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, the one that contains registration forms, doctor information for all the office and directions to the office is located at:

www.conejofeet.com   ç Click here

I am Dr. Michael Zapf. I have been offering a full range of podiatric medical services, from ingrown nails to heel pain and foot surgery, to my friends and neighbors in the Las Virgenes, Conejo and Simi Valleys since 1985. This is my personal web site. It has been up since 1990 and has received more than 2 million visits. The entire site is my responsibility only and nearly 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 Things happen fast in medicine so whatever you read could well be outdated, especially if it was written many years ago. On this site you will read 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. You may wonder why I have my own site even though there is also an official practice site. Well, my partners are of a younger generation raised on tweets, e-mails and iPhones. They want a professional site that they believe better represents the professional nature of our practice. They also believe that people no longer take the time to read anything of length. I, on the other foot, think there is still a world out there full of people who still read lengthy descriptions of problems and solutions. if you are one of those old fashioned readers, then this site if for you. Let me know what you think. Let me know you are out there.

Please note that all information and photographs on this site are copyrighted by me, 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 philosophy. Do not expect them to practice the way I do or even believe in any of the speculation I present here. 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 first, " He is booked until next month",  I still want to see you as long as you are a little flexible with your schedule. If your visit is an emergency, I know that  you will be happy with either of my associates, Dr. Darren Payne or Dr. Steve Benson. They are exceedingly well trained and capable in any foot emergency.

Michael Zapf, DPM, MPH, FACFAS, FACFAOM     (If you want to know what all those initials mean, click here   è  

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

Agoura Hills Office: 28240 Agoura Road, Suite 101, Agoura Hills, CA 91301

Thousand Oaks Office: 555 Marin Street, Suite 290, Thousand Oaks, CA 91360

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

07/24/2010

To Order Foot Supplies è ç click

For Information about Laser Treatment for Fungal Nails Click hereè
 

For information about Shockwave Therapy for heel pain          click here è

Exciting news!!! New Thousand Oaks Location  è

The delightful bump you see on the side of this lady's foot is a ganglion cyst. If you puncture it (and I did) you would see that it is filled with a thick gel. The gel is called synovial fluid better known as joint fluid. It is the material inside every joint and the outside sheath of many tendons that helps to lubricate and nourish the joint. The fluid is held inside the joint by a covering called a capsule. If something causes the capsule to tear just a little the inside bag of fluid can pop out and form a ganglion. Early on ganglions typically get larger some days and smaller other days depending on the activity of the joint. After several months they stay pretty much the same size and start to get harder as the fluid inside gets thicker.

Ganglions can occur anywhere on the body. The ones on the wrist are sometimes called Bible Cysts because of an old fashioned treatment of whacking them with a heavy object, like a book. This thump sometimes ruptured the cyst on the inside and it would go away.

In a more civilized method of doing the same thing we sometimes "incise" them in the office. Using a local anesthetic block on the skin a needle or blade is used to puncture the cyst and the fluid can be expressed out. Replacing the gel with a small quantity of a steroid medication can sometimes get the thing to stay away. Ganglions can be subjected to this "incision and drainage" several times. If it does not go away you might want to have it surgically removed.

To see a photo of a large ganglion that was removed from a foot

just double click on this picture --->

Ganglions are not visible on plain x-rays but they are sometimes taken to see if there is any bone abnormality under the lesion. Ganglions can be seen with ultrasound examination and with MRI (magnetic resonance imaging). I sometimes ask for a pre-surgical MRI for particularly large ganglions to see if the lesion tracks down to a bone joint or to see if it is arising from a tendon.

Small ganglions can be removed in the office but larger ones, like this one, are done at the surgery center or the hospital using a bit of gentle sedation and local anesthesia (general anesthesia is not needed). The sutures left in the skin after surgical removal are removed in 2 weeks. Most foot surgeons will want you to keep the wound dry for the 2 weeks that the sutures are in the foot. During this time you will have dressings on your foot and will probably be walking in a surgical shoe.

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: July 24, 2010