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 Things happen fast in medicine so whatever you read could well be outdated, especially if it was written many years ago.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


07/24/2010HomeNews+FAQShock Wave

 

To Order Foot Supplies è ç click

For Information about Laser Treatment for Fungal Nails Click hereè
 

For information about Shockwave Therapy for heel pain          click here è

Exciting news!!! New Thousand Oaks Location  è

 

 

 

 

ACORN September

Neuromas - My Two Scents Worth

By: Michael Zapf, D.P.M., M.P.H., F.A.C.F.O.

Some days are weirder than others and I thought last Wednesday was going to be one for the books. On my daily schedule was a new patient. Her name was Miriam and she said she was coming to see me about a painful aroma. For a podiatrist such feet are sort of an occupational hazard. Fortunately bad cases are few and far between and are easily treated. But Miriam said she had a painful aroma. How bad could it be, I wondered. And what would make it painful? She was scheduled for the afternoon so I just had to wait and see.

When I returned from lunch Miriam was already in a treatment room. As I walked toward the room I did not sense any strange scents. The smoke alarm was quiet. I approached the room and gently opened the door. I was surprised. Sitting in the chair was a demure, pretty young woman. The only thing I could smell was a delightful perfume. She introduced herself and pointed to her toes. "I have a painful naroma", said Miriam with a decided southern drawl. From where she was pointing I surmised that she had, not a naroma, but a neuroma. The afternoon was saved.

I explained that neuromas are as painful as they are common. A nerve that supplies sensation to one of the spaces between the toes gets trapped and hurts. Nerves are similar to an electric cord. In an electric cord, a wire is surrounded by a rubber insulation that protects the wire. Similarly, a nerve is surrounded by an insulating cover called a sheath. The sheath similarly protects the nerve.

This is where the analogy ends. If the wire was caught under the leg of a chair, multiple movements of the chair might cut the wire. If a neuroma is caught between two metatarsal heads, the sheath gets thicker. This whole process is designed to protect the nerve. If the swollen nerve sheath gets too large, the pressure of any part of the foot causes pain. The pain is often described as a sharp needle-like pain at the base of the toes with occasional shooting pains that travel to the tip of the toe.

In short, Miriam has a trapped nerve that is causing pain. It is made worse by shoes that are tight at the ball of the foot, especially elevated heels. This is just the kind of shoe that Miriam needs to wear at work.

A neuroma will either get larger or stay the same size. Without outside help it rarely gets smaller. One possible way to shrink a neuroma is with cortisone. An injection of cortisone can sometimes eliminate the pain by shrinking the thick neuroma sheath.

Should the injections not work, Miriam will be looking at a surgical solution. Neuromas can be removed from the foot in an out-patient surgery performed under local anesthesia. The recovery is rapid with patients returning to tennis shoes within two weeks and leather shoes shortly thereafter. Neuroma removal results in numbness between the toes where once there was pain. The numb sensation seems to decrease after several months.

I explained all this to Miriam and administered her first cortisone injection. I believe she will do well with just an injection or two. I smelled success.

 

 

 

Dr. Michael Zapf is a board certified podiatrist with offices in Agoura and Thousand Oaks. For more information you can call his office at (818) 707-3668.

 

 

 

 

 

 

   

 

 

 

 

 

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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