In the United Stated there are more skin cancer diagnosis than all other cancer diagnosis combined. Podiatrists can detect skin cancer below the knee but we want all of our readers to be educated on the basics of identifying questionable skin lesions.
A – Asymmetry
If a skin lesion in asymmetrical when you draw a line through the middle of it and it will not look the same on both sides. Freckles, age spots, and other benign pigmented skin areas will look more or less like a circle. The lesions of concern are those that do not have a symmetrical look.
B – Border
The border of the area in question should be even and make a roundish shape. An uneven border that changes in thickness, color, and makes many turns is an indication of unhealthy skin.
C – Color
If the spot on your skin is a uniform color or changes only slightly than you are more than likely safe. If the skin spot makes a drastic change from a dark brown to a very pale brown then it is time to show your skin to a professional. Malignant lesions could range from brown, blue, red, tan, white, and black.
D – Diameter
Most normal skin lesions are below 6 mm. Once the area gets larger than a pencil eraser there is a higher potential for malignancy.
E – Evolving
when a mole starts to change in any of the above characteristics it is time to have it looked at. Occasionally benign moles will make alterations especially with sun exposure but large change in color, size, and shape are not normal.
There is reason to be concern if a mole become itchy frequently, bleeds regularly, takes an extended period of time to heal, or frequently crusts over. These are just a few other indications that your skin needs treatment. The above guidelines are valuable considering one in five Americans before the age of 70 will be diagnosed with skin cancer.
Don’t forget to apply sun screen all year around and for any skin questions below the knee Frederick Foot & Ankle is ready to address you concerns.
Katie Ormerod, a promising 20-year old snow boarder from Great Britain, must cancel on her Olympic plans the week before the winter games start. Ormerod suffered a wrist injury while training but pushed through, only to fracture her calcaneus days before stepping onto the Olympic stage in Pyeongchang. For a snowboarder a heel fracture cannot be ignored but calls for emergency surgery.
Heel fractures tend to happen in high-energy traumatic events such as; extreme sports, falling from a high distance, or a severe car crash. Often after severe trauma the heel can become deformed. The heel can change shape by widening or shortening after a fracture, often surgery is used to restore the normal calcaneus shape. With a change in heel shape the limb length can differ from the right to the left leg leading to a limp.
Arthritis, joint stiffness and joint pain frequently manifest after trauma because of changes that takes place in the foot with any fracture, but on a larger scale with a calcaneal fracture. The calcaneus is the largest bone in the foot and shares a joint space in multiple locations with 3 other bones in the foot/ankle making the calcaneus an integral part of lower limb anatomy and mechanics. To off-set these issues post calcaneal fracture healing occasionally orthotic devices might be needed. Luckily, heel fractures account for only 2% of all fractures but if you happen to fracture your heel Frederick Foot & Ankle is ready to assist you in your recovery.
Taking care of ulcers at home can be intimidating for some patients, but it does not have to be that way.
- Off-loading the ulcer site - Reducing the pressure that is placed on the wound site is beneficial because it decreases the amount of damage to the site and keeps a larger blood supply to the wound. An important part of offloading is wearing the correct shoe, padding around the ulcer, and walking only if permitted by your podiatrist.
- Use the correct wound dressing - Ulcers need to have the proper environment to promote healing. You do not want the environment too wet or too dry. Excessively dry wound beds hinder the movement of the healing cells. When an area is really wet the skin becomes very fragile and is easily disrupted. The proper treatment should be applied directly to the wound and then covered with a secure wound dressing. The area should always be covered when it is not being assessed or cleaned. Keeping the wound covered is necessary for many reasons; keeps out potential infections, allows the topical treatment to stay at the wound site, and applies a small amount of pressure to combat excessive inflammation.
- Never miss your appointment - Your appointment with your podiatrist is to check and make sure that the area has not become infected. If the site does become infected the open wound can lead to infection spreading into the blood stream or perhaps into the bone. Debridement, when the hard-callused skin is removed with a blade from the wound site, allows for the area surrounding the wound to have a healthy tissue with a blood supply.
The above steps are general guidelines, be sure to follow your doctor’s orders for your specific case.
Second year podiatric students are required to take the American Podiatric Medical Licensing Exam (APMLE) step 1. This exam tests the students on the knowledge that they have acquired through their first two years in school. General Anatomy, Biochemistry, Microbiology, Pharmacology, Physiology, Pathology, and Lower Extremity Anatomy are covered by AMPLE standardized test. After having gone through the whole process of taking multiple boards exams myself several years ago, I compiled some pointers to direct current students in the right direction and hopefully to a passing grade.
Focus on the Main Three
Although there are seven categories in total on the exam there are “The Big Three.” These three categories will be where the largest percentage of questions originate from, therefore spending the most time on “The Big Three” will be the best use of your time. Lower Extremity Anatomy, Pharmacology, and Microbiology are known as “The Big Three” will be the largest percentage of the test.
The percentage of questions are broken down as reported
· Lower Extremity Anatomy: 25%
· Pharmacology 15%
· Microbiology and Immunology 15%
· General Anatomy: 13%
· Physiology 13%
· Pathology 12%
· Biochemistry 7%
Make a Schedule
With your study partner choose deadlines for yourself that are obtainable to stay on track. Even if you and your study partner do not study together as a team they can be someone to show-up at the library and hold you accountable for being present for a study session. Having a schedule will show you how far out it might be necessary to study, and when it is ok to take study breaks. Many students make the mistake of starting too late because they underestimate the amount of time needed to get through their study material. No student has ever said “I started studying too early.”
Choose Your Resources Wisely
Pick 3 or 4 strong resources to learn the material from. When you start jumping around and using multiple resources for different subsections there is a higher chance that you will miss necessary topics and that you will be wasting time going between different sources. Listen to upperclassman, do a quick online search, and follow guides set-up by your professors to narrow down what you want to use for your study materials.
From my experience the following materials are worthwhile for boards part 1 studying.
- Take Advantage of resources made available by APMLE which include study tools, an outline by topic, and practice questions
- Anatomy TV is a free online resource for helping you visualize the structures for lower extremity anatomy.
- First Aid USMLE for Step 1 is a concise book that over views all of the necessary topics. The book is well organized, includes mnemonics, and includes pictures. Although obviously written for those taking the USMLE it works great for APMLE.
- Pathoma is a great book and video content combo for studying anything pathology associated. Sign-up for the free trial first to see if it will work for your studying style.
- SketchyMedical is for all you visual learners out there. SketchyMedical includes a story along with a picture full of mnemonic devices to help you remember microbiology, pathology, and pharmacology topics. Follow the website below to view a free trial and potentially purchase the subscription.
To all the medical students out there Frederick Foot & Ankle wishes you the best of luck in your studies!
Although I have completed a few half marathons I occasionally walk for exercise. I feel that walking is an underrated form of exercise. Many diseases that affect people today both physical and mental can be warded off with the help of daily walking. Cardiovascular workouts should be incorporated into everyone’s daily activities but the type and intensity of the workout should be modified to meet each person’s capabilities. Read the 6 health benefits below to get your motivated to start your walking routine.
According to the CDC more than 100 million Americans have Diabetes. Studies have shown that walking benefits both Type 1 and Type 2 diabetics by aiding in glucose control. In one study of 201 type 2 diabetics, each participant added 2,600 steps to their daily activity and had an average of 0.2% decrease in their Hemoglobin A1c. Diabetes Care also published an article that pre-diabetics can reduce their chances of developing the disease by just walking for 20 minutes daily.
- Heart disease
Heart disease is a large category of conditions that plague the function of the heart. Some symptoms of heart disease include shortness of breath, chest pain, irregular heart beats and more. A Harvard Medical School study showed that walking reduced the occurrence of heart disease by 30% by including 2.5 hours of walking a week.
- Joint pain
Joint pain often happens because of arthritis, which is inflammation in the joint. Walking builds muscle and this helps to support the joints relieving some of the pressure and pain. Additionally, with movement in the joints the synovial fluid is able to move around the joint surfaces to lubricate and nourish the area. Using your joints through exercise also protects the bone density, the bone density increases to meet the demands of the workout.
The American Cancer Society published a study that there was a 14% reduction in breast cancer diagnosis for those who walked 7 or more hours a week versus their less active counterparts. A second study completed by Harvard University assessed women who walked 3 to 5 hours a week were 54% less likely to end up with breast or uterine cancer.
5. Immune support
Do you want fewer sick days? Taking up walking during the week for a minimum of 20 minutes will leave you with 43% fewer sick days in comparison to those exercising once a week or less. Research from Appalachian State verified that 30 minutes of walking a day can increase the number of immune cells that help combat future sickness.
- Mental Improvements
Not only does walking help with physical ailments but with mental diseases as well. The University of California found that memory changes due to advanced age decreased 17% in those that walked 2.5 miles or more daily. In the same study those who walked less than ½ mile daily had a 25% decline in memory retention. An additional study found that those who walked ¼ of a mile per day were 50% less likely to develop dementia and Alzheimer’s disease. The memory improvements can be attributed to exercises ability to help the body retain the same brain size.
Remember to always consult your doctor before starting a new workout routine. So, keep counting your steps and reaching your goals for a healthier and happier 2018!
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