Frequently Asked Questions

Diabetes

What is Diabetes?

Diabetes is a condition in which the amount of glucose (sugar) in the blood is too high because the body is unable to use it properly. This is because the body’s method of converting glucose into energy is not working as it should.


There are two common forms of diabetes:

  • Type 1, also known as insulin dependent diabetes. This usually affects children and young adults. People with this type of diabetes require daily insulin injections.

  • Type 2, also known as non-insulin dependent diabetes, is by far the most common and usually affects people over the age of 40 years.

How can diabetes affect your feet?

Your feet are supplied with blood to keep them healthy. They also have a multitude of nerves that act as an emergency warning system. For example, if you have a stone in your shoe, nerves will send a message to your brain to investigate. However, if your diabetes is neuropathy’, which impairs sensation to the feet, and/or reduced blood supply, also known as ‘poor circulation’. Nerve damage may mean that you no longer notice the stone in your shoe, due to loss of sensation to your feet. This could then lead to an injury you can’t feel, and possibly infection. If you have poor circulation, any injuries or infections to your feet (ie cuts, burns or scratches) will take longer to heal. This is due to less blood flowing into the arteries in your feet. Blood provides energy to working muscles and aids in healing any tissue damage. If you have poor circulation, you will need to take extra care to protect your feet from injury.


Most foot problems in people who have diabetes occur when injuries — and often infections –go unnoticed and untreated, or when healing is delayed due to poor circulation. poorly controlled for a long period of time, this may lead to: nerve damage, or ‘peripheral with diabetes, even corns between toes should be treated seriously. The bruising that has appeared beneath this corn is a warning sign that ulceration and infection may soon develop.

How can I detect any changes early?

A six monthly foot assessment by your podiatrist will help to detect any changes early — before they become a problem. In an assessment, your podiatrist will examine your circulation by feeling foot pulses. They will also examine sensation by testing reflexes, vibration and pressure sensitivity. Your podiatrist will also look for general foot conditions which may lead to future problems. They will work with you to show you how to monitor your own feet, in between consultations. We generally review our Diabetic patients every 10 weeks to monitor any changes and maintain health feet. We find by providing regular treatment our patients have a better outcome than managing their care at home.

As a general rule:


  • Maintain acceptable blood sugar level control

  • Don’t smoke

  • Exercise regularly

  • Avoid barefoot walking

  • Keep your feet clean

  • Wear well-fitting shoes

  • Cut and file nails carefully

  • Have corns, calluses and other foot problems treated by a podiatrist

  • Seek your podiatrist’s advice before using a commercial corn cure

Footwear advice

The best type of footwear fits well and protects your feet. Wherever possible, wear shoes to avoid injury. Ensure your shoe is — deep enough and broad enough. Our podiatrists are trained in Diabetic footwear and can provide advice regarding the right footwear for you. We also stock a range of Dr. Comfort Diabetic footwear.


Government funded programs such as the Medicare ‘Enhanced Primary Care Program’ available to those patients who suffer from Diabetes and Department of Veterans’ Affairs patients are able to attend our practice and consultations will be bulk billed.


Published by the Australasian Podiatry Council.

 

Nail Surgery

What is nail surgery?

Nail surgery is a common procedure performed by most podiatrists to effectively treat an ingrown toenail – a nail that has pierced (or is pressing against) the adjacent skin of the toe causing pain and inflammation and sometimes infection. Surgery may be required when an ingrown toenail repeatedly gets infected, is continually painful, the patient is unable to wear shoes or the condition inhibits work, sporting or other activities.


Before surgery is recommended, your podiatrist will explore other conservative treatment options. Nail surgery performed by podiatrists A ‘Partial Nail Avulsion’ (known as a PNA or nail root and matrix resection) is a minor nail procedure which aims to permanently treat ingrown toenails. The procedure is usually performed in podiatrists’ rooms, takes around one hour and the patient is able to walk immediately afterwards. The offending portion of the nail is trimmed away only the affected segment of nail is removed, leaving a small area at the base of the nail underlying the cuticle) to heal after the procedure.

What does a partial nail avulsion involve?

Your podiatrist will conduct a complete assessment, taking a medical history, a list of any medications that have been prescribed for you as well as considering any other clinical factors that will determine whether or not this surgery is suited to you. An assessment will generally also include an examination of blood supply to the foot. The procedure itself is performed under local anaesthetic via injection into the toe to numb the area. The anaesthetic will wear off in about two hours. Once numb, a tight elastic ring called a tourniquet is applied to the toe to control bleeding and the area is prepped to minimize the risk of infection. The offending portion of the nail is then gently lifted and trimmed away, generally without the toe being cut or stitched. Both sides or the entire nail may be removed this way. A chemical may also be used at this point to assist in preventing nail re-growth.


Once the procedure is completed, the tourniquet is removed and a sterile surgical dressing is applied. The patient is able to walk immediately afterwards, however assistance getting home is strongly recommended.


Postoperative dressings will require some further attention at home.

What happens after the procedure?

Re-dressings at home and a few consultations with your podiatrist may be required over the two to three weeks following the procedure. For the first few days after the procedure pain relief, the use of open toed shoes and activity modification may be necessary; however interference with day to day activities is generally minimal.

What are the potential complications?

As with any surgical procedure there is some risk of complication, however this procedure is known to be very safe and effective. The most common side-effects are post-operative infection in the short term and the possibility of re-growth of the nail over time. The risks of infection can be minimized through good post-operative care and your podiatrist will advise and assist with your situation.

How can a podiatrist help?

Regular visits to your podiatrist can manage and prevent ingrown toenails, alleviate pain, and help keep you on your feet and mobile.


Published by Australasian Podiatry Council.

 

Orthotics

What are Orthotics?

Orthotics are medical devices that support and gently reposition the heel, arch, muscles, ligaments, tendons, and bones in the feet, enabling these structures to work together as nature intended, to make each step you take pain-free.



Custom made orthotics are built from molds of your feet to meet your unique needs. They’re typically made with comfortable thermoplastic materials, which are guaranteed to last for years, and can be designed to fit in dress shoes, athletic shoes, boots, and skates. Pre-made orthotics are a standard device, while cheaper than Custom made they only last 3—6 months and are not made to suit all feet.

Why get Orthotics?

Custom-made orthotics can relieve many different types of foot pain. These including: heel pain; plantar fasciitis; arch pain; shin splint; flat feet; trauma; bunions and sprains. Symptoms from sport and other activities including pain caused by running and walking.

Custom made Orthotics process

There are 4 appointments involved in the production and dispense of Custom Made Orthotics.
When you attend you Initial Consultation the Podiatrist will review your medical history, complete an assessment and discuss your treatment options and perscription of Orthotics.


An appointment will be scheduled for the preparation and casting of your feet. The Podiatrist will complete a biomechanial assessment and clinical testing including gait analysis.This appointment generally takes 40 minutes. The casts will be sent to the Orthotics Factory and the devices created, this process takes 2 weeks.


At your dispense appointment the Podiatrist will assess your feet and gait with the new orthotic devices.


A follow up appointment is scheduled for 2 weeks after the dispense of the orthotics, this appointment will allow the patient to discuss their progress and raise any questions or concerns.

Pre-made vs custom made Orthotics

Pre-made Orthotics

  • Cheaper

  • Easily Dispensed

  • Only Last 3-6 Months

  • Applicable for minor conditions

  • Some health insurance will not cover pre made but only

Custom made Orthotics


  • Provide extra support rather than pre-made Orthotics

  • Made to your foot shape

  • Lasts 4—5 years

  • Easily modified and customized, rather than pre-made which are standard in size, shape and control

  • Claimable through private health insurance for podiatry