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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Question to Kay, a recent Shockwave Patient: Did it work?

Podiatrists grade pain on a 10 point scale with 10 being the worse. Rarely do we see a 10. Kay was a 10. She lives and works in the relatively far away town of Palmdale, California. Because of her extreme heel pain she was not able to work or even walk without crutches. She gave up on a social life and her pain was so great that she rarely ventured out of the house. She tried shoe modifications, heel pads, orthotics from her podiatrist oral anti-inflammatory medications and even a series of cortisone injections. Nothing was helping and she was scheduled for the traditional open surgery. Her podiatrist was an acquaintance of mine and suggested that she give Shockwave a try. We met in my Agoura Hills office and discussed her options. Frankly I was skeptical that Shockwave could help such severe levels of pain. She has an HMO and had to pay for this one out of her own pocket. Fortunately the company I use charges only $500 maximum put of pocket for the treatment even if insurance pays nothing toward the procedure. Well, I asked her, was her experience worth $500? Did the treatment work? 

Answer: It did for me! I was experiencing pain in my heel with every step. I was limping, trying to prevent any flexing in my foot that would cause any pain. After the shockwave therapy was performed, I was in a soft cast for about 6 weeks. During that time I was careful not to traumatize it with excessive walking, standing or exercise. Today I can walk without pain, making sure I wear a shoe with a heel. (I feel some discomfort the day after if I wear a flat sandal or shoe.) I experience some minor stiffness in the heel area after getting up each morning from bed, but it works itself out in a short period of time. I am very pleased with the result as is my husband as he doesn't have to wait as I limp along behind him any more. I'd recommend it to anyone with similar pain

                                                                    ... Kay

As a subscript, I have done the Shockwave procedure on 16 patients, all of whom have had heel pain for at least a year (some as long as 10 years) and at least a level of 6 (some (some, like Kay, at a 10!). My results for the procedure are as follows.

100% complete pain relief                                    2

Reduction of 7 or 8 points on the pain scale       2

Reduction of 4-8 points                                          8

Reduction of 2-3 points                                          3

Reduction of 0-1 points                                          1

I need to point out that the patient with 0-1 points reduction in pain also has a stress fracture of the heel that is causing pain. As she recovers from the stress fracture she is feeling better. We may never know how much pain reduction is due to the Shockwave and how much to healing her stress fracture.

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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