BROOKINGS – Thirty-five years old and just out of his residency at the Iowa Methodist Medical Center in Des Moines, lifetime Hawkeye Ryan Prusa, DPM (doctor of podiatric medicine), and his family are now settling into Brookings. And he’s practicing his specialty with Avera Medical Group in Brookings.
The doctor grew up and graduated from high school in Gilbert, a small town in central Iowa north of Ames. For his undergraduate studies, he attended Grand View University in Des Moines and earned a bachelor’s degree in biology and chemistry. Next came four years at Des Moines University College of Podiatric Medicine and Surgery, where he earned his DPM credentials. He completed his professional studies and preparation with a three-year surgical and medical residency at Methodist Medical Center, also in Des Moines.
During the first two years of DPM schooling, Prusa spent time with doctors of osteopathic medicine on main science and all the other systems of the body; the third and fourth years were spent “focusing on the foot and lower leg,” with clinical rotations in the third year and a lot of traveling in the fourth year.
“I went all over the country to experience different residencies,” he explained. “I went everywhere from Seattle down to Kentucky and Texas. Even spent a couple months in Hawaii.
“That’s where you really start getting hands-on experience: seeing patients and working them up and working with attending residents to gain the knowledge that you can’t get out of a textbook. And during that time, you also get to experience each residency program, because you’re rotating through different programs for about a month. That’s how you decide where you want to be for the next three years.”
Prusa and Jones: A pair-of-docs team
In welcoming Prusa, Avera noted that he “provides expert diagnosis and treatment for foot and ankle conditions due to trauma, deformity or conditions such as flatfoot and more. He also offers a wide range of treatment options – from conservative to surgical – to make sure you experience the best outcomes.”
The doctor explained that there can be sub-specialities within podiatry, such as trauma, reconstructive surgery, limb salvage for diabetic foot infection, and charco neuroarthropathy (a destructive disease of bone structure and joints, most often caused by uncontrolled diabetes).
Prusa said that he’ll be working with fellow podiatrist Dr. Nephi Jones (a fellow Hawkeye) adding that he and Jones trained in the same residency program, “worked with some of the best docs in Iowa, for sure.”
They’ll team up and work together “on some of the bigger surgeries, foot reconstruction, dealing with charco, things like that.”
Other patients the doctors will work with include acute injuries, and fixing and management of fractures of the feet and ankles. Add to that treatment of foot pain, including ways to “keep moving and be active and pain-free.”
One surgical procedure that Prusa trained to do in his residency, but hasn’t done one here yet, is “total ankle replacement.” Add to that sports injuries, “everything from an acute ankle sprain that can be treated conservatively to more overuse injuries, (such as) tendonitis and inflammation of all kinds of areas of the foot.”
Educating the diabetic
The doctor will also work with the “newly diagnosed diabetic to (go) further into it when patients start to have complications, issues with wounds, things like that.”
Prusa explained that the treatment regimen for each patient is different.
“First of all, you have to have a really good, established care team: the primary care doctor who will be managing their diabetes and trying to keep their blood sugars under control.
“We on the lower-limb side of things can definitely go through conservative measures and things to prevent diabetics from getting wounds or ulcers and just doing their routine diabetic foot exams to make sure that their feet are staying healthy.”
Prusa acknowledged that the numbers of Americans being diagnosed with type-2 diabetes are increasing.
“Foot care is a critical part of the treatment of that disease.”
In a team approach to treating diabetes, the patient’s primary care provider has the lead in managing “medications and lab work, to make sure their blood sugars are well controlled.”
“On our side of things, we educate the patient on the things that they are at higher risk for,” Prusa explained, noting the DPM’s role. “Something that’s common with diabetes is peripheral neuropathy, where the patient kind of loses feeling in their feet; it can also cause a tingling sensation or pain. So with that, it’s easier to get a wound or an injury that they might not even be aware of.
“Something that we really push for in our diabetics is daily foot checks: you’re checking your feet every day to look for problems that can be addressed right away before they get worse.
“I’m here, I’m ready to help get (my patients) back to an active lifestyle. I think as a doctor I have the heart of a teacher. It’s just super important for patients to really understand their condition so that we can work as a team to treat what’s going on and create a customized plan for them.”
Prusa and his wife, Mary, have three boys and one girl, all 6 years old and younger; one is a first-grader and one is in junior kindergarten. Mary is a registered nurse, but for now she’s busy as a stay-at-home mom.
Contact John Kubal at jkubal@brookingsregister.com.
