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One gout attack + other painful joint(s) in the body, is enough to consider Krystexxa.

KRYSTEXXA has a different way of lowering uric acid levels, which is the key to stopping gout flares. In about 6 months, it can remove years of uric acid crystal buildup from your joints. Many patients have a longstanding history of misdiagnosis of arthritis, when actually the joint is eroded from Gout. This often appears the same on radiographs.


  • CONVERT URIC ACID: KRYSTEXXA is the only gout treatment that changes uric acid into a water-soluble substance called allantoin that your body easily gets rid of through urine.

  • SIGNIFICANTLY LOWER URIC ACID LEVEL IN 24 HOURS: After just one IV treatment, it starts to lower your uric acid level enough to begin dissolving years of uric acid crystal buildup.

  • DISSOLVE YEARS OF GOUT BUILDUP IN JUST MONTHS: It can take more than two years for oral gout medicines to dissolve even a small amount of uric acid crystal buildup. KRYSTEXXA can dissolve most of it in about 6 months.

Before prescribing KRYSTEXXA, your doctor will test you for a rare G6PD (glucose 6-phosphate dehydrogenase) deficiency that would prevent you from starting treatment. Once cleared, your doctor will confirm KRYSTEXXA is covered by your insurance. Take advantage of support services throughout your treatment as much or as little as you’d like.

How to get ready for a Krystexxa treatment?

If you are scheduled to receive Krystexxa treatment, there are several steps you can take to prepare.

  • Follow your doctor’s instructions: Be sure to follow your doctor’s instructions regarding when and how to take any pre-treatment medications or supplements. This may include taking an over-the-counter pain reliever or an antihistamine to help prevent an allergic reaction.

  • Drink plenty of fluids: It is important to drink plenty of fluids in the days leading up to your Krystexxa treatment. This can help keep you hydrated and reduce the risk of certain side effects, such as kidney problems.

  • Avoid certain foods and drinks: Your doctor may advise you to avoid certain foods and drinks in the days leading up to your Krystexxa treatment. For example, it is generally recommended that you avoid alcohol and foods high in purines, such as red meat, seafood, and organ meats, which can exacerbate gout symptoms.

  • Plan for transportation: Because Krystexxa is administered intravenously, you will need to plan for transportation to and from your treatment. You may feel tired or groggy after your treatment, so it is best to arrange for someone to drive you home.

  • Wear comfortable clothing: It is important to wear loose, comfortable clothing on the day of your Krystexxa treatment. This will make it easier for the healthcare provider to access your veins for the IV injection.

  • Bring a book or other form of entertainment: Krystexxa treatment can take several hours to complete, so it is a good idea to bring a book, tablet, or other form of entertainment to keep yourself occupied during the procedure.

  • Inform your healthcare provider of any changes in your health: If you experience any changes in your health or develop any new symptoms, be sure to inform your healthcare provider before your Krystexxa treatment. They may need to adjust your treatment plan accordingly.


A dedicated Patient Access Manager (PAM) can help you navigate your insurance and support you through treatment at your discretion. All KRYSTEXXA support services are optional.


Your doctor may check your baseline uric acid level. You’ll get rechecked a day or two before each IV treatment to ensure KRYSTEXXA is working as planned. You should stop oral urate-lowering therapy one week before your first treatment.


Your doctor may prescribe steroids or antihistamines to help you better tolerate KRYSTEXXA. You can not stop treatment and then decide again later to begin once again as your body will have created antibodies and the treatment would be rendered ineffective.


IV treatment is actually quite routine.

Check in

Start IV treatment

Wait about 2 hours

Check out

Drive yourself home!

As parents, we often worry about our children, especially when it comes to their health. If you’ve noticed that your child appears to have flat feet, you’re probably wondering if it’s a cause for concern.

Let’s take a look at exactly what flat feet are, and how to treat flat feet in children.


What Are Flat Feet?

Flat feet is an umbrella term for a condition where the inside arch of the feet is visible seen to lower at times almost or touching the ground. Flat feet can also be known as fallen arches, pronated feet or ‘rolling in’. Various conditions can cause the feet to become flat and it’s critical to have proper diagnosis.

It’s important for patients to note though they might appear to be similar there is a difference between adult flat feet and pediatric flat feet.

A child’s foot arch develops over time, so most children at some point in their lives will have what appear to be flat feet. Usually the foot arch starts to develop once a child starts walking and running, and can develop over several years, up to around the age of 10 in some cases.

This means that you shouldn’t panic if your child is very young and seems to have flat feet. However, if you are concerned about their feet, don’t hesitate to consult Dr. Shirazi to put your mind at rest.


How To Treat Flat Feet In Children

As with any medical condition, treatment will vary from individual to individual. How to treat flat feet in children depends on a variety of factors – the age of the child, the severity of the flat feet, level of activity and presence of symptoms, are just a few of them.


No Treatment Needed

In many cases, children with flat feet will not need any treatment for the condition. Historically flat feet have been considered an undesirable disabling problem. This is no longer the case and clinical opinion has now changed.

Podiatrists now use a step by step approach to treatment. By making sure we do a thorough clinical examination and provide a correct diagnosis it may be the case that your child may not require treatment.

It’s always a good idea to speak to a pediatric podiatrist like Dr Shirazi, if you have any concerns though, as they can help put your mind at rest, even if it’s just to tell you that your child doesn’t need any treatment.


Keep An Eye On It

A podiatrist may recommend watching your child’s feet and monitor for any changes before making the decision to treat their flat feet.

Keep an eye out for any changes in the appearance of your child’s feet while standing or walking. Any changes to your child’s foot posture in general should be discussed with your pediatric foot and ankle specialist.

If there is a family history of flat feet, it’s a good idea to keep an eye on the development of your child’s feet to pick up any issues as soon as you can.


Treatment Of Flat Feet In Children 

If your child has flat feet and it is causing them pain or restricting their mobility, it may be recommended that they receive treatment.

Treatment could be as simple as changing the style of footwear they wear or undertaking some simple postural exercises which could help to strengthen the foot and help to develop an arch naturally.

In a severe case, your podiatrist may recommend insoles or custom orthotics to help both your child’s feet and posture.


How We Treat Children’s Foot Problems


At Pasadena Orthopedics, we perform a gait analysis as well as static stance testing to determine the extent of the problem. These results are referred back to over time to track the progress your child is making with their foot development.

We also understand that, though ideal, custom orthotics for children can be expensive when their feet are constantly growing. That’s why we have special techniques, and also discounts in place when it comes to custom orthotics for under 18 years old. It shouldn't break the bank to treat our kids.

There’s no doubt that the holiday season is a beautiful time of year. From the colorful lights to the magical scenery to the snow glistening under the moonlight, it definitely gives a reason to pause and enjoy the sights around us. However, this time of year can also bring along harsh winter weather. With freezing temperatures, icy roads and slick walkways, it’s important to ensure you are taking all of the safety precautions necessary—including wearing proper winter footwear.

Many don’t realize the importance of what goes on your feet during the cold, wet weather. Whether you are just walking into work or venturing out on an enchanting snowy hike, proper winter footwear is critical for a number of reasons. Keep reading to learn why the shoes you chose this winter should be more than just a fashion statement.

They Keep Your Feet Dry

Good hygiene is a vital factor in overall health. This includes your feet. While regularly washing your feet with soap and water is important, it is just as important to make sure you are able to keep them dry. Fungal organisms are attracted to moisture around the feet and in between toes. By keeping your feet dry, you are able to lower the possibility of fungal infections or painful blisters. These conditions can potentially lead to greater health risks.

To ensure your feet remain free of moisture during wet weather conditions, look into shoes that are built to handle water. Footwear that offers waterproofing technology will be able to keep feet dry for extended periods of time. This is because the outer layers are designed to keep water out. The upper layers also allow for breathability so any moisture from sweating is reduced—ultimately preventing any discomfort.

They Keep Your Feet Warm

The cold weather and holiday season gives many memories of warm drinks, a cozy fire, beautiful snow falls… and the cold and flu. Experts have said for years that the winter months are when individuals are most likely to get sick. And keeping your feet warm is the first step to ensure you stay healthy. Warmer feet open up the blood vessels and allow better blood flow, moving heat to every other part of the body to boost energy and protect your immune system. Wearing proper winter footwear, especially during outdoor winter activities, can help keep you healthy.

There are plenty of ways to keep your feet nice and toasty during the colder months. As a first line of defense, we recommend pairing wool-lined or thermal socks with insulated, water-resistant boots for keeping feet warm (not hot) and comfortable. If you are more sensitive to cold temperatures or just want a little more warmth, there are also other options available on the market, such as:

  • Electric heated socks

  • Disposable toe warmers

  • Insulated footbeds

  • Thermal sock liners

  • And more!

They Provide Support

When many people are shopping for new footwear for the winter, they often gravitate towards the more fashionable or season-trendy options. There isn’t a lot of time spent researching all of their selected footwear’s features nor do they take the level of support into account. By wearing boots or other winter shoes that do not provide proper support, you are at risk of ankle, foot or shin fractures, ankle sprains, plantar fasciitis, arch spasms, heel spurs, tendonitis and other conditions. Purchasing the correct footwear can prevent pain from worsening.

When shopping for new winter shoes, you should be looking for items that have lacing, a firm structure and sides that are padded. We also stress that you are getting options that truly fit. Make sure you have enough room to move your toes and the heel does not rub. These types of factors and features will help ensure you are getting a durable, comfortable piece of footwear.

They Prevent Injury

While the arrival of the snowy, wet, and icy winter season causes safety concerns for drivers, it can also provide hazardous conditions for pedestrians. Snow-blocked sidewalks and icy pathways put walkers at risk for the potential of slipping and falling, which can lead to serious injuries. If you know your usual route into the office isn’t always prepped properly after heavy snowfall or isn’t de-iced after a particularly cold night, you should grab the right shoes that will keep you safe.

To prevent injuries caused by slipping and falling on ice-covered surfaces, you should look for footwear that offers anti-slip technology. Extra grip is highly recommended for the winter. It provides the right amount of traction for when slip hazards on snow and ice are more pronounced.

Consult Board Certified, Dr. Sara Shirazi

If you are planning on engaging in outdoor activities this season and are unsure if your winter footwear is causing issues, please contact us. We can evaluate your current health, understand your activity level, and review any previous foot issues to help determine the best footwear for you.

626-517-0022 to make an appointment today!

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