Toenail Fungus

February 26, 2011 by · 1 Comment
Filed under: Foot Care 

I get a lot of emails asking for help . Here is a recent question and my response – about toenail fungus.

nail_fugusDarbla asked a question, “I have an older edition of your book, bought when I used to do adventure racing. But if your new book can tell me how to get rid of toenail fungus, I will buy it! A podiatrist and then several rounds Sporonox, Lamisil, and Penlax helped none at all. I developed my own strategy of grinding them down with a motorized dremel, then rinsing off with bleach water, as the best thing I’ve tried so far. But then I’m not doing that regularly enough to completely get rid of it. I will only do this outside because I don’t want particles of that fungus getting all in my bathroom and shower from the shavings and powder thrown up by the dremel, and then when it’s cold or bad weather I cop out of going outside to do it. So I’ve created this whole big treatment that would probably seriously work, but it’s got too many difficulties to do it as often as it’s going to take to solve the problem. So if you’ve got the solution in your book, please let me know and I’ll buy!”

Here’s my response:

Ah, you want a guarantee to get rid of toenail fungus! I am not sure anyone can offer you that. But there are some good options. It sounds like you have done a good job of trying the medications. A friend, a podiatrist mentioned Carmol as a topical prescription. She also suggests doing both an oral and topical medication at the same time. Not sure if you are still on one, but if you have not done both at the same time, it could be worth trying. Of course, I’d be amiss if I did not mention toenail removal. This allows the topical medication to get to the nail bed. Over 8-10 months, the nails will grow back. Permanent nail removal is another more serious option.

Then there is laser treatments, which are somewhat new and apparently quite good. Figure on about $1000 for all 10 toes. Studies show 88% success after one treatment. Vicks-VapoRub, tree tee oil, manuka oil, and eucalyptus oil, are other topical options. Apply twice daily for at least 90 days. You use of the Dremel to thin the nail is good. That allows the topical medication/oils to get deeper into the nail. Put the medication/oil to the cotton on a Band-Aid and apply it to the nail. Some people try soaking their toes twice daily in Listerine or a mixture of Listerine and white vinegar. One fellow wrote that he use an antiseptic surgical scrub called chlorhexidine gluconate with good results. All that said,  the thinning and filing down of the nail’s surface is a huge part of helping any topical treatment be more successful.

Not sure what edition you have. What I wrote above is from the 5th edition. Much in the book has changed from the earlier editions. Good luck and please let me know what happens.

An Introduction to Fixing Your Feet

February 21, 2011 by · Leave a Comment
Filed under: Books, Foot Care, Health 

Today I want to share the new Introduction to the 5th edition of Fixing Your Feet. I think the Introduction to any book is one of the first parts buyers should read. It usually sets the tone for the rest of the book. While authors’ struggle to make sure the whole book is complete and thorough, we often sweat over the Introduction. Personally, it is one of the last sections I write. Here is the new Introduction to the 5th edition.

For years, I have signed copies of Fixing Your Feet with the following inscription, Best wishes for healthy and happy feet. That has been my motivation for more than 14 years of learning as much as possible about foot care – and helping people. I love to see athletes able to finish their race without foot problems.

Those reading this fifth edition of Fixing Your Feet are, by their very nature, active people. They love the outdoors. They love challenges, often pushing their bodies beyond normal. Oftentimes this is done in less than ideal conditions – rain, cold, snow, sand, and on feet that hurt. And more often than not, on blistered feet. If there is one injury that has plagued the majority of athletes, it’s blisters.

Mark Swanson, an ultrarunner, sent an email to a listserv in response to a comment about blister prevention. He wrote: “Let’s remember the lesson John keeps emphasizing – what works for you may not work for the next person and what works for you now may not work for you next time. But what works for you will help some people and may work for you for a long time!”

There is a lot of value in these two sentences. A common saying is, “We are each an experiment of one.” That applies to foot care, and especially blister prevention. Ever since I wrote the first edition of Fixing Your Feet, I have tried to get people to learn about how to prevent blisters with a variety of techniques and products.

Yes, blisters are the number one issue, the number one question, that athletes ask about. I wish I could tell you the one answer that would solve all your blisters problems. But there’s not one solution. In this book are hundreds of tips to help prevent blisters, and if you get them anyway – products to fix them. You need to find which ones work for you. By doing your homework, you’ll be closer to solving your foot problems. This goes for other foot problems too.

Fixing Your Feet is filled with information to help you keep your feet happy and healthy. Rather than read looking only for a solution to your problem or injury, I encourage you to learn as much as you can about what caused the problem or injury. It is important to eliminate the cause to achieve a long-term solution. Start with the new chapter on Getting the Most Out of Fixing Your Feet.

In the publishing world, not many books make it to a fifth edition. Fixing Your Feet has because, as I said earlier, we are active people, loving the outdoors and challenges, and we pushing their bodies beyond normal – and when our feet give out – we look for solutions. This book offers solutions.

In each edition, the Foreword presents a perspective that emphasize a unique point that we need to understand:

  1. Our feet are our primary mode of transportation and require our attention and preparation. Billy Trolan, MD, 1st edition
  2. Most of our foot problems could have been avoided with proper care. David Hannaford, DPM, 2nd edition
  3. Our feet will take us to new challenges and adventures if we make the conscious choice to care for them. Dan Barger, the Primal Quest Expedition Adventure Race Founder, 3rd edition
  4. If your feet are happy, you’re happy. If your feet are miserable and want to quit, you are miserable and want to quit. Demetri ‘Coup’ Coupounas, 4th edition
  5. It’s our feet that connect us to the surrounding terrain, propelling us toward our next destination. Take care of your feet and the world is yours to enjoy. Ignore your feet and life can be a miserable experience. Brian J Krabak MD MBA, Sports Medicine Physician and Medical Director, RacingThePlanet 4 Desert Series, 5th edition

Fixing Your Feet is for you – solutions for your feet. I would love to hear from you. Send me an email and let me know your story about your feet.

Running on Empty: 3000+ miles, 52 days, 57 years old

February 14, 2011 by · Leave a Comment
Filed under: Books, Sports 

When Marshall Ulrich ran from San Francisco to New York City in 52.5 days, he was 57 years old and making an attempt to break a world record set by a man half his age.

Marshall Ulrich

Marshall Ulrich

Completing the mind-bending and body-breaking equivalent of 117 back-to-back marathons, Marshall ran an average of more than 400 miles a week, gained 84,430 feet in elevation, dealt with temps ranging from below freezing to the upper 90s, and crossed 12 states. He wore out 15 pairs of shoes.

I have known Marshall, and his wife Heather, for many years. I met them first at Death Valley at one of the Badwater Ultramarathons that he was running and I was patching feet. He is one of the icons of ultrarunning – and the best part, he’s a nice guy. No fluff. No attitude. Just a nice guy with a big heart.

As I read through my advance copy of Running on Empty, of course I looked for the parts where he talked about his feet. Chapter 7, This is Not my Foot, caught my attention. Marshall writes, “… I disowned my foot. Instead of embracing the pain, I rejected it completely. If I wanted to keep running, I’d have to stop thinking about my foot altogether. I wouldn’t be able to just gut it out as I had before, during the painful few hundred miles to the finish during the Badwater Quad. I still had over fifteen-hundred miles to go, close to three weeks before we reached New York….” This is a book that tells it like it is. No sugar-coating here.

This is a gutsy story that will intrigue you and you’ll wonder what make his tick. You’ll ask yourself, could I have done that? What am I made of? Could I make the sacrifices and remain motivated through it all. You’ll read Marshall’s Ten Commandments of Endurance, which kept him going during the 3000+ miles.

Running on Empty

Running on Empty

Marshall is a versatile, world-class extreme endurance athlete, not only a legendary ultra-runner but also Seven Summits mountaineer and adventure racer. So his new book, Running on Empty, is a memoir mostly about the transcontinental run, but it also includes tales and lessons learned from all his athletic pursuits, some painful, some funny, some completely surprising. You’ll come away appreciating a man who is soft-spoke, genuine, and honest. And you’ll appreciate the relationship between Marshall and his wife Heather, who shares in making this a great story.

In Running on Empty, Marshall shares the gritty backstory, including brushes with death, run-ins with the police, and the excruciating punishments he endured at the mercy of his maxed-out body. He also reaches back nearly thirty years to when the death of the woman he loved drove him to begin running-and his dawning realization that he felt truly alive only when pushed to the limits.

Now, Marshall has given us the inside scoop for you on how to order your copy today. You can also get some valuable “give-aways” I know you’ll love by pre-ordering your copy.

The back cover has a line that spells out the important message of Marshall’s book, “Face the toughest challenges, overcome debilitating setbacks, and find deep fulfillment in something greater than achievement.” I think, deep down, that is what we all strive for.

I have my preview copy, and I know this is something you’ll be interested in reading for yourself! Here is what others are saying about the book.

“Riveting–the man has endured more, experienced more, accomplished more than you can imagine.” ~ AMBY BURFOOT, editor at large of Runner’s World

“An athlete of astonishing grit …” ~ MARK BURNETT, producer of Survivor, Eco-Challenge, The Apprentice and others

“Marshall is The Man. Definitively … Nothing can stop him, and that gives us all hope, gives us resolve to keep trying.” ~ DEAN KARNAZES, ultra distance runner and author of Ultramarathon Man

“Tempting as it might be to describe him as superhuman, Marshall has fallen and struggled … His story … is ours.” ~ ARON RALSTON, author of Between a Rock and a Hard Place and subject of 127 Hours

You can read more of Marshall’s work on his blog.

Fixing Your Feet is on Kindle

February 5, 2011 by · Leave a Comment
Filed under: Books 

Personally, I like the feel of books – you know the paper kind. But the world is changing – and people are reading books on their Kindles, iPads, iPod Touch, Nooks, eReaders, eBook Readers, iPhones and other smart phones, and laptops and desktops.

fyf-kindle2

I’m happy that my publisher has made Fixing Your Feet, 5th edition, available on the Kindle. For $9.99, you can buy the Kindle version and have it on your Kindle or your Kindle app equipped devices.

My publisher tells me they will also have it converted into the ePub version for other readers, and Apple’s ePubLibrary and iBookstore. I will let you know when that happens.

I think this is the best of all worlds. The ability to have the book in a really “portable” format is great. Take your Kindle, iPad, iPod Touch, smart phone or other devise right into the field. You can have it at the aid station, at the side of your runner, or in your backpack.

In order to do justice to this post, I went to Amazon and bought the Kindle version of my book. Since I don’t have a smart phone or Kindel or iPad, etc., I downloaded the Kindle app for my Mac. Below is a screenshot of page 139 in the physical book. It shows how clear the photos and text are.

fyf-kindle-look-inside4

Here is the link to Fixing Your Feet – Kindle version at Amazon. Check it out and give me your feedback.

Disclosure: same as before. I make a few pennies if you buy through this link.

The Foreword

February 1, 2011 by · Leave a Comment
Filed under: Books 

I want to share the new Foreword to the 5th edition of Fixing Your Feet. With the planning for each new edition, I struggle over who to ask to write the Foreword. Is famous better then credibility? My choices have always been someone who brings something new to the table. A perspective that is new. I met Brian Krabak through emails and his work at some of the Racing the Planet six-day races. I think you will enjoy what he wrote. Thanks Brian.

The Foreword to the 5th edition of Fixing Your Feet

Whether you are participating in a 5-kilometer or 150-kilometer race, all athletes need to train appropriately to hopefully avoid injury. Train correctly and you can experience the wonders of the outdoors or the thrill of competition. Train incorrectly and you may sustain a significant injury that will not allow you to compete or obtain your goal. In extreme situations, where athletes are out in the wilderness, these injuries can have deadly consequences. Good athletes train appropriately and prepare for whatever obstacles might come their way.

Spending years competing as an endurance athlete, including adventure racing and triathlons, has taught me the importance of preparation and prevention. I can remember finishing 24-hours races having crossed several river beds, hiking over mountain passes and through slots canyons – thankful that my feet, though sore, were fine. Unlike the poor soul I passed at a checkpoint tending to a horrific blister requiring him to drop out of a race, I’ve learned the importance of taking care of one of the most important parts of our body, our feet. It’s our feet that connect us to the surrounding terrain, propelling us toward our next destination. Take care of your feet and the world is yours to enjoy. Ignore your feet and life can be a miserable experience.

I’ve witnessed the impact of injuries to the feet as Medical Director for RacingThePlanet. These ultra-endurance running events challenge athletes to cross over 150 miles over seven days through some of the harshest terrains around the world. My research has identified that for the majority of athletes who experience some sort of race injury-it’s an injury related to their feet. Yet, almost 25% of these athletes will not need medical care. How can that be? The answer is training and prevention. Fortunately for those with injures, most are blisters that can be managed appropriately if identified early. In fact, our medical team spends a good amount of timing reminding athletes to protect their feet. Strategies include the use of lubricants, changing of socks, checking of skin for hot spots, staying well hydrated and well nourished. However, mismanage these blisters or other lower extremities injuries and most athletes experience some serious illnesses including skin infections that causes them to drop out of the race.

That is why Fixing Your Feet is such an important resource. The comprehensive book provides some of the most detailed information regarding your feet and how to prevent or treat injuries from one of the experts in the field. Looking through the pages, you’ll learn about the basics of footwear, including new information regarding minimalist and barefoot running verses shod or traditional footwear. Preventive strategies focus on the role of clothing, compounds, taping and impact of various extreme conditions on your feet. Treatment recommendations will help manage the typical foot injuries relating to skin, muscle and ligaments. Throughout, practical tips will help you no matter where you go. It’s why I will typically recommend the book as a resource for any medical personal helping with an ultra-endurance running event or wilderness expeditions. So whether you are an athlete competing in a race or part of the medical team taking care of an athlete, I recommend you keep Fixing Your Feet close by.

Brian J Krabak, MD MBA
Sports Medicine Physician
University of Washington and Seattle Children’s Hospital
Rehabilitation, Orthopedics and Sports Medicine
Medical Director, RacingThePlanet 4 Desert Series

* * * * * * * * * * * * *

I already have decided who I want to write the Foreword for the 6th edition! That’s a long ways off and may never happen, but I remember back in 1997 when Fixing Your Feet was a self-published book done on a shoestring – and a lot of hope. Now, 15 years later, Fixing Your Feet has earned it place in foot care history (if there is such a thing).

Thank you all my faithful readers and followers. Thank you all those who have shared their ideas photos. I pray you enjoy the 5th edition and it saves you pain and discomfort. You are the reason I do this.

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