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 Things happen fast in medicine so whatever you read could well be outdated, especially if it was written many years ago.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


07/24/2010Home Karen SlcerosingNews+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

 

 

How well does sclerosing for nerves work? read this by a patient names Karen with a painful neuroma. Read Karen's story at -->

Sclerosing Corns and Nerves

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

wpe2.jpg (4278 bytes)

The other day I was trying to explain to a culinary oriented patient something I had recently learned at a seminar. It was a new (to me) method of treating a variety of conditions using a concoction consisting of local anesthesia and pure alcohol. I told her we might consider sclerosing her corn and I spelled the technique, “s-c-l-e-r-o-s-i-n-g”. “Thank goodness you spelled it”, she replied. “I thought you said slow roasting.”

Sclerosing has been used for years to eliminate varicose veins without surgery. Using a variety of agents, this alcohol solution being one, a thick vein is injected with the sclerosing solution. In effect the solution scars both sides of the vein. When compression, in the form of an elastic bandage is applied, both sides of the vein scar together and the vein is closed permanently. Sclerosing has proven to be safe and effective.

In podiatry we are continually confronted by calluses, called corns, caused by prominent parts of bone rubbing against other bones or shoes. These corns are conservatively treated by trimming, padding and changing shoes. Surgery is directed at reducing the bony prominence. Surgery for corns is very common and very effective.

Sclerosing injections can often eliminate plugged sweat ducts and neuromas without surgery

A less common type of corn is the porokeratosis or, for the podiatrically challenged, a “plugged sweat duct” (PSD). They have also been given the name seed corn because they seem to have a central core that reminds people of a seed. PSDs are usually found on the bottom of the foot in weight bearing locations. PSDs are not caused by a bony prominence and there is no easy way to get rid of them forever. The only two choices were to trim them every few months or to surgically excise them with an incision going through the whole thickness of the skin. Any such surgery will leave at least a fine scar. Because scars in a weight bearing location can be as uncomfortable as the corn, surgery is not often performed. This is where slow roasting, er, sclerosing, comes in. PSD will often go away with a series of sclerosing injections performed with tiny needles and tiny syringes. Sutures and bandages are not required.

Sclerosing is also a great way to kill nerves (neurolysis). Killing nerves is not something to be undertaken lightly. But sometimes, in cases of neuromas or trapped nerves, for instance, the nerve is the problem. With sclerosing injections the nerve can be eliminated as a source of pain without surgery.

Sclerosing corns or nerves requires up to seven or eight weekly injections. Because injections have been given a “surgery code” by insurance companies, it will appear on your bill as a surgery even though you never approached an operating room.

Now you know when your hear me telling you about sclerosing corns, I am not referring to a summer barbecue.

From The Doctor’s Desk:

It is wonderful when a simple therapy can take the place of a more involved open surgery. It is even more wonderful when it can treat a problem that is otherwise untreatable. Such is the story with the annoying problem known as seed corns, plugged sweat ducts or porokeratotic lesions.

On a hard surface these little lesions hurt - sometimes a lot. Until now, none of our simple treatments, such as using a wart remover, has not worked. Getting rid of them permanently has required a full thickness skin excision. Such an incision can leave a painful scar, especially if a patient walks on it during healing.

I was very happy at a recent seminar to learn about sclerosing injections. It is an old technique used in a new method. Sclerosing can treat seed corns, neuromas and certain other conditions. I am happy to offer this to my patients as a non-surgical option in treating these vexing problems.

Dr. Michael Zapf

---------------------------------------------------------

I received the following letter about a seed corn April 21, 2001

Dear Dr. Zapf,
It was good to find your web site, it was the only useful information I
was able to find.  I have a seed corn under my foot which causes a lot
of pain and because I tend to walk differently on that foot now, causes
shooting pains all the way up my leg, especially when I am laying in bed
at night.  In desperation I decided to have surgery in the doctor's
office (I live in the small town of Athens, Ohio).  After the surgery I
had stitches in my foot and was on crutches for three weeks.  After that
it was great and the shooting leg pains had stopped.  Five months later
they came back, that is when I realized the seed corn had returned.  Now
I am desperate.  You mentioned SCLEROSING, what exactly would that do
for a seed corn?  Would it cure it, or just stop me from feeling it?
Thank you.

Susan R.

Dear Susan,

As you can see from what I wrote above I do use sclerosing as a first step in treating seed corns before I would ever try to surgically excise them. The surgery is cumbersome and for best results you need to be off the foot for 3 weeks afterwards. Seed corns seem to occur in little crops of three or four. The picture at the top of this page shows two seed corns in the middle of a long "linear" callus. If you successfully remove one of the little guys you might have a sibling pop next to (or in) the incision site. This new one would seem to be a recurrence of the original corn but I believe that the surgery completely eliminated the original and the "recurrence' is really a second corn. You could, of course, remove this second corn with the same surgery. As an alternative you can "sclerose' this corn just as you could have sclerosed the first one. My success of sclerosing seed corns is good but not great. In a study I did of 32 of my patients I found that they completely resolved (went away) about 1/3 of the time. In another third they did not go away but the nerve under them must have been killed because they no longer hurt. I consider this a success because if they do not hurt most people can live with the little callus under the foot. Finally in 1/3 of the cases there was no improvement and I would have to consider the treatment a failure. Keep in mind that a successful treatment takes a series of 7 or 8 (or sometimes more) weekly injections of a small quantity of the alcohol solution just under the lesion. I hope this helps

Dr. Zapf

Another note:

 From Jane B. She returned to my office for an unrelated problem but had her neuroma "sclerosed" 6 years before. She noted that she had no pain whatsoever from her neuroma since she has the treatment. She made the following note; "I will always choose an alternative method to surgery first and Dr. Zapf's special Zapping method for neuromas, sclerosing, really worked for me!"

 

   

 

 

 

 

 

Home Up Karen SlcerosingHit Counter

Send mail to (zfootdoc at doctor dot com) with questions or comments about this web site.
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