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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Getting Your Feet Back In Circulation

Acorn September 2009

By: Michael Zapf, DPM

   September is peripheral artery disease (PAD) month and a perfect time to bring up this important topic. PAD is also called peripheral vascular disease (PVD) or “poor circulation in the legs” and occurs when the little blood vessels in the legs and feet become clogged with fatty deposits (plaque) and reduce blood flow to the legs. The condition varies from those without symptoms to those with pain in their calves when they walk or exercise all the way to cold and pulseless feet.

   More than 8 million Americans have PAD and it affects about 20% of people over age 70. Smoking is a huge risk factor but so are high blood pressure, elevated cholesterol levels and the presence of diabetes.

   If you have pulses in your feet that we can palpate and you can walk briskly for 15 minutes without stopping because of pain in the calves, you probably do not have PAD. At your routine health exams your doctor should check for your foot pulses. If he or she does not, you should ask the doctor to examine them. If you are not very active and if your pulses do not feel strong, we will perform a blood pressure test on your feet and compare the results of a blood pressure taken on your arm. This comparison is called the ankle-brachial index (ABI). All foot doctors should be able to perform this test in the office or send you to a vascular surgeon or a blood flow lab at the hospital to have it done if PAD is suspected. An ABI of around 1 is considered a passing grade.

   Diabetes and PAD is a dangerous combination. More than half a million of the nation’s 24 million diabetic patients get a foot ulceration every year. If patients have PAD those simple ulcerations are more likely to result in one of the 80,000 plus amputations performed every year. In our office when we have patients with PAD we will send them to a vascular surgeon who can often help restore circulation with a variety of interventions. But he or she cannot intervene if PAD is not detected by personal doctors or podiatrists.

   Prevention of PAD should be everyone’s goal and is accomplished by six factors: not smoking, controlling hypertension, controlling high cholesterol, controlling blood sugar if diabetic, maintaining proper weight by eating well and exercising regularly. Remember what ever good you do for your peripheral arteries you also do to arteries to the heart and brain.

  If you have PAD you need to see a podiatrist on a regular basis for nail and callus care that includes an examination for problems like hot spots that can lead to an ulcer. Wearing proper shoes is also important and Medicare even pays for a pair of extra depth shoes once a year for diabetic patients with PAD. Even a well fitted athletic shoe is preferable for a PAD patient than sandals, slip-flops and  bare feet. More information on PAD is available at www.padcoalition.org.

   If you have PAD and develop any kind of ulceration, infection, ingrown nail or even a nick in the skin, get thee to a podiatrist straight away. Many feet that that seem to do well without an ulceration cannot easily heal the ulcer if one forms. So, in short, if you keep your feet circulating, they will do the same for you.   

Dr. Michael Zapf is a board certified podiatrist with offices in Agoura Hills and Thousand Oaks. For more information on PAD please see his web site www.zfootdoc.com or call his office at 818-707-3668.

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