National Public Radio has a segment called “On Your Health.” And believe it or not this morning it was on why your shoe laces come untied. (Is this a health problem?) A professor was wondering about this phenomena and had three graduate students study the problem.

The long and short of it is that walking flings the ends of the laces outward and loosens the knot. Further walking causes the knot to spontaneously come undone but this occurs much more often if the knot does not lay flat against the shoe when the knot is not perpendicular to the shoe. Please see the picture below and for details - please go to the link below:

The importance of this? Well it turns out such complex things like DNA molecules may be folded in similar ways as our shoelaces. Understanding how shoelaces unravel may help us to understand some of the fundamental ways that DNA molecules function.  It never fails to amaze me how some simple things can help us understand very complex things!


The knot on the left is twice as strong as the knot on the right!

It’s a good idea to Google something that you really know about once in a while. I was just looking  at instructions  for postoperative care of ingrown toenails. Ingrown toenail are one of the most common things we treat every day.  Frankly the instructions I saw on the Internet labeled “typical aftercare instructions,” were different from the instructions I give my patients. Thankfully the “Dr. Google” instructions have the disclaimer: “many doctors prescribe their own treatment regimen. Make sure you adhere to your doctor’s counsel.” Excellent advice!

General aftercare is described:  Get home, lay down and place your feet above your heart until the local anesthetic wears off. They say that the numbing agent will wear off in one to 2 hours. We use a much longer lasting anesthetic that usually lasts  8 to 10 hours and sometimes 20 hours. Our record anesthetic time is 50 hours! Dr. Google also recommends that you keep the bandage dry until the next morning. We recommend soaking that night and squeezing out the water with a paper towel. They recommend soaking for 10 to 20 minutes 2 or 3 times a day in a solution of Epsom salt. We recommend soaking for 20 minutes 3 times a day for the first 3 days in a solution of a quarter cup of white vinegar per quart of lukewarm water. The reason we recommend the vinegar rather than Epsom salt is because the water in our area has a basic pH which promotes the growth of a particularly nasty bacteria known as Pseudomonas. A slightly acidic soak as provided by the diluted vinegar solution will inhibit  the Pseudomonas.

Doctor Google says that redness around the surgical area is normal unless “it increases dramatically.” I agree. We tell patients to be concerned if there is increasing pain, thick plus, and redness going to the knuckle of the toe. It is not unusual to see some clear drainage and even tinged with blood for a few days. Doctor Google goes on to extol the benefits of Amerigel which I agree is an excellent product which we stock at the office.

Dr. Google gets it mostly right – it’s just those pesky details that can cause you so much trouble!

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