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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Acorn September 1999

A Thursday Full of Foot Surgery

By: Michael Zapf, D.P.M.

                So, I hear you asking, what does a podiatrist do all day? Well, sometimes, quite a bit. This is now Thursday evening and I did four surgeries today in addition to seeing a dozen patients in the office. Let me go over them and see how feet can be made better.

                We started at 7:30 at the hospital with a nurse named Ginny. She had a bunion surgery on one foot and a tailor’s bunion and hammertoe repair on the other. A tailor’s bunion is a bony swelling on the outside of the foot just behind the little toe. It was named after the tailoring profession when tailors used to sit crossed-legged and the outside part of their foot rubbed against the floor. A tailor’s bunion and a regular bunion are both fixed with a surgical bone fractures, repositioning of the bones and holding it in place with a wire, pin or screw.  As I told you last month a bunion surgery is not particularly painful, and neither is tailor’s bunion surgery. All three of these procedures were performed under local anesthesia with a little sedation administered by the anesthesiologist. General anesthesia was not needed. Ginny was home about noon.

                The second surgery, on Theresa, was cancelled because of abnormal pre-operative laboratory tests. At a routine pre-operative visit her family doctor found that her thyroid levels were too low for an elective surgery. After a week or two of adjusting her thyroid levels she should get her surgery.  Theresa has no motion in her big toe joint and it hurts to walk. The joint is completely worn away. She needs a surgery to replace the joint with a titanium-nickel-chromium replacement.  This will allow her to get on with her life without pain in her foot.

                Next up was Lena, a17 year old who had a procedure performed at the surgery center. Because she was only 16, and scared, a general anesthesia was used. She has what is usually called an extra bone on the inside of her foot by the ankle. This little bone, the size of a grape, rubbed against her shoe and caused her pain. It was not very difficult to pop this little extra bone out of the foot. Afterwards I put Lina into a plaster splint and she is will get around for a week or so on crutches.

                In the mid-afternoon I removed a cyst from the top of a foot. This was Ali, a young mother who found the lump very irritating whenever she wore shoes. Originally I thought it was a fluid filled cyst called a ganglion but I had some doubt when I couldn’t get any fluid out when I tried to puncture it in the office under local anesthesia. We scheduled a time to remove it right in the office. In a surgery that took about 35 minutes the lesion, which looked like a dried-out ganglion, was removed and sent to the laboratory for analysis.

The final surgery on Deanna was also performed in the office. It is one I am particularly happy with and few others around here perform it. It is done for heel pain when heel elevation, ice therapy, orthotics, stretching, exercise, injections of cortisone and oral anti-inflammatory medications fail. It involves a partial cutting of the ligament that runs from the toes to the heel called the plantar fascia. Inflammation of this structure, called plantar fasciitis, is one of the most common reasons a person hobbles into a podiatry office. Ninety-nine percent of the time patients get over plantar fasciitis without surgery. When conservative therapy fails, surgery may be the answer. Usually the surgery is rather involved with a 2 to 3 inch incision on the side of the heel. Mine is different. I use a tiny 1/8” hole to advance a tiny little blade and cut a few of the fibers of this ligament. If Deanna is like my other plantar fascia surgeries, she will be back working in just a couple of weeks.

Add to these the dozen patients I saw and it was a typical busy Thursday. Which is a lot like a busy Friday, which, … well, you get the picture.

Dr. Michael Zapf is a podiatrist in private practice with offices in Agoura Hills and Thousand Oaks. For more information or a copy of his monograph “What Every Patient With A Bunion Needs To Know” Please call his office at (818) 707-3668. Also visit his web site from www.foothealth.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