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Dr. Brandon Macy
Podiatrist - Clark, NJ
1114 Raritan Road
Clark, NJ 07066




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Posts for: January, 2011

By Brandon Macy, D.P.M.
January 28, 2011
Category: Uncategorized

I was home this afternoon helping nurse my wife past a bit of minor surgery and the famous Dr. Oz was on he TV. He had segments on athlete's Foot (Tinea Pedis) and fungal nail infections (onychomycosis, tinea unguium).


He recommended terbinafine-based topical creams as over the counter remedy for athlete's foot infections.


For the nails, he mentioned that laser treatment of the nails is a very promising and effective way to treat fungal nail infections. While he said that laser therapy for the nails is fairly expensive, here at Clark Podiatry Center, we have set a treatment protocol that is much more reasonably priced.


Laser therapy is both safe and effective for treating fungus in the toenails. Contact us for more information or schedule an appointment so that you can be examined and we'll discuss your treatment options.


Dr. Oz recommends it!

By cl7219
January 20, 2011
Category: Uncategorized
Tags: Untagged

The January 18 edition of the NY Times published an article about foot orthotics. The article used comments from a few doctors, particularly a Dr. Nigg from the University of Calgary to raise doubts about their use and effectiveness.


Much like a short feature on your local television news, the article was a superficial presentation of a complicated topic. It had a particular premise--a "warning" about the downside of a common treatment modality for a wide range of foot problems. Scientific resources were used to back up the viewpoint the writer was espousing. The problem is that the article is too brief and narrow in its point of view to be of significant value.


Biomechanics, as with so many issues dealing with the human body, is an inexact science with several overlapping, competing and sometimes contradictory theories of explanation. Therein lies a common problem in medicine--we want definitive answers to our problems, backed up by pr oven science, that are virtually assured of solving those problems. There are plenty of common issues to be found, but there are physical, social and psychological factors which can render any situation unique. On top of that, the government and the insurance industry want to manage health care by statistics--only doctors and their patients want customized care.


The academic world is one thing. I live and practice in a clinical world. My focus is on accurate diagnosis and treatment of a patient's given problem. When it comes to biomechanics and orthotics, my goal is to relieve pain as quickly and efficiently as possible while doing what can be done to limit recurrences. Sometimes that can be done with a prefabricated orthotic, sometimes with something custom made.


Orthotics are similar to eyeglasses in that eyeglasses help you see better--they don't change your eyes. I don't utilize orthotics to correct deformities--I use them to reduce mechanical stresses, to make foot function more balanced and efficient, allowing you to walk "better". By doing that, it is part of a process to relieve a particular pain and possibly prevent a recurrence or other new pains from popping up.


In the case of plantar fasciitis, the use of orthotics is the foundation of a treatment plan. Oral anti inflammatory medications, cortisone injections, laser therapy, along with other treatments such as shockwave therapy are frequently added as part of the process. The orthotics deal with the biomechanical stresses that are at the root of the problem.


Why are some orthotics comfortable and helpful while others don't help or seem to cause even more pain? Store bought and orthotics found on infomercials are too flimsy or have so many hard lumps and bumps that they don't work or are too uncomfortable to wear. Just because you have a custom made orthotic doesn't mean it was made well. The foot impression could have been made poorly or the materials used may have been too rigid or too flexible. A great orthotic worn in an old, beat-up pair of shoes won't help as much as it could until the shoes are replaced.


If an orthotic isn't comfortable, then something is wrong, period. That's when you should bring it back to the doctor to loo into the reason for the problem. Often, it is a simple adjustment that has to be made.


Its all about being comfortable, not about whether the scientists and/or doctors can agree on all the details about why they work. Ask questions, find out the whole story for yourself--not just the small portion that one reporter put out there.





By cl7219
January 17, 2011
Category: Uncategorized
Tags: Untagged

I just got back from a medical conference. In the middle of winter, they aren't exactly going to be held at the North Pole, so as an incentive to increase attendance they're held in nice, warm locations such as Paradise Island in the Bahamas. Yes, I do attend [most of] the lectures and speak with the vendors, sponsors and other doctors. And yes, there's ample time to enjoy the respite from the winter weather that's in the Northeast.


What does that have to do with fungal infections of the toenails? Well, there is the taste of late spring/summer-like weather and with it there were plenty of people on the beach and poolside. Of course, there are many of us (myself included) who have work to do to look better in the swimwear come summertime. But that also applies to those who don't like the looks of their toenails. Fungal infections in the nails are ugly, often painful, and can lead to some secondary problems if unchecked.


Treating fungal nail infections is a slow, process--VERY slow--so if you want to look better when it is truly beach/pool season this summer, now is the time to begin treatment.


The last time I saw a statistic, approximately 8% of the public gets a fungal infection of the nails. I think the estimate is too low. Fungus is an environmental bug, that can be caught most anywhere, not just from pedicures at nail salons. There's a page in the library on this website that has some basic information about fungal nails.


Treating fungal nails is so difficult and slow, not because of the fungus, but because of the nail plate itself. It isn't porous like the skin, and it can take 8+ months to grow a new nail from start to finish, so growth is very slow. The thicker the nail, the more difficult it is to obtain results as well.


Over the counter topical medications and home remedies such as Vick's vapo-rub rarely work because they don't penetrate the nail very well. There's even a warning on the label of those products "do not use on scalp or nails" for that very reason. On top of that, because improvement is so slow it is difficult for most people to stick with the program long enough to see any changes, so they give up.


Percentage-wise, the best results have been achieved with the oral medication, terbinafine, also known by its trade name, Lamisil. The problem with it is that many patients do not like taking oral medications because of drug interactions or potential side effects, even though terbinafine has been shown to be relatively safe.


Roughly speaking, an equivalent success rate has been found via the use of laser therapy of toenails. Laser has been demonstrated to be both safe and effective for treatment of fungal nails. Treatment is pretty much painless and our office protocol is for three 8-minute treatments spaced a week apart. Simultaneous topical anti-fungal treatment is recommended to boost the success rate and limit additional exposure to fungus during the treatment period.


If there is any question as to whether you have a fungus infection of the nails, we'll send a sampling of your nail clippings to the laboratory for analysis prior to initiating any treatment.


Contact us to ask more questions or schedule an appointment. We'll be happy to answer any questions you have about the process or costs involved. We'll discuss the various treatment alternatives and preventive measures as well. But if you want those nails to look better by this summer, now is the time to act! Call or drop us a note today!






By cl7219
January 05, 2011
Category: Uncategorized
Tags: Untagged

Ok, so who amongst us hasn't made a New Year's resolution to lose weight/exercise more?


The health clubs are chock-full all through January. Some will keep going well into February and beyond, the rest are what the health clubs refer to as "profit margin". Many will be working out on the treadmills, elliptical exercisers, bicycles and participating in varying types of exercise classes to get a head start on the summer bathing suit season. I want you to be successful. I don't want an injury to be the downfall of your exercise program and New Year's resolution.


Here's how:


Wear the proper shoegear. Whether on a treadmill or doing a Zumba class, protect your feet at all times. Proper shoes/sneakers, and in good condition, are paramount. I've seen many, many problems caused by old, worn out shoes or ones not designed for the stresses of exercise. Same for exercise classes on hard floors with people being barefoot or stocking feet with no shoes. If you're starting out with brand-new shoes, break them in a bit before you exercise.


Take it slow. Speaking of breaking things in, you should break your body into the exercise routine gradually. Not just warmups, but you're not going to sweat off the extra 5-10-20 pounds in a week or two of exercise. Start slowly and build up the intensity and duration of your exercise program by about 10% per week. Too much, too soon can lead to injury and the frustration that puts a dent into your good intentions.


"Maybe it will go away." It is what I call the 5 most dangerous words in medicine. While some post exercise soreness is to be expected when starting on your program, pain that occurs during exercise or persistent pain that lasts more than a day or two warrants medical attention. Achilles Tendonitis, arch pain, shin splints, and heel pain are quite common. If recognized and treated promptly, appropriate treatment can get you back on track as fast as nature will allow.


Heel pain, frequently known as heel spur syndrome -- but more properly called plantar fasciitis will because by running or those dance classes. Achilles tendonitis or Posterior tibial tendonitis, usually experienced as pain under the peak of the arch on the inside of the foot are common overuse injuries caused by doing too much, too fast, too soon.


All can be treated by conservative means with a combination of extra support, rest and sometimes some anti-inflammatory medication. In our practice, we've found that the use of our laser therapy greatly accelerates the healing process, minimizing down time and getting you back out there ASAP.


If you have questions, or if you have a problem that needs attention, ask us a question or request an appointment. I want to help you keep your resolution!

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1114 Raritan Road
Clark, NJ 07066

Podiatrist - Clark, Dr. Brandon Macy, 1114 Raritan Road, Clark NJ, 07066 732-382-3470