It was a big Friday night football game for Olentangy Liberty High School. Brian Johnson, a junior, for Liberty went down right in front of Dr. Philbin on the field. Dr. Philbin ran to his attention right away. The athletic director said he had never seen Dr. Philbin run that fast; he even beat the trainers out on the field! Brian had fractured and dislocated his right ankle.

Fortunately, Dr. Philbin and his staff were on top of things. Unfortunately, Brian’s injury was bad enough that he needed to go to the hospital. Dr. Philbin sent Brian via ambulance to Dublin Methodist Hospital where one of our junior partners, Dr. Hatic, met Brian and his family. Dr. Hatic was able to reduce and splint Brian, as well as, make him more comfortable with his pain, and then sent him home. Surgery was then performed within a week.

Brian was very lucky to have a great medical team at the game. Much less pain and valuable time was saved for Brian by having Dr. Hatic meet him at the hospital instead of waiting in the ER for the on call doctor. Dr. Philbin already briefed Dr. Hatic on Brian’s condition so the physician knew what to expect when he arrived at the hospital, and surgery could be set up very quickly so Brian could get on his way to a faster recovery.

Brian and his family continue to be very pleased with our staff at OFAC. They said everyone they have encountered has been very patient and kind. Dr. Philbin and the team at our office have also been very encouraging and have made a very stressful situation more manageable due to our seamless process. Brian is now looking forward to rehabbing and getting back on the field again next year to play football his senior year.

Our goal at OFAC is to continue to help similar patients like Brian to get back to playing sports with excellent communication between medical teams and outstanding clinical care.

Did you know that 1 in 3 children in the US faces a future with diabetes if the current trends persist?Please join us this Halloween weekend so together we can all STOP DIABETES at the American Diabetes Association StepOut Walk.

The walk will be held this Satiurday, October 30, 2010 at Polaris Fashion Place. The event is a family-friendly fundraising walk sprinkled with HOOPLA to raise your diabetes awareness and bring a smile to your face. The HOOPLA will include a Kids Fun Area, team photos, local mascots, Red Strider Tent, an expo and more!

Our physicians and staff are committed to fighting diabetes and would love for you to join us at the event. Please click here for more information on how you can be part of this exciting day!

Date: Saturday, October 30, 2010

Time: 7:30am Registration/ 8:15 am Start

Place: Polaris Fashion Place (entrance between Von Maur
and Saks)

Cost: $20 min. donation

Every patient who comes to OFAC is there to see the doctor. They are looking for the physician’s opinion, his diagnosis and cure. But behind our skilled physicians is a team of forty employees working to make every patient’s experience the absolute best it can be.

Our Phone Operators take hundreds of calls per day, answering questions, directing calls and making appointments. The Receptionists greet patients when they arrive; collect demographic data while our Check-Out staff and Outside Test Schedulers coordinate the physicians’ orders and make
follow-up appointments.

The Nurses and Medical Assistants escort the patients to the exam room, review medical history and make notes for the day’s visit. They work in unison with the X-ray Techs, Cast and Ortho Technicians to take radiographs; MRI’s and apply/remove casts. All of this is done with great care and efficiency in preparation of the physician’s visit with the patient.

After the physician discusses his findings with the patient and potentially; plans surgery, other OFAC staff members step in to apply boots and braces and recommend retail products that can be found at our FootSourceMD store. At FootSourceMD we have knowledgeable staff on hand to assist in fitting shoes, getting crutches or padding to make patients feel more comfortable.

For some patients, the Surgery Schedulers take time to plan a surgical date, answer questions and complete the necessary paperwork for a variety of procedures.

As the day moves ahead, our billing staff enters the day’s charges, submits electronic claims, posts payments and works accounts receivable. At the same time, the Managers try to keep all the moving parts in motion while tending to everyday accounting, payroll, personnel and business issues.

This team of forty OFAC employees supports the physicians so they can provide their opinion, diagnosis and cure. We love what we do and hope all our patients will come to see the physician – and the staff at OFAC.

We are honored to announce that our physicians of Orthopedic Foot & Ankle Center are being honored at The Arthritis Foundation’s 35^th Annual Crystal Ball. They are receiving the Pioneers of Medicine Award for our years of dedication to improving the lives of patients with arthritis. Jim & Walene Borowske will also be honored with the Lifetime Achievement Award for their unwavering support of the Arthritis Foundation’s mission.

The Crystal Ball will be held on February 26, 2011 at the Aladdin Shrine Temple. Last years event was a tremendous success and raised more than $205,000. This year we would like to raise even more in order to help win the fight against arthritis.

We would love to ask all of our family, friends, and business partners to help support this event. Even more importantly, please come and enjoy a wonderful evening to support a great cause and honor the physicians of OFAC. There will be a silent auction, vacation package raffle, entertainment by The Conspiracy Band, a delicious dinner, and a few other surprises that night.

For more information about the Crystal Ball and how you lend a hand; click here.

The Doctors Perspective of Fungal Nails

Fungal nails are a very common condition in the foot and ankle. About 3% of the population will be affected. More men are affected than women and generally the infection will occur after the age of 40.

Like bacteria, fungus spores are everywhere in normal daily life. Because of its organic structure, it is stronger and heartier than bacteria and viruses so once a fungal infection takes root, it is more difficult to treat.

Fungus grows selectively in the warm moist environment of the foot. With improper shoewear, the area of the toes and nail have the ideal temperature, moisture content and pH for fungal infection.

The infection will begin in tiny cracks within the nail or skin. The nail will show early signs of change with color changes or small white or yellow spots. The nail will begin to thicken and turn yellow and begin to flake off.

Because the infection is within the substance of the nail as well as in its growth center, fungal infections can only be treated if the very roots of infection get exposed to the treatment.

There are several different types of fungal infections. The most common is Trichophyton rubrum. This type of infection can start at either the end of the nail and raise the nail up or start at the base. Most infections start at the end of the nail. It is caused by an invasion of the nail through a split in the skin or nailbed. Risk factors will include age, swimming, athlete’s foot, psoriasis, diabetes, other family members with nail infection, or a depressed immune system. If the nail raises from the base (less common), it is usually a sign of a systemic infection in people with a damaged immune system.

Another type of infection is caused by yeast or Candida. This is more common in fingernails. The nail will be yellow, brown, white or thickened. People will almost always have simultaneous infections in their mouths or thrush.

A culture is sometimes necessary to identify the exact species but most people will be able to identify the early signs of infection by the look and feel of the nail.

Treatment

Because of its common nature, there are many home remedies for fungal nails. Most home remedies use a footbath with a solution of sterilizing liquids. The most common have used a combination of Listerine, alcohol, vinegar, Vicks VaporRub, or beer. These home remedies may have some effect if the infection is detected early. But because most fungal infections involve the whole nail and its growth center, most soaking techniques do not have the penetration to make a difference.

Another treatment involves tea tree oil. This hydrophobic essential oil has been thought to have antiseptic, antibacterial, and antifungal properties. Its molecular structure is similar to phenol and consider 10x more effective.

Some topical treatments such as Formula 3 Liquid antifungal merge the best of all the home treatments with an effective antifungal solution, which has been shown to have sufficient penetration to kill most of the fungus and provide a protective coat on the nail to prevent further reinfection.

Several prescription oral medications can be used. These are the same strong systemic antifungal treatments often used in conjunction with chemotherapy and AIDS treatment. Though effective, they frequently require 12 months of treatment with regular blood tests to monitor liver function. Common options include Griseofulvin (Fulvicin, Gifulvin, Gris-Peg), Terbinafine (Lamisil), Itraconazole (Sporanox), and Fluconazole (Diflucan).

Lasers

The off label use of lasers for the treatment of fungal nails has great potential. Laser treatment of fungal nails have been getting a lot of national newsworthy attention as well.

http://abcnews.go.com/Health/OnCall/story?id=7113863&page=1

http://www.nytimes.com/2009/03/20/business/20fungus.html

By using the focused energy of a laser directly onto the nail matrix, the resistant fungal cellular walls are neutralized and eradicated. A laser can effectively penetrate into the deep nail structure. But because of the differing stages of fungal growth within a nail, a pulsed schedule of 2 or 3 treatments are often required to completely cure the condition. The procedure is safe with remarkably few
side effects.

In the end, the best treatment for fungal nails is prevention. Keep your nails cut straight across. Keep your nails and foot dry with plenty of room within all shoes. Avoid non breathable sock and shoe materials. Sterilize the inside of shoes with regular treatments of ultraviolet light. Oral medications can be effective but may have more side effects than benefits. Some topical treatments can work. New technologies such as lasers have promising potential, though often not covered by insurance.

Many of the newer commercial treatments for fungal nails can be found at a trusted source for foot and ankle products: www.footsourcemd.com

We welcomed 2 physicians from Harvard Medical Center, Dr Richard DeAsala and Dr. Robert Scardina, this week to see how we do things at Orthopedic Foot & Ankle Center. They visited both of our fantastic teams at our home, as well as, The Orthopedic Center, Foot and Ankle at Dublin Methodist Hospital (DMH). It was great opportunity for us to compare notes.

In addition, Dr DeAsala treated us to a great lecture on ankle kinematics (biomechanics and motion of the ankle) at the inaugural DMH Orthopedic grand rounds on Tuesday. He is head of foot and ankle for Harvard and Mass General Hospital and one of the authors of this article that he discussed. Effect of post-traumatic tibiotalar osteoarthritis on kinematics of the ankle joint complex. We welcome you both back anytime and thank you for the valuable information.

We look forward to continuing the grand round series at the hospital so we can effectively provide the best clinical care for every patient!