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.

 


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ACORN September 1993

Back To School Time For Feet

By: Michael Zapf, DPM, MPH, FACFAOM

This September marks both the beginnings of both school and "health care reform." Since my thoughts on reform couldn't possibly be limited to just one column I will spend my time musing about the former. Suffice it to say that I wish President Clinton the best of luck in reform. Great ideas can often result in unworkable programs after they are dissected and reassembled by the legislature. I am sure that when it was first proposed, the Medi-Cal program seemed like a great idea. Now the overwhelming paperwork, lack of coverage for needed tests and procedures and unrealistically low fees make it a program most doctors want to avoid. I pray that this new program is successful. Now to the kids.

I see many high school age patients. Almost 90 per cent of the time they come to my office with three problems: ingrown nails, plantar warts and overuse injuries.

Ingrown nails come in two varieties: acute and chronic. Adults get the chronic kind where the toe looks, at worst, a little red. A chronic nail hurts with pressure of a show on the side of the toe. A sure sign of a chronic ingrown nail is the "sheet test." This is a name I coined to describe a condition where a toe hurts in bed with just the pressure of a bed sheet. A chronic ingrown nail can hurt just a little for years at a time but it never gets red, swollen and infected like an acute ingrown nail. A chronic ingrown nail needs treatment when you either are tired of the pain or when it "passes the sheet test."

For some unknown reason, teenagers usually have an acute ingrown nail for quite sometime before they bring it to their parents attention. By then they have tried a variety of "bathroom surgery" techniques to cure their problem. Sometimes parents notice the evidence on an acute ingrown nail on the child's socks at laundry time. In any event, an acute ingrown nail can be infected and almost always needs professional treatment.

In the office an acute ingrown nail is quickly and nearly painlessly treated. After anesthesia of the toe, the edge of the nail is delicately trimmed away and the toe is allowed to heal. Regular activities can begin immediately in most cases including, to the dismay of many kids, P.E.

Plantar warts are caused by a virus that gets into the crack in the skin and invades a deep layer of the skin. It reproduces in a skin cell. When the cell bursts the virus invades surrounding cells. This continues until there is a little lump on the bottom of the foot. If the wart is on a weight bearing surface it can cause a stinging, burning pain.

Treating a wart is easy. Getting it to go away and stay away is the hard part. Plantar warts can be very resistant and are prone to recur. In my office I, like most doctors, use more than one treatment method to treat warts. They vary from removing the wart on the first visit to using topical acids that take several to many weeks to eliminate the wart. I base the treatment I use on the number and location of the warts, the pain tolerance of the patient and the activities in which the child is involved. The main ingredient in treating warts is patients.

Over use injuries happen when too much stress is placed on the body in too short a time. This is common during the first weeks of practice in a sport or activity the child has not played either ever of for a long time. Muscles, tendons and even bones can fail when placed under this stress. The key to over use injuries is prevention. Activity levels should be increased no more than 10 per cent a week. If a sport begins with a "hell week" where the coaches demand 100 per cent from day one, then preparation for this sport needs to begin weeks earlier. Without that preparation injuries are sure to follow.

 

Dr. Michael Zapf is a podiatrist in private practice in Agoura Hills and Thousand Oaks. He specializes in the foot care of adults and children. For more information, please call his office at (818) 707-3668.

 

 

   

 

 

 

 

 

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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