Garry Sherman, DPM, ABPOPPM, APMSB
There are numerous factors involved in the etiology (cause) of Fungus nail infections. Fungus proliferates in an environment that includes darkness, moisture, warmth and various forms of traumatic issues that compromise the circulation in the toes, making it difficult for the body to fight the infection. People who experience resistant toe nail fungus infections have usually experienced black nail, thickened and/or discolored nails and often overlooked various biomechanically related issues like shin splints, Osgood Shlatter’s disease, Sever’s Disease, foot pain, knee pain (77% of all knee issues are caused by biomechanical dysfunction-Lutter LD. Foot related knee problems In the long distance runner. Foot Ankle 1980.1:112-116 ), Iliotibial band syndrome, trochanteric bursitis, etc. These symptoms are associated with various phases of the gait cycle that can traumatize the toenails which is probably the factor that is overlooked in most resistant fungus nail treatments.
In 2004, for his research on fungus infections of the foot. Dr Sherman received the award of “Outstanding Physician Researcher of the Year” from Morristown Memorial Hospitals (currently part of the Atlantic Health Systems). Using original treatment regimes (which have improved through the years) he achieved an 83% cure rate. His protocol did not use oral medication (of which only .001% reach the toenails) which has numerous warnings about their negative affect on the human body.
Dr Sherman also specializes in the biomechanics of the lower extremity assessing torque, acceleration, lines of force, angles of inclination, etc., factors that can cause traumatization of the toes as noted above.
OVERVIEW OF TREATMENT PLAN
- Improve the local environment in the area of the toenails.
- Improve the traumatic issues affecting the circulation of the toes.
- Create angiogenesis (bring more blood to the area).
- Destroy the local fungus utilizing Laser treatments and local (non-oral) medication.
Considering the fact that it can take 6 months or more for the great toe nail
to grow one nail length, the treatment regime takes a year (or more). However improvement is often observed at 2-3 months while the look of the nail can be improved within a couple of weeks after the start of treatment and women can have a normal appearance by using nail polish.
COST OF TREATMENT
- The initial consult is $125. If at the time of the initial consult Dr. Sherman does a more comprehensive exam then the initial consult is $280.
- Computerized testing and biomechanical assessment is $195
- Exercise advising session is $50.
- The cost of orthotics is $575.
- The first Laser treatment is $150. Subsequent treatments range from $25 (1-2 nails) to $150 (all 10 nails). The frequency of treatment:1st, 3rd & 5th week, 9th, 13th,17th, 21st, 29th, 37th, 45th and 53rd week. The cost depends on the number of nails involved. For only 1-2 nails the overall cost for the year is $400.
- To improve the circulation (angiogenesis) Dr, Sherman uses local (involving only the foot) electromagnetic energy (no known side effects). An angiogenesis treatment is given at every Laser treatment at $25 per treatment. The overall cost for the year is $275.
- Local medication is over the counter and obtained at your local pharmacy.
- A $25 office fee is charged at the time of each treatment (11 times) The overall cost for the year is $275.
Approximate overall cost (considering only 2 nails or less) over the span of a year is $2050 (which includes a biomechanically designed custom orthotic). With the exception of Medicare, Dr Sherman does not accept insurance assignment but does bill your insurance company for you. Depending on your coverage and your deductible at the time of each visit and whether or not your insurance company pays out of network, your insurance might cover nothing to as much as ¾ of the cost.
- PAYMENT PLAN (CONSIDERING ONLY 2 NAILS)
- INITIAL VISIT A DEPOSIT OF $125 (short consult) or $280 (extended consult).
- DEPOSIT ON ORTHOTIC: $350 (1ST OR 2ND VISIT) AND $195 FOR A COMPUTER & BIOMECHANICAL ASSESSMENT.
- WHEN ORTHOTICS ARE DISPENSED:$275 (APPROXIMATELY THE 3RD WEEK- ALSO INCLUDES A $50 EXERCISE CONSULT)
- EACH TREATMENT VISIT: $75 (INCLUDES A LASER & ANGIOGENESIS TREATMENT).
To find out what your Insurance might cover, call your carrier with the following information:
Typical diagnoses:835.1 Fungus infection
M76.821, M76.822 (associated with shin splints)
M 72.2 (plantar fasciitis-pain in bottom of foot)
M77.31, M77.32 (heel spur- would probably show up in
an x-ray-doesn’t have to be painful))
Procedure codes & fees:
- 99203…..office visit…………$125
- 99204…...Extended visit……$175
- 99214…...Extended visit……$125
- 99212…...Simple visit………$ 75.
- 97750…...Computerized gait analysis…$195
- Laser treatment…..not a covered service by all insurance companies
- 90140…...Angiogenesis Modality..………….$50