Protect Your Diabetic Feet – Before It’s Too Late

Protect Your Diabetic Feet - Before It's Too Late
Diabetes is a systemic, progressive condition that is thought to affect more than 30 million Americans—including 1 out of every 6 persons over age 60. Because some people can live with it for years (or even decades), a lot of people mistakenly believe that it isn’t a big deal, or they’ll worry about protecting their feet later if they start to notice symptoms. Unfortunately, this isn’t the way it works—particularly for the feet. High blood sugar slowly corrodes and destroys the nerves in your feet, over the course of years. By the time you notice pain, it’s likely that significant damage has already been done. And the longer you wait to get serious, the harder it will be to turn the ship around. Far too many people don’t act in time, or even at all. That’s why diabetes is by far the most common underlying cause of non-traumatic amputations in this country. This year alone, more than 100,000 Americans will undergo a lower-limb amputation related to their diabetes—usually due to an infected ulcer that wouldn’t heal. ​ Almost all of such cases are preventable. So if you want to avoid that fate yourself, you’re going to want to have an effective plan to protect your diabetic feet! Not only will your risk of catastrophic complications go way down, but your feet will just plain feel better—less pain, improved stability, and continued ability to live your best life. And we can help you with that.  

Preventative Care Services for Diabetic Patients

At FASA, we take a comprehensive approach to helping you manage and alleviate any pain that you do have, while keeping your feet as healthy and safe as possible—so that you can live an active lifestyle without fear or pain. Here are some of the ways we can help you:

A Thorough Examination

We see patients with diabetes-related foot pain all the time, but that doesn’t mean everyone has the same problem—or the same solution! Pain can manifest itself in different ways, for different reasons. Maybe your biggest struggle is with your diet. Or maybe the shape and structure of your feet themselves are creating dangerous pressure spots. There are many different risk factors for diabetic foot pain and complications. Understanding which of these factors apply the most to your situation is crucial in order to tailor our treatment recommendations so that they’ll be most effective for you personally. ​We strongly encourage all people with diabetes to see us for a comprehensive foot exam on a yearly basis, even if there’s no history of foot problems. Catching emerging problems early, and dealing with the risk factors as soon as possible, is the best way to ensure those foot problems never develop in the first place.

Lifestyle Coaching and Recommendations

As important as it is to see a podiatrist at least every year, that still leaves 364 days out of 365 where you’re going to have to be responsible for managing things on your own. In short: the most important member of your diabetic foot care team is you. ​That’s why we make sure you have all the knowledge and resources you need to properly examine and care for your feet on a daily basis. That may include:
  • Instructions on how to perform a quick-yet-thorough self-exam of your feet each day, what to look for, and how to determine when it’s time to call us for a closer look.
  • Instructions on how to properly handle common “maintenance” issues before they develop into bigger problems—such as toenail trimming or dealing with dry, cracked skin.
  • Guidance on how to maintain a diabetes-friendly diet, from our on-site nutritional specialists. Tips on how to pick out the best socks and shoes.
And of course, we’re always a phone call away if you need anything.
Custom Orthotics and Diabetic Shoes

Custom Orthotics and Diabetic Shoes

One of the best and simplest ways for those with diabetes to reduce pain and protect their feet and skin from damage and breakdown is through the use of custom orthotics. In short, depending on the shape and needs of your feet, the standard insoles that come with your shoes may not really be offering your feet what they need to protect themselves—especially if you have a deformity like flat feet or bunions. Pressure spots and friction can not only cause pain and fatigue, but in some circumstances can even break the skin and form sores. So to help mitigate that risk, we’ll fit you for a brand new set of custom insoles. They’re made from molds of your own two feet, so they fit just right and provide the exactly right amount of cushioning and support. For some people, replacing the regular insoles of their shoes with their new orthotics will be sufficient. For others, we recommend getting a dedicated pair of diabetic shoes. Before you start getting concerned, understand that diabetic shoes come in all the same cute (or manly!) styles as any other pair of “normal” shoes. There are really only two main differences:
  • They’re a little deeper / taller than normal, in order to make sure that custom orthotics fit as easily as possible.
  • They tend have a few subtle, diabetes-friendly construction choices to reduce the risk of skin breakdown. For example, the uppers are almost always made from breathable fabrics, and the interior lining may be seamless to cut down on the risk of scratching or snagging on skin.

Other Treatments

Of course, when pain or problems do arise, we’re also here to help you stay on top of them so you can make a full recovery, before those problems have a chance to get worse. For example, for tingling pain related to your diabetes, the right choice may be an injection, laser therapy, or an appointment with one of our physical therapists. We also provide comprehensive wound care services, including advanced techniques and amniotic tissue grafts. The last thing you want is for an ulcer to get infected, and the best way to avoid that outcome is to protect and heal any wounds as quickly as possible. We’ll do everything we can to help you do this. ​If we need to refer you to other specialists, we absolutely will. But the truth is that, for the vast majority of cases, we can handle all of your diabetic foot care needs right in our office. That saves you time, money, and worry!

Tabby’s Story

If you want a great, real-life example of this comprehensive approach in action, we’d like you to meet Tabby. Tabby has known Dr. Hess for almost 20 years, but was only recently diagnosed with Type 2 diabetes. She came in to see us about burning pain in her feet, among a few other symptoms. ​After performing a comprehensive evaluation to narrow down the possible diagnoses and causes, we gave Tabby a temporary walking boot to immobilize her foot and give it a chance to heal. We also recommended injection therapy (for the short-term pain) and made her a new set of custom orthotics (for long-term protection). Tabby also spoke with our nutritionist, who helped her reconfigure her diet in order to avoid aggravating her condition and make sure that her feet and nerves are getting enough of the essential nutrients they need. This also helped greatly improve her symptoms. To hear from Tabby herself, make sure you watch the video above!

Don’t Let Diabetes Get Control Over Your Feet

If you have diabetes, the right care and advice from one of the foot and ankle experts at FASA can truly make a radical difference in your life. If you don’t yet have any foot or ankle symptoms from your condition, we’ll do everything we can to keep it that way. If you do have symptoms, we’ll do everything in our power to address them so you can get back to doing what you love. But you need to take that first step. If you’re experiencing any foot pain, or it’s been more than a year since your last diabetic foot checkup, let’s get in touch! Feel free to drop us a line online, or call (360) 754-3338 to schedule an appointment at any of our convenient South Sound locations.
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bryan alvarez

comptroller

Bryan graduated from Stetson University, a small private university located north of Orlando, with a Bachelors degree in Accounting. He worked at One Stop Cooling & Heating in Orlando as their Chief Financial Officer for nearly 7 years until moving to Olympia in early 2019. He moved to Olympia so that he can enjoy the beautiful environment and all of the rainy days.

Marta Bushay

hr coordinator

With just under a decade of experience in the HR field. Marta Bushay serves as the HR Coordinator, Co-leading the HR team for FASA Family Wellness.

Marta offers a unique blend of leadership, vision and Knowledge of the HR world. She has helped increase productivity through implementing policies and procedures and employee growth and satisfaction.

Marta has a diverse HR background and is a subject matter expert in the areas of HR administrative, HR compliance, handbook development, policy and procedures, reviews and updates, employee relations issues and training and development.

Prior to taking on her current role with FASA. Marta spent the first 7 years of her career serving as an Hr Manager for the Olympia Toys,r,us in Washington State. There she provided strategic HR support and acting as a team mentor.

Marta earned her HR Business Professional Certification in November 2019. She is currently working on receiving her SHRM Certification as well as completing her Global Professional HR Certification.

She resides in Tumwater, WA, with her three children Zander, Romen and Scarlett 

Destini Martinez

Marketing Coodinator

Destini is born and raised in Washington state. She is currently pursuing her bachelors degree in elementary education to follow her dream of becoming an elementary school teacher. Helping and bonding with children is one of her passions. She began working at Foot and Ankle Surgical Associates as a receptionist, but found herself helping in the marketing department more and more and eventually fell for the work related to the department. You may see her driving around in the FASA foot car, popping into local offices regularly or maybe at a local event. She rarely sits still! She just welcomed a beautiful baby girl to the world and has been enjoying spending time as a family with her husband, daughter and golden retriever, Diamond.

Taylor Reed

PTA

I’m from Olympia born and raised, I graduated from Olympia High School and did my PTA program up in Bellingham at Whatcom Community College. I decided to get into physical therapy after injuring myself and becoming interested in healing people as a career. When I’m not nerding out on Marvel Comic books, my hobbies include skateboarding, snowboarding, hiking, camping, really anything being outdoors and active; injuries are nothing new to my friends and I! Physical therapy has and continues to be a fun and fascinating world that I continue to learn and grow from every day. I love our FASA team here and am excited to be part of our family. 

Kali Beaird

LMT

Kali Beaird graduated from the Massage Studies program at Clover Park Technical College in 2008. She worked at Chiropractic offices for 8 years before joining FASA in 2016. 
 
 Kali incorporates a relaxing environment and touch with deep tissue treatment to areas of concern while treating other muscles that could be contributing to the problem. She specializes in injury treatment with years of experience treating patients with chronic back pain, migraines, surgeries and more.  
 
 In Kali’s spare time she enjoys gardening, cooking and home renovation projects. She also teaches continuing education to massage therapists. Kali lives in Tumwater with her son and daughter. 

Joelene Gioulis

CEO

As the CEO of FASA Family Wellness, Joelene is responsible for the strategic growth and innovation of the company. Joelene came on board in 2014 to create the foundation for Foot & Ankle Surgical Associates to grow and help more patients, not only in expanding podiatry but also in areas that serve the wellness of the entire patient like physical therapy, family practice, nutrition and massage and in 2015 FASA Family Wellness was born.

Since joining FASA Family Wellness she has succeeded in growing the company by 103%. Her strategic plans for the company moving forward is providing a world class patient experience by achieving operational efficiencies and continually investing in the staff and the community.

Joelene believes that investing in the lives of others ultimately positively affects the bottom line of business.

Joelene has a proven executive management track record and over 20 years of experience in the leadership field. Prior to joining FASA Family Wellness, Joelene worked in the health and wellness field with a history in Human Resources and regulatory compliance.

 Joelene is a Washington native with three amazing grown children. In her spare time, she has a passion for mentoring incarcerated youth and youth at risk. For fun she loves the lake life of wake surfing, paddle boarding and enjoying the sunsets, when there is no sun to be found you can find her on the slopes, hiking or traveling to the sun.

Adam Saleh

DPM

Doctor Saleh is a highly energetic and motivated foot and ankle surgeon with over three years of practice under his belt. With his captivating personality and motivation to succeed, he has a remarkably promising future in medicine. He finished his three-year Podiatric Medicine and Surgical residency in Harrisburg, Pennsylvania, and is coming up on his 1 year anniversary at Foot & Ankle Surgical Associates.

Not only is he board eligible in foot and ankle surgery, he is also impressively certified in Hyperbaric Oxygen treatment. In addition, Doctor Saleh carries prestige certifications in microvascular surgery from the Cleveland Clinic, and advanced lower extremity orthopedics from the Rubin Institute.

With Foot & Ankle Surgical associates recent PIE partnership with the North Thurston school district Dr. Saleh has also been avidly working with students as a coach and mentor for those interested in entering into the medical field.

When Doctor Saleh is not working towards his career in medicine, he embraces his love for traveling and experiencing what the world has to offer. He is also avid in his physical health, proudly entering in competitive weightlifting competitions.

He is an extremely determined, caring, and patient-driven person. Foot & Ankle Surgical Associates is lucky to have such an ambitious and talented team member like Doctor Saleh.

Michael Lundborg

DPM

Born and raised in Colorado, Doctor Lundborg has had a lifelong passion for medicine. Over the course of the last four years, he has successfully performed well over 1,300 surgeries in areas such as diabetic wound care, forefoot and bunion procedures, and trauma and reconstruction.  He is adamant in giving every one of his patients the best solutions to ensure their confidence that they are in the best care.

After earning his Integrative Physiology Degree from the University of Colorado at Boulder, he shadowed a wide variety of experienced physicians, where he ultimately gravitated towards foot and ankle specialization as his desired career path.

Doctor Lundborg received his Doctor of Podiatric Medicine Degree at the Temple University School of Podiatric Medicine, where he proudly graduated at the top of his class. In order to complete his residency training, he traveled to Boston, where he spent three years focusing on trauma and reconstructive surgery at Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School.

Doctor Lundborg is an extremely hard-working individual and always looking to better himself. However, to make sure he is able to thrive every day with recharged batteries, he invests time into his other interests. In this spare time, he happily spends it with his wife and dog as well as enjoying diverse outdoor activities such as golfing, hiking and skiing.

It is no secret that Doctor Lundborg is an excellent care provider, with a wide array of experience adding to his diversity as a foot and ankle surgeon. Though he is fully capable of handling any challenge, his favorite cases are flatfoot and cavus reconstructive surgery, trauma, sports medicine, biomechanics, and diabetic foot ulcers. When you come to Foot & Ankle Surgical Associates, you can be confident that your needs and expectations will be exceeded with a patient-focused person like Doctor Lundborg.

Huy Dang

DPM

Originally from Chicago, Illinois, Doctor Dang is a podiatric physician that has been proudly practicing medicine in the Northwest for over 13 years. He has a variety of specialties that patients can benefit from, which include wound care, pediatrics, and foot and ankle reconstruction. With his skill and experience he ensures each and every patient’s needs are met completely.

Doctor Dang always knew he wanted to become a surgeon someday. To make this passion come to life, he started his journey by graduating from Dr. Scholl Podiatric Medical School at Finch University/Chicago Medical School in 2004. Upon earning his degree, he decided to relocate to the Northwest, where he successfully completed a three-year foot and ankle reconstructive surgical residency. During this time, he also impressively served as a chief resident for two out of those three years.

When not in the office or focusing on his work, Doctor Dang immerses himself in the outdoors, participating in sports and other activities that involve fresh air. His love for being outdoors and rigorous sports also sparked his special interest in sports medicine and becoming proactively involved in community services. It brings him great joy to be able to serve the community with his podiatric services and humanitarian efforts. Doctor Dang has a monumental aspiration to start his own non-profit canine sanctuary and rehabilitation center in the future.

Doctor Dang is excited and looking forward to becoming an integral part of the Foot & Ankle Surgical Associates involvement in the community. He is always learning and avidly improving himself professionally and personally to enhance his skills in order to give his patients the best experience they can possibly have.


Scott Duncan

DPT

Doctor Duncan brings his physical therapy expertise to enhance every patient’s experience at Foot & Ankle Surgical Associates.  He has worked with innumerable physical therapy situations and firmly believes that every patient deserves to reach the highest level of clinical outcomes.

In 2001, Doctor Duncan graduated from Creighton University, where he successfully earned his Doctorate Degree in Physical Therapy. Afterwards, he decided to relocate to Washington State to begin his career as a physical therapist at Riverside Nursing Home in Centralia. This is when Doctor Duncan first met Doctor Hess and started to form their working relationship, bounded by mutual respect for patient care.  

While in Centralia, Doctor Duncan started to work for Foster Farms in Kelso, treating all work-related injuries for those who were employed there. Later, he started working for Costco in Tumwater, providing similar services.

In 2003, Doctor Duncan took on a new journey and opened a clinic called Physiotherapy Associates, where he was proudly the clinic director who provided orthopedic outpatient physical therapy for his patients. What makes this so ironic is that his clinic was directly across the parking lot from Doctor Hess’s prior clinic, which only sharpened their patient-focused relationship.

In 2010, Doctor Duncan decided that he wanted to be a part of the Foot & Ankle Surgical Associates team, expanding his practice at what he believes is the best association for communication between physical therapists and doctors in the area.  In addition, on the weekends, Doctor Duncan started working at Shelton’s Mason General Hospital, where he provides care to the patients there.

Doctor Duncan is incredibly diverse and willing to take on any challenge he faces with confidence and determination. His philosophy is to provide every patient with individual care while obtaining the highest level of manual therapy and therapeutic exercises so they can return to their healthy lifestyles.

 

Casey Bowles

DPM

Born and raised in Lacey/Olympia, WA, Doctor Bowles is extremely patient-driven and actively demonstrates his passion for foot and ankle surgery. With his extensive background he gives every patient a positive experience when they come to Foot & Ankle Surgical Associates.

After graduating from North Thurston High School with honors, Doctor Bowles attended Brigham Young University, successfully obtaining his Bachelor’s Degree in Biology with a minor in Chemistry. During this time, he also actively served at his church in Buenos Aires, Argentina. For two years, he was able to help the community there and become fluent in Spanish.

Doctor Bowles has always shown a particular interest in Biomechanics and Pathology and knew he would choose a career in medicine. Initially, he had his eye on becoming a Dentist and almost attended dental school instead.

While studying for his Dental Admission Test, Doctor Bowles had the opportunity to work at Foot & Ankle Surgical Associates as a back-office assistant. During this position, he had the fantastic opportunity to travel to Nicaragua for a medical mission. This gave him the ability to observe surgical practices and methods, which drove him down a new inspirational path to become a surgeon himself. With his new career mission in sight, he quickly started his education at the Temple University School of Podiatric Medicine, where he proudly achieved his Doctor of Podiatric Medicine Degree.

It is not all work and no play for Doctor Bowles. During his downtime, he enjoys attending musicals and symphonies quite frequently. He is also an avid hiker, embracing the outdoors and challenging himself to a variety of different terrains.

Doctor Bowles has a significant background that helped shape him to become the incredible foot and ankle surgeon he is today. He is extremely compassionate and is always provides excellent service to each and every one of his patients.

David Huebner

DPM

Prior to joining Foot and Ankle Surgical Associates, Dr. Huebner was in Great Falls, Montana.  Dr. Huebner has his undergraduate degree from the University of Illinois, with a B.S. degree in Physiology, where he had a full scholarship for football.  He then attended the Scholl College of Podiatric Medicine, earning his DPM degree.  After completing a residency in foot and ankle surgery at St. Anne’s Hospital West in Northlake, IL, he practiced in the suburbs of Chicago for two years.   He then moved to Great Falls, MT, where he practiced for twenty three years.  While in Montana, he served on the Board of Medical Examiners for eight years by appointment from the Governor.  He is board certified in foot and ankle surgery by the American Board of Podiatric Surgery. He is a Fellow in the American College of Foot and Ankle Surgery, and maintains active memberships in the American Podiatric Medical Association and state affiliates.

THOMAS BURGHARDT

DPM

Former president of the Washington State Podiatric Medical Association, and serving on the board of trustees for the Podiatric Association for eight years, Doctor Burghardt is an excellent board-certified physician and surgeon. He is not only extremely proficient in his field, he always ensures to put his patients first to come up with the best treatments for their needs.

Doctor Burghardt began his career by earning his Bachelor of Science Degree in Microbiology at the University of Washington. From there, he enrolled in Podiatric Medical School in San Francisco, proudly graduating with honors. To complete his training, he went to the University of Southern California Medical Center and Whittier Medical Center, where he became a specialist in foot and ankle reconstructive surgery and diabetic foot care.

Doctor Burghardt established his own private practice at Foot & Ankle Surgical Associates at the Tumwater location, providing incredible service to everyone who consults with him. Though he enjoys all of his patients, his favorite area of interest is treating and assisting athletes. This passion stems from his athletic children, who immensely inspired him to go down this specialized route.

In addition to his dedication to medical practice, Doctor Burghardt is a travel enthusiast, avidly preparing and hosting lectures to physician groups, nurses, and non-medical groups to enlighten them on diagnosis and treatments regarding foot and ankle problems. He thoroughly enjoys sharing his knowledge and opening the doors to brainstorming with other Podiatrists on seeking out perfect and customized solutions for difficult cases.

Patients describe Doctor Burghardt as a caring, enthusiastic, and extremely motivated person. His intensive background with surgical procedures and personality make him a perfect person to thrive at Foot & Ankle Surgical Associates. He is always pushing himself to improve and actively seeks out innovative ideas to make excellent treatment options for his patients.

TERRENCE HESS

DPM, Chairman of the Board

Since 1995, Dr Hess has dedicated his time and fed his passion for Podiatric Medicine in the Northwest to improve the lives of his patients, staff and the community.

Doctor Hess started his career by obtaining his degree in Pharmacy at the University of Washington. He diligently worked in the pharmaceutical industry for three years before discovering that becoming a Podiatrist was his real desire in life. In 1992, he graduated from California College of Podiatric Medicine in San Francisco with honors. Continuing his career path, Doctor Hess flourishingly completed his residency training, specializing in foot and ankle surgery at Lakewood Regional Medical Center and Kaiser Foundation Hospital in Portland, Oregon. He then finished out strong and perfected his abilities at Harborview Medical Center, which gave him the drive to establish Foot & Ankle Surgical Associates in 2002.

As the years went by, Doctor Hess’s private practice has only grown and expanded, with now impressively containing six offices in Tumwater, Centralia, Yelm, Olympia, Tacoma, and Lacey Washington. In addition, he now has seven exceptional Podiatric Physicians working with him to ensure every patient has a positive experience.

Doctor Hess not only dedicates his time to his practice, he also is avid in helping and preparing other Podiatrists to understand the evolving and upcoming healthcare transitions. Throughout his career, he has shared his knowledge by giving numerous lectures to physicians, nursing groups, and patients to shed light on foot and ankle pathologies and treatment options. During this time, he also embraced his love for traveling, frequently heading to Central America on surgical mission trips in El Salvador and Nicaragua.

When Doctor Hess is not on duty, he enjoys engaging in water and snow sporting activities, travelling and working on his collection of cars. He also loves spending time with his children, making sure to seize every moment to create beautiful memories with them.

Doctor Hess is passionate about what he does and always puts his patients first. Between his extensive skill set and experience, you will undeniably be in excellent hands with him.