Welcome to the personal website of

Dr. Michael A. Zapf, DPM, MPH, FACFAS, FACFAOM

Thank you for visiting the web site of Dr. Michael Zapf. He is a member of the Agoura-Los Robles Podiatry Centers

The "real" practice web site, the one that contains registration forms, doctor information for all the office and directions to the office is located at:

www.conejofeet.com   ç Click here

I am Dr. Michael Zapf. I have been offering a full range of podiatric medical services, from ingrown nails to heel pain and foot surgery, to my friends and neighbors in the Las Virgenes, Conejo and Simi Valleys since 1985. This is my personal web site. It has been up since 1990 and has received more than 2 million visits. The entire site is my responsibility only and nearly everything on the site was written by me. You are welcome to peruse this site and learn what you can about me, your feet and the problems your feet can develop. Things happen fast in medicine so whatever you read could well be outdated, especially if it was written many years ago. On this site you will read historic articles that I wrote for a lay audience as long as 25 years ago, so please do not take anything on this site as definitive or as applying directly to your condition. You may wonder why I have my own site even though there is also an official practice site. Well, my partners are of a younger generation raised on tweets, e-mails and iPhones. They want a professional site that they believe better represents the professional nature of our practice. They also believe that people no longer take the time to read anything of length. I, on the other foot, think there is still a world out there full of people who still read lengthy descriptions of problems and solutions. if you are one of those old fashioned readers, then this site if for you. Let me know what you think. Let me know you are out there.

Please note that all information and photographs on this site are copyrighted by me, Michael Zapf, DPM, and cannot be used for any private or commercial purposes. I work with two other podiatrists in my practice who may or may not share any of my ideas and philosophy. Do not expect them to practice the way I do or even believe in any of the speculation I present here. If you appreciate what I have written and want me to be your treating doctor, you will have to ask for me specifically. Even if my office says at first, " He is booked until next month",  I still want to see you as long as you are a little flexible with your schedule. If your visit is an emergency, I know that  you will be happy with either of my associates, Dr. Darren Payne or Dr. Steve Benson. They are exceedingly well trained and capable in any foot emergency.

 

Michael Zapf, DPM, MPH, FACFAS, FACFAOM     (If you want to know what all those initials mean, click here   è  

Our office phone number is (818) 707-3668 and my e-mail address is zfootdoc [at] doctor [dot] com

Agoura Hills Office: 28240 Agoura Road, Suite 101, Agoura Hills, CA 91301

Thousand Oaks Office: 555 Marin Street, Suite 290, Thousand Oaks, CA 91360

For the address, hours and registration forms please see the practice web site: www.conejofeet.com


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ACORN May 1994

The "Emergency" Ingrown Nail

By: Michael Zapf, DPM, MPH, FACFAOM

"I am tired of wearing Birkenstocks with everything I own", was how Marlene explained why she decided to seek care of her ingrown nail.

Marlene is an emergency room nurse. Her job requires her to work on her feet for hours at a time. And for every one of those hours her foot hurt. More specifically, her right big toe hurt. Sometimes it was swollen, red and hurt and other times it just hurt. This went on for years. When it got particularly bad she would soak the foot and take antibiotics. This brought down the pain from wild to mild. When it did not hurt so bad she merely limped. It hurt nearly all the time. Marlene did not know what most of the readers of this column know: that fixing this problem permanently in a podiatrist’s office is quick, slick and close to painless.

Contrary to popular opinion, ingrown nails are not usually due to improper cutting of the toenails. The usual cause is a nail shape that is incompatible with the shape of the toe, especially when confined in a shoe. The more recurrent the ingrown nail or the longer it has persisted, the more likely that the shape of the nail is the culprit. I have seen nails that were the "U"-shaped, shaped like a staple or hooked on one side. When these nails hurt it is almost entirely due to their shape.

To make matters worse, nails tend to get more curved and thicker as we go through life. Even if the nail starts out well-shaped, they can curve enough to hurt as we approach middle age (which, from my perspective, is getting later and later and is now between the ages of 60 and 80!). I have no idea why our nails have to get more curved as we go through life. It is on my list of questions to someday ask the Master Designer (along with why cars break down only after the warranty runs out, how single socks manage to escape from the washer and why the Ventura freeway traffic needs to come to a stop at Tampa Blvd.).

Ingrown nails caused by the shape of the nail are mainly painful. They are seldom the red and draining kind that look infected. The latter are more characteristic of the ingrown nails of teenagers. I say look infected rather than are infected because even the worst looking nails are more a product of a foreign body reaction than an infection. The nail plate, like hair, is an external structure. When the nail plate cuts into the skin your body does everything it can to get rid of it. It sends in white blood cells (pus) and red blood cells (blood) and inflammatory fluid (swelling) to eliminate the offending nail. Eliminating the offending nail edge, and not antibiotics, is the key to relief. This is usually done under gentle local anesthesia.

After gentle local anesthesia I removed a tiny edge of Marlene’s toe nail. The piece I removed was so thin that no one except she and I could tell any nail was removed. I knew she would feel better immediately. Because Marlene had a long history of ingrown nails I could safely assume that when the nail grew out it would be ingrown again. To prevent this from happening I added a little bit of chemical into the area where I removed the nail. The chemical will inactivate a portion of the nail root and prevent the misshapen edge of the nail from ever growing again. The visible portion of the nail is left alone and is neither removed or damaged. I bandaged the toe and sent her home to rest her foot for a few hours. The following day she redressed her toe with a Band-aid and was back at the emergency room saving lives. This time without pain for the first time in almost a decade.

Like many people, Marlene said that the procedure was much less traumatic that she ever imagined. She had heard stories about how painful the procedure was, how much bleeding occurred and about the great disability afterwards. While these may have happened in the past they are not typical of what happens in most offices today. She was thoroughly amazed and delighted at the procedure. When asked how it went, she told me I was a "lifesaver." I believe that I will leave that title to her, but, I do admit that I might have helped a little to save her "sole".

 

 

 

Dr. Michael Zapf is a board certified podiatrist in practice in Agoura Hills and Thousand Oaks. For more information please call his office at (818) 707-3668 or (805) 497-6979.

   

 

 

 

 

 

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Copyright © 2000 Michael A. Zapf, D.P.M., F.A.C.F.A.S., F.A.C.F.AOA.M.
Last modified: July 24, 2010