Dr. Irina Tsyganova

Dr. Irina Tsyganova
Another Day at the Office

Monday, July 7, 2014

Lasers and its role in Podiatry

Medical Lasers have many different uses within the medical field; some uses include Lasik eye surgery, cosmetic surgery, tumor removal, dental procedures etc. In the field of Podiatry Medical Lasers can be useful to treat many different conditions. In this blog I will discuss the relevance of lasers to the field of podiatry.
How do Lasers work?
LASER, which stands for Light Amplification by Stimulated Emission of Radiation, work by having an intense beam of light, of a specific wavelength, which then allows the beam to focus on a small area. By having the beam focus on a small area the Laser can be used for surgical work by removing a lesion, burning, destroying or cutting etc.
Are Medical Lasers safe?
Medical Lasers has a source of radiation that is minute, due to the fact that the source of light is so small that it is safe and poses no health risks. Due to the fact that the light is so small it allows a physician to treat specific lesions without destroying the surrounding healthy tissues.
How are lasers used in Podiatry?
In our private practice we utilize 2 different types of laser to combat many different medical conditions.
Our first laser, which is called Sciton Laser, more specifically JOULE ClearSense . This laser is used to treat toenail fungus (also known as onychomycosis) and plantar warts. As per the Sciton’s website, the way the laser works is that the temperature of the laser is high that is heats the nail and decreases the nail fungus and increases the growth of the healthy nail. (http://www.sciton.com/treatments/onychomycosis)
This treatment is painless and takes 15 minutes. We recommend 4 treatments within a 2 month period.
In relation to treating plantar warts, it is a onetime treatment, also using the ClearSense,  that requires a local anesthetic prior to treatment. The treatment of the plantar warts works similarly to the fungal nails, in that is heats the warts and kills the roots.
What about other applications in Podiatry?
We use K laser in our office to treat many different alignments such as plantar fasciitis, Achilles tendonitis, and pain from residual ankle sprains. The way it works is to increase blood flow to an area, which will then increase the oxygen to the area and then increase the healing to the area. We recommend 10 treatments within a 5 week time frame. The treatment is under 10 minutes, is painless and you are able to drive home without sequela.
As technology advances, scientists are finding new ways to treat old conditions. I have had success with these lasers that I have not seen in the past, therefore, I recommend someone with these conditions to try the laser and they will notice the improvement of their conditions.

For more information please visit our website at footnj.com

Monday, June 2, 2014

Heat and your feet eht nj

Heat and your feet
As the summer months approach the topic of sun burns tend to be popular discussions as people spend more times outdoors. I would like to discuss burns in general, and the different degree of burns and how they relate to the foot and ankle.
What are the different levels of burns and how are they treated?
A burn can be caused by many different factors, such as over exposure to the sun, a fire, a chemical burn etc. It is the degree of the burn that will dictate the treatment as well as the outcome.
First Degree Burns
A first degree burn only affects the epidermis, which is the outer most layer of skin. Symptoms include red painful patches to the area affected and this can last up to 10 days until the burn resolves. These types of burns tend to resolve on their own. The most common type of first degree burn is caused by sunburn and as it is well known that sunscreen can prevent these types of burns.
Second Degree Burns
A second degree burn penetrates deeper into the epidermis and the dermal layer of skin. This type of burn can causes extremely painful blisters, which can become infected and cause a skin infection called cellulitis. This may take 3-8 weeks to resolve. Sometimes these types of burns can cause long term scars.
Third Degree Burns
This type of burn penetrates into the epidermis and throughout the entire dermal layer of skin.  This type of burn can cause the skin to look white, yellow or brown. Many times this type of burn requires immediate attention at a burn center. This type of burn can cause severe scaring, require many skin graft surgeries and perhaps even amputation. These types of burns are highly susceptible to infection.
Fourth Degree Burns
A fourth degree burn is so severe in many cases it causes death. This is when the burn extends from the superficial skin to the level of fat, muscle or bone. Most of the times these burns require amputation as a treatment option. In addition, these patients are so medically compromised that infection and death are serious complications.
So how are burns related to the foot and ankle?
This is an easy answer, with the summer around the corner many people forget to put sunscreen on their feet. This can lead to painful burns. In addition, I have treated numerous diabetics who “forgot” a heater was on or fell asleep in the sun and caused severe 2nd and 3rd degree burns to the feet.
In conclusion, do not forget to place sunscreen on your legs and feet. Also if you are a diabetic be careful with the heat and your feet.
For more information, please visit our website at footnj.com and visit our NEW location at:
3003 English Creek Avenue, Suite C5

Egg Harbor Township, NJ 08234 

Sunday, May 4, 2014

Heel Pain in Children

One of the most common causes of heel pain in young athletic children is something called Sever’s disease or calcaneal apophysitis. In this blog I will discuss what exactly is Sever’s disease, who it affects, how it can be treated and is it avoidable?

What exactly is Sever’s disease?
Sever’s disease, which is also called calcaneal apophysitis, is inflammation in the growth plate of the calcaneus (which is the heel bone). This occurs in a growing child, usually between the ages of 9-11. It presents as heel pain and is usually brought on by an increase in physical activity. If the pain in this area gets severe many times the child will be limping due to the pain. If this worsens it can lead to a red swollen heel.

How is Sever’s disease diagnosed?
Sever’s disease is usually diagnosed by signs, symptoms and clinical exam. A typical patient will be a 9 or 10 year old boy that has been playing a lot of soccer, or basketball, and has pain to the back of his heel while playing sports. He states when he rests the pain resolved. Squeezing on the back of the heel will elicit pain with Sever’s disease. In addition, x-rays can be taken, but are usually normal.

What Causes Sever’s disease?
This is caused by overuse and the stress that it causes to the bone and tendons. Many times with this disease the bones and the child are growing at an excessively quick rate.

How is Sever’s disease treated?
The principles of treatment are RICE, which include rest, ice, compression and elevation. Stretching the tendons attached to the heel (i.e. Achilles tendon, plantar fascia) is very important. Wearing good supportive shoes with custom orthotics will help. If the pain is severe oral anti-inflammatory medications can help.  Physical therapy may help if none of these other treatments resolve the pain. Many times taking a break from physical activity is required until the pain is resolved.
Even if treatment is not sought out it will resolve slowly on its own within a few weeks.

How can I prevent my child from getting Sever’s disease?
Stretching before and after activity is very important, avoiding excessive amounts of physical activity is good to prevent any type of injury. Lastly, wearing the appropriate supportive shoes with orthotics can prevent many different foot aliments.

For more information, please visit our website at http://www.footnj.com/podiatrist-new-jersey-about-us/23/237-heel-pain

Monday, April 21, 2014

How can the Holiday’s affect your feet?

No matter what holiday you celebrate caution should be taken so you don’t have problems with your feet. Most holidays are filled with family, prayer and of course eating too much food.  Many of these activities can lead to problems with feet.

To start off many people go to pray with their family during the holiday, which means people will dress in their Easter best. Most times this means that shoe gear is more about appearance than comfort. I agree that it is okay once in a while to wear stylish, not so comfortable shoes, but if someone isn’t used to this type of shoe they may run into problems. As the weather is warming up and Easter/Passover is upon us many people will wear high heeled open toe shoes. I would like to warn those high heel open toe shoe wearers to be careful about developing blisters or wearing shoes that are too tight. Most importantly, twisting ankles is a common occurrence for the novice high heel wearer. A good suggestion would be to wear comfortable shoes to the event and perhaps change into a high heel shoe once at the location.

The second aspect of a holiday weekend for people to be aware of is the eating aspect of it. Most holidays are centered around families sitting and eating large quantities of food. The two groups of people to be concerned about this are diabetics and people who suffer from gout. Diabetics who over indulge are concerned about elevated blood sugar levels. As I have spoken about in past blogs, long term elevated blood sugar levels can lead to neuropathy, diabetic wounds, infections and a multitude of other problems.

People with gout can exacerbate their condition or bring on a gouty attack with certain foods. Therefore, they should be careful not to eat large quantities of meat, seafood or drink too much wine. If someone with gout has questionable symptoms of an attack they should seek attention with their physician. Remember the most common place for a gouty attack is the big toe joint of the foot.

In conclusion, holidays are times to spend with loved ones, but be careful because anything in excess can cause problems down the road.

For more information, please visit our website at footnj.com

Monday, April 14, 2014

Medical Foot Wear Podiatrist Shoes Podiatrist shoes 08234

What does warmer weather mean for your feet?

As this long and snowy winter finally comes to an end, everyone cannot wait to get out of their boots and into slippers, sandals and flip flops. But are sandals bad for your feet and what can you do to wear open toe shoes in the summer without any problems?

In the summer most people, including myself, like to expose their feet in some sort of open type of shoe, but before doing this think of the risks that this may involve. If you are a diabetic or have peripheral vascular disease, wearing an open type of shoe can be a disaster. If you are a diabetic with neuropathy (see earlier blog for definition) and you are wearing open toe shoes and get a cut on your foot, it can get infected and by the time you notice it there can be an infected wound. Therefore, it is highly recommended for diabetic and people with PAD to wear closed toe shoes throughout the entire year.

Another problem with wearing open toe shoes is that many sandals and flip flops that are sold in the summertime have no support built into the shoe. Therefore, many people in the summer tend to spend long hours outdoors exercising, walking and doing leisurely activities. This means that people spend more time on their feet with less support than during the winter. If someone wears a shoe with no support for hours at a time they are more than likely to begin to get achy, sore feet. Many patients actually spend weeks of the summer suffering with painful feet and by the time they seek help it is the beginning of fall and they are returning to supportive shoe gear. At the Foot and Ankle Center in Egg Harbor Township, NJ, we have a solution to this problem. We sell Spenco sandals/flip flops. Spenco’s are a sandal orthotic; the orthotic is built into the sandal. This is a great solution because this way you can still enjoy wearing a sandal during the warm months, but you can have support at the same time.

One more thing to consider when wearing open toe shoes in the summer is applying sun screen to your feet. Many people forget to do that and skin cancer can form on the feet. So don’t forget to apply sunscreen before leaving the house.

For more information, please visit our website at www.footnj.com.

For more information on how to purchase Spenco sandals please call the office at 609-272-1450

Wednesday, April 9, 2014

Podiatry and the Importance of Utilizing Other Specialties

Many patients present to a Podiatrist with a variety of foot and ankle complaints. As a Podiatrist I like to take a whole body approach to treating patients. I tend to utilize other medical specialist to help with diagnosis, treatment and ultimately to heal patients. I think all physicians should use all the tools that are available to them to help treat patients.

While performing a foot exam I tend to break down the exam into four components. The four components of the foot exam are the dermatological, vascular, orthopedic and neurologic aspects. I think that during an exam it is important to listen, examine and ask appropriate questions in order to get a complete picture of what the problem is. The foot and ankle are connected to the body and even though someone may think their symptoms are in the feet many times it is related to something else going on in the body.

For example, during the winter months many patients come into the office complaining about cold, purple toes. They state that as the weather gets colder they toes change colors, from red to white to blue to purple. It is important to perform a vascular lower extremity exam, but it is also important to ask if they get similar symptoms in their fingers. This disorder can be a variety of things, include Raynaud’s, Chilblains, but what is important is to ask general questions. Once I diagnosis the problem I frequently get other specialties involved in the patient’s care. I will refer the patient to a vascular surgeon, since this is not only a lower extremity problem, but a vascular problem as well.

Another example that I see very frequently is a patient who presents with numbness, tingling and burning to the feet. When a patient presents with neurological problems in the feet the first question I ask is do they have a history of pain back, spinal stenosis or disk disease. Nine out of ten times the patients have low back complaints and nine out of ten times the foot problems are coming from the back. At this time I complete my exam and make my treatment plan. Most times a neurologist consult is recommended. Many people say “well I came to see you because of my feet but you are sending me to a neurologist”. What I explain is that the foot is connected to all other systems of the body.

So whether the foot problem is related to the circulation (vascular), the skin (dermatology), the nerves or the biomechanics I utilize other medical specialists to give my patients a complete and thorough  treatment plan.
With medicine emerging and physicians becoming sub-specialized it is importation for doctors to rely and ask for assistance from their counter parts to help treat their patients.

For more information, please visit our website at www.footnj.com

Monday, March 31, 2014

Deep Vein Thrombosis and its relationship to podiatry

Deep Vein Thrombosis and its relationship to podiatry

What exactly is a Deep Vein Thrombosis (DVT)?

DVT is when a blog clot forms in the deep veins, this most commonly occurs in the legs. Symptoms of a DVT can include pain, swelling, redness in the leg. These symptoms can present themselves in different medical conditions, such as infection or lymphedema, therefore, if someone suspects they have a DVT IMMEDIATE medical attention should be sought.

How does a DVT develop?
There are three main risk factors for developing a DVT. They are venous stasis, hypercoagulability and damage to the endothelium. Venous stasis is when the veins are static and not moving. Hypercoagulability is when the blood has a higher change of clotting. Endothelial damage is damage to the blood vessels. Each of these causes has multiple causes. These 3 risks factors together are known as Virchow’s triad. The more risk factors a person has the higher chance of developing a DVT.

Who is at risk for developing a DVT?
Taking Virchow’s triad into consideration the following are some of the risk factors for developing a DVT: immobilization, obesity, surgery, birth control pills, age, cancer, pregnancy, trauma to the leg, infection, HIV and blood clotting disorders etc. There are many other risks factors, but these are the common ones.

How are DVT’s diagnosed and treated?
Immediate diagnosis is critical because if a DVT goes undiagnosed it can travel to the lungs, cause a Pulmonary Embolism and possible death. If a patient has a painful, swollen, red calf an Ultrasound should be performed immediately. There is a blood test that can help rule out a DVT but it is not as sensitive as the ultrasound in diagnosing a DVT.

A DVT is treated with anticoagulation medication, such as Coumadin, Lovenox, or  Xarelto . Treatment is usually required for a few months after a DVT is diagnosed. If someone has a history of DVT a filter can be placed surgically in their veins.

Can I prevent a DVT?
If someone has many risks factors they can take medication for prevention. In addition, exercise, compression stockings and staying active can help.
For more information, please visit our website at www.footnj.com