The modest objective of this newsletter is to get 60% of the upside of the market and avoid 60% of the downside of the market utilizing various economic indicators with the use of Exchange Traded Funds (ETFs). E-mail alerts will be issued when a change is recommended.
Kenneth Lavin has worked as an economic consultant for the 360 Huntington Mutual Fund since 2009. He has conducted investment and economic research. He has a Masters of Science in Finance from Northeastern University, Boston, MA
This material has been prepared solely for informational purposes and not for individual financial planning. The opinions and analyses included herein are based on sources believed to be reliable and written in good faith, but no representation or warranty, expressed or implied is made as to their accuracy or timeliness. PAST PERFORMANCE IS NOT A GUARANTEE OF FUTURE RESULTS.
There are three important factors that impact the success of bunion surgery:
Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient's foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won't recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
Bunion surgery is not a magic bullet. Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.
What to Expect
Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.
Prior to the surgery, patients will need to make some preparatory arrangements. These include:
Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
Arranging your schedule to make sure you don't need to take any long trips for at least two to three weeks following the surgery.
Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.
The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.
Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into "twilight" so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.
The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.
During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.
Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.
By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.
By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.
Podiatrist Sheldon Nadal discusses the symptoms, causes and treatments for Heel Pain (Plantar Fasciitis).
What causes heel pain? One of the most common causes of heel pain is plantar fasciitis or heel spur syndrome.Other causes include gout, arthritis, broken heel bone, infection, foreign bodies (such as stepping on a needle). Your podiatrist can determine the exact cause of your heel pain.
What is plantar fasciitis or heel spur syndrome? Plantar fasciitis is due to a tight tendon located under the arch and attached to the bottom of the heel. It has become strained and inflamed, often due to a lack of proper support, or due to an injury, or overuse. Over time, the tendon may begin to pull away from its attachment at the heel and a bone spur develops. Generally, the problem is not due to the heel spur, it is due to the inflamed tendon.
How do I know if I have plantar fasciitis? Usually, you will experience pain at the bottom of the heel, particularly when getting out of bed in the morning or when starting to walk following a period of rest. It tends to feel better after a moderate amount of walking. It may not hurt during a workout but usually hurts more the next day following the workout.
What can I do at home to relieve the pain of plantar fasciitis? Applying ice to the tender area for short periods may help. Also, try gentle calf stretches. Aspirin may relieve the inflammation. Elevating the heel by putting a soft pad in the shoe under your sore heel may help. Women may feel better in a shoe with a higher heel.
What if my heel still hurts? It's time to see a podiatrist.
On August 26 2010 our Toronto podiatry office introduced in Canada, laser treatment for toenail fungus or onychomycosis using a 1320 nm YAG laser .
A preliminary study performed in Roseville California indicates that up to 75-80% of patients with mild to moderate onychomycosis or fungal toenails will experience a significant improvement following treatment.
The laser is an alternative to topical medications such as Pen Lac, which has limited efficacy, and anti-fungal pills such as Lamisil or Terbinifine, which have associated side effects.
With our laser, there is usually very little discomfort, anaesthetic is unnecessary and you may walk and resume normal activities immediately.
Please call our Toronto foot clinic at 416-486-9917 today to find out how we can help you with your toe nails.
Bunions are progressive bone deformities of the foot that often cause recurring or chronic inflammation, irritation, and pain that require surgical correction. Surgical removal of a bunion is called a bunionectomy. However, there are multiple types of bunionectomies, each designed to resolve different structural changes caused by the deformity.
Bunion surgeries fall into two major categories:
Head procedures that treat the big toe joint. In a head procedure bunionectomy, the bone is cut just behind the joint, moved into its proper position, and fixed in place with a screw or pin. Head procedures are often used for patients who cannot be immobilized for long periods of time.
Base procedures concentrate on the bone near or behind the big toe joint. Different types of base procedures are conducted depending on the nature of the deformity. These range from cutting a wedge out of the bone and splitting it so that it can be moved into its proper position; making a semi-circular cut and rotating the bone into its correct position; or fusing the joint. Ligaments inside and outside the toe may also be treated during a base procedure.
There are three important factors that impact the success of bunion surgery:
Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient's foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won't recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
Bunion surgery is not a magic bullet. Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.
What To Expect
Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.
Prior to the surgery, patients will need to make some preparatory arrangements. These include:
Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
Arranging your schedule to make sure you don't need to take any long trips for at least two to three weeks following the surgery.
Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.
The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.
Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into "twilight" so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.
The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.
During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.
Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.
By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.
By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.
There are three important factors that impact the success of bunion surgery:
Choose a surgeon with extensive experience with bunionectomies. Because a deep understanding of the biomechanics of each patient's foot as well as the intricacies of each surgical option is needed, surgeons with more experience at doing bunionectomies are better able to help each patient achieve the best outcome.
Be realistic in your expectation about what a bunionectomy can accomplish. No physician can guarantee that a bunion won't recur or that a patient will be absolutely pain free. Additionally, because of the complexity of the foot structures impacted by a bunion, patients may never be able to wear normal or slender shoes. Bunion surgery can reduce or eliminate the bone deformity, improve foot alignment and function, and prevent damage to other toes, but it does have its limitations. Be sure you understand all the possibilities before opting for this surgery.
Bunion surgery is not a magic bullet. Surgery alone may not be all that is needed to achieve your best outcome. After surgery, many patients experience long healing and recovery times and often have to spend time in physical therapy. Additionally, you may need a corrective orthotic device on an ongoing basis.
What to Expect
Most bunions surgeries today are performed on an outpatient basis at a surgical center or hospital. Set aside the entire day for the surgery, although you may only be at the facility for a half day.
Prior to the surgery, patients will need to make some preparatory arrangements. These include:
Seeing your Primary Care Physician (PCP) to make sure any other health conditions are stabilized prior to surgery and to document your complete medical history, which can then be given to the foot surgeon.
Arranging your schedule to make sure you don't need to take any long trips for at least two to three weeks following the surgery.
Lining up another person to drive you home and stay with you for the first 24 hours after the surgery.
Stopping the use of any anti-inflammatory medications, such as aspirin, ibuprofen, or acetaminophen, for five to seven days before the surgery.
The night before the surgery, you will not be able to eat or drink anything after midnight. You should also wash your foot the night before and morning of the procedure to help reduce surrounding bacteria and prevent infection.
Bunion surgery is usually performed with a local anesthetic and is administered by an anesthesiologist. This may be combined with sedation medication to put you into "twilight" so that you are fully relaxed. After the surgery, patients are often given a long-acting anesthetic and pain medication, which is why someone else must drive the patient home.
The type of procedure you have will determine the degree to which you can put weight on the foot immediately after the surgery. Some patients, particularly those having base procedures, may have to use crutches; others may be sent home wearing a surgical shoe. The foot will be covered in a dressing, which you will need to keep dry for up to two weeks or until the sutures are removed.
During the first week after surgery, you will need to keep the foot elevated as much as possible. Ice packs also should be applied for the first three to four days to reduce swelling. Limited ambulation or walking is required over the first two weeks to promote healing. Most patients also are instructed on some basic exercises that need to be performed daily.
Sutures are generally removed about two weeks after the surgery in the doctor’s office. Once the sutures are removed, you can bathe and shower normally, but will still need to wear a dressing over the wound to keep it clean and prevent infection.
By the third or fourth week post surgery, swelling generally subsides enough for the patient to begin wearing a wide athletic shoe. It is important to continue daily exercises. If recommended, physical therapy may be initiated at this time. Once the wound has completely closed, you can use lotions to soften the skin in the surgical area.
By week five after the surgery, you will be able to walk short distances and do mild fitness activities. Continue following your surgeons instructions for increasing exercise and activities until you are back to normal.
Podiatrist Sheldon Nadal discusses How to Choose Shoes and Preventing Foot Problems http://www.footcare.net
Examining old shoes before buying new ones can help you evaluate your wear patterns and buy new shoes with a better fit and style that compensates for the stresses you place on shoes.
What are your shoes trying to tell you? Here is a translation of basic wear patterns:
A bulge and wear to the side of the big toe means too-narrow fit or you have a bunion.
Outer sole wear means you turn your foot out. Orthotics may help.
Toe-shaped ridges on the upper means your shoes are too small or you have hammertoes.
Wear on the ball of the foot means your heel tendons may be too tight.
Wear on the inner sole means you pronate or turn your foot inward. Inner liners or orthotics may help.
Wear on the upper, above the toes means the front of your shoe is too low.
Laser therapy is use for pain management. The effects of Laser Treatment include but not limited to improved healing time, pain reduction, increased circulation, decreased swelling and vasodilation. Laser therapy has been widely utilized in Europe by physical therapists, nurses, and doctors as far back as the 1970s.
Podiatrist Sheldon Nadal discusses laser therapy for Toenail Fungus.
On August 26 2010 our Toronto podiatry office introduced in Canada, laser treatment for toenail fungus or onychomycosis using a 1320 nm YAG laser .
A preliminary study performed in Roseville California indicates that up to 75-80% of patients with mild to moderate onychomycosis or fungal toenails will experience a significant improvement following treatment.
