends, pets and family helps make connection with more people building a network beyond your confinement or condition.

I want to thank news sources at Angie’s List for bringing this suggestion to our attention. I hope that the idea can have value for you and I would certainly like to have you email the link to your blog back to me. You can leave a message at the Feedback about Your Appointment .

If you are a member of Angie’s List, please use the badge for our listing to access more information about Hoosier Foot and Ankle. There are some special items there for you as you search Angie’s List for Dr. Patrick A. DeHeer.

The support isn’t for every condition, but there are some such as long neglected clubfoot or  conditions developed after trauma from accidents or medical issues that truly benefit from the extra support.  Having this can make a difference on when or what weight can be placed on the limb after treatment such as surgery.  Being able to step out can speed recovery and help maintain balance skills.

The frame being removed in the video is one option for external fixators.  It  was done for a non-union of medial column fusion and a non-union of the calcaneal-cuboid fusion.

As an experienced surgeon, I use external fixations where the patient will benefit from the process and carefully monitor the process from installation to removal.

Other sources for more information about external fixators include http://www.instepankle.com/ilizarov-external-fixation-system.html> and http://www.podiatrytoday.com/article/1410

The surgery ‘operates’ as a team; when there is a checklist that everyone on the team is accountable to, then fewer errors occur. Systems are changed when the checklist calls for the change, not when someone who is already over-tasked remembers.

Actually, while lives were saved through the implementation of the checklist, there is another earlier benefit to the medical staff. Knowing that everything has been accounted for relieves incredible stress and potential for distraction at any level of patient treatment.

I’ve been looking at Hoosier Foot and Ankle to develop a working checklist for us that will benefit both patients and podiatrist. Implementation can be made smoother with a plan such as those discussed in another revealing book Switch | How to Change Things when Change is Hard, written by Chip and Dan Heath. We want to make sure we offer the best in foot care at our clinic. That means using calm wisdom to bring efficient practices to the patient along with a hearty dose of compassion and consideration.

Checklists can be useful to us to deliver our services with the highest quality possible. But we know that our patients are much more to us than a ‘tick’ on a list. And that knowledge is at the top of any list we develop.