So today we had one of the vascular doctors (aka. the artery and vein dr) come into the office and talk to us about PAD or peripheral arterial disease. We see this in a lot of our patients and its basically where the arteries get blocked, therefore, there is less blood flow, which therefore causes pain, and decreases the chances of a patient healing in that area and increases the chances of amputation. Its something that we as podiatrist see a lot and work a lot with vascular Drs. to help our patients with this. So he came in and spoke to us about some of the surgeries they are doing now to re-open up certain arteries.
In the old days, when they had to re open arteries, there was an incision made up the ENTIRE back of the leg. I could be here ALL day explaining all the complications and problems you can have with that, but one of the big ones being infection. Now a days, they have a scope, similar to the one orthopedics use for the knee. And these scopes also have a long long leash attached to them so the surgeon can send them down longer arteries. These scopes have cameras on them and can have different attachments to open up the arteries. So cool to see these instruments. It was like remote controlled toys. Pretty cool if you ask me! Unfortunately I could not find any pictures online of these instruments, but they were pretty cool. So that was a nice little educational experience we had at the office today (and they bought us lunch, sandwiches to be exact, with cannoli's for dessert...I was in heaven)
Last week we shaved off a heel spur on a patient. I have never seen a heel spur this large in my life, no wonder she was in so much pain.
Check that puppy out. Holy Heel Spur!
We wanted to try to to resect the spur without having to detach the Achilles tendon. So we dissected through all the other soft tissue and took our trusty saw and just took it off. No more heel spur there.
The second surgery I got to see last week was a amputation of the end of the second toe. The reason we had to amputate was because there was nothing left of his bone at the end of the toe. How does this happen? Bone infections that you have for a long time and DO NOT got taken care of. This patient had an infection at the end of his toe that moved to his bone.....back in DECEMBER. (lets double check...yep, its almost June) So unfortunately for this patient, the infection was not taken care of and basically ate away at the bone until there was nothing left. We ended up meeting this patient as a hospital consult, met him on a Thursday, had him in surgery Friday am. If you look at the x ray below, you can see at the end of all the toes is a mushroom kinda shaped bone...except for at the second toe...you can barely see it anymore..thats the infection. Thankfully, the human race does not usually put a lot of weight on the end of the second toe, so even though he is missing the end of his, he should be able to walk without having any problems.
Bye Bye Bone
Other than that I have been getting a bunch of experience in the clinic this week. The clinic we work at is attached to what use to be a hospital which is now turned nursing home. So once a week we head up to the nursing home floors and trim the toenails of those in need. These little trips are usually pretty interesting and today was no exception. I walked around the corner of one of the floors of the nursing homes and this patient was screaming with joy, " THE PODIATRIST!!! THE PODIATRIST!!!" Can I just tell you... I felt like freaking Santa Clause at an elementary school Christmas party!!!! These patients are never happy to see me..this lady was practically jumping for joy. Either she was on crazy meds or she was actually happy to see me. I was clearly thinking the first option...but nope..she was just so happy that I was there to cut her toenails. Another patient I saw today on the same floor had a similar reaction. Just so happy that I was there. I am not curing cancer here..just clipping toenails..and it made these peoples day. It brought me back and reminded me why I went into medicine to begin with, to make a difference in peoples lives...even if it is as simple as a hello and to cut some toenails. It was a little more confirmation to me that this dream I have been chasing is where I need to be and what I love to do. Good ending to the day if you ask me:)
Shout Outs
~To all of those who are serving or have served for our country. Thank you to you all.
~ To Shannon and Sam, my roommates for the May, thank you for letting me come live with you all. Its been a fantastic time.
~To the newest graduated Doctors of Podiatric Medicine from OCPM. Wishing you all the best of luck in the future!
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