Gina Kaye (Host): Welcome to the Arbor Health and Life podcast. I'm Gina Kaye. And with me is Dr. Parker Peresko, a surgical podiatrist. And today, we are discussing foot and ankle issues. Welcome, Dr. Peresko. It's great to have you with us today

Parker Peresko, DPM: Thanks, Gina. I appreciate you having me on. Happy to be here.

Host: Great. For those who may not be familiar with your specialty, what does a surgical podiatrist do and what types of conditions do you treat?

Parker Peresko, DPM: Yeah, great question. So, a surgical podiatrist is a physician who treats ailments of the foot and ankle. Depending on which state you're in, they may have different scopes of practice. We can treat soft tissue sometimes up to the knee and hip, such as, you know, diabetic wounds, things of that nature.

Other issues such as bunions, hammer toes, all the way up to ankle fractures and other traumatic issues. So, both surgical and conservative treatment.

Host: What are some of the most common foot and ankle problems you see? And when should someone seek care instead of trying to live with it?

Parker Peresko, DPM: I get this question quite a bit. So, some of the more common things I see are just like I was talking about hammertoes with calluses and painful corns, bunions that can be associated with that. You know, someone going on a hike, they twist their ankle, sprains, ankle fractures, other various fractures of the foot as well.

That kind of goes into the last part of that question whereas how long do you live with it? It's dependent on what you have. People with the bunions and hammer toes, you know, you can go on for it as long as you want. It's not necessarily a question of, "Is it going to kill you?" It's how long can you tolerate the pain until it starts really affecting your life. Whereas if you have an ankle fracture or something like that, maybe you need to come in sooner than later so we can get back to walking.

Host: Many people hear the word surgery and feel anxious or nervous. What are some conditions that can be treated without surgery? And then, when does surgery become the best option?

Parker Peresko, DPM: Yeah. So, segue from the last answer into this one. Surgery is the best option definitely for things that are more traumatic. Like I said, those fractures, bad infections, things that needed to be treated immediately, whether they require hospitalization or if it can be done on an outpatient basis. Other things such as heel pain like plantar fasciitis, painful bunions, those ankle sprains, we can kind of take those along a more conservative route and see if someone can't get better with that, you know, trying it for weeks up to months until they decide they want to take a different route and do something a little more invasive.

So, it's really dependent on the patient's preference as well as where they're at in life and how long and how bad is this going to affect them down the road.

Host: Diabetes can have a major impact on foot health. Why are regular foot exams so important for people with diabetes and what warning signs should they never ignore?

Parker Peresko, DPM: Yeah. So, a aood population of the patients I see are diabetics. A lot of them are really well managed and they don't necessarily have to be very worried about some of these bad signs, but it's always better to be safe than sorry. Because the last thing you want to do is as much as I like seeing a lot of my patients, they have to see me all the time for something that can pop up, right?

One of the more concerning things is a diabetic foot ulcer and that's where some of the signs that we may see is someone getting what's called neuropathy, which it could be numbness tingling burning causing a loss of sensation in the foot, which means that we can't feel some of those indicators of when we might have pain. We get this repetitive pressure that can cause a callus, and then an underlying wound to develop, which makes them more prone to getting infections. It has the potential to cause, you know, more long standing issues and could result in amputation or even worse down the line. So again, looking out for things by checking your feet daily, coming to see me on a routine basis so we can look out for other things that may be a little harder to do on your own, as well as getting the right shoe gear and managing your diabetes are all things to consider if you are someone who has diabetes and may have some of these other symptoms that we talked about.

Host: What are some simple things people can do every day to keep their feet healthy and prevent injuries or chronic problems?

Parker Peresko, DPM: Shoes is probably the number one best thing. I am guilty myself of having worn, you know, maybe not the best shoes in the past when I was younger and everything. Some women and other folk like to wear high heels, which as good as they may look, may not have the best result for our feet down the line or our feet may make us pay for it.

So, shoes, good comfortable shoes, nice support. Having a good amount of cushion, but not too soft they can't roll over themselves, as well as just again monitoring everything. And if it's something you have to fight through the pain, maybe call and make an appointment and we'll both take it on from there.

Host: Let's talk about advances in podiatric care and surgical techniques. How have they improved recovery times and outcomes for patients?

Parker Peresko, DPM: Actually, even within just the last five years not to mention the past ten to twenty years we made quite a bit of advances. There's a lot of minimally invasive surgeries. Some people may hear MIS that has made a very large comeback and we have made a lot of advances in that alone. That increases both the healing time as well as the postoperative outcomes in patients. It's surgery done through a very small surgical incision, usually with a certain kind of bur, which is almost like a Dremel of sorts that use on bone or other types of tissue in the body.

Not having to make that big surgical incisions means that there's less swelling. There's less pain typically postoperatively. That would probably be the number one advancement I've seen in the last about five or so years. And we are seeing pretty good results with a lot of these things in all realms, whether they are like I said traumatic injuries all the way to minimally invasive bunions and hammertoes being done, minimally invasive plantar fasciitis surgery. I think its something to stay, and its a very good armament to have in a surgeon's profile.

Host: That's wonderful news. If you could leave our listeners with one piece of advice about taking care of their feet and knowing when to seek treatment, what would that be?

Parker Peresko, DPM: Yeah. So, not everything needs to be seen immediately. There are a lot of things to where the best thing you can do is come in and we have a conversation. Not everything needs to necessarily get a treatment or get a specific type of surgery. There are a lot of patients that I have that we have a good conversation. And sometimes it's the devil you know versus the devil you don't, and you're able to go about your day knowing you're not going to make things worse.

You're not going to injure it or cause something that's irreparable in the future. So, knowing that being able to have a conversation and understand that, and being able to go out and enjoy life without having to be so hesitant about anything you do would probably be some of the best overall advice I could convey.

Host: Dr. Peresko, thank you very much for sharing your knowledge and your time. It is very much appreciated.

Parker Peresko, DPM: I appreciate you having me on. It was wonderful talking to you.

Host: Thank you for listening to the Arbor Health and Life podcast from Arbor Health. If you found this information helpful, please share it on your own social media channels. Those interested in more information about surgical podiatry services at Arbor Health may visit myarborhealth.org. Thanks for listening.