By Scott Scanlon – Refresh Editor
Dr. Jeffrey M. Carrel is quite the inspiration to his patients at Podiatry Associates.
At age 72, the foot doctor who grew up in North Buffalo is still going strong in his practice and on his bike.
Next Saturday, he aims to ride 62.5 miles as part of the Buffalo Tour de Cure, which benefits the American Diabetes Association. Register to participate under the “Find Tour” link at tour.diabetes.org.
Read more about him today in the In the Field feature in WNY Refresh.
The 1959 graduate of Bennett High School went to the University at Buffalo for two years after that, including summers, grabbed his bachelor’s degree and set out for the New York College of Podiatric Medicine in Harlem. He graduated with the highest GPA in his class, did his surgical residency in Detroit, and returned to Western New York in the late 1960s. He and Dr. David Davidson are the lone doctors from the early days of the practice who remain on the job.
“I’m still having fun,” he told me earlier this month, “and plan to practice as long as I can keep going. I have no real plans to move.”
He and his wife, Sheila, who will celebrate their 50th anniversary on June 21, have three sons: Aaron, a pediatric endocrinologist in Madison, Wis.; Mitchell, a lawyer in Chicago; and David, a business consultant in Chicago. The boys often come home to ride the Tour de Cure with Dad.
The event offers riders several scenic loops at distances from 6 to 100 miles through Niagara County, starting and ending at Niagara County Community College, at 3111 Saunders Settlement Road in Sanborn. “The newest 30-mile ride will be a flat and beautiful trip along the Niagara River and a halfway point photo opportunity with Niagara Falls as the backdrop,” race organizers said in a news release.
“The Tour de Cure is a ride, not a race, with routes designed for everyone. Whether you casually ride around your block or cycle competitively, there is a route right for you,” said Kelly Arthur, Tour de Cure manager for the American Diabetes Association. “And we hope the new 30-mile ride, with the mighty Niagara Falls in the distance, will inspire even more riders to join in our fight against diabetes.”
Independent Health is presenting sponsor. This year’s fundraising goal is $420,000. Each rider is required to raise a minimum $200.
Carrel had lots of interesting things to say about the race and podiatry that I couldn’t squeeze into the print edition. Below are a few more excerpts
How many bikes to you have?
Three. One’s a recumbent in the basement that I stare at a lot in the winter. The other is my current, which is a road bike, and my previous is a hybrid which is still functional.
How do you prepare for the Tour de Cure races?
I try to get out two to three times a week in the good weather. I usually ride 10, 15 miles. My wife and I would do 20 miles on a Sunday, stopping for coffee at the Clarence Coffee House.
Is bike riding a good idea for a number of your patients?
Bike riding is good because it’s not as stressful on the foot as running or even walking on a treadmill at the gym. A recumbent bike at the gym is much easier on the foot. With many patients with specific foot problems, we take them off the treadmill and put them on the elliptical or bicycle.
You’ve tended to be one of the top five fundraisers for the race over the years.
One or two over the last five years. Single digits for many years.
What’s the secret?
I reach out to people on an individual level. I write a letter explaining what I’m doing and the impact it has on my patients, and I ask for their help and support. I send probably 200 to 250 letters out each year and I put a handwritten note on each one. ... I sign it. Friends who donate $50 or more get a hand-written thank you note by snail mail, with a real stamp on it, rather than an email and a quick thank you.
What are some of the more common procedures you handle at work?
Bunions, hammer toes, nerve problems of the foot ... things similar to carpel tunnel, growths on the nerve, and plantar fasciitis, which is a sort of heel pain.
What percentage of foot issues tend to be behavioral-based?
Probably only 30 percent. I would say 70 percent are genetic due to the bone structure of the foot. These people are predisposed (to problems). If the foot wiggles too much one way or another, you’re prone to ligament and tendon inflammation. Most of those are corrected with inserts in the shoes.
And you’re looking at one aspect, feet?
We’re looking at the whole body. We do a history and physical, which includes a lower extremity and complete medical history, and I would say today probably 70 percent of these patients are referred by primary care physicians or endocrinologists who then provide us with the background and history of the patient. Now, with electronic medical records, that information is transmitted and received almost instantaneously.
How often should they see you once they’re diagnosed with a diabetic-related foot problem?
The should get a foot examination once a year in the absent of any problems or symptoms. They’re encourage to call right away should anything develop and we squeeze them right in.
Are feet a window into overall health and, if so, how so?
They can be. Certain things that show up in the feet can be a sign that there are problems elsewhere. Since the foot is connected to the rest of the body, you can’t really separate it. We see changes that occur in the skin, changes that occur with circulation, all of which can point to systemic problems. So a decrease in the pulsations of the arteries of the feet, or a decrease of hair growth on the top of the foot, shiny skin – these kinds of things will point to more pervasive vascular disease. ... It can be a sign of decreased flow in the coronary arteries.
So it pays to pay attention to your feet?
Foot massages are helpful?
If it feels good, it’s fine. I don’t believe in reflexology because nobody has been able to demonstrate something significant scientifically, but I certainly can’t say it doesn’t exist because acupuncture, also from ancient Chinese medicine, has done some miraculous things and we can’t really explain that completely with Western medicine.
Can you talk about diabetes prevention?
The Type 1 diabetic is usually diagnosed early in life and that seems to be genetic. It’s a decrease mostly in the beta cell production of insulin in the pancreas. It can also be induced by a virus infection. Once that occurs, the patient is required to take insulin on a daily basis. The prevention part comes in Type 2 diabetes where there is a period of time where the patient is prediabetic. It used to be called borderline. Now, it’s defined as a fasting blood sugar between 100 and 125 (mg/dl). In the period of time when the patient is prediabetic, diet and exercise can decrease the onset of diabetes. So it’s possible to prevent the onset of diabetes completely through diet and exercise. The problem ... is the symptoms are very slight and people may not be aware of them (until it’s too late).
Do foot problems tend to get worse as you get older?
They usually do, because they’re progressive and usually attributed to the bone structure. Most of it is genetic. Your feet change over the years and that’s why your shoe size changes. Your feet stop growing when your 17 or 18, and your foot size tends to get longer and wider. This causes many patients problems because they’re not realizing it. We explain to them that there are 26 bones in the foot and they’re held together by ligaments, and as we age these ligaments loosen up and these bones start to spread, and they spread sideways and they spread length-wise. So your shoe size will slowly change in width and length as you get older. As these bones change, they also will produce small deformities, so a bone will start to stick up or a bunion will start to stick up. Metatarsal bones will move and this movement of the bones many times will create problems. ... Getting older is not for whimps!