The PODdoctors with Dr. Dauphinee and Dr. Hussain
The PODdoctors: Diabetic Neuropathy: What role does Nerve Decompression play?

The PODdoctors: Diabetic Neuropathy: What role does Nerve Decompression play?

April 7, 2021

Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, start season two of The Pod Doctors podcast talking about diabetic neuropathy and what role nerve decompression plays into it. They discuss what they typically see with patients who have diabetic neuropathy and the various ways to treat it from conservative therapy to surgery.

 

“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

The PODdoctors: Jones fractures

The PODdoctors: Jones fractures

March 24, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about Jones fractures, a common foot fracture that can be quite complicated. They discuss the mechanics of the injury and treatment options. Listen as they talk about what makes these fractures so complicated.

 

“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

The PODdoctors: Hammer Toes

The PODdoctors: Hammer Toes

March 17, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about hammer toes. They discuss what causes this cosmetic and physical problem, the three main reasons for hammer toe contractures and other associated problems. They also describe the most common treatment options from conservative to surgical treatments.

 

“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

The PODdoctors: Charcot Foot

The PODdoctors: Charcot Foot

March 10, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about Charcot food, a typical problem seen in neuropathic patients. They discuss the two theories behind this condition: neuro-traumatic theory and neurovascular theory. They share examples of what they see at the clinic and how they treat it through internal and/or external fixations.

 

“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 and 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

The PODdoctors: Hallux Rigidus

The PODdoctors: Hallux Rigidus

March 3, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about hallux rigidus, a common problem and specific arthritic joint pain in the big toe. They share what they typically see with the disorder clinically and why x-rays are important to diagnose the problem. They also discuss the various treatment options for hallux rigidus.

 

“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 completely
  • [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

The PODdoctors: Achilles Ruptures

The PODdoctors: Achilles Ruptures

February 24, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about achilles injuries. They discuss what causes the chronic and acute injuries and how they treat them. Listen to why it’s important to treat an achilles injury as quickly as possible.

 

“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

The PODdoctors: Modern Wound Care

The PODdoctors: Modern Wound Care

February 17, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, speaks with Toni Rodriguez on wound care centers. Toni has worked with wound care centers since 1996. She discusses with Dr. Dauphinee the type of services wound care centers offer and how a team of specialists work together. She also talks about how she is helping with developing a wound care program in Argyle that is projected to open this summer.

 

“We are actually a minor emergency, physician specialty center. Kind of a three in one.” - Toni Rodriguez [13:23]

 

Top Takeaways:

  • What are wound care centers and why they’re important
  • The services they offer
  • Toni’s work with wound care centers
  • Why it’s helpful to have different specialists involved in wound care

 

What You Will Learn:

  • [00:40] Intro
  • [01:37] Toni’s work with wound care programs
  • [06:55] What wound care centers offers
  • [12:42] Why it’s helpful to have different specialists involved in wound care
  • [18:45] What is a valid, viable level of an amputation
  • [19:28] What is debridement
  • [20:23] An interesting aspect of wound care
  • [23:48] What is hyperbaric oxygen therapy
  • [31:28] Why Argyle is a good place to open a wound care system

 

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

The PODdoctors: Corns and Calluses

The PODdoctors: Corns and Calluses

February 10, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, talk about one of the most common (and annoying) skin lesions they see in patients: corns and calluses. They discuss what these skin lesions are and how some could be caused by an underlying bone problem. They also share how they treat them and suggest some ways to treat them at home.

 

“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

The PODdoctors: Tarsal Tunnel Syndrome

The PODdoctors: Tarsal Tunnel Syndrome

February 3, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, discuss the often missed cause of chronic pain in the foot: tarsal tunnel syndrome. Dr. Dauphinee has sub-specialized in peripheral nerve injuries and pathology. He discusses neuritic or nerve-related pain and how this nerve-entrapment problem presents.

 

“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

The PODdoctors: Ankle Fractures

The PODdoctors: Ankle Fractures

January 27, 2021

In this episode of The Pod Doctors podcast, Dr. Damien Dauphinee, a board-certified foot and ankle surgeon, and Dr. Raafae Hussain, fellowship trained foot and ankle surgeon, discuss the scourge of winter, the slip and fall injury: ankle fractures. They review some of the mechanics around these injuries and how they approach treating these often challenging musculoskeletal problems surgically.

 

“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

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