Welcome to the personal website of

Dr. Michael A. Zapf, DPM, MPH, FACFAS, FACFAOM

Thank you for visiting the web site of Dr. Michael Zapf. He is a member of the Agoura-Los Robles Podiatry Centers

The "real" practice web site, that contains registration forms, doctor information and directions to the office is located at:

www.conejofeet.com

Dr. Michael Zapf has been offering a full range of podiatric medical services, from ingrown nails to heel pain and foot surgery, in the Conejo Valley since 1985. This site is my responsibility only and everything on the site was written by me. You are welcome to peruse this site and learn what you can about me, your feet and the problems your feet can develop. Things happen fast in medicine so whatever you read could well be outdated. In addition I have historic articles that I wrote for a lay audience as long as 25 years ago, so please do not take anything on this site as definitive or as applying directly to your condition. Please note that all information and photographs on this site are copyrighted by Michael Zapf, DPM and cannot be used for any private or commercial purposes. I work with two other podiatrists in my practice who may or may not share any of my ideas and practices. Do not expect them to practice the way I do or even believe in any of the speculation I present on this site. If you appreciate what I have written and want me to be your treating doctor, you will have to ask for me specifically. Even if my office says at fisrst that "I am booked" I still want to see you and ask your to be flexible in your scheduling time. If there is any emergent nature to your visit, I know that  you will be happy with either of my associates, Dr. Darren Payne and Dr. Steve Benson. They are exceedingly well trained and capable in any foot emergency.  

Our office phone number is (818) 707-3668 and my e-mail address is zfootdoc [at] doctor [dot] com

For the address, hours and registration forms please see the practice web site: www.conejofeet.com


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What is bleomycin?

Bleomycin is an anti-cancer drug that can also treat warts.

 

How do you use it?

The area to be treated is first anesthetized (numbed or frozen) with local anesthesia. Then, using a very tiny needle, a tiny quantity is injected into the skin just under the wart. Multiple punctures are used in a "needling" fashion making the wart into a pincushion. The body then forms a blood blister under the wart with the wart in the roof of the blister. The blister needs no care other than taking weight off of it if it hurts. Two weeks later the blood blister is "trimmed" and, with luck, the wart goes along with it. One cc is the most bleomycin that should be injected at one time. This will treat up to six or seven regular sized warts. It is not unusual to have warts so numerous or so large as to need more than one treatment.

 

Is it safe?

Millions of people have received bleomycin safely. In high doses it can cause cancer in rats. Because of this potential, I prefer not to use bleomycin in women who might be or could soon get pregnant. There is no reason to believe that the small quantity injected into a foot wart could cause damage to an unborn baby, but I do not want to take a chance.

 

Is it expensive?

The cost is the worst part of bleomycin treatment. The smallest vial contains 15 units and costs about $350! If your insurance pays for medications, I can give you a prescription for it and you can bring it to the office. Alternatively, I can bill your insurance company for one third of the medication, but they might not pay for it. I divide the medication into thirds and charge $120. If your insurance company does not pay for it, I will ask you for the $120.

 

Is it successful?

Treating warts with bleomycin is about 80% effective, or the same as surgical excision. If you have 10 warts, two of them are likely to remain after bleomycin treatment.

 

What does it look like?

   

 

 

 

 

 

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Send mail to (zfootdoc at doctor dot com) with questions or comments about this web site.
Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: January 02, 2010