Welcome to the Website of

Dr. Michael Zapf, DPM, MPH, FACFAS

 Thank you for visiting my website. I have been placing information and articles on this site for many years and have received millions of  hits during that time (and not that many of them were mine). I have designed it for people who like to read about their foot and ankle problems. Since I started the web site, I have added two associates to my practice, Dr. Darren Payne and Dr. Stephen Benson.  Since my site is filled with just my thoughts and opinions they are not, necessarily, shared by my colleagues. To see our less controversial (and less windy) practice web site, I offer you: www.ConejoFeet.com, the practice site for The Agoura Los Robles Podiatry Centers (ALRPC). The ALRPC practice site has a lot of material about our office, many of our policies and the registration forms to be filled out before your visit. I suggest all prospective patients visit www.ConejoFeet.com.

 I made the web site to give my patients the extra depth information that I don’t always have time to cover in the office visit. Visitors who are not my patients are welcome to browse the information found here. My younger colleagues are both under 50 and they, like many their age, do not favor in depth reading. They prefer their information presented to them in a few short, crisp bullet points. I, being of the, ahem, older generation, like to read about my ailments in greater depth. Here, I present the greater depth. If you ask a question about heel pain or bunions that I have not answered in my two monographs, I will quickly add it so that it is as complete as I can make it. If you agree with this philosophy, welcome to my page. If you correspond with me please let me know if you like the in depth reporting.

 Remember, this site is in no way intended to tell you how your own ailment or problem should be treated, only the approach I use when confronted with certain situations. Your problem may well be different from what you think it is and should always be evaluated by the appropriate professional, whether podiatrist, orthopedist or other authority. Please understand that I, nor anyone else, can offer you a proper diagnosis or treatment plan without seeing and feeling the problem at hand (foot?).  Happy reading.

 Sincerely, Michael Zapf, DPM, MPH, FACFAS, FACFAOM

 P.S. All the information in this web site is © by me and it is mine alone. No picture or any of the articles cannot be used by anyone without permission from me, personally.

 


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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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Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: January 08, 2012