THE ANKLE is a complex body part that plays a critical role in mobility and stability. Ankle pain may be due to sprains, arthritis, breaks and tendon problems.
THE FOREFOOT extends from the ball of the foot to the toes. Forefoot pain may be due to bunions, toe deformities and neuromas.
THE MIDFOOT runs from the ball of the foot to the heel and includes the arch. Midfoot pain may be due to arthritis or stress fractures.
THE HINDFOOT, also known as the heel, is the area between the ankle and the foot's arch. Heel pain may be due to plantar fasciitis or Achilles tendon problems.

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Frequently Asked Questions

Staying well informed can help you be prepared and feel more at ease before and throughout your experience as an Orthopaedic surgery patient. To assist you in your research, Dr. Jan-Eric Esway and our experienced medical team have provided the following answers to frequently asked questions (FAQs). If you would like more information, or to schedule a consultation, please contact our office at 540-372-7579..

Practice FAQs

What are the practice hours of operation?
Please call the office for hours.

How can I reach someone after hours?
If you have questions after our practice has closed for the day, please call the office number to leave a message.  

How can I refill my prescription medication?
Prescription pain medication is closely monitored at our practice. To receive a renewal of your medication, we recommend contacting our office. Dr. Esway will review all prescription requests made by telephone. In some cases, he may wish to set up a consultation for reassessment before fulfilling the request. This is designed to give you the best care possible.

Patient portal is a secure online website that gives patients convenient 24-hour access to personal health information from anywhere with an Internet connection. Using a secure username and password, patients can view health information such as:

  • Recent doctor visits
  • Medications
  • Test results

Patient portal also allows patients to:

  • Exchange secure e-mail with their health care teams
  • Request prescription refills
  • Schedule non-urgent appointments
  • Check benefits and coverage
  • Update contact information
  • Make payments
  • Download and complete forms
  • View educational materials

How does it work?
When you make an appointment, you will get a secure access code that allows you to LOGIN HERE:

Why use patient portal?
EFFICIENCY. Complete all paperwork at home instead of in the waiting room.
BETTER COMMUNICATION. Ask your doctor a question or make a request for an appointment instead of calling.
CONVENIENCE. Pay your bill when the time is right for you.

General FAQs

What is an Orthopaedic surgeon?
An Orthopaedic surgeon is a medical physician who has extensive training in the prevention, diagnosis, and treatment of injuries and diseases of the musculoskeletal system (bones, joints, muscles, ligaments, tendons, and cartilage). Some Orthopaedic surgeons further specialize in body parts (the foot and ankle, for instance) or areas (such as pediatrics).

What is the difference between an Orthopaedic foot and ankle surgeon and a podiatrist?
Simply put, the primary difference between a podiatrist and an Orthopaedic surgeon who specializes in the foot and ankle, is the extent of training. An Orthopaedic surgeon must complete four years of college/university, followed by four years of medical school, then five to six years in Orthopaedic surgery residency. To further specialize in foot and ankle surgery, the physician must also complete an additional year of subspecialty training. Podiatrists are not medical doctors; they do not go to medical school. Podiatrists must complete undergraduate school and earn a four-year degree from podiatry school, with the option of completing an additional two-to-four-year residency.

What is physical therapy?
Physical therapy is designed to help a patient transition back to daily activities and athletics by increasing strength, motion, and function in the area of concern. Physical therapy often includes stretches, exercises, and other forms of training. Sometimes, it is ideal to have appointments with a trained professional. A licensed therapist can design a program that fits your specific needs, monitor your progress and guide you toward a successful recovery. In other cases, you can recover just as well by following therapy instructions given by your surgeon and doing exercises on your own.  

What is a tendon? A ligament? Cartilage?
These are all types of tissue that connect other types of tissue. A tendon holds muscle to bone. A ligament is stretchy and holds bone to bone to help stabilize a joint, for instance. Cartilage is softer and designed to provide cushioning and ease of movement between bones.

What is a tendon? Tendonitis? Tendinosis?
A tendon is a white, elastic structure that connects muscle to bone so that joints can move. For example, the quadriceps tendon connects the thigh muscles to the shin bone (tibia) allowing the knee to extend.

When injured, tendons are typically either strained or torn. For example, the hamstring tendon is commonly strained or “pulled,” and many famous athletes have experienced an Achilles tendon tear or “rupture.”

When tendons are overused, they become inflamed; the medical term for this condition is tendonitis. When tendonitis goes untreated and inflammation persists, tendons eventually become permanently damaged; they become discolored, weaker and lose their elasticity. This painful condition is called tendinosis.

What is a ligament?
A ligament connects one bone to another to help stabilize a joint. For example, the anterior cruciate ligament, or ACL, travels from the tibia to the femur and prevents the knee from shifting out of place or dislocating.

When injured, ligaments are either sprained (stretched) or torn.

What is cartilage?
Cartilage is found in joints and is designed to provide cushioning and ease of movement between bones. Cartilage does not heal well due to its limited blood supply, and wear and tear damage eventually leads to a common condition known as osteoarthritis.

General Injury Treatment FAQs

Can heat and/or ice help my injury?
Within the first 24-48 hours of an injury, or whenever there is swelling, ice can be used to reduce blood flow and inflammation. Heat, on the other hand, increases blood flow, which can help to alleviate pain once swelling has gone down, or to loosen muscles in preparation for physical therapy.

What is a cortisone/corticosteroid injection?
This is a type of medication that can be injected into or near the area of concern to reduce inflammation and, as a result, pain. Cortisone is a form of steroid that is naturally produced by the body. Synthetic versions of cortisone can be used as treatment for arthritis, tendinitis, and other chronic conditions. Most problems resulting from cortisone happen when it is used indiscriminately. For example, if more than two injections are given for tendinitis (i.e. plantar fasciitis), the cortisone can weaken the tendon and increase the risk of rupture.

What are NSAIDs?
NSAID stands for Non-Steroidal Anti-Inflammatory Drug, and NSAIDs are available over-the-counter to help relieve pain. Some examples of NSAIDs include ibuprofen (Advil® and Motrin®) and naproxen sodium (Aleve®). They can help relieve discomfort due to aches, pains, and arthritis.

Pre-Operative FAQs

What medications should I stop taking before the surgery?
In general, you should stop taking aspirin (1 week), NSAIDs (3 days), and other anti-inflammatory drugs before surgery, as they can thin the blood and slow healing. However, if you require one or more of these medications for vascular or cardiac health, you should discuss this with your primary care physician and/or your surgeon to determine the best course of action. You should also tell your surgeon if you are on birth control or taking hormones, as these medications may increase your risk for getting a blood clot (DVT) after surgery. Nicotine constricts blood vessels and causes problems with healing. You should stop using all nicotine products one week prior to surgery.

When should I arrive at the hospital or surgery center?
Please arrive promptly at the time scheduled for your surgery. If you need to arrive earlier, the surgery scheduler will let you know when you need to be at the hospital or surgical center.

What should I wear the day of surgery?
You may shower the day of your surgery, but you should avoid using makeup or wearing jewelry. If you wear corrective lenses, wear glasses rather than contacts. Additionally, you’ll want to dress comfortably in low-heeled shoes and loose clothing that can be worn over any bandages after the procedure.

How long will I stay in the hospital?
If you are having an outpatient procedure performed, you should be discharged approximately one to three hours after surgery, depending on your individual needs. Certain operations may require you to remain overnight, and the length of your stay will depend on the type of surgery and anesthesia, as well as your unique rate of healing.

What happens after surgery?
Immediately following the procedure, you will be taken to a recovery room. Here, nurses will monitor you for some time, after which you will either go to a holding room until released, or you will be admitted to the hospital for an overnight stay. If you are leaving the same day, a nurse will discuss post-operative instructions, provide prescriptions for medication as needed, and inform you when to follow up with the surgeon. He or she will also demonstrate how to use any crutches or other medical equipment you may need.

If you have additional questions, we can help. Contact our office today at 540-372-7579 to learn more or to schedule a consultation.

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