Acorn August 1999
I want to thank all of you Acorn
readers who tell me they read this column and have missed it the last couple of
months. I have been busy. As the current sitting President of the Westlake
Sunrise Rotary Club I was sent to the International Convention in Singapore with
a side trip to Thailand. This was a wonderful chance to experience a culture
that I never thought I would get to see. Thailand is just coming out of a
depression and the country is slowly coming back to life. Lunch for two in
Thailand can be had for as little as $5. Singapore is a different story. They
managed to survive the “Asian Economic Flu” and $5 barely gets you Starbucks
coffee for one.
In the office I have been busy
getting caught up on all the people I did not see when I was gone. I returned to
a surgery schedule booked two months in advance. I was doing one of these
surgeries, a bunion, this morning when a delightful thing happened. The surgical
tech commented on how well all of the podiatrists on staff do bunion surgeries.
It reminded me of a similar comment I heard from another surgical tech at the
hospital a few years ago that “podiatrists treat feet the way ophthalmologists
treat eyes.”
Knee, hip, back and shoulder
surgery command high respect in the orthopedic world. They are relatively large
structures, produce dramatic results when they are performed and have a
reasonably high degree of tolerance. Our local orthopedists are very good at
these procedures. They are so good that I am surprised when I hear one of my
patients say they are going anywhere else to have them done.
Bunion surgery, on the other hand,
does not rate so high on the glamour list.
The structures are small, it is technically difficult to get everything
aligned just right and it has precious little tolerance for errors. A tiny
little error in foot surgery is magnified many times when you stand on your foot
for hours. The only way to minimize the little errors of any surgery is by doing
them week in and week out. That is why your local podiatrists have managed to
create such a great track record in bunion surgery. It is quite uncommon for one
of us to have a serious complication. That cannot be said for those surgeons
who, no matter what their training, do a only a couple bunion surgeries a year.
If you only do a few, you are bound to see more cases of misalignment, over
correction, under correction and post-operative stiffness. This might
be why these doctors have such a dim view of bunion surgery.
Doing one or two bunion surgeries
a week has another advantage: reduced post-operative pain.
I had a patient come to me saying her insurance-referred surgeon told her
it was best to avoid the surgery because it was so painful. She was sent to a
surgeon who did only one or two bunion surgeries a year (with his attitude I see
why). She wanted my opinion. I told her that in my hands post-operative pain is
not common. On the average my patients take fewer than six pain pills after
bunion surgery. From talking to my fellow podiatrists, this is their experience
as well.
So, my Acorn friends, if having
the kids back in school and the vacations over with mean that it is bunion time,
fear not. It really doesn’t hurt and you will be back to regular activities in
no time.
Dr. Michael Zapf is a podiatrist in private practice with
offices in Agoura Hills and Thousand Oaks. For more information or a copy of his
monograph “What Every Patient With A Bunion Needs To Know” Please call his
office at (818) 707-3668.
