Why do we need DPM’s?

Posted on December 2, 2019

It’s finally here! We just got to the few lectures that we have this semester about the foot! The podiatry students are loving it! I had one of the DO students ask me last week why we really need podiatrists to have their own program and degree of DPM. Honestly it was a hard question to answer because in the context he asked it in, it was almost as if he was assuming that an

Footgiving

Posted on November 18, 2019

Sometimes as a medical student, you tend to forget that you have a real life outside of school. This week I was reminded of that and about how important balance is as a med student. On Friday my DPM class had what they called “Footgiving” which was a get together that they want to do annually to have a Thanksgiving dinner as friends. It was a lot of fun to meet them all outside of

Shining Shoes

Posted on November 12, 2019

In my last post I explained that I had my SPAL this last week. Well…it happened. It went well. There were a few minor details that I had missed during my physical examination, which were silly mistakes that I know I won’t make again, I was given lots of positive feedback from my proctor about things that went well. I’m certain that I scored high on the humanistic and technical sides of the exam. When

Scariest Test of the Year

Posted on November 8, 2019

Considering Halloween, I will tell you what scares me the most right now! SPAL’s are coming this week! AAAH!!! The SPAL exam is an exam in which we get to work up an actor-patient in a doctor/patient interaction. We will have multiple of these exams in the upcoming semester but just the one this semester. Mine is on Tuesday and I am nervous! I shouldn’t be because I feel well prepared for it. I’ve done

Ups and Downs

Posted on October 30, 2019

Well…my streak of getting A’s on exams is over. I ended up with a 78% on my Biochemistry exam and an 80% on my Medical Cell Biology exam. These were both a little bit disheartening on Tuesday. I know I should have done better, and I learned from the experience and I’m moving on. Thankfully those grades are still passing and were close to the average scores on the test. I am still making it.
This week has been another one of those preparation-for-tests weeks. Oh wait…I suppose that’s pretty much every week isn’t it. Medical school has a lot of tests and each one is so heavily weighted that you must be 100% prepared for each one. On Tuesday I have tests over Biochemistry and Medical Cell Biology. These two classes are arguably the toughest classes this semester. Everyone says, “oh medical school isn’t hard material, it’s just a

Short but Wonderful Vacation

Posted on October 18, 2019

This week while I was studying a lecture about the four types of tissue in Medical Cell Biology, (which are epithelial, connective, muscle, and neural or nerves) I found myself making simple connections between the types of tissues without realizing it. This may not seem like a big deal to anyone but to me it means that my techniques for learning that I’ve been trying are working and my brain is, in a way, adapting

Wound Care

Posted on October 8, 2019

There are three main type of chronic wounds that we treat at Pueblo Ankle and Foot Care. These wound are diabetic foot ulcerations, wounds originating due to swelling and vein problems, and wound coming from artery problems. Diabetic wounds typically result from increased pressure areas that the diabetic patient may not be able to feel while walking due to decreased pain sensitivity. These wound are typically found in high-pressure areas on the bottom of the
Swelling and pain are common after foot injury or surgery. Gravity is not a podiatrist’s best friend. After insult to a lower extremity, the vasculature gets larger in order to send increased blood flow and starts the healing process to the injured area. Many times, patients are informed to ice the injured area directly, however many times this can cause increased discomfort due to the pressure of the ice pack pushing on the painful area.

Surgery of the Foot and Ankle

Posted on October 8, 2019

There are two types of physicians that can perform surgery of the foot and ankle. The podiatric physicians at Pueblo Ankle and Foot Care attended 4 years of undergraduate education, 4 years of podiatric medical school and 3 years of extensive elective, limb salvage and trauma surgical residency training. We have focused on the foot from the first day of podiatric medical school. Orthopedic foot and ankle physicians complete 4 years of undergraduate training, 4

Sports Medicine

Posted on October 8, 2019

Pueblo Ankle and Foot Care provides sports medicine care to all athletes from the pee-wee league to the big league and from the weekend warrior to the elite athlete. Injuries can occur from one single event, or miles of repetitive injury, all leading to pain and inflammation that limit your ability to be as active as you want to be. In fact, over a million doctor visits a year are related to ankle sprains! Prompt

Skin Cancer on your Feet!

Posted on October 8, 2019

Although cancer is relatively rare in the foot and ankle, we do diagnose it here at Pueblo Ankle and Foot Care. Signs that you should look for when examining your skin follow the ABCD acronym. A is for asymmetry. A skin lesion that looks different when imagining it cut in half should warrant further inspection. B is border. A skin change that have edges that are raised, bumpy or blurred should raise suspicion. C stands

Reconstructive Surgery

Posted on October 8, 2019

Chronic foot and ankle pain caused by foot deformities, arthritis and tendinitis can become debilitating despite all conservative efforts. When conservative measures fail, surgical correction to remove arthritic joints, straighten crooked bones, and repair tendons and ligaments may be required. Reconstructive surgeries are carefully planned and executed to provide long term relief of these painful conditions. Recovery can take anywhere from 6-12 weeks depending on the procedures performed with physical therapy often needed to complete

PADnet Arterial Testing

Posted on October 8, 2019

PADnet arterial testing uses a cuff-based method to record Ankle-Brachial Index (ABI)/Toe- Brachial Index (TBI) values and Pulse Volume Recording (PVR) waveforms. ABI and an assessment of flow are included in each test. Using PADnet, all major arteries in the ankle are occluded, and the ABI is calculated based on the highest pressure present. PADnet uses recording oscillometry rather than mechanical oscillometry; as such, it records the oscillations detected by the plethysmograph, and processes those

The Moore Balance Brace

Posted on October 8, 2019

Over 14 million American adults aged 65 and older experience a fall each year Every 15 seconds, an older adult is seen in an emergency room for a fall-related injury In 2010, such falls resulted in direct costs to the US healthcare system of over $30 billion dollars More than 20,000 of those falls resulted in death In light of the staggering number of falls occurring in the older-adult population – nearly 40,000 each day

Gait Analysis

Posted on October 8, 2019

From a newly walking toddler to the more senior of walkers, the way we walk, known as our gait, can sometimes lead to tripping, dragging of feet or abnormal shoe wear. These abnormal gait patterns may be observed by others and brought to your attention or may be evident in the wear pattern on your shoes. With a biomechanical exam and simple gait analysis via observation, these abnormal patterns can be diagnosed and treated through

Fracture Repair

Posted on October 8, 2019

At Pueblo Ankle and Foot Care we provide many valuable services above and beyond what is normally offered in a typical medical office. First, all of the doctors at Pueblo Ankle and Foot Care are highly skilled fracture care specialists. We take broken bones seriously. A fracture can definitely prevent you from living the active lifestyle you are used to living. With the benefit of digital x-ray technology, subsequent evaluation of the x-rays with you

Fall Risk Assessment

Posted on October 8, 2019

Preventing Falls In The Elderly: Where DPMs Can Have An Impact Author(s): Douglas H. Richie, DPM, FACFAS Over the past two decades, podiatric medicine has become a vital member of the healthcare team treating important health issues around the world. For example, the role of the podiatric physician in the team approach to treating the diabetic foot has elevated our profession to a level of esteem where we are on a par with any medical

Digital X-Rays

Posted on October 8, 2019

What is Digital Radiography (DR) Technology? Digital radiography is a form of X-ray imaging, where digital X-ray sensors are used instead of traditional photographic film. Advantages include time efficiency through bypassing chemical processing and the ability to digitally transfer and enhance images. The easiest way for most people to relate to this advanced technology is to first think of the older film based personal cameras. Before the digital age, people had cameras that had to

Diabetic Socks

Posted on October 8, 2019

All styles of Diabetic socks are designed and manufactured with your foot health in mind. They’re perfect for people living with diabetes, arthritis, edema, neuropathy and circulation issues. They’re available in a range of men’s and women’s sizes, and ankle or crew or high styles. And the dye in our colored socks doesn’t bleed out of the fabric, reducing your risk of foot infection. Why Nano Bamboo Charcoal Fibers? Nano Bamboo Charcoal Fibers in our

Diabetic Inserts

Posted on October 8, 2019

Diabetic inserts are designed to provide the perfect fit for wearers living with diabetes, arthritis and a range of other medical conditions. For people who just want to take care of their feet, too. The specific diabetic inserts we recommend for our patients are heat moldable and are a multi density insert that are designed to be supportive and reduce the risk of diabetic foot ulcers. Most Diabetics receiving diabetic shoes from our office will

Diabetic Shoes

Posted on October 8, 2019

Diabetic shoes are designed and manufactured to the highest standards of foot wellness, especially for people living with diabetes and other health conditions that affect their feet — including swelling, bunions, hammertoes and more. Based on more than 25 years of footwear design experience and with input from board-certified podiatrists, our selection of shoes are made using only the finest quality materials — so they’re as fashionable as they are comfortable and healthy for your

Conservative Treatment

Posted on October 8, 2019

Surgery is cool. I get it. Nothing gets you more sympathetic looks and offers of help than saying: “I just had surgery” … read … “Bring me stuff including dinner and come over and visit me and play video games and read me books and watch movies with me – I’m sooo bored because my foot and ankle surgeon said I need to elevate my foot for days and days … ahhh!” Sounds nice right?

CMO Explanation

Posted on October 8, 2019

The whole world has heard of arch supports, custom insoles or orthotics. They are as common as sliced bread or canned soup. And most of them are fairly worthless. Why? The foot is actually a complex machine that depends on all of its 26 bones and even more joints to work in harmony. When it works as designed, the foot is capable of remarkable things which all help insure not only pain-free health of the

Getting Ready for Test Day

Posted on October 8, 2019

This week I spent more time studying for anatomy. I feel confident about the tests I have for anatomy coming up on Monday. I also had my second test in Principles and Practices of Podiatric Medicine this week on Thursday. Thankfully, I got another A! It was close though, 90%. Honestly, I feel pretty good about any A that I get in medical school. On this test, we were tested over a little bit about
We take an average of 7,500 steps each day that allows us to circle the globe 5 times in our lifetime. With each step, we expose all the joints in our legs and feet to stress and gradual wear and tear. How well these joints hold up is determined by our alignment (be that good or bad). Consider the alignment of a car and the wear and tear on the tires to the alignment of
Study! It means study. This week I didn’t have any tests, which was nice, but it also meant that outside of class, I had a lot of extra time. It seemed like classes were less dense this week as well. So, I did a lot of much needed studying, especially in Anatomy. Next Monday is my Anatomy Lab practical. It’s going to be over about 300-400 structures. Yeah seriously. And I know most of them!

Be prepared!

Posted on October 3, 2019

I can’t believe it. My tests went so WELL!!! I scored a 90% on my biochem test which was MUCH better than the 76% that I got on the first one. I also scored a 94% on the medical cell biology test. Instead of having tests more spread out (one on Tuesday, another on Thursday, etc.) they are doing what they are calling a block schedule. So, we had both tests on Wednesday, back to

Typical Life of a Podiatric Student

Posted on October 2, 2019

A few weeks ago, we had a couple of lectures in anatomy about the lungs. It was pretty incredible. I learned so many things about the lungs that I never knew before. It’s incredible that I have had these organs that I’ve been using literally every second of every day of my life since my first breath, and I knew so little about them! We really take for granted sometimes how awesome it is just

Self Care and Disc Golf

Posted on September 30, 2019

For Labor Day Katelyn, Clara, and myself (wife and daughter) went to a park in Waukee where we got to play Disc Golf! Those who know me know that I love to play disc golf. It was a lot of fun to play a new course. I really love the course at City Park in Pueblo but it’s always fun to play somewhere new! Des Moines has quite a few courses and I can’t wait

Vitamin B, Thiamine and Neuropathy

Posted on September 28, 2019

This week in biochemistry, we learned about the TCA cycle (Tricarboxylic Acid). This cycle is important in reducing some of the electron carriers (NADH) for the electron transport chain in the mitochondria (lots of science words), which ultimately is important in making energy (ATP) for our cells to function! Anyway, there are multiple B vitamins that go into the cycle which we get from our diets. One of those is Thiamine. When we are Thiamine

Clinical Medicine class

Posted on September 26, 2019

Another of the books that we read in book club at Pueblo Ankle and Foot Care was reference this week in my lecture! My Clinical Medicine class is teaching us about the basic physical, what questions to ask during a physical, the structure of a doctor’s note, and multiple other important features to an exam. During one of the lectures, the professor mentioned some principles from, and referenced, a book called, “How to Win Friends

White Coat Ceremony

Posted on September 24, 2019

On Friday the DOs, DPMs, DPTs and PAs had our white coat ceremony. You will probably see pictures posted in the blog which were taken immediately after. The white coat ceremony is tradition for most medical school students when they first start medical school or in their second year. DMU adopted the tradition in the late 90’s. In this event, the incoming or first year students gather together, in our case at the event center
Today was my first day of orientation at Des Moines University. It was a simple day, thankfully. Moving, unpacking, and living in a new place away from family has been stressful enough. We drove into Des Moines on Thursday and we are happy to be here. We are still getting used to the humidity though. That may take some time. We were measured for our white coats today and took our pictures for our ID’s
By Levi Smith Week one is done! And I survived! I’ve been thinking this week about one of the books that we read for the Pueblo Ankle and Foot Care book club that the employees get to participate involuntarily. One of the books that we read was called The Happiness Advantage, by Shawn Achor. It was a great read and I recommend it. Shawn was a man who spent quite a few years teaching at

Medicine Is Currently Evolving

Posted on August 13, 2019

By Levi Smith Here we are at the start of the real first week of medical school! I am so excited and ready to get started! Last week ended up seeming like it passed very slowly. There were some high points in orientation, but they were few and far between. One point I would quickly like to make is the nature of my gross anatomy lab. During orientation, we took a class called, What the

My Acceptance Into Podiatry School

Posted on July 22, 2019

My name is Levi Smith. I have been a team member at Pueblo Ankle and Foot Care since January of 2016. My time has been spent both in insurance and medical assisting and I am now the lead medical assistant for the office. Currently, I am preparing to leave Pueblo for Podiatry School starting at the end of July this year. Getting into Podiatry School has not been an easy task. During my time at

Meet Dr. Sarah Thompson

Posted on July 22, 2019

Dr. Sarah Thompson was born and raised in Central Wisconsin. After graduating High School, she studied biology with a pre-med emphasis at University of Wisconsin Milwaukee where she received her bachelor’s degree. Dr. Thompson studied at Des Moines University College of Podiatric Medicine and surgery where she received her Doctorate of Podiatric Medicine in 2012. While there she was an active member in many organizations at the University. Upon completion of medical school Dr. Thompson
At the beginning of last summer, while working in my yard one Saturday, I turned my foot on a tree root arising to the surface of the ground. I felt a “pop” and twinge of pain not unlike anything I had experienced before. I thought I had a slight sprain, perhaps. I continued to work in the yard, hobbling around, thinking the mild pain would cease. Within an hour my shoe was too tight to

Nsaid Overdose Is Real

Posted on July 22, 2019

What is a Nsaid? It is a nonsteroidal anti-inflammatory drug used to relieve or reduce pain and swelling, such as Advil, Aleve or Motrin. Going back to July 2017, someone close to me was having a great amount of pain in a joint, he started taking Advil several times a day to help relieve the pain. When that stopped working he was taking 4 Aleve 4 times a day, which helped with the pain, but
All new patients seen in our office are asked a series of health-related questions and to provide lists of medications, allergies, past surgeries and complications with anesthesia. These questions should be asked by all of your healthcare providers. All providers should be notified when or if a medication has been prescribed to maintain an accurate list of medications for the patient. This is to avoid or prevent any interactions with other oral medications by all

Swollen Feet While Pregnant?

Posted on July 22, 2019

Some helpful information to avoid and how to prevent swollen feet. Take short walks to ensure the blood is recirculating properly from your heart down to your toes. Try to avoid sitting for long periods at a time and if you are sitting, elevate your feet above your heart to increase blow flow. Do not cross your legs, this can cause your blow flow to your feet to decrease and can not recirculate to your
Mission: We provide comprehensive ankle & foot medical & surgical care utilizing state of the art technology. We provide excellent patient service in an enjoyable and safe environment. As stated in our mission statement we strive to deliver foot and ankle care using state of the art technology. We are excited to announce our addition of Diagnostic Ultrasound imaging.  Diagnostic Ultrasound is one of two types of ultrasound, diagnostic imaging is a non-invasive imaging technique
Dr. Marble has participated in the CSU-Pueblo Biology’s Health Science Panel since 2011. The panel is asked a series of questions. Each panelist begins by introducing themselves and usually includes a little bit about why they chose their profession or specialty. Dr. Marble indicated that he had sustained an ankle injury in high school from running where he had stepped on the rail that was lining the track. A family friend that was also a

Athlete’s Foot (Tinea Pedis)

Posted on July 22, 2019

Athlete’s Foot is a fungus caused rash on the skin of the foot and ankle and grows on the top layer of the skin. Fungus grows in warm, wet places such as the areas between your toes. This fungus spreads easily and can be obtained by walking barefoot on contaminated areas or by touching the toes or feet of another person who has it. The fungus then grows in your shoes, especially if your shoes

What Is Neuropathy?

Posted on July 22, 2019

Peripheral Neuropathy is a degenerative condition, which manifests as burning, tingling, or numbness in the hands and or feet. Affected persons often describe symptoms in a stocking or glove distribution. Peripheral Neuropathy can result from endocrine abnormalities such as diabetes mellitus, traumatic injuries, over exposure to toxins such as alcohol or chemotherapy. In some instances, peripheral neuropathy may improve, particularly if it is caused by a treatable condition. Most medications for the treatment of neuropathy
The extensor tendons to the foot come from muscles in the front of the leg. The two main extensor muscles are the extensor hallucis longus muscle and the extensor digitrorum longus muscle. The tendons from the muscles cross the front of the ankle, over the top of the foot and attach to the big toe and smaller toes. These tendons pull the foot upward and work with resistance from the Achilles tendon and the calf

Are You At Risk Of Falling?

Posted on July 22, 2019

The likelihood of slipping and falling should not be ignored.  Tripping, falling or losing your balance for any reason can have lasting and sometimes fatal results.  Helping to reduce the risk of falling by making your home safe, having your vision checked, wearing appropriate foot wear and improving muscle strength will preserve your quality of life in the long term. If you answer yes to any of the following questions, you may have a balance

Could You Have Fungal Toenails?

Posted on July 22, 2019

Toenail fungus (onychomycosis) is a slowly progressing infection that damages the nail over time.  This infection is the same one that causes athlete’s foot. The fungus lives in the toenail bed and feeds the keratin in the nail. The nail is discolored, thickens over time and can become painful.  A foul odor occurs, and ingrown nail can result. The contagious fungus is acquired in a few locations: Public swimming pools, gyms and community showers. Sweaty

Hallux Limitus (Stiff Big Toe)

Posted on July 22, 2019

The Hallux is the medical term for the big toe. Stiffness of the big toe is called Hallux Limitus. When there is no motion of the big toe it is called Hallux Rigidus. The big toe joint can appear to have normal motions, but this motion can be limited when weightbearing. As with many conditions of the foot function conditions progress to structural deformities. As the condition progresses, degenerative arthritis develops in the big toe

Hammertoes

Posted on July 22, 2019

Hammertoes are a contracture of the toes as a result of a muscle imbalance between tendons on the top and bottom of the toes. They can be flexible or rigid. When rigid, they are not able to bend or straighten manually. The toes may develop corns on the top due to the rubbing of the shoe. Calluses may form on the ball of the foot due to pressure of the bone against the ground. Hammertoes

Ingrown Toenails

Posted on July 22, 2019

Ingrown toenails are due to the growth of the edges of the nail plate into the soft tissue of the toe. With bacterial invasion the tissue around the nails becomes red, swollen and sore. There could be drainage or pus around the site which indicates infection. For people who have diabetes or poor circulation this problem can become severe. For the diabetic, a simple ingrown toenail can develop into gangrene of the toe. Patients with

Athlete’s Foot (Tinea Pedis)

Posted on July 22, 2019

Athlete’s Foot is a fungus caused rash on the skin of the foot and ankle and grows on the top layer of the skin. Fungus grows in warm, wet places such as the areas between your toes. This fungus spreads easily and can be obtained by walking barefoot on contaminated areas or by touching the toes or feet of another person who has it. The fungus then grows in your shoes, especially if your shoes

Amerigel Premium Care Lotion

Posted on July 22, 2019

Restore dry, damaged or discolored skin naturally.  It’s the only lotion with the natural healing compound called oakin.  Oakin, a natural oak extract, is available exclusively through the Amerigel Skin and Wound Care product line. Developed by Amerx Health Care Corporation, this natural extract has been proven to promote healing in wounds, ulcers, cuts, burns, rashes, and skin conditions caused by poor circulation, infection and bacteria. Maximum strength Amerigel Premium Care Lotion rehydrates and soothes

COULD YOU HAVE A BUNION DEFORMITY?

Posted on July 22, 2019

A bunion is a bump on the side of the great toe and represents a deviation of the first metatarsal.  The deviation causes the great toe to lean toward the second toe. Bunions are caused from a weak or abnormal foot structure which placed a heavy load on the tendons, soft tissues and joint capsule of the first metatarsal or great toe. Stiff leather shoes or shoes with pointed toe box will aggravate a bunion.

Ganglions

Posted on July 22, 2019

Ganglions are soft tissue masses that can occur on top of the foot, in front of the ankle or on the outside of the ankle. A common characteristic is that the ganglion will enlarge and then shrink in size. Ganglions arise spontaneously from a weakness in the soft tissue covering of a joint or tendon sheath. Ballooning out of the tissue occurs and it fills with thick mucoid fluid. Ganglions are not painful until they

Charcot Joint Disease

Posted on July 22, 2019

Charcot joint disease was given its name by the French neurologist Jean-Marie Charcot in 1868. He noted an unusual pattern of bone destruction in patients with tertiary syphilis and the absence of sensation. William Jordan described a similar pattern in diabetic patients since 1936. Certain predisposing factors appear to be necessary for Charcot to develop. First, Neuropathy or total absence of sensation. Second, the circulation in most commonly normal. Third, preceding injury to the foot,
As a provider, our job is to help our patients feel comfortable and help them take care of their foot health. One way we help our patients with their foot issues is to get a proper diagnosis and get them in suitable footwear. Before measuring our patients for their diabetic shoes, it’s essential to assess their feet. *According to Medicare DMEPOS, when fitting for therapeutic shoes and inserts, an assessment is conducted for the following
When patients are experiencing symptoms like cold feet, cramping, or pain and weakness while walking for a certain amount of distance and must stop to rest. First, it is important to be seen by your podiatrist to evaluate you for poor circulation. While sitting in our podiatric chair, we assess for pedal pulses. This is evaluating the dorsalis pedis pulse and posterior tibial pulse. Those pulses should be palpable (where you can feel them) if