Open Enrollment for the Affordable Health Care Act (Obamacare) is Nov. 1st – Feb. 15th.  

It is important for you and your family to have health insurance, it is also the law.

Seton Harker Heights will hold open enrollment here in our lobby Tuesdays and Thursdays from 6 p.m. –  9 p.m.

Please stop by and enroll you and your family for Health Insurance.  Don’t be penalized!

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Young child holding stack of books and back to school written on chalk blackboard

Written By: Ashley Ledger, DPM, FACFAS, CWS, FACCWS

With kids back in school after a summer of bare feet and sandals, parents are shopping for shoes for feet that seem to have grown longer in just a few months. To help busy parents with shoe choices, a Central Texas foot and ankle surgeon recommends some simple guidelines to prevent or minimize possible foot problems from inappropriate shoes, such as painful ingrown toenails, blisters, heel pain and flat feet.

“When choosing kids’ shoes, size and shock absorption are the key considerations, especially if your child has flat feet that can worsen from improper fitting or worn-out shoes,” says Ashley Ledger, DPM, FACFAS, a member of the American College of Foot and Ankle Surgeons (ACFAS). “Also, a child’s foot can grow a size or two within six months, so it’s critical to allow room for growth in the toe box—about a finger’s width from the longest toe.”

Ledger says snug shoes put pressure on the toes, causing ingrown nails.

“The nail compresses and grows down into the skin,” says Ledger

According to, consumer website, infection can occur when an ingrown nail breaks through the skin.

“If there’s pain, redness and fluid draining from the area, it’s probably infected,” He says. “The ingrown nail can be removed in a simple, in-office procedure. Don’t try to remove a child’s ingrown nail at home; this can cause the condition to worsen.”

Tight-fitting shoes also cause blisters, corns and calluses on the toes and blisters on the back of the heels.

“Never buy shoes that feel tight and uncomfortable in the store,” says Ledger. “Don’t assume they will stretch or break in over time.”

Conversely, He notes that shoes that are too loose can cause problems, too.

“If a shoe is too loose, the foot slides forward and puts excessive pressure on the toes.”

Ledger also recommends parents carefully inspect both new and old shoes to check for proper cushioning and arch support.

“Shoes lose their shock absorption over time, and wear and tear around the edges of the sole usually indicates it’s worn out and should be replaced,” says Ledger. “If a child keeps wearing worn-out or non-supportive dress or athletic shoes, it elevates the risk for developing heel pain, Achilles tendonitis and even ankle sprains and stress fractures.”

A good tip for parents when buying new shoes: The toe box should flex easily and the shoe shouldn’t bend in the middle of the sole.

For children with flat feet, Ledger says parents should buy oxford, lace-up shoes that have enough depth for an orthotic insert, if necessary.

“Unfortunately, there isn’t much choice for kids with flat, wide feet. They need shoes with a wide toe box and maximum arch support and shock absorption,” He said. “Slip-on loafers aren’t right for them.”

For more information about childhood foot care, contact Ledger at (254) 519-3668H or visit


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 Contact: Drs. H. Ashley Ledger and Roderick Hunter
(254) 519-3668

Local Foot Surgeon Urges Patients Not to Ignore Foot Pain

Harker Heights, TX — Unexplained foot and ankle may lead to osteomyelitis, a bone infection which can affect healthy children and adults, patients with diabetes mellitus, the elderly, or anyone with a compromised immune system.

According to Harker Height foot and ankle surgeon H. Ashley Ledger DPM, FACFAS, osteomyelitis can occur in bones within days of an infection on the skin, known as cellulitis; from a wound, traumatic or surgical; and spontaneously.  Dr. Ledger explains that the porous nature of bones in people allows infection a fast path of travel, which makes the bone susceptible to amputation. “Because the bones in the feet are close to the skin surface, it’s a short distance to travel from the skin to inside the bone.  Infections can eat a hole in bone quickly,” says Dr. Ledger.  “In fact, many patients visit their foot and ankle surgeon for an infection too late and the damage to skin and bone is too advanced to save the affected area of the foot and/or the leg.  Patients may have to go on long-term antibiotics or worse, amputation.”

While osteomyelitis is most commonly seen in diabetic wounds, healthy adults and children are also affected.  Early symptoms can include increased pain, redness, increased temperature of skin, swelling, and difficulty with normal weight on the foot.   “Oftentimes patients don’t seek treatment for their symptoms for days or weeks thinking the pain will pass or there is delay with their referral to see someone for an infection,” says Dr. Ledger “The best advice is don’t ignore foot pain of any type. Early intervention can make all the difference in your treatment and recovery.”


Foot and ankle surgeons are able to diagnose osteomyelitis through X-rays, MRI, and/or bone biopsy. Bone biopsies are the most accurate. “This is why prevention and early intervention are key; you never want to be too late in treatment of an infection,” Dr. Ledger explains.

If you are diagnosed with osteomyelitis, it is important to identify the bacteria and start the appropriate antibiotic. MRSA, Methicillin Resistant Staph. Aureus is the hardest to treat.  Its resistance to multiple drugs make it costly to treat and hard to get rid of. “In a recent study, hospital curtains were tested twice a week for three weeks. The 180 samples produced 119 germs. Twenty-six (26%) tested positive for MRSA and 44% tested positive for enterococcus.  Thirteen (13) new curtains were replaced during the study and 12 were contaminated within a week.”

Based on the study, Ledger Foot and Ankle Clinic will be having SparGuard sprayed on all surface to prevent clinic acquired infection from occurring and reduce its spread. Texas Bioguard, the exclusive distributor for SparGuard, is already using this green technology in Texas schools and day cares. Very soon hospitals will be using this to reduce hospital acquired infections, HAI’s.

“We want to do everything possible to keep our patients that do not have infections from getting ones that we treat in the office,’ says Dr. Ledger.

If you are suffering from foot pain or suspect you may have a foot or ankle infection, call Ledger Foot and Ankle Clinic at 254-519-FOOT (3668) for an evaluation.

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I found myself thinking about life recently. About living. Of the average life, so to speak. And how it’s evolved over time in the recent past. Consider this, the average life expectancy for a person born in 1850 was about 38 years old. By the turn of the century it had risen to around 48 years. Thirty years later it was up to 58 years. By 1970, another 40 years later, and it had risen up to 68 years. Now, present day, another 40 years or so later and we find ourselves enjoying, under best circumstances, a life expectancy of about 76 for men and 81 for women in this country. That’s pretty remarkable when you think about it; the average life doubling in time over the span of a 150 years.

What that means for a society, a country, a community, is that more and more of us are going to be reaching an age that at one time wasn’t so commonplace. And more and more families are going to be touched by this effect in a very tangible way and in fact most are, or have been.

The word dementia is derived from Latin and means to be “out of one’s mind.” Not a place anyone wants to be, as our mind is central to who we are, to our essence. But the risk for dementia goes up each decade of our lives to where, by the age of 65, nearly 1 in 10 will suffer from it.  Just as the aging of one’s heart and the vessels that supply it can lead to health consequences, and can be seen elsewhere in the body with the aging of our brain.

I was sitting with friends recently discussing their personal experience with dementia in their families. The struggles it brought. The challenges. It requires the best of us as individuals. As families. As communities.

From a simplified perspective, dementia refers to a loss of function in the brain. In an acute setting such concerns require a prompt medical evaluation for potential reversible and/or treatable causes. Thyroid dysfunction and Vitamin B12 deficiency are examples of such treatable problems for which recommended screening tests exist. Other potential causes related to infectious causes such as lyme disease, syphilis, or HIV can be considered and screened for.

However in the majority of cases, dementia proves chronic. Over 50% will meet criteria for Alzheimer’s, and another 20% relate to vascular issues. Quite frankly dementia often becomes tied to the decline and aging of one’s brain. And with more of us living longer lives, and with parents or other family members doing the same, we all will ultimately prove to be touched by it.

It is difficult knowing this not to harbor a degree of fear over it, and it is not uncommon for a family physician to discuss this concern with a patient, that their memory isn’t what it used to be. True dementia requires more than this, however. It requires broader effects upon our brain’s function such as impacting speech or the ability to perform simple tasks, so it is often a matter of reassurance from a clinical standpoint.

When it is real. When it does exist. Effective treatment often proves elusive. The differences in treatment for the consequences of aging of our brain versus our heart, relates to our ability to acutely detect and then effectively intervene in the causes. As treatment from a surgical approach is infrequently indicated, the treatment from a pharmaceutical standpoint often proves to be of debatable value and must be determined on a personalized basis.

What isn’t debatable is the importance of being vigilant in early assessment. The earlier the identification, regardless of treatment options, the value found for families being able to effectively plan and address it is clear. We must also remain vigilant in our support of our friends, families, and neighbors who might confront it. Vigilant in our support of continued research for future treatments and hope for a cure. And most importantly, mindful of the value for such vigilance.

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09/05/13- “Dr Galt and Dr Gonzalez are both treasures. They are fabulous. If you have to stand on your head to keep them at Seton-Do it.”

09/05/13-“ I really like Seton. I’m glad you are here and I hope you stay here.”

08/16/13-“ Excellent care. Best hospital I’ve ever been in.”

08/16/13-“‘A+ care. I will choose Seton if I ever need care again.”

08/16/13- “I have traveled around the world and I have been in many hospitals. I have never been in a hospital like yours. The rooms were beautiful, the nurses were great, the techs were great. I didn’t want to go home. I’m switching from Scott&White to Seton.”

08/13/13- “Amazing care. Everyone was nice, even the pharmacy. They even used warm packs on my arms before drawing my blood and starting my IV. I will choose Seton over any other hospital in town.”

07/13/13- “I arrived at the front desk in the ED to fill out paperwork. I was having chest pain. I was told, that I was more important than paperwork and we would take care of that later. Everyone was wonderful-Excellent care.”

07/31/13-“The doctors were wonderful-Le, Gonzalez ,Ledger, McCollough, Johnson. Mr. Mike was terrific.”

07/30/13- “Excellent care. I knew the nurses would come to me right away when I called.”

07/29/13- “I’m switching all of my hospital care to Seton.”

07/31/13- “10 out of a 1-10 scale.”

07/31/13- “ One a scale from 1-10, Seton was an 11. All of the nurses were very polite and nice to me.”

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