Peripheral Arterial Disease (P.A.D.)

Foot Facts

  • Each foot has 26 bones
  • There are more than 100 ligaments in each foot
  • Diabetes is the #1 cause for lower extremety amputation
  • A toenail takes 4-9 months to completely grow out
  • Pain in the feet is NOT normal

Surgery: YES OR NO????

  • Deciding whether or not to have surgery is a big decision. 
  • Our foot and ankle surgeons are skilled in both surgical and conservative options. 
  • We will present the options most suitable for you and help you with your decision.

How much pain should I be in before I make an appointment?

  • Foot pain is not normal.
  • Foot pain is a signal that something is not right.
  • Any degree of foot pain warrants an evaluation to determine the source of the pain and possible treatment options.
  • Most foot pain left untreated will get worse and become more difficult to cure.
  • If you have foot or ankle  pain, make an appointment, do not wait.

Will soaking cure my ingrown toenail?

  • Soaking an ingrown toenail will often make it feel better, but it will not cure it. 
  • The symptoms of an ingrown toenail include pain, redness, and swelling.
  • An ingrown toenail is easily cured with a simple in office surgical procedure. 
  • The toe is anesthetized so that pain is not felt during the procedure.
  • The ingrown nail, or portion of the nail, is removed.
  • Most people feel no pain afterwards and return to normal activities the next day. 

What are orthotics?

  • Custom made foot arch supports designed to hold the foot in its optimum position
  • Can alleviate the discomfort caused by a number of foot conditions such as heel pain, bunions, and flat feet. 

Happy Feet...Happy Bride

happyComfortable footwear can help make the perfect day even better. Many times foot or ankle discomfort can be alleviated with appropriate shoes. It is not unusual for people to buy shoes that are too small for their feet. If your foot problem has an easy solution, our podiatrists will gladly provide you with that information. Sometimes the right shoe is not enough and custom-made orthotics is necessary to help the feet maintain the best position. Our podiatrists can utilize a three dimensional digital scan to have custom made inserts (orthotics) fabricated for your shoes, made from the scan of your feet to correct your specific foot abnormality and fit your feet only. If your foot or ankle problem can be resolved with conservative treatment, our podiatrists will advise you of the best treatment for you. There are times when the best solution for a foot or ankle problem is surgery. If you require foot or ankle surgery, our podiatrists can provide you with the latest state of the art surgical techniques. They will take the time to explain to you what to expect before, during and after surgery and will try to answer all your questions. Whatever your foot or ankle problem may be, our podiatrists will explain the various treatment options available to you. Everyone is happier when their feet are happy!

Thoughts on Celebrating 30+ Years

anniversarySome thoughts from Dr. Jacoby:
On April 30, 1984 I took over this podiatry practice. Elgin became my professional home as well as my personal home. I am forever grateful to Dr. Roger Hess who started this practice 50 years prior. Dr. Hess was a gentleman whom I admired and emulated both professionally and personally. I am forever honored to continue caring for the patients who initially trusted Dr. Hess.

My first office was at 860 Summit on the East Side of Elgin. I remember painting the office myself. I moved twice into larger space at 860 Summit. Eventually we outgrew the space there and moved to larger space at the Sherman Hospital Medical Building and then finally here to 750 Fletcher. I am grateful to the multitude of patients we have had the privilege of treating and that have kept us growing. I am also grateful to the multitude of other physicians in the area whom I am so privileged to work with.

Not only has this practice grown in physical space, but we have grown technologically as we offer many state of the art alternatives.  My staff has been and continues to be essential.  To all my staff, both past and present, I say a most sincere Thank You.

I look back on the years with much pride and sentimentality. I look forward to the future with the same enthusiasm and joy I felt on April 30, 1984. I love what I do and every day I realize how blessed I am to be in this wonderful profession!

What is Peripheral Arterial Disease?
Commonly referred to as “poor circulation,” Peripheral Arterial Disease (P.A.D.) is the restriction of blood flow in the arteries of the leg. When arteries become narrowed by plaque (the accumulation of cholesterol and other materials on the walls of the arteries), the oxygen-rich blood flowing through the arteries cannot reach the legs and feet.

The presence of P.A.D. may be an indication of more widespread arterial disease in the body that can affect the brain, causing stroke, or the heart, causing a heart attack.

Signs and Symptoms
Most people have no symptoms during the early stages of P.A.D. Often, by the time symptoms are noticed, the arteries are already significantly blocked.

Common symptoms of P.A.D. include:

  • Leg pain (cramping) that occurs while walking (intermittent claudication)
  • Leg pain (cramping) that occurs while lying down (rest pain)
  • Leg numbness or weakness
  • Cold legs or feet
  • Sores that won’t heal on toes, feet, or legs
  • A change in leg color
  • Loss of hair on the feet and legs
  • Changes in toenails—color and thickness

If any of these symptoms are present, it is important to discuss them with a foot and ankle surgeon. Left untreated, P.A.D. can lead to debilitating and limb-threatening consequences.

Risk Factors of P.A.D.
Because only half of those with P.A.D. actually experience symptoms, it is important that people with known risk factors be screened or tested for P.A.D.

The risk factors include:

  • Being over age 50
  • Smoking (currently or previously)
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Personal or family history of P.A.D., heart disease, heart attack, or stroke
  • Sedentary lifestyle (infrequent or no exercise)

Diagnosis of P.A.D.
To diagnose P.A.D., the foot and ankle surgeon obtains a comprehensive medical history of the patient. The surgeon performs a lower extremity physical examination that includes evaluation of pulses, skin condition, and foot deformities to determine the patient’s risk for P.A.D. If risk factors are present, the foot and ankle surgeon may order further tests.

Several non-invasive tests are available to assess P.A.D. The ankle-brachial index (ABI) is a simple test in which blood pressure is measured and compared at the arm and ankle levels. An abnormal ABI is a reliable indicator of underlying P.A.D. and may prompt the foot and ankle surgeon to refer the patient to a vascular specialist for additional testing and treatment as necessary.

General Treatment of P.A.D.
Treatment for P.A.D. involves lifestyle changes, medication and, in some cases, surgery.

  • Lifestyle changes. These include smoking cessation, regular exercise, and eating a heart-healthy diet.
  • Medications. Medicines may be used to improve blood flow, help prevent blood clots, or to control blood pressure, cholesterol, and blood glucose levels.
  • Surgery. In some patients, small incision (endovascular) procedures or open (bypass) surgery of the leg are needed to improve blood flow.

P.A.D. and Foot Problems
Simple foot deformities (hammertoes, bunions, bony prominences) or dermatologic conditions such as ingrown or thickened fungal nails often become more serious concerns when P.A.D is present. Because the legs and feet of someone with P.A.D. do not have normal blood flow—and because blood is necessary for healing—seemingly small problems such as cuts, blisters, or sores can result in serious complications.

Having both diabetes and P.A.D. further increases the potential for foot complications. People with diabetes often have neuropathy (nerve damage that can cause numbness in the feet), so they don’t feel pain when foot problems occur. When neuropathy occurs in people with P.A.D., ulcers can develop over foot deformities and may never heal. For this reason, P.A.D. and diabetes are common causes of foot or leg amputations in the United States.

Once detected, P.A.D. may be corrected or at least improved. The foot and ankle surgeon can then correct the underlying foot deformity to prevent future problems should the circulation become seriously restricted again.

Avoiding P.A.D. Complications
Getting regular foot exams—as well as seeking immediate help when you notice changes in the feet—can keep small problems from worsening. P.A.D. requires ongoing attention.

To avoid complications, people with this disease should follow these precautions:

  • Wash your feet daily. Use warm (not hot) water and a mild soap. Dry your feet—including between the toes—gently and well.
  • Keep the skin soft. For dry skin, apply a thin coat of lotion that does not contain alcohol. Apply over the top and bottom of your feet, but not between the toes.
  • Trim toenails straight across and file the edges. Keep edges rounded to avoid ingrown toenails, which can cause infections.
  • Always wear shoes and socks. To avoid cuts and abrasions, never go barefoot—even indoors.
  • Choose the right shoes and socks. When buying new shoes, have an expert make sure they fit well. At first, wear them just for a few hours daily to help prevent blisters and examine the feet afterward to check for areas of irritation. Wear seamless socks to avoid getting sores.
  • Check your feet—every day. Check all over for sores, cuts, bruises, breaks in the skin, rashes, corns, calluses, blisters, red spots, swelling, ingrown toenails, toenail infections, or pain.
  • Call your foot and ankle surgeon. If you develop any of the above problems, seek professional help immediately. Do not try to take care of cuts, sores, or infections yourself.