Leg, ankle and foot problems affect many people. Pain caused by these problems can severely impact patients’ quality of life. Froedtert South podiatrists are applying leading-edge treatments to help patients eliminate the pain and maintain their quality of life.
“I was disabled for almost 11 years with my ankle,” said Susan Aulozzi of Kenosha. “I worked as a teller at a credit union until I couldn’t walk very well, so they made me a greeter. I was living like a hermit — just going to work and coming home and doing the best I could to make it through another day. When the pain started, my doctor told me a drug I have to take for an autoimmune disorder was destroying my ankle joint. So, I wore a brace and learned to live with it.”
Susan Aulozzi
Finding relief close to home
She, like so many other people within the Kenosha County community, turned to the podiatrists at Froedtert South for help: Dr. Anthony Montemurro and Dr. Ryan Holmbeck.
“As podiatrists, we treat any foot and ankle ailments that a patient develops, whether it’s a fracture, an ingrown toenail, a bunion, a flat foot or other problems such as plantar fasciitis or Achilles tendinitis,” Dr. Holmbeck said. “Podiatry issues affect everyone — from a newborn with a club foot to an older patient with an ingrown toenail and everyone in between.”
“Patients like Susan who suffer from degenerative arthritis in an ankle struggle with pain when they’re walking or even just standing,” Dr. Holmbeck said. “And like Susan it can be hard for them to have a job that involves doing more than sitting. Often, they end up limping to compensate for the pain in their ankle, which can cause additional problems in their knees, hips or lower back. Previously, oral medication, cortisone injections and bracing were the typical approaches to treating these patients. The surgical alternative was fusing the joint into one position, which leaves patients unable to move their ankle at all. But today, there are excellent implants available to replace the damaged bone and cartilage in a patient’s ankle.”
Advanced in treatment
“Dr. Montemurro told me that the treatment options for my ankle have come a long way,” Aulozzi said. “I didn’t want to end up with a foot that I couldn’t bend because the ankle was fused, so replacement was the right option for me.”
“It’s an outpatient procedure, so you go home the same day,” Dr. Holmbeck said. “It’s usually done under general anesthesia along with a nerve block that makes the patient’s leg numb from the knee down. An incision is made on the front of the ankle so the damaged cartilage can be replaced with metallic implants and a spacer that allows the ankle to move up and down normally.”
“Patients are able to walk on the ankle right away, so we can get them into rehab and maintain their range of motion,” Dr. Holmbeck said. “The whole recovery is three months or so, including healing the incision and transitioning from a boot into physical therapy.”
“The results have been wonderful for me,” Aulozzi said. “I get up in the morning and I can stand and walk without pain. After the surgery, I was in the office for my checkup and I just hugged Dr. Montemurro and said, ‘Doctor, I can walk.’ I didn't even say thank you. I said, ‘Doctor, I can walk.’”
Staying on her feet
Laura Gulatz, also of Kenosha, had struggled with a bunion on one of her feet for a long time. “At least 10 years,” Gulatz said. “It kept getting bigger and more uncomfortable. It was to the point where I couldn’t wear some of my shoes. Plus, I hike for at least an hour almost every day, so I was concerned that I wouldn’t be able to do that for much longer.”
Dr. Holmbeck surgically removed the bony growth from the side of Gulatz’s foot and inserted a titanium plate where the bunion had been.
“They gave me a nerve block, so I had no pain for the first 24 hours,” she said. “I spent a couple days on the couch taking it easy and taking pain medication, but I was walking within a week after I had the surgery.”
Today, she is happy with the results.
“It doesn’t hurt or bother me,” she said. “I can still do all the things I did before: I’m in the kitchen standing for hours preparing food for my family when we have big meals. I’m playing on the floor with my grandkids. I hike whenever I want to. I’m very glad that I had the procedure.”
Laura Gulatz with her family
Relief for nerve pain sufferers
“We are also offering patients more innovative treatments for neuropathy — something that is increasingly common in our community,” Dr. Montemurro said. “We see five to 10 people each day who have neuropathy — patients who experience relentless numbness, burning, tingling and chronic pain in their legs, ankles and feet. It makes people miserable, especially at night, because it tends to keep them awake. Diabetes is the main cause, but there are many other reasons someone might experience this condition.”
“In the past, treatment options were limited. Neuropathy can’t be cured, so patients often had to stay on pain medications to relieve their symptoms,” Dr. Montemurro said. “But one of the treatments we now provide to patients is a stimulator that we implant in an area of their leg near the main nerves. This technology has been used for quite some time to treat back pain, but applying it to patients’ lower extremities is relatively newer.”
“It’s about a five-minute procedure that we usually perform under local anesthetic in an operating room,” Dr. Montemurro said. “We put the tiny electrodes in place, and patients wear an external device that they use to activate the electrodes when they want to calm the numbness, burning, tingling or pain they’re feeling. This helps patients control their neuropathy, while avoiding the side effects of pain medications.”
“The treatment has a high success rate,” Dr. Montemurro said. “Patients tell us it really works, especially in terms of helping them sleep at night.”
Listening to patients
“We really listen to what patients want to tell us and focus on what’s going on with them so we can treat them appropriately,” Dr. Holmbeck said. “Going to a doctor can be a scary experience for some patients, so we try to make them feel as comfortable as we can.”
“Nobody knows a patient better than they do,” Dr. Montemurro said. “That’s why I make it a point to listen very carefully to each one of them.”
For more information, please visit froedtertsouth.com.
