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New Patient Appointment / What to Bring:

• Complete the New Patient Form in advance, and either email it to the office at orthopedics@mfa.gwu.edu or print it out and bring it with you. 

• If you were a trauma patient at GW Hospital, please know or bring your trauma alias name so that prior records and imaging can be accessed.

• Dr. Chodos can directly view imaging (xrays, MRI, CT, etc) from GW Hospital, Washington Radiology, Progressive Radiology, and the GW urgent care centers such as Metro IPC. If you have prior imaging that was done elsewhere, please bring the actual imaging on a disc. You can obtain this from the place that did the imaging study. For more complex studies such as MRI, CT, bone scans, and similar, please also bring the report (but the report by itself without the imaging is not sufficient). For foot and ankle problems, as a general rule if you can walk on it then the xrays can be done standing (as opposed to sitting on the xray table). If you do not bring your prior imaging and Dr. Chodos cannot access it online, it will unfortunately probably need to be repeated. If your prior imaging was not done standing, then it may need to be redone at the time of your appointment.

• If you have had prior surgeries done elsewhere, please bring the operative reports and prior records. If you are transferring care acutely after a surgery, please obtain a postoperative treatment plan from the doctor who did the surgery, so it can be reviewed at the appointment.

• Try to arrive 20-30 minutes early so that any registration, paperwork, and radiographs can be completed prior to your appointment time.  This will greatly improve our ability to maximize your time while at the appointment.

• Anticipate that the appointment will take some time. Things that MAY need to take place while you are at the appointment include: registration/paperwork, xrays, doctor evaluation, fitting of DME including boots/braces/casts, surgical scheduling, etc. Additionally, Dr. Chodos tends to spend significant time with each new patient.  

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Interesting Foot-Related Tidbits

Fact or Fiction? The foot has 26 bones

It is often quoted that the foot has 26 bones. If you include the bones that make up the ankle, there are 28 bones. This is not entirely accurate though. People generally have 2 sesamoid bones below the base of the big toe, similar to knee caps. Additionally, there is a whole assortment of ossicles or small bones that some people have and others do not. And if this is not complicated enough, some people have bones in the foot that are developmentally connected as one bone instead of two. A common example of this is the last two bones in the small toe. Put it all together and between both feet this accounts for about 25% of all the bones in your body!

Fact or Fiction? The world's largest feet ever recorded were 18.5 inches long

Robert Wadlow (1918-1940) had the largest feet ever recorded. He was 8 foot 11 inches tall and his shoe size was a 37AA (18.5 inches long).

Reference:

• Robert Wadlow: Tallest man ever | Guinness World Records

Fact or Fiction? The world's smallest feet are just 5 inches long

Jyoti Amge, the world’s smallest person, has the smallest feet of any adult, 3.74 inches long. That is equivalent to a toddler size 2 shoe. She wears size 4 shoes though, to accommodate leg braces.

References:

• World's Smallest Feet and Largest Feet Meet to Launch Amazing Feet Challenge
• Jack Kotarbinski – Medium

Fact or Fiction? Your feet sweat more than any other part of your body

The toes and bottoms of the feet have some of the highest concentrations of sweat glands in the body. There are about 500 sweat glands/cm2 on the bottom of the feet, adding up to over 260,000 glands in total. These glands produce relatively less sweat than other areas of the body though, and only account for 2.6-3.6% of the relative contribution towards evaporative heat loss overall.   

Reference:

• Regional variations in transepidermal water loss, eccrine sweat gland density, sweat secretion rates and electrolyte composition in resting and exercising humans | SpringerLink

Fact or Fiction? The most letters typed alphabetically in one minutes using the feet is 251 letters

Lui Wei lost both arms in an accident at the age of 10. After many hours of practice, he has learned to play the piano, and won China’s Got Talent in 2010. He holds the Guiness Book of World Records for most letters typed alphabetically in 1 minute using the feet: 251 letters.  

References:

• Liu Wei (pianist) - Wikipedia  
• Armless Pianist Liu Wei played the piano by feet on China's Got Talent Final 2010 - YouTube

Fact or Fiction? The largest feet ever recorded were 15 inches

Actually, Robert Wadlow (1918-1940) had the largest feet ever recorded. He was 8 foot 11 inches tall and his shoe size was 37AA (18.5 inches long).

Reference:

Robert Wadlow: Tallest man ever | Guinness World Records

Fact or Fiction: The smallest recorded adult feet can fit inside a size 2 toddler shoe

Jyoti Amge, the world’s smallest person, has the smallest feet of any adult, 3.74 inches long. That is equivalent to a toddler size 2 shoe. She wears size 4 shoes though, to accommodate leg braces.

References:

• World's Smallest Feet and Largest Feet Meet to Launch Amazing Feet Challenge - (prnewswire.com)
• Jack Kotarbinski – Medium

Fact or Fiction? The world record for longest toenails is 7 feet

Louise Hollis is reported to hold the world record for longest toenails. Set in 1991, the combined length of all 10 toenails was 87 inches. When she wears shoes, they need to be open toed and at least 3 inches high so the nails don’t drag on the ground. According to Guiness Book of World Records, she currently keeps the nails about 6 inches long each. 

Reference:

• Longest toenails | Guinness World Records

Fact or Fiction? A Rubik's cube has been solved using only the feet in less than 1 minute

The fastest time to solve a standard 3x3x3 Rubik’s cube using only the feet is held by Mohammed Aiman Koli (India). He solved the puzzle in 15.56 seconds at a competition in 2019. 

Reference:

• Fastest time to solve a rotating puzzle cube using feet | Guinness World Records

Fact or Fiction? The longest toes, excluding elephantitis, are 4 inches long

Actually, the record for longest toes (excluding elephantitis) is held by Matthew McGrory.  His big toes measured 5 inches long, and the little toes 1.5 inches.

Reference:

• Longest toe | Guinness World Records

Fact or Fiction? The thickest skin on your body is on your feet

This skin on the bottom of your feet is very special, and is designed to protect you from the rigors of life. It is some of the thickest skin on your body, about 1.5mm thick. It also has one of the highest levels of nerve density, just behind that of the fingers. Things that compromise normal function of this structure can result in ulcers, infection, and worse. Diabetes is the most common cause of damage to the small peripheral nerves in the feet.

Fact or Fiction? It's possible to become a certified scuba diver even if you have no arms

Jessica Cox was born without arms. Despite this, she has learned to use her feet like most people would use their hands. She is a has an unrestricted driver’s license, is a licensed pilot, a certified scuba diver, and holds a third degree black belt in taekwondo. She can even put in and take out her own contact lenses using her toes. 

References:

• Jessica Cox - Wikipedia  
• Jessica Cox - YouTube

Fact or Fiction? It's impossible to play the guitar using only your feet

Actually, there are many talented people out there who use their feet like hands. Mark Goffeney, born without arms, was a talented musician, playing guitar and bass with his feet. Known as “Big Toe,” he was a professional musician. This documentary is a must watch. 

Reference:

• "Big Toe" Documentary on musician Mark Goffeney, born with no arms and plays guitar with his feet - YouTube

Fact or Fiction? Primates such as monkeys have more highly developed maps of their toes in the somatosensory cortex of the brain compared to humans

The somatosensory cortex of the brain contains a highly organized map representing the body. In humans, the region representing the hands and fingers is particularly well developed, but this is not the case for the feet and toes. In fact, most people do not have an individual region for each toe. In contrast, primates such as monkeys have a highly developed map of their toes. To study whether this is something that has been lost in evolution, or is acquired as a result of lack of use of the toes in modern humans, Dempsey-Jones et al used functional MRI to study people born without arms who use their feet for everyday tasks. Interestingly, these individuals had highly developed toe and foot regions in their brains, similar to the hand and finger maps seen in most people. Additionally, the “unused” hand areas of their brain appeared to be recruited to support skilled toe movement and function. This demonstrates the extreme plasticity of the brain.

Reference:

• What Happens to Your Brain When You Use Your Feet as Hands? | Psychology Today

Fact or Fiction? The most letters typed alphabetically using the feet is 150 letters

Lui Wei lost both arms in an accident at the age of 10. After many hours of practice, he has learned to play the piano, and won China’s Got Talent in 2010. He holds the Guiness Book of World Records for most letters typed alphabetically in 1 minute using the feet: 251 letters.

References:

• Liu Wei (pianist) - Wikipedia
• Armless Pianist Liu Wei played the piano by feet on China's Got Talent Final 2010 - YouTube

Fact or Fiction? The longest walkable distance without involving boats or planes would take someone three years to complete

“Everywhere is walking distance if you have the time”  Steven Wright

The longest walkable distance using roads on earth is from L'Agulhas (near Cape Town), South Africa to Magadan, Russia. It crosses 17 countries and 6 time zones, and involves no boat or air travel. This route covers about 14,000 miles and would take someone walking 8 hours per day over 3 years to complete (if you survive it, since it goes through some of the most dangerous places in the world). 

References:

• If You're Wondering What the Longest Walkable Distance on Earth Is, Watch This Video - interestingengineering.com
• Is This The World’s Longest Continuous Walk? Cape Town To Magadan - Brilliant Maps

Bonus Facts: Running

“There is a fine line between hobby and mental illness; many a runner has crossed it.” Dean Karnazes

The longest distance run without stopping to eat or sleep was set by Dean Karnazes October 12-15, 2005. He ran 350 miles over 80 hours and 44 minutes without a break. This included taking in about 40,000 calories, going through a lot of shoes, and hallucinating during parts of the last 50 miles.  Separately, he once ran 50 marathons in 50 different states, in 50 days. After finishing the final marathon in New York, he then ran back to where he started, St. Louis.

The longest time run continuously without stopping was set by Kim Allen in 2013. While she only ran 310 miles (332 laps around the same park), she didn’t stop for 86 hours, 11 minutes.  

The longest distance run continuously while taking breaks to eat and sleep is 12,526 miles, completed in 263 days by Istvan Sipos.

Serge Girard holds the record for longest distance run in 365 days. He ran about 16,784 miles, going through 50 shoes and 25 countries.

Among other ultramarathon records set by Yiannis Kouros is the 24 hour track world record. He ran 188 miles around a track in 24 hours-- averaging 7 minutes and 40 seconds per mile.

The longest running streak is held by Ron Hill.  Starting December 21, 1964, he put in a run for 52 years and 39 days before having to miss a day because of an undiagnosed heart condition in 2017.

References:

• What's the Farthest Anyone Has Ever Run Without Stopping? (adventure-journal.com)
• Amazing Athletic Feats - A Review at AthleteInMe.com
• Longest distance run in 365 days - Serge Girard sets world record (worldrecordacademy.com)
• The longest running streak ever ended Saturday at 19,032 days - The Washington Post

Bonus Fact: The Beer Mile

This race involves drinking 4 beers and running 4 x 400m laps (1 mile) around a track in alternating fashion, starting with a beer. The beer choice is the runner’s, but must be at least 12oz per beer and must be at least 5% alcohol. The combined residual liquid and foam from all 4 bottles must be less than 4oz. Vomiting before completing the race is penalized by having to run an additional lap.  Not challenging enough? There is also a beer 2 mile race….

World Records:
Men:         4:33.06    Corey Bellemore (Canada)
Women:    6:08.51    Erin O’Mara (USA)

References:

• Beer Mile Records & Results – The Beer Mile
• Corey Bellemore sets Beer Mile World Record: 4:33.6 - YouTube

Bonus Facts: World Records

Marathon:
Men:        2:01:39   Eliud Kipchoge (Kenya)    4:38 minutes per mile pace
Women:   2:14:04   Brigid Kosgei (Kenya)       5:07 minutes per mile pace

10k:
Men:        26:11.00   Joshua Cheptegei (Uganda)   4:13.38 minute per mile pace
Women:   29:17.45   Almaz Ayana (Ethiopia)          4:43.46 minute per mile pace

5k:
Men:        12:35.36   Joshua Cheptegei (Uganda)   4:03.66 minute per mile pace
Women:    14:06.62  Letesenbet Gidey (Ethiopia)   4:33.1 minute per mile pace

Mile:
Men:          3:43.13   Hicham El Guerrouj (Morocco)
Women:     4:12.33   Sifan Hassan (Netherlands)

Reference:

• World Athletics

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