Key Takeaways:

● The Allay Hydrogel Cap received de novo FDA classification in July 2024, representing a new category of in-situ forming nerve cap technology distinct from traditional biologic caps

● In a retrospective multicenter analysis of 23 patients, no neuroma formation was observed in either prophylactic or therapeutic groups, with an average pain score reduction of 5.5 points

● The sutureless application eliminates the need for microsurgery training, enabling general surgeons and non-fellowship-trained physicians to achieve outcomes previously limited to microsurgical specialists

● Traditional neuroma treatments like TMR show only 50% pain reduction and 25% cure rates in revision cases, while early Allay results are demonstrating superior and more consistent outcomes

● Patients are discontinuing opioids within days of surgery, a finding replicated across multiple surgical sites and a significant departure from typical post-neurectomy recovery

● The hydrogel is 90% water, remains stable for three to four months past the neuroma formation window, and fully hydrolyzes within eight months, leaving no scarring or remnants

● Surgeons should dissect back to normal, healthy nerve tissue before capping, and ensure adequate nerve length to position horizontally in the form for optimal gel application

● The "unmasking phenomenon," where resolving dominant nerve pain reveals secondary musculoskeletal or nerve issues, is common and requires careful patient counseling and precise post-op pain assessment

● Tulavi is expanding into TMR applications, pediatric use (patients over 25 kg), and has pipeline products targeting nerve repair expected in early to mid-2027

Guest Info:

Josh Vose, MD, MBA

CEO, Tulavi Therapeutics

Background: Chemical engineer (Georgia Tech) turned surgeon-operator with 25+ years building peripheral nerve and surgical device startups. MD from the Medical College of Georgia in Augusta; general surgery training in Boston. Former CEO of Peak Surgical (Plasma Blade, acquired by Medtronic) and Sia (resorbable mesh for breast reconstruction, acquired by Integra). Joined Tulavi to commercialize the Allay Hydrogel Cap and scale peripheral nerve solutions beyond microsurgery-only centers.

LinkedIn: https://www.linkedin.com/in/josh-vose-7306661

Website: www.tulavi.com

Andrea Para, PhD

Senior Director of Medical Affairs and Strategy, Tulavi Therapeutics

Background: Medtech strategist, patient advocate, and bioengineer with 14+ years across medtech R&D, hospital and medtech consulting, and strategic planning. BS, MS, and PhD in Bioengineering from Georgia Tech, where her doctoral thesis under Dr. David Ku focused on preventing rapid platelet accumulation under very high shear stress. Previously Director of Exploration at Edwards Lifesciences, Sr. Manager for Product Development and Strategy at Accenture, Consulting Director at Vizient, and R&D Engineer II at St. Jude Medical working on next-generation heart valves. Also Principal/CEO of Medivici LLC, providing technical due diligence for medical device and IVD investors. Joined Tulavi in November 2025.

LinkedIn: https://www.linkedin.com/in/andrea-para

Website: www.tulavi.com

Resources:

● "Saving Limbs, Saving Lives: Advanced Treatments to Prevent Amputations in Diabetic Populations" by Dr. Damien Dauphinee (Kindle): www.amazon.com

● Tulavi Therapeutics: www.tulavi.com

● Dr. Eddie Cobray's publication on first 11 patients with Allay Hydrogel Cap (published approximately four months before recording)

● American Society of Peripheral Nerve (ASPN) abstract: retrospective multicenter analysis of 23 patients

● Vizient Innovative Technology Contract: www.vizientinc.com

● Association of Extremity Nerve Surgeons (AENS): www.aens.us

● Incept (medtech accelerator, parent company family of Tulavi)

● Gerson Lehrman Group (GLG): www.glg.it

Connect:

● The Pod Doctors: www.thepoddoctors.com

● The Pod Doctors on Spotify, Apple Podcasts, Stitcher, and YouTube

● Tulavi Therapeutics: www.tulavi.com

● The Pod Doctors on Facebook and Twitter

#ThePodDoctors #Podiatry #FootAndAnkle #PodiatricMedicine #WoundCare #DiabeticFootCare #PeripheralNerve #Neuroma #FootSurgery #LimbPreservation #TulaviTherapeutics #AllayHydrogelCap #NerveCap #PeripheralNerveSurgery #NeuromaTreatment #MedicalDevices #SurgicalInnovation #PainManagement #OpioidReduction #Neurectomy

Listen as they examine how innovation and evidence-based medicine come together to elevate patient care and improve quality of life.

Top Takeaways:

• Introduction to SAM (Synthetic Antimicrobial Matrix) and its role in next-generation wound care
• How lidocaine integration enhances pain management at the wound site
• Insights from Dr. Victoria Miles and Brad Wiggins of Embed Biosciences
• Applications of SAM technology in burn care and podiatric surgery
• Benefits of a dual-action matrix: accelerated healing and meaningful pain relief
• Impact on postoperative outcomes and reduced reliance on opioid medications
• The importance of clinical research and early case studies in validating new technologies
• Real-world patient experiences demonstrating improved comfort and recovery
• The future of wound care innovation and its role in improving patient quality of life

Resources:

Visit our website: https://thepoddoctors.com/

Top Takeaways:

• The evolution of advanced therapies for diabetic limb preservation showcased a significant increase in treatment options over the last two decades.
• Plantar fibromas, while often benign, can cause significant discomfort and should be evaluated through careful examination and imaging techniques like ultrasound.
• Treatment for plantar fibromas often begins conservatively with physical therapy and may escalate to injections or surgical options if necessary.
• Understanding the potential for benign versus malignant processes is crucial in managing plantar fibromas effectively and safely.
• The importance of proper post-operative care and rehabilitation after surgical removal of plantar fibromas cannot be overstated for optimal recovery.

Resources:

Visit our website: https://thepoddoctors.com/

Top Takeaways:

• The podcast episode discusses the significant advancements in diabetic limb preservation over the last 20 years, highlighting new technologies and treatment options.
• Doctor Damian Dauphine emphasizes the importance of understanding complex cases in diabetic patients to prevent amputations.
• The surgical correction of big toe hammertoe, particularly its complications in patients with neuropathy.
• The risks associated with untreated hammertoe deformities can lead to dangerous ulcers, especially in diabetic patients.
• The anatomy of the big toe and the surgical procedures involved in correcting contractures.
• The importance of post-operative care and recovery strategies for patients undergoing foot surgery.

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• "It’s been estimated that one in four people have some level of fungal pathology going on at some time or another. So super common athletes foot, it's a fungal infection typically of the interspaces between your toes because it stays moist, and it typically presents with burning, itching, and scaling of the skin.” -Dr. Raafae Hussain

• "People will have athlete’s foot for years and not realize that they have it because they don't feel the itching. We have to cure them of that thought process and say, no, that's athlete's foot until proven otherwise.” -Dr. Damien Dauphinee

Top Takeaways:

• Topical Antifungals: Start treatment using topical antifungals like fungifoam that pull moisture off the foot while killing the fungus.
• Moisture Control: Employ methods for controlling foot moisture including moisture-absorbing shoe liners and antiperspirant products like Drysol.
• Oral Antifungals: For severe, recalcitrant cases, consider oral antifungals but be mindful of their potential side effects on the liver.
• Importance for Diabetics: Diabetic patients must pay attention to athlete's foot due to their higher risk of complications like foot ulcers and infections.
• Treating Shoes and Feet: Clean shoes thoroughly using products like Lysol and ensure they are dry before use to prevent re-infection.

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• "Orthotics are about architectural support, not just cushioning. Stiffer devices are more effective than gel insoles for plantar fasciitis.” -Dr. Raafae Hussain

• "Standing calf stretches are technique dependent, and that's where the ProStretch shines by leveraging gravity for optimal stretch.” -Dr. Damien Dauphinee

Top Takeaways:

• Steroid Injections: Steroid injections can help in reducing inflammation and pain, making it easier to follow through with other treatments like stretching and wearing orthotics.
• Advanced Treatment Options: For chronic cases not responsive to conventional therapies, treatments like Topaz and amnio injections offer promising results.
• Diagnostic Imaging: Utilizing tools like ultrasound to measure plantar fascia thickness can aid in determining the severity of the condition and tailoring the treatment plan accordingly.

What You Will Learn:

• Effective stretching exercises, such as standing calf stretches, towel stretches, and using tools like the ProStretch, play a crucial role in managing plantar fasciitis.
• Choosing well-made, supportive shoes and custom orthotics can significantly alleviate plantar fasciitis symptoms. 

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• "We did what's called an interference screw or anchor. We drill a pocket hole for that tendon to go through, and then we'll put an anchor in right next to it that will hold that tendon up against that bone without any type of limitations.” -Dr. Raafae Hussain

• “The non-absorbable suture will tear your gloves and tear your finger before it'll break. You can really crank on this stuff, which is perfect for stout, tender repairs where you're going to be putting a tremendous amount of force through this tendon.” -Dr. Damien Dauphinee

Top Takeaways:

• Achilles Tendon Repair with FHL Transfer: The utilization of the FHL tendon to enhance the strength and functionality of a damaged Achilles tendon.
• Surgical Case Details: Insight into a complex foot surgery involving a patient with previous clubfoot reconstructions.
• Advanced Surgical Techniques: The use of advanced techniques, such as the whip stitch and interference screw, to ensure successful tendon transfer.

What You Will Learn:

• The importance of post-surgery protocols, including non-weight bearing periods and early active range of motion exercises.
• Surgical procedure steps and the reasoning behind specific surgical choices.

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• "When tamping the bone you can use screws, wires, staples, plates, but I think the most common is a single screw.” -Dr. Raafae Hussain

• “The moral of the story from a surgeon's standpoint is, MRIs can lie to you Have a backup for your backup.” -Dr. Damien Dauphinee

Top Takeaways:

• Cadaveric Achilles grafts can be a viable option to bridge extensive gaps.
• Encouraging interdisciplinary learning through real-life cases is vital for medical professionals' growth and preparedness for complex surgeries.

What You Will Learn:

• Postoperative care involves lengthier immobilization and physical therapy when using cadaveric grafts, highlighting the need for tailored recovery protocols.
• MRIs can sometimes provide misleading information; it's important to be prepared with multiple treatment plans.
• Proper fixation using screws and consideration for nerve location, such as sural nerves, is crucial during Achilles tendon surgery.

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• "Nerve flossing is a really great technique. We'll get folks into the physical therapists and have them start nerve-flossing as quickly as we can. Usually, right after we get the stitches out at two weeks.” -Dr. Raafae Hussain

• “You've got to always keep in mind that when patients are complaining of burning, stabbing, shooting pain, tightness at nighttime, that is nerve-related pain for sure.” -Dr. Damien Dauphinee

Top Takeaways:

• Fibular nerve release is improving patient outcomes, with modern technology playing a pivotal role.
• Detailed nerve anatomy understanding and careful surgical techniques are essential for the successful treatment of the fibular nerve and its branches.
• The surgical approach to decompressing the fibular nerve involves meticulous dissection 
• Diagnostic blocks are a helpful tool in identifying specific nerve entrapments that could contribute to conditions like restless leg syndrome (RLS).
• Nerve flossing is crucial to prevent adhesions and maintain nerve health.

What You Will Learn:

• Surgical procedures to address nerve entrapment
• Using diagnostic blocks as a tool
• How the application of protective materials like umbilical cord tissue prevent scarring and promote healing
• Postoperative care that encourages movement

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• "The difference between doing an open versus MIS is minimally incisional surgery. The benefit is that you don't have a long incision.” -Dr. Raafae Hussain

• “Most bunion surgeries that fail, are a failure of the choice of the bunionectomy.” -Dr. Damien Dauphinee

Top Takeaways:

• The success of bunion surgeries largely depends on selecting the proper procedure that aligns with the patient's degree of deformity and clinical presentation.
• The Lapidus Bunionectomy: among other techniques, is becoming increasingly popular for treating severe and hypermobile bunions
• Minimally invasive surgeries (MIS) for bunions require careful patient selection, with ideal candidates being young, healthy, and free of complicating factors like smoking or diabetes.
• Revision bunion surgeries are sometimes the consequence of an initial procedure that did not sufficiently address all aspects of the deformity
• Fusion of the big toe joint can be a highly effective solution for long-term relief in patients with recurring bunions or persistent joint breakdown.

What You Will Learn:

• Different options for revision bunion surgery
• Common complications and concerns
• Patient Selection Criteria for MIS Bone Healing
• How to Choose the Right Bunion Surgery and Surgeon

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• "When chilblains occurs, you can put your feet in lukewarm water for a certain period of time. Not blazing hot, not boiling. You just want them to be lukewarm. If this is a more chronic problem, it flares up every couple months, or during the cold weather, your doctor might prescribe something topical.” -Dr. Raafae Hussain

• “Between chilblains and frostbite, the difference is temperature. So it doesn't require a frigid 20, you know, in the teens Fahrenheit to cause chilblains. It could, like we talked about, be in the forties outside.” -Dr. Damien Dauphinee

Top Takeaways:

• Chilblains: a condition characterized by itchy, red, and tender skin lesions, often exacerbated by cold, damp conditions, without necessitating freezing temperatures.
• Individuals with a history of Raynaud's or who are smokers may be more susceptible to developing chilblains.
• While self-limiting, recommendations include lukewarm foot baths, topical steroids, or vasodilators like topical Nitroglycerin for acute cases. Systemic medications are considered for more chronic issues.
• Appropriate insulative clothing and thick socks are key preventive measures during cold weather, especially for slender individuals who may be more prone to the condition.
• Patients with sensory loss due to neuropathy should take extra caution when using heat-related treatments to prevent accidental burns.

What You Will Learn:

• What is chilblains?
• The difference between chilblains and frostbite
• Treatment options and prevention tips
• Neuropathy Consideration

Resources:

Visit our website: https://thepoddoctors.com/

Quotes

• " There's a lot of different types of wounds out there, but the dressings themselves are fairly similar. So there's primary intention healing wounds or secondary intention healing wounds, and there's tertiary intention healing wounds. Primary are your surgical incisions. The dressings on those are very simple. Secondary intention healings are like your sores and ulcers or big gouges. And tertiary intentions are more of like a delayed primary healing type of surgical incisions.” -Dr. Raafae Hussain

• “It still seems to be deeply embedded in the brainstem of human beings that you need to let wounds air out. They don't need to be aired out. The dressing needs to be applied. And you need to change that dressing in a reasonable schedule to prevent maceration, which is the white stuff, and to prevent things from drying out. So if there's got to be a happy medium there somewhere where you're changing the dressing frequently enough that you're avoiding some of those complications we got way better wound dressings and capabilities in 2023.” -Dr. Damien Dauphinee

Top Takeaways:

• Proper wound dressing technique involves moistening dry wounds and drying excessively moist or draining wounds.
• Hydrofera blue is a versatile dressing that absorbs drainage, provides antimicrobial properties and helps maintain a balanced wound environment.
• Coban wrap is an elastic dressing that can be easily molded and provides secure coverage for the wound.
• It is important to maintain sterile technique during dressing changes and to avoid using household scissors or unclean instruments.
• Modern wound dressings have advanced significantly, and the belief that wounds need to be aired out is outdated.

What You Will Learn:

• How to do a wound dressing change 
• Explanation of different types of wounds and dressings 
• Debunking the myth of letting wounds air out 
• Qualifications for being considered homebound for Medicare patients

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

"As long as that end nerve is no longer connected to the brain, that's going to wither and shrivel up and go through Wallerian degeneration and go away." -Dr. Damien Dauphinee

“Complex regional pain syndrome. There are two versions. There's a type one, which is nondescript, there's no specific nerve pathway, and there's a type two, which it's more associated with a specific nerve pathway, usually associated with an injury.” -Dr. Raafae Hussain

Top Takeaways:

• Complex regional pain syndrome (CRPS) can be misdiagnosed if a discrete nerve injury is not identified.
• Discrete nerve injuries can cause chronic pain and other symptoms similar to CRPS.
• Surgical intervention, such as capping the damaged nerve and burying it in muscle, can provide significant pain relief for patients with a discrete nerve injury.

What You Will Learn:

• Differentiating between general CRPS and discrete nerve injury
• Options for nerve reconstruction or capping
• Preventing stump neuroma
• Importance of identifying discrete nerve injuries in CRPS patients 
• The need for psychiatric care in some cases 
• The importance of multimodal pain management 
• CRPS Warriors support group for patients

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

"You can get something called lipidema, and that's a different animal where a known normal fatty deposit can become painful. A lipedema can be a real problem in different parts of the body, and that's a normal place for adipose tissue. But if it becomes painful, sometimes we have to consider removing it. I've not appreciated that as much over the years as I do now. I think I'm seeing that that can become a source of pain all by itself in some patients. And I think it's probably a poorly understood problem." -Dr. Damien Dauphinee

“So we get the closure on this and you'll see we'll do deep to superficial. The reason we do that is so the knot stays buried. It's not close to the skin. So when she ends up tying this, you'll see that the knot will stay nice and low and hopefully the patient won't ever feel it. And then as time goes on, the weeks go on, the stitches will dissolve away, and hopefully no more score. There no more palpable nodule there using.” -Dr. Raafae Hussain

Top Takeaways:

• Lipomas are benign fatty nodules that can cause pain in the foot and ankle.
• Lipomas are commonly found in the subcutaneous layer and can be misdiagnosed as ankle sprains.
• Clinical diagnosis is crucial, as an MRI may not show whether the lipoma is causing pain.
• Surgical excision involves making an oblique incision along the relaxed skin tension lines and carefully dissecting the lipoma.

What You Will Learn:

• Surgical procedure for lipoma excision 
• Importance of dissecting carefully to avoid nerve damage 
• Closure technique: two layers, running subcuticular, deep vertical mattress 
• Superficial dressing choice: zebra foam
• Post-op shoe preference
• Risks: injury to lateral dors-cutaneous nerve branch, stunt neuromas

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

"The tibialis anterior vessel was the one that they were not able to open up. And that was his downfall because the tibialis anterior is the one that comes and perfuses the top half of your big toe. Kind of important when you have blood flow problems, you don't have blood flow coming in, you're losing that toe or whatever part of the body." -Dr. Damien Dauphinee

“Anytime we can get collateralization or new tributaries to grow into an area that is not getting enough blood flow, we can improve pain.” -Dr. Raafae Hussain

Top Takeaways:

• Considerations for patients with severe vascular disease
• Importance of incision placement and goal of restoring healthy blood flow

What You Will Learn:

• Gangrenous toe amputation case
• Bone marrow aspirate concentrate injections
• Potential use of BMAC for staving off major amputations

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

"Ischemic pain is deep. It's not responsive to narcotics. The only thing that's gonna fix it is, unfortunately, amputation or fix the blood flow problem." -Dr. Damien Dauphinee

“One of the things to keep in mind about ABIs ankle-brachial index is it can be falsely elevated in diabetic patients.”  -Dr. Raafae Hussain

Top Takeaways:

• External Fixation and Limb Salvage
• Advanced Treatments for Diabetic Limb Preservation

What You Will Learn:

• Diabetic limb preservation
• The types of gangrene and treatment options
• Wound care and recovery

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

"I really do think that for certain disease states that we don't run into routinely, possibly some of the more obscure skin lesions that we might see, it would be nice to be able to plug those signs and symptoms into Chat GPT and see what it comes up with.” -Dr. Damien Dauphinee

“We can do tendon work, but obviously if you're only addressing the tendon, the foot structure is always gonna be the origin of the problem. The tendonitis is just the secondary effect of it."  -Dr. Raafae Hussain

Top Takeaways:

• Chat GPT could potentially change the way we do medical research 
• The use of AI in medicine requires control and restrictions to avoid potential dangers
• AI can help in the management of underlying conditions

What You Will Learn:

• The Potential of Chat GPT in Healthcare
• Podiatrists do more foot and ankle surgery than any other specialty

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

“We felt that it was very important for it to be antimicrobial to kill bacteria. And we all know as providers that bacteria in the wound impairs wound healing. That was an essential part of the technology. The second thing that we wanted to do, we wanted to make this bioresorbable so you could put it in a wound and not have to take it out. That also gives you some flexibility to take an antimicrobial matrix and maybe prevent a wound complication.” -Dr. Michael Shurr

“It is amazing what the body can do when it's also not trying to fight microbes and fight bacteria and fight other things. And so you're providing really just the optimal healing environment and allowing the body to do what it does."  -Elliot Phillips 

Top Takeaways:

• The Benefits of Synthetic Wound Dressings
• Antimicrobial Product for Department of Defense Use

What You Will Learn:

05:48 Bioresorbable Antimicrobial Matrix for Wound Healing

11:17 Microlyte: A Disruptive Antimicrobial Product for Wound Care

20:50 Case Study: Successful Treatment of Radiation Wound 

27:28 Silver-Polymer Wound Healing and Antimicrobial Product

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

“I think biologics are becoming a bigger part of a lot of the procedures that we do, and we're trying to use them…And if it makes that procedure that much more effective than it's completely worth it." - Dr. Damien Dauphinee 

“Most of the time, conservatively, we're able to take care of plantar fasciitis."  -Dr. Raafae Hussain 

Top Takeaways:

• Treating Planar Fasciosis With Surgical Procedures
• Utilizing Biologics for Chronic Planar Fasciitis

What You Will Learn:

02:48 - The Impact of Overused Planar Fascia 

09:40 - The Benefits of Umbilical Cord Grafting 

11:54 - The Spur and Pain Management 

Resources:

Visit our website: https://thepoddoctors.com/

QUOTES:

“Quite often with restless leg syndrome, the patient will also have sleep disorders. They'll have insomnia, irritability, discomfort, and sensitivity, all from their lower extremities.” - Dr. Damien Dauphinee [03:04]

“Spinal cord stimulators are expensive and it's an invasive procedure. I think for the patients who failed everything else, that may be an option. But if nobody's looked at whether or not there is the potential for nerve entrapment, the neurolysis procedure or the nerve decompression procedure there are far fewer potential complications from that than having wires inserted into your spinal column.” -Dr. Raafae Hussain [13:12]

Top Takeaways:

• Common symptoms of restless leg syndrome
• Fibular nerve entrapment treatment options
• Managing chronic pain with Gabapentin and Lyrica

What You Will Learn:

2:32 Common Symptoms of Fibular Nerve Entrapment 

4:28 Treatment of Restless Leg Syndrome

8:16 Gabapentin and Lyrica for Pain Management

16:52 Anatomy, EMG Testing, and Surgical Procedures with Jim Anderson

22:09 Benefits of Using Thickened Nerve Conduction Gel for Peroneal Muscle Stimulation

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

Quotes:

“One of the reasons why we wanted to do this particular show was to highlight the potential for patients to have both plantar fascial pain and peripheral nerve pain at the same time. This is a subset that is more common than not. It's incumbent on us to be able to tease that out from the patient and that there is a potential surgical option for these folks if they fail the conservative stuff where we can address both at the same time.” - Dr. Damien Dauphinee [20:52]

“With tarsal tunnel syndrome, you'll have those symptoms with the tingling, burning, most commonly we associate with nerves. But you can also have that sharp pain usually in that arch or in that forefoot. But that first branch that comes off that nerve also goes to the heel, that medial calcaneal heel nerve that comes down right here and innervates that plantar fascia area.” -Dr. Raafae Hussain [05:05]

Top Takeaways:

• Treating heel pain caused by plantar fasciitis and tarsal tunnel tyndrome
• The differences between fasciitis and fasciosis
• Peripheral nerve pain treatment

What You Will Learn:

• [00:39] Intro
• [02:50] Plantar fasciitis and tarsal tunnel syndrome
• [07:11] Treatment options for tarsal tunnel syndrome and plantar fasciitis
• [15:18] Releasing fascia tissue to heal nerve compression 
• [21:18] Treatment of chronic plantar fasciitis and nerve compression

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

“Depending on who you read they estimate the first MPJ should take about forty to sixty percent of the forefoot pressure and the lesser metatarsal should take about ten percent across the board. When you have a bunion you have a toe that has deviated out and it is hyper-mobile which is why we correct it sometimes.” -Dr. Raafae Hussain [02:38]

“Equinus is the root of all evil. It destroys the biomechanics of the foot like nothing else and if you have neuropathy that is gonna drive Charcot. But in patients that have normal sensation they get the forefoot capsulitis if it is one particular joint capsule, so lengthening that joint tissue can be a tremendous benefit to those patients.” -Dr. Damien Dauphinee [04:12]

Top Takeaways:

• Hallux valgus deformity and the effects of stretching
• Recommended procedures for the deformity and presence of a bunion
• Equinus and the Achilles lengthening 

What You Will Learn:

• [00:39] Intro
• [02:14] X-ray analysis: bunion and hallux valgus deformity 
• [07:29] Treatment suggestions and surgery 
• [19:01] Screw placement
• [26:50] Lazy S incision 
• [30:13] Lengthening the Achilles
• [34:04] Protecting the tendon from becoming adhered 

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“Generally speaking, ankle replacements are super new as far as joint replacements go.” - Dr. Raafae Hussain [08:13]

“The 3D printed options for these templates has really made a huge difference in that those templates literally fit the anatomy based on that three-dimensional CT.” - Dr. Damien Dauphinee [15:59]

“The technology has finally caught up with the need and the need is only getting greater with the folks that have had ankle fracture repairs… the car accident victims, people who have slip and fall injuries… even if it was fixed correctly 15-20 years ago.” - Dr. Damien Dauphinee [20:01]

Top Takeaways:

• When is ankle surgery necessary?
• Types of ankle replacements: old vs. new
• Recent innovations that make total ankle replacements more effective
• What the recovery process is like for a total ankle replacement?

What You Will Learn:

• [00:39] Intro
• [02:16] Overview of the ankle
• [03:30] Examining an arthritic ankle & Pain management options for acute injuries
• [06:11] Ankle surgery options
• [07:59] Ankle replacement types & cases
• [17:42] Recovering from a total ankle replacement

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“Probably the most common that we’ll see is your neuropathic, aka your diabetic, foot ulcer. This is when you have uncontrolled diabetes, you have that neuropathy, you have that poor healing potential, and they end up walking until they get a sore, typically on the bottom of their foot, on a high-pressure spot. These are things we’re able to take care of if we stay ahead of it.” - Dr. Raafae Hussain [04:51]

“It’s probably more important to get rid of the dead tissue, the broken-down collagen in the wound bed, than it is to use a silver dressing to prevent infection.” - Dr. Damien Dauphinee [18:23]

“Every day a wound is open, especially in diabetic patients, is another chance for that to get infected. So, we really need to use whatever advanced therapy that we can get ahold of to get that wound closed rapidly because the expenses in these wounds are not in the stuff we’re using to treat them. The expensive stuff is the amputation, the six weeks of antibiotics, the 3-4 trips to the hospital.” - Dr. Damien Dauphinee [22:40]

Top Takeaways:

• 4 major types of chronic wounds 
• Methods of treating and dressing diabetic foot ulcers
• Santyl vs. Silver dressings: Which is better?
• How to offload diabetic foot ulcers to facilitate healing
• Can you reverse neuropathy in diabetic patients?
• Treating vascular and venous issues in patients with foot ulcers
• Key methods and biologics used in treating chronic wounds

What You Will Learn:

• [00:39] Intro
• [02:07] Common wounds we see on a daily basis & Their causes
• [07:56] Diagnosing and treating ulcers on the feet
• [15:19] Dressing foot ulcers after the first treatment
• [23:33] Offloading diabetic foot ulcers
• [26:47] Important data & statistics on diabetic foot ulcers
• [28:46] Why podiatrists work with vascular specialists
• [36:04] Using hyperbaric oxygen therapy and NPWT to heal wounds
• [46:33] Biologics used for treating wounds
• [52:19] Important takeaways on chronic wounds in diabetic patients
• [57:23] Breaking down a few of Dr. Dauphinee’s past chronic wound cases

Resources:

Visit our website: https://thepoddoctors.com

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

Learn more about the Wise Healing Center in Argyle, TX: https://www.wisehealthsystem.com/location/wise-healing-center-argyle 

QUOTES:

“The way that salicylic acid works is it’s an anti-karatolytic agent, fancy words for saying that the cells, the way that they adhere to one another like bricks and mortar, it goes in and breaks up that mortar around the bricks and lets that skin just kind of shed off, which works great for corns, calluses, warts, [and] diffuse, dry, cracky skin. That’s why we use it for warts.” - Dr. Raafae Hussain [09:22]

“Recovery for any of these… you just got to keep it covered, keep the pressure off of it as much as you can… and let that wart resolve.” - Dr. Raafae Hussain [21:34]

“If you decide to use oregano oil on your foot, I will find you.” - Dr. Raafae Hussain [23:17]

Top Takeaways:

• What are plantar warts? Are warts worrisome?
• How to know you have a plantar wart
• The two types of warts
• How to treat warts & Do home remedies actually work?
• Best wart treatments for children
• When is surgery needed to remove a wart?
• At-home wart recovery protocol

What You Will Learn:

• [00:39] Intro
• [02:13] Diagnosing a plantar wart
• [06:42] Treatments for warts at home and in the office
• [18:37] When do warts need to be surgically removed?
• [21:34] Wart recovery at home

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES: 

“Even here in the U.S., diabetic foot care, ulcers, wounds, very common. We just started with a wound care clinic of our own just because it’s become so prevalent in the practice.” -Dr. Raafae Hussain [09:22]

“Mind you, it’s not the amount of hours that you do, it’s the work you do.” -Dr. Ramnik Singh [29:58]

“I think the team approach is so vital in what we do for a living, for sure.” -Dr. Damien Dauphinee [33:32]

Top Takeaways:

• The medical training program in the UK
• The scope of practice as a podiatrist in the UK
• The use of information technology
• The lifestyle of a UK podiatrist: private practice or hospital-based?

What You Will Learn:

• [00:39] Intro
• [02:32] Medical training in the UK
• [07:53] The scope of practice in the UK
• [18:39] Research is a big part of training
• [22:56] The lifestyle of a UK podiatrist
• [33:37] Continuing medical education classes
• [34:37] Treating lymphedema

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“It pretty much works like a canned boot or a fracture boot in the sense that it locks up the ankle, except it has some nice little differences that make it that much more better.” -Dr. Raafae Hussain [04:52]

“The big thing is the continuum of care that you can get with a brace like this.” -Dr. Jordan Meyers [12:29]

Top Takeaways:

• What is TayCo brace and how it helps with ankle problems
• The benefits of the TayCo brace
• Common uses for the brace
• The future of total ankle replacements with the TayCo brace

What You Will Learn:

• [00:50] Intro
• [02:02] Jordan’s background
• [04:44] What is TayCo brace
• [09:57] The benefits
• [16:02] Personal experiences
• [24:17] Common uses
• [28:54] The future of total ankle replacements
• [33:05] Where to learn more about the TayCo brace

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“If I was looking at just one joint I would think this is probably osteomyelitis or some type of septic arthritis. But if we are seeing it (no cartilage) uniform across all their joints we know this is most likely rheumatoid arthritis.” -Dr. Raafae Hussain [07:17]

“If your patient is on DMARDs, they are relatively well controlled and they’re not dealing with polyarthritis all the time, I would treat them like any other hallux rigidus patient. Give them the option of fusing it or doing an implant. Because this is a progressive problem, you want joint fusion over an implant” -Dr. Damien Dauphinee [22:45]

Top Takeaways:

• What is rheumatoid foot?
• Treatment options for rheumatoid arthritis
• Post-surgery recovery 

What You Will Learn:

• [00:50] Intro
• [02:00] What is rheumatoid foot 
• [10:14] Offloading weight from bone sites 
• [15:17] Treatment options
• [20:05] DMARDs
• [23:25] Implants
• [26:00] Recovery

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“A Tailor’s bunion, people assume it’s a bump, it’s a growth, it’s a tumor. Can you knock it down? But then I talk to them, Look, it’s an ​​angulation or a deviation of that fifth metatarsal. It’s literally just slightly rotating out.” -Dr. Raafae Hussain [06:11]

“These are common problems. They have reasonable success with conservative, non-surgical options, but you have to be willing to adjust your shoes.” -Dr. Damien Dauphinee [20:08]

Top Takeaways:

• What is Tailor’s bunion
• How the PODdoctors treat a Tailor’s bunion
• The recovery process

What You Will Learn:

• [00:50] Intro
• [02:22] What is Tailor's bunion
• [07:18] Two measurements they look at
• [08:56] Treatment options
• [19:01] Recovery

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“We see ankle problems. We see synovitis. We see these aches and pain. And I feel like we’re doing conservative therapy, steroid shots and all that, and we’re worried about the next step, big surgery, but that medial ground, that middle ground, that ankle scope, super underutilized.” -Dr. Raafae Hussain [02:01]

“It’s a great underutilized technique for lingering ankle pain.” -Dr. Damien Dauphinee [19:09]

Top Takeaways:

• What is ankle arthroscopy and why it’s underutilized
• Examples of interior ankle pain such as synovitis
• Portal placement - the most important part of arthroscopy
• Recovery

What You Will Learn:

• [00:50] Intro
• [01:43] What is ankle arthroscopy
• [03:00] Interior ankle pain
• [06:54] The portal placement process
• [12:28] A walkthrough of a recent case
• [18:34] Recovery
• [20:23] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“The downside and the risk are extremely low and the upside when it works makes this an incredibly effective procedure.” -Dr. Damien Dauphinee [11:45]

“If you have nerve pain in your foot, talk to your doctor about releasing that nerve rather than cutting that nerve out.” -Dr. Raafae Hussain [13:49]

Top Takeaways:

• What is neuroma pain and typical symptoms
• A walkthrough of MEND surgery

What You Will Learn:

• [00:50] Intro
• [02:23] Typical symptoms for neuroma pain
• [04:14] Traditional treatments
• [05:34] What is MEND surgery
• [10:09] Recovery
• [14:42] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“You want a locking type suture that will help hold the tendon.” -Dr. Raafae Hussain [03:37]

“If you lose a centimeter with that tendon, it’s not that big a deal. They can gain that back with physical therapy.” -Dr. Damien Dauphinee [07:42]

Top Takeaways:

• A walk through of the surgical procedure 
• The type of suture the PODdoctors use to repair the tendon
• Why it’s important to avoid adhesions
• The recovery period

What You Will Learn:

• [00:50] Intro
• [02:28] The exams to determine the injury
• [03:26] How the PODdoctors repair the tendon
• [07:51] Repairing the synovial lining
• [11:07] How they do the hand ties
• [16:06] Recovery
• [16:48] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“Seven in ten people don’t know that gout is a type of arthritis. People think it is a come and go deformity. ” -Dr. Raafae Hussain [14:35]

“They call gout “The Great Imposter” because it could be a number of different things. The workup requires us to usually get blood work and x-rays to see what is going on.” -Dr. Damien Dauphinee [03:02]

Top Takeaways:

• What is gout?
• Gout: an indicator of other serious problems
• Uric acid crystallization
• Gout flares and the impacts of climate
• PODdoctor’s surgery experiences
• Treatment options

What You Will Learn:

• [01:39] Intro
• [02:20] Common indicators of gout
• [06:45] Things that add to your risk of gout
• [10:08] The two types of gout
• [13:43] Treatment options
• [18:18] What gout is signaling in the body
• [22:50] Krystexxa treatment
• [24:21] Caring for the joint

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“Sprain ankle is the number one injury in sports injuries.” -Dr. Raafae Hussain [02:18]

“We never want to forget about the nerves. ‘Cause these will come back to bite you if you ignore them.” -Dr. Damien Dauphinee [09:40]

Top Takeaways:

• What causes ankle pain and common ankle injuries?
• What is traction neuritis?
• Most common anterior ankle pathologies
• What is posterior tibial tendon dysfunction (PTTD)?
• Other pain people will feel inside the ankle
• What is Os trigonum syndrome?
• Treatment options

What You Will Learn:

• [00:49] Intro
• [02:34] Common ankle injuries
• [04:28] How they determine ankle sprain from strain
• [07:16] Treatment options
• [09:34] What is traction neuritis
• [12:20] Conservative management
• [15:18] Common anterior ankle pathologies
• [22:45] What is PTTD and treatment options
• [26:12] Other pain inside the ankle
• [28:30] What is Os trigonum Syndrome
• [33:14] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“If you’ve got a joint issue, and you’re asking a lot of that joint because of the flexibility of the shoe, you're going to make it worse and it’s gonna really hurt.” -Dr. Damien Dauphinee [02:53]

“When we decide to do surgery and what type of surgery we decide to do is based on the patient’s activity level and based on how much damage is done to the joint.” -Dr. Raafae Hussain [03:37]

Top Takeaways:

• What is hallux rigidus
• When the Pod Doctors decide to do surgery and what type of surgery
• A walk through of a recent hallux rigidus surgery

What You Will Learn:

• [00:50] Intro
• [02:07] What is hallux rigidus
• [03:37] When to do surgery and what type
• [05:02] A walk through a recent case
• [18:18] Recovery protocol
• [20:41] Outro 

Resources:

Previous episode on hallux rigidus: https://poddoctors.podbean.com/e/the-poddoctors-hallux-rigidus/

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“If you’ve got a motor injury, you’ve got up to a year to do something, but realistically, you have nine to ten months.” -Dr. Damien Dauphinee [12:44]

“So our different treatment options for all of these, they’re all different. That’s the downside of this, because every injury needs a specific type of repair.” -Dr. Raafae Hussain [24:52]

Top Takeaways:

• The two major parts of the nervous system and where they meet
• The different classification of nerve injury
• An overview of Wallerian degeneration
• Common types of reflect tests they conduct in office
• Treatment options

What You Will Learn:

• [00:40] Intro
• [02:21] Two major parts of the nervous system
• [05:59] What a nerve looks like in cross section
• [07:44] Different classification of nerve injury
• [12:01] An overview of Wallerian degeneration
• [13:08] Some of the tests they do in office
• [24:52] Treatment options
• [30:35] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“The paratenon has been argued should you dissect it free or should you not dissect it free. I’ve gone both ways and I feel in my mind that the less trauma you cause to it, the better you end up doing, so I don’t like to dissect mine free too much.” -Dr. Raafae Hussain [04:40]

“The dissection around those spurs is time consuming, and if you do it right and if you save as much tendon as possible, your repair is going to be much more vigorous and robust.” -Dr. Damien Dauphinee [07:01]

Top Takeaways:

• A quick recap on how the “pump bump” appears
• A walk-through of the surgery to handle this deformity
• Recovery from surgery

What You Will Learn:

• [00:40] Intro
• [02:06] A quick recap on “pump bump”
• [04:09] How they approach the incision
• [06:24] The surgical procedure
• [12:31] Inserting suture anchors
• [19:08] Repairing superficial achilles tendon
• [21:06] Mobilizing the patient and recovery
• [22:49] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“As far as surgery’s concern, there’s no conservative treatment to get rid of the bone. So when you have a golf ball in the back of your heel... so when you have that mass, that golf ball, that’s going to continue to be a source of irritation and the only way to fix that is surgery.” -Dr. Damien Dauphinee [11:14]

“I had plantar fasciitis. It’s cumbersome and weird. But if you put (a night splint) on and you’re watching TV, you’re computering, you’re Facebooking, YouTubing, whatever you’re doing, you watch an episode of Tiger King, bam, that’s an hour of stretch right there. Super easy.” -Dr. Raafae Hussain [08:43]

Top Takeaways:

• What is Haglund's deformity and what do the Pod Doctors seen in the X-rays
• What is Equinus
• Conservative and surgical treatments

What You Will Learn:

• [00:40] Intro
• [01:58] What they see in the deformity
• [03:17] What they see in the X-rays
• [05:57] What is Equinus
• [07:06] Conservative treatment
• [11:04] Surgical treatment
• [20:45] Recovery
• [22:15] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

Revisit our episode on Jones fracture: https://poddoctors.podbean.com/e/the-poddoctors-jones-fractures/

 QUOTES:

“I tell them if it’s good apposition and you can stay off of it, we can definitely try conservative, but more often than not, these fractures are gapped just on the mechanism of how they're pulled. Their tendon’s pulling one way. Their foot’s pulling the opposite way. There’s typically a gap there and we typically end up fixing these surgically.” - Dr. Raafae Hussain [03:51]

“Not only is the tendon attachment working against you, but it’s just hard to keep people to stay off their foot.” - Dr. Damien Dauphinee [04:15]

Top Takeaways:

• What qualifies as a Jones fracture
• How the Pod Doctors treat Jones fracture

What You Will Learn:

• [00:40] Intro
• [02:08] A recap of what Jones fracture
• [05:26] How Dr. Hussain treats a patient’s Jones fracture
• [16:52] Recovery
• [17:37] Bad outcomes do happen
• [20:03] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

Revisit our episode on Jones fracture: https://poddoctors.podbean.com/e/the-poddoctors-jones-fractures/

QUOTES

“You can see the curvature of that proximal phalanx or if they just got a lot of soft tissue pulling on that toe, you’re just going to get a better correction, you’re going to have a happier patient, if you just take that wedge out.” - Dr. Damien Dauphinee [16:36]

“Quick and easy. You know, your classic bunions. We’re not doing anything fancy. We’re literally going in, fixing the problem.” - Dr. Raafae Hussain [24:23]

Top Takeaways:

• What they see clinically with bunions
• The step-by-step process of bunion surgery, including incision placement, lateral release and the osteotomy procedure
• The Pod Doctors’ thought process during the procedure
• The recovery options

What You Will Learn:

• [00:40] Intro
• [02:27] What they see with bunions
• [03:04] Incision placement and lateral release
• [07:57] The osteotomy procedure
• [15:18] The Akin osteotomy
• [21:14] Closure technique
• [24:47] Recovery
• [25:24] A listener question
• [27:16] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“The issue, we believe and have believed for decades now, is that the ligament is the problem.” - Dr. Damien Dauphinee [03:11]

“Here’s what a classic stump neuroma looks like. You have the nerve spindles coming through and the end is blocked off, injured, whatever, so instead of growing out to where it’s supposed to provide either sensation or muscle intervention, it’s a little bundle ball of angryness.” - Dr. Raafae Hussain [08:41]

Top Takeaways:

• What is a recurrent neuroma and the issue they are treating
• The go-to treatment for stump neuroma and other treatment options
• What is endoscopic nerve decompression
• What a classic stump neuroma looks like

What You Will Learn:

• [00:40] Intro
• [01:42] What is Recurrent Neuroma
• [03:34] The go-to treatment for stump neuroma
• [05:57] What is endoscopic nerve decompression
• [08:40] What a classic stump neuroma looks like
• [10:05] Other treatment options
• [19:26] Recovery
• [20:51] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“If you don’t fix the boney aspect well the first time, all the soft tissue correction in the world is probably not going to make up for that.” - Dr. Damien Dauphinee [05:24]

“One of the big things that we’ve noticed over time is that different specialities that do foot and ankle surgery do different incision placements.” - Dr. Raafae Hussain [05:37]

Top Takeaways:

• Basic bunion procedures
• Why they do different incision placements
• More common incisions
• Lateral release, suture button and lengthening techniques

What You Will Learn:

• [00:40] Intro
• [02:19] A brief recap on bunions
• [03:34] Basic bunion procedures
• [05:44] Different incision placements
• [10:45] The lateral release
• [16:21] Suture button technique
• [21:43] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“It’s a complex balancing act between the ligaments and the plantar plate holding that second toe where it’s supposed to be.” - Dr. Damien Dauphinee [04:36]

“It’s so, so hard. You have to understand. If this was your finger, we can strap that down. You’re not walking on your hand. You’re walking on these and that’s the hard part.” - Dr. Raafae Hussain [12:20]

Top Takeaways:

• What happens with crossover toes
• What is the plantar plate
• How they look at the condition of the deformity
• Conservative therapy and surgery options

What You Will Learn:

• [00:40] Intro
• [02:40] What is crossover toe and plantar plate
• [06:55] How they look at the deformity
• [11:55] Conservative therapy options
• [14:58] Surgery options
• [23:10] Recovery
• [25:07] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“A lot of this has to do with whether your immune system can fight it off. And some people don’t have that capability so they get this over, over and over.” - Dr. Damien Dauphinee [05:23]

“It’s a very straightforward problem and we offer very straightforward solutions.” - Dr. Raafae Hussain [17:16]

Top Takeaways:

• What is athlete’s foot
• The different types of infections
• Home remedies and topical treatments

What You Will Learn:

• [00:40] Intro
• [01:49] What is athlete's foot
• [04:02] Three types of athlete’s foot
• [08:46] What happens with tinea pedis
• [09:17] Home remedies and topical treatments
• [17:33] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“One does not simply pop a Ganglion cyst.” - Dr. Damien Dauphinee [06:08]

“The surgery part works really well. Like you said, maybe 10-20 percent it’ll come back, but yeah, very low chance of it coming back.” - Dr. Raafae Hussain [15:59]

Top Takeaways:

• What is Ganglion cysts
• What the Pod Doctors see common see with Ganglion cysts in the clinic
• How they determine it’s a Ganglion cyst
• How they treat a Ganglion cyst with aspiration surgery
• The recovery period

What You Will Learn:

• [00:39] Intro
• [01:42] Why you should get the COVID-19 vaccine
• [05:59] What is Ganglion cysts
• [06:28] What the Pod Doctors see clinically
• [08:18] How they determine it’s a Ganglion cyst
• [11:33] Treating with aspiration surgery
• [16:41] Recovery
• [17:43] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“Bunion is not a bony growth.” - Dr. Raafae Hussain [03:27]

 “When patients are saying, ‘Well Doc, when do I need to get this fixed?’ I usually say, ‘Look, once you start having internal joint pain in the great toe joint or if you start to see it deform your other toes, it’s time to get it fixed.’” - Dr. Damien Dauphinee [12:03]

Top Takeaways:

• How bunions present themselves
• How the Pod Doctors categorize the severity of the bunion
• What they look for in imaging
• Conservative therapy and types of ​​bunionectomy

What You Will Learn:

• [00:39] Intro
• [01:58] The different ways to fix a bunion
• [03:12] How bunions present themselves
• [04:58] How to categorize the severity
• [06:39] What they’re looking at in imaging
• [08:08] Conservative therapy
• [13:03] Various types of bunionectomy
• [27:22] Fixation methods and minimally invasive surgery
• [38:09] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES: 

“So general rule of thumb, all you young docs out there, soft tissue procedures and flat foot deformities, you’re fighting an uphill battle. You got whatever hundred pounds of weight in a young child, 80 pounds of weight in a young child, whatever it might be, coming down on a specific tendon. You can’t expect that tendon, especially a tendon like that, to hold that arch up. There’s too much fighting against it. You gotta do your additional procedures behind it.” - Dr. Raafae Hussain [21:33]

“It’s important to note that not everybody grows out of this. That it is ok to watch it until they’re preteen age wise. You can prevent really a world of hurt as an adult if you address it early.” - Dr. Damien Dauphinee [25:46]

Top Takeaways:

• The two common foot problems with kids
• What the Pod Docs see with pediatric flat foot clinically
• How they treat pediatric flat foot
• Three common ways to lengthen the Achilles tendon
• Conservative treatment and surgery

What You Will Learn:

• [00:39] Intro
• [01:44] How pediatric flat foot is a common problem
• [03:16] What the Pod Docs see clinically
• [06:11] How they use imaging to check the condition
• [12:51] Conservative measures and treatment
• [15:22] How they treat this problem with surgery
• [25:07] Recovery
• [26:59] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“So just getting the heel into position is a huge part of this. So we’re really kind of yanking on that thing trying to pull it down back into at least a neutral position, if not, back to an anatomic position.” - Dr. Damien Dauphinee [06:38]

“It’ll be one giant platform that he’s standing on. The motion of mobility, he’s lost that. The motion of mobility has kind of led to the problem that he has, and we want to lock that up to make sure everything stays stable.” - Dr. Raafae Hussain [20:54]

Top Takeaways:

• A recap of what is Charcot foot
• An indepth look of charcot reconstruction
• Why it’s such an issue for diabetic patients
• Thinking process as they go through the surgery step by step

What You Will Learn:

• [00:39] Intro
• [02:18] What is Charcot foot
• [04:29] Dissecting the ankle joint
• [09:10] Why Dr. Dauphinee prefers the frame
• [10:05] Dissecting the subtalar joint
• [15:04] Working on the midfoot
• [20:14] The working conditions
• [22:08] Creating the frame and the stability block
• [28:20] The before and after
• [30:16] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“The lack of range of emotion certainly puts people at greater risk for lateral ankle sprains.” - Dr. Damien Dauphinee [03:06]

“This is my all-time favorite surgery, especially because at the end of this, this tendon, it looks so beautiful.” - Dr. Raafae Hussain [09:35]

Top Takeaways:

• A brief overview of the anatomy
• How they perform surgery to repair the lateral ankle ligament, 
• How they repair the Peroneal Tendon with groove deepening
• The recovery process

What You Will Learn:

• [00:39] Intro
• [02:18] A brief overview of the anatomy
• [03:13] The surgical procedure
• [11:05] Tendon repair with groove deepening
• [14:03] The ligament disrepair
• [18:18] Recovery
• [20:18] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“The worst part about them is it’s so small, but it’s so painful.” - Dr. Raafae Hussain [01:56]

“I think addressing this on both sides of the problem is far more effective long term. You’re hedging your bets.” - Dr. Damien Dauphinee [09:36]

Top Takeaways:

• Which toes they commonly see the Heloma Molle
• Why you must address the underlying bone issue to care for Heloma Molle
• How they treat Heloma Molle through conservative and surgical options
• What to expect with recovery
• What is heterotopic bone

What You Will Learn:

• [00:39] Intro
• [02:21] Typical corns and calluses on the foot
• [03:34] Conservative and surgical options
• [10:00] Recovery
• [12:50] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES: 

“Once this joint goes, they’re painful until you do something about it.” - Dr. Damien Dauphinee [06:23]

“There’s a big push on flexible shoe gear right now, where these slip on type shoes, and they show in the commercials where you can bend and fold them and stuff them into your pocket. Horrible for your feet.” - Dr. Raafae Hussain [08:49]

Top Takeaways:

• What is Freiberg’s Disease and what do the Pod Docs see clinically?
• The Smillie classification for Freiberg disease
• What causes this problem?
• Conservative therapy and surgical treatment options
• What is recovery like after treatment?

What You Will Learn:

• [00:40] Intro
• [02:00] What is Freiberg’s Disease
• [02:35] What they see clinically
• [05:13] Smillie classification for Freiberg’s disease
• [07:03] What causes this problem
• [08:00] Conservative therapy
• [10:26] Surgical treatment
• [22:31] Recovery after treatment
• [23:24] Outro

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“This is definitely a problem that we like to say, ‘You got to attack it with everything but the kitchen sink.’” - Dr. Damien Dauphinee [03:03]

“Give it some time. It’s something that you’re walking on. You have to go through all the steps: stretching, good shoes, good insoles.” - Dr. Raafae Hussain [28:09]

Top Takeaways:

• Why plantar fasciitis is the most common foot problem
• How they use the endoscopic and gastroc recession techniques
• Pros and cons of performing a gastroc recession
• Recovery for plantar fasciitis

What You Will Learn:

• [00:40] Intro
• [02:01] The most common foot problem: plantar fasciitis
• [03:35] How they use the endoscopic technique
• [08:59] What is gastroc recession
• [14:23] One thing Dr. Raafae Hussain adds with plantar fascia surgeries
• [15:56] Recovery for plantar fasciitis

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“I say get it fixed while you’re younger.” - Dr. Raafae Hussain [06:26]

“So getting in early. Getting it checked out. Getting some x-rays. Determining what your options are is important. Burying your head in the sand and waiting for your joints to break down to the point where they’re broken down into oblivion is probably not in your best interest.” - Dr. Damien Dauphinee [47:21]

Top Takeaways:

• How posterior tibial tendonitis (PTT) presents
• What the Pod Doctors see in the clinic
• The different stages of flat foot
• What is the heel rise test
• Conservative treatment and surgery options for PTT

What You Will Learn:

• [00:39] Intro
• [02:07] How PTT presents and what they see in the clinic
• [07:27] Flat foot staging and the heel rise test
• [10:59] How they use imaging to see the structure of the foot
• [16:34] Conservative treatments
• [20:44] Surgery options
• [43:05] Recovery

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“You see how he’s cutting out that damaged tendon, because we want to get it back to where it’s a solid core. Sometimes if they’re salvageable, we’ll tuberlize them, but in this case, you can tell. That tendon has gone. It’s like string cheese. Like I said this last time, you squish that string cheese and that’s what that tendon looks like. You’re taking all those fibers and you’re smooshing them and laying them out. Very unhealthy to say the least.” - Dr. Raafae Hussain [06:22]

“That’s the other advantage of I think of the Artelon. I can get them into early physical therapy, which I think is important for all of these issues.” - Dr. Damien Dauphinee [28:05]

Top Takeaways:

• A recent case where they conducted peroneal tendon repair surgery
• A walk through of the procedure
• The type of incisions and sutures they use in this type of surgery
• What is  Broström procedure?
• What is Artelon material?

What You Will Learn:

• [00:40] Intro
• [01:35] An interesting case
• [03:20] A walk through of the procedure
• [13:02] Part 2 of the surgery
• [21:27] Critical part of the procedure
• [21:47] A quick recap
• [25:06] The delivery system
• [29:30] Coming up in future episodes

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

"I think that’s the restriction nowadays. People are like it’s diabetic neuropathy. There’s no treatment aside from treating the diabeties which is not true.” - Dr. Raafae Hussain [05:33]

“That study is going to be remarkable. It’s going to be groundbreaking, and it already is. And I think the repercussions of it are hopefully that people will take another look at the option of surgical decompression in diabetic neuropathy as something for pain relief, but also sensory restoration and to prevent wounds. I think it can do all of those things.” - Dr. Damien Dauphinee [54:44]

Top Takeaways:

• What is neuropathy?
• What role does nerve decompression play into neuropathy?
• Typical symptoms for patients with diabetic neuropathy
• What is the double crush theory?
• What are some conservative therapy before surgery?
• The different levels of release through surgery and treatment plans
• Why it’s important to take prescribed supplements
• What is a sham surgery?
• How can a sham surgery be used for the painful diabetic neuropathy patient

What You Will Learn:

• [00:39] Intro
• [02:29] What is neuropathy
• [07:51] What they see in patients with diabetic neuropathy
• [10:32] What is double crush theory
• [17:23] Conservative therapy options
• [28:04] Different levels of surgery
• [39:14] What is restless leg syndrome
• [40:32] Why it’s important to take the prescribed supplements
• [44:44] Slight symptoms vs sever symptoms
• [49:25] What is a sham surgery

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“This one can have some healing complications and oftentimes require surgery.” - Dr. Damien Dauphinee [02:06]

“Jones fractures are known to be at-risk for what is called a nonunion. A nonunion happens when the blood supply or the area that needs to heal isn’t healing as well, and your bone is trying to push to heal. It’s not healing, and it just becomes a chronic fracture. Painful, tender and obviously unstable.” - Dr. Raafae Hussain [06:54]

Top Takeaways:

• What is a Jones fracture
• The mechanics of the injury
• Why are Jones fractures complicated
• Treatment options

What You Will Learn:

• [00:39] Intro
• [02:13] What is a Jones fracture
• [04:39] What the Pod Doctors look for
• [06:48] Why are Jones fractures complicated
• [09:12] The mechanics of the injury
• [12:14] Why this fracture is so important
• [14:27] Treatment options
• [20:56] Recovery

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“There’s not a lot you can do conservatively to fix the hammer toe. You’re pretty much cushioning the problem.” - Dr. Raafae Hussain [19:10]

“They’re not just a cosmetic problem. They are a mechanical issue. There’s a hereditary component obviously with a lot of folks. But we’re able to address both the cosmetic aspect of it and the mechanical aspect of it, which is a nice win-win for the patient.” - Dr. Damien Dauphinee [38:31]

Top Takeaways:

• What is a hammer toe?
• Why are hammer toes a problem?
• What do the Pod Doctors look for in clinical exams?
• What causes a hammer toe?
• Three main reasons for hammer toe contractures
• Associated problems with hammer toes
• Treatment options

What You Will Learn:

• [00:40] Intro
• [02:07] What is a hammer toe
• [03:19] Why are hammer toes a problem
• [09:12] What do the Pod Doctors look for in clinical exams
• [09:48] What causes a hammer toe
• [13:08] Associated problems
• [13:53] Most common treatment options
• [24:28] Surgical options
• [31:26] Additional procedures
• [35:34] Recovery for hammer toe surgery

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES: 

“The real issue is these feet become severely deformed. And when you have neurotrophy and you can’t feel it, the deformations then lead to ulcers which get infected and then can cause amputations.” - Dr. Damien Dauphinee [03:38]

“You can chase the bump all you want, but then that bump is just going to keep on collapsing more and more and more.” - Dr. Raafae Hussain [20:10]

Top Takeaways:

• What is Charcot foot? Plus, two theories about it
• What are the surgical goals when trying to fix these?
• Why they over-engineer during treatment
• When it’s appropriate to use internal or external fixation
• The social problems associated with this condition

What You Will Learn:

• [00:40] Intro
• [01:39] What is Charcot foot
• [02:33] Two theories about it
• [03:52] Why they have to over engineer during treatment
• [10:41] The surgical goals to fix these
• [19:08] An example of not addressing the original issue
• [22:37] When it’s appropriate to do internal or external fixation
• [30:04] Dr. Damien Dauphinee’s theory on Charcot ankle
• [31:21] How someone broke their ankle brushing his teeth
• [35:02] A sad, difficult outcome
• [41:27] Social problems that associated with this condition 

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“A lot of people will come in with those memory foam, the gel inserts. And it’s like look, these are great and comfortable for the first day or two you wore them, but the problem isn’t that you’re walking on stones. The problem is that your foot is not functionally to its peak biomechanical ability.” - Dr. Raafae Hussain [12:37]

“The goal of the surgery is pain relief.” - Dr. Damien Dauphinee [21:07]

Top Takeaways:

• What is hallux rigidus?
• How does it differ from gout?
• What happens to your foot with hallux rigidus?
• Treatments options for hallux rigidus

What You Will Learn:

• [00:39] Intro
• [03:06] What is hallux rigidus?
• [03:59] What the Pod Doctors see clinically
• [06:58] What happens when you lose the joint movement compl?etely?
• [07:58] What happens to your foot with hallux rigidus
• [12:16] Why over-the-counter arch supports are not helpful for hallux rigidus
• [13:01] How x-rays determine how bad the joint is
• [13:49] Some conservative options to take care of the pain
• [16:04] Available procedures based on the damage

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“A lot of women are in high heel shoes and they come back down. They’re like ‘Oh, my heel hurts, but I’m so comfortable in these shoes. It’s the only shoes I’m comfortable in....’ That’s that problem. When you’re in that short achilles state, when that heel is elevated, right? That tendon… so it’s new normal is nice and short. If you spend seven, eight hours a day in those types of shoes, it’s going to add up.” - Dr. Raafae Hussain [18:39]

“The goal is try to catch these as early as possible because the neglected ones are much harder to fix.” - Dr. Damien Dauphinee [27:25]

Top Takeaways:

• The basic anatomy for the achilles tendon
• The different types of achilles injuries
• Treatment and recovery for acute and chronic injuries

What You Will Learn:

• [00:40] Intro
• [02:44] The basic anatomy of the achilles tendon
• [04:11] Types of minor achilles injuries and most common causes
• [10:18] Treatment options for acute injuries
• [17:07] Chronic injuries - causes and how it differs from acute injuries
• [20:50] Treatment options for chronic injuries
• [24:46] Recovery for these injuries

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

"And people, I think, have the misunderstanding that you get rid of it once that it’s gone. And you brought up the fact that no, it’s a mechanical problem here. It’s going to keep coming back and you don’t want something like that on your skin in perpetuity. You want to make sure that you’re doing it for a short period of time.” - Dr. Damien Dauphinee [10:27]

“You’ve got to always wear your orthotics if they’re being used to offload certain areas, no matter what you’re doing.” - Dr. Raafae Hussain [20:03]

Top Takeaways:

• The difference between a corn, a callus and a wart
• What is the core of corns and calluses
• Treatment options
• Why it’s important to always wear your orthotics shoes

What You Will Learn:

• [00:39] Intro
• [04:24] Corn vs callus vs wart
• [07:42] If a callus protect the skin
• [08:23] Things people can use to treat at home
• [10:47] Other treatment options
• [15:43] The core of corns and calluses
• [19:05] The importance of wearing orthotics shoes
• [21:30] How they treat it topically

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“Tarsal tunnel syndrome, very similar to carpal tunnel syndrome except of the ankle.” - Dr. Raafae Hussain [05:48]

“Diabetic patients get carpal tunnel syndrome about 30% more frequently than non-diabetics, so it makes sense that diabetic patients would be at risk for nerve entrapments in the lower extremity to roughly the same degree.” - Dr. Damien Dauphinee [11:16]

Top Takeaways:

• What are the signs and symptoms of tarsal tunnel syndrome?
• What causes tarsal tunnel syndrome?
• The anatomy behind the chronic pain
• How they treat tarsal tunnel syndrome

What You Will Learn:

• [00:41] Intro
• [01:49] Information about the COVID-19 vaccine
• [05:47] What is tarsal tunnel syndrome and the signs and symptoms
• [07:54] The anatomy and what they look for when they treat it
• [10:54] What causes tarsal tunnel syndrome and most common reasons
• [16:29] The biomechanical problems associated with tarsal tunnel syndrome
• [22:49] Diabetes and Double Crush Theory
• [27:49] Other things to note about tarsal tunnel syndrome

Resources:

Study on the Role of Decompression of Lower Extremity Nerves for the Treatment of Patients With Symptomatic Diabetic Neuropathy With Chronic Nerve Compression (DNND) by Shai Michael Rozen, University of Texas Southwestern Medical Center

Morphological and functional changes in the diabetic peripheral nerve: using diagnostic ultrasound and neurosensory testing to select candidates for nerve decompression by Doohi Lee, MD and Damien M. Dauphinée, DPM

Anatomic site for proximal tibial nerve compression: a cadaver study by Eric H. Williams, MD

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“You have to understand that once you’ve had a significant ankle injury like this, the joint is never going to be the same.” - Dr. Damien Dauphinee [16:58]

Top Takeaways:

• What is an ankle fracture and how it differs from ankle sprain and twisted ankles 
• How they treat pediatric fractures and fractures in diabetic patients
• Two major classification systems of ankle fractures
• How they treat these injuries

What You Will Learn:

• [00:40] Intro
• [02:23] Difference between ankle fractures and ankle sprains
• [04:14] Ankle anatomy and two classifications of ankle fractures
• [07:39] Examples of ankle fractures
• [12:46] Types of fixations
• [18:12] Treatment after surgery
• [21:31] Pediatric fractures
• [24:40] Some important things to note
• [27:24] Ankle fractures in diabetic patients

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“That’s what makes nerve problems so difficult because they have so many different sensations and so many different characteristics.” - Dr. Raafae Hussain [10:36]

“You’re like how can that silly little nerve be causing this much trouble, but it’s because of the ligaments.” -Dr. Damien Dauphinee [16:54]

Top Takeaways:

• What are Morton’s neuroma and common nerve entrapments
• What are some common nerve-related issues
• How do the Pod Doctors determine which nerve innervates a specific area
• Symptoms and treatment options

What You Will Learn:

• [00:44] Intro
• [01:44] What are some common nerve entrapments
• [07:45] Why you should be careful with certain shoes / boots
• [09:51] The POD Doctors discuss issues with nerve problems
• [11:34] How they determine what nerve innervates what area
• [16:11] What is “Morton’s neuroma”
• [18:48] Some of the presenting symptoms of nerve entrapments
• [22:13] Treatment options for interdigital neuritis (Morton’s Neuroma)
• [32:47] The risks of taking the nerve out (nerve excision)

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“We’re all in this together. This is a global pandemic. This is a global problem and without data, we don’t see the trends and these trends are God awful.” -Dr. Damien Dauphinee [05:24]

“COVID is the third leading cause of death in the US right now. Compared to heart disease and cancer, it’s number three. We’re not fighting something that’s a minute, little problem right now. This is something that’s taken out hundreds of thousands of people without a flinch.” -Dr. Raafae Hussain [25:06]

Top Takeaways:

• Why there’s a push for more rapid testing
• The number of COVID-19 deaths in the US
• The increase in amputations and other unintended consequences of the pandemic
• The difference between the PCR testing and the rapid testing
• The importance of face masks and what fabric is most helpful
• What people can do to help stop the pandemic

What You Will Learn:

• [00:44] Intro
• [02:44] Michael Mina’s push for more rapid testing
• [04:24] General numbers of COVID-19 deaths in the US
• [06:31] The Pod Doctors’ request to distribute vaccines
• [09:08] Why widespread and frequent rapid testing is the best tool to suppress outbreaks
• [15:12] Debunking a myth about rapid tests
• [16:56] What can help stop the pandemic
• [20:36] What would make Dr. Damien Dauphinee more confident about the situation
• [27:38] A reminder of the simple things to do during the pandemic
• [28:17] The difference between the PCR testing and the rapid testing
• [29:13] Why the type of fabric matters for face masks
• [32:49] The unintended consequences of COVID-19
• [39:38] Two things you can get out of this episode

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

Article Mentioned: How We Can Stop the Spread of COVID-19 By Christmas by Michael Mina

QUOTES:

“Our surgical answer for this is really straightforward and works well and doesn’t have to be painful and I think we are really good at numbing up toes and that's half the battle.” - Dr. Damien Dauphinee [03:05]

Top Takeaways:

• Learn about ingrown toenails and what causes them
• Learn about common treatment options and how to prevent ingrown toenails
• Learn about the surgical recommendations available for your nail problems 

What You Will Learn:

• [00:44] Intro
• [01:31] Addressing ingrown toenails  
• [04:04] What causes an ingrown toenail?
• [05:28] Common treatment approaches: bathroom surgeries, antibiotics and ingrown toenail devices 
• [11:13] Surgical approaches to ingrown toenails  
• [18:58] Prevention: What can I do to prevent this problem?
• [23:17] The POD Doctors’ surgical recommendations to address nail issues

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“It's not like a cold, it isn't gonna go away completely and you'll never have to deal with it again because it's a biomechanical problem, it's a structural support problem” - Dr. Damien Dauphinee [45:19]

Top Takeaways:

• Learn about heel pain and what causes it
• Learn about plantar fasciitis as one of the most common causes of heel pain
• Learn about how plantar fasciitis occurs and the options available to treat it.

What You Will Learn:

• [00:39] Intro
• [02:30] How common is plantar fasciitis? 
• [03:43] Other causes of heel pain 
• [04:43] How does plantar fasciitis occur and why do people get it? 
• [08:49] The mechanics of stretching 
• [10:16] Recommended treatment protocol
• [16:17] Orthotics: what are they? And how are they a long term solution for heel pain?
• [20:29] Night splint for plantar fasciitis
• [22:06] Heel pain injection treatment
• [24:14] Physical therapy treatment
• [26:07] The effectiveness of extracorporeal shockwave therapy
• [28:18] Surgical options for treating plantar fasciitis 
• [32:19] Topaz Microdebridement treatment for plantar fasciitis
• [33:15] What is the Tenex procedure?
• [38:40] The MLS laser options for treating musculoskeletal pain
• [41:25] What is “stem cell therapy” for plantar fasciitis?
• [44:57] Prevention practices to fight plantar fasciitis 

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

 QUOTES:

“The only downside of any type of tendon-, muscle-type of injury is that it takes forever… Skin takes two to three weeks to heal. Bones take six to eight weeks to heal. Tendons, muscles, ligaments take three to four months to heal and nerves can take months to years. It’s just the nature of the beast.” -Dr. Raafae Hussain [16:15]

Top Takeaways:

• Learn about lateral ankle injuries
• Learn the difference between an ligament sprain and an ankle level tendon strain
• Learn about common ankle injuries and type of ligament tears
• Learn what kind of treatments are used to heal the injury
• Learn about tendon and nerve injuries related to ankle sprains

What You Will Learn:

• [00:44] Intro
• [01:47] The difference between a sprain and a strain
• [03:55] The ligaments that make up your ankle
• [05:46] Common ankle injuries
• [08:03] Three most common areas you’ll feel the pain and types of tears
• [11:01] What tests check for signs and symptoms
• [16:01] Treatments for ankle injuries, physical therapy and how long it takes to heal
• [21:55] How to address tendon injuries
• [25:28] Nerve injuries and how to treat them

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“It’s really hard to rationalize spending tens of thousands of dollars on wound healing technology, amniotic tissue, growth factors and surgeries when someone’s not going to stop smoking.” -Dr. Damien Dauphinee [05:06]

Top Takeaways:

• Learn ways to prevent amputations from diabetes issues
• Learn how smoking can raise the risk of peripheral artery disease (PAD)
• Learn how hyperbaric medicine and vacuum-assisted closure (VAC) improve wound healing capacity
• Learn about amniotic and stem cell therapy

What You Will Learn:

• [00:44] Intro
• [01:22] What they can do to prevent amputations and how stents have evolved
• [04:41] How smoking can raise the risk of PAD
• [06:05] What is hyperbaric medicine and other methods to improve wound healing
• [09:58] What is a wound VAC
• [12:09] How moisture balanced wound healing is the goal
• [14:45] How are amniotic or placental tissues used in wound care
• [18:08] Some important stats about diabetic foot problems

Resources:

Visit our website: https://thepoddoctors.com/

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

QUOTES:

“Our general advice is to always catch it early. Fix it early because if you can catch it early, it’s usually the least likely to ever come back type of situation.” -Dr. Raafae Hussain [05:08]

Top Takeaways:

• Learn what causes a bunion
• Learn what the doctors typically see in the clinic
• Learn how to handle the bunion to slow down the progression and when surgery is needed
• Learn the different types of bunion surgeries and how long it takes to recover

What You Will Learn:

• [00:43] Intro
• [01:46] What is a bunion and what they typically see in the clinic
• [04:14] What causes a bunion and tips to handle it
• [10:20] When it’s time to fix it
• [11:06] The different types of bunion surgeries
• [20:13] Recovery after surgery
• [22:06] Pre-op and post-op course
• [26:24] When physical therapy is needed

Resources:

Visit our website: https://thepoddoctors.com/

Listen in to learn about the most common foot and ankle problems in podiatric medicine and how they can be treated effectively.  This inaugural episode will introduce you to many of the common complaints patients present with every day.

QUOTES:

“We need to figure out what we can do to eliminate diabetes from the planet because it’s one of the few problems that affect so many different organ systems.”-Dr. Dauphinee [57:19]

Top Takeaways: 

• Learn how podiatric medicine and surgery as a specialty is a family-friendly career path.
• Learn how podiatric surgeons focus on conservative or non-surgical options when possible, and move to surgical options when necessary.
• Learn how and why diabetic patients end up with wounds caused by sensory loss, which are as dangerous as colon cancer. 
• Learn about the importance of preventing diabetic foot complications, which increase the amputation rate and the dangers that go along with it. 

What You Will Learn:

• [0:43] Intro 
• [3:02] Dr. Hussain explains podiatric surgery and where to study it, plus where the two doctors studied. 
• [8:28] Dr. Hussain discusses the physical diagnosis training and exam that podiatric medical students have to undergo to be competent in comprehensive history and physical exams.
• [9:47] Dr. Dauphinee explains the process he underwent during his surgical residency training.
• [11:41] Dr. Hussain describes the experiences that were included in his fellowship program. 
• [13:22] The POD doctors discuss many of the most common foot and ankle problems like fungal infections, sprain injuries, and many more.
• [28:02] Dr. Dauphinee discusses his sub-specialization in peripheral nerve injuries, neuropathy, and trauma over the last 15 years, plus some of the cases he deals with.
• [40:20] How to prevent limb amputation for diabetic patients. 
• [57:00] The doctors continue to discuss the scourge of diabetes.

Resources:

Website: https://thepoddoctors.com/ 

Book Mentioned: Saving Limbs, Saving Lives: Advanced Treatments for Preventing Amputations in Diabetic Populations by Dr. Damien Dauphinee

https://www.amazon.com/Saving-Limbs-Lives-Amputations-Populations-ebook/dp/B07PFV1CTX