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.

01/08/2012

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Giving Gout the Boot                                                                Acorn - January 2008

 By: Michael Zapf, DPM, MPH, FACFAS

David was a 32 year old teacher who came to the office with a sudden onset of an excruciatingly painful right foot without any history of trauma. He pointed to the big toe joint and thought he had a bunion like his wife’s. The good news, I told him, it was not a bunion; the bad news was he had gout. He was one of 2 million Americans with the somewhat inherited disease that is definitely modified by lifestyle..

Gout is getting more common in my practice. It is associated with obesity, diabetes, high blood pressure and a protein rich diet. David was guilty on all counts. When proteins that contain purines are broken down, uric acid is produced. Gout is caused when high blood levels of uric acid form crystals in the cooler joints, like those in the feet. The body fights the crystals and mounts a large immune response resulting in a red, hot and swollen joint. Surprisingly treating this joint with an ice bag only makes the situation worse by causing more crystals to form.  

Uric acid is easy to measure with a blood test. Low uric acid levels of 4 or 5 mg/dl will not cause gout but David had a level of 8mg/dl. That high level combined with his near miraculous 1-day response to treatment with an anti-inflammatory pill, confirmed for me that he had gout. Once the attack was over I sent him back to his primary care doctor to get his uric acid levels to a lower level. There are some medicines, like allpurinol, that do this very effectively with minimal side effects.

When he asked me what he could do to prevent future attacks, besides taking medication, here is the game plan I gave him based on the most recent research by Dr. Choi of Harvard Medical School:

David thanked me and I heard he spent a painless New Year’s Eve. He was able to dance all night and toasted his health at midnight, not with his traditional glass of beer but with his new non-purine favorite, champagne.

Dr. Michael Zapf is a board certified podiatrist in private practice with the Agoura – Los Robles Podiatry Centers (Drs. Zapf, Payne, Robinson and Benson). For more information call 818-707-3668 or 805-497-6979 or see the web site www.conejofeet.com.

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 08, 2012