Monthly Archives - February 2018

Infected ingrowing toe nail | Antibiotic resistance | Wimbledon

How can a Podiatrist help to reduce antibiotic resistance?

Ingrowing toe nails can become red, hot and swollen.  They are very tender to touch and commonly become infected by bacteria.  The toe may bleed, be malodorous and discharge yellow pus from the toe nail.  Inappropriate management of ingrowing toe nails may require a series of antibiotic prescriptions.  Having multiple antibiotic treatments increases the risk of bacterial resistance or antibiotic resistance.

Ingrowing toe nails are easily managed by foot specialists, conservatively and surgically without the need for multiple prescriptions of antibiotic therapy.   Early intervention and treatment is key to reducing antibiotic resistance in the treatment of ingrowing toe nails.

Public Heath England have published the following video regarding antibiotic resistance:

To slow resistance we need to cut the unnecessary use of antibiotics. Public Health England.

To reduce antibiotic resistance and review your conservative and surgical treatment options of ingrowing toe nails, click on the link below:

 www.swpodiatry.co.uk/common-conditions/ingrown-toenails/

 

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Wimbledon podiatrist | Interview | Brunilda Agalliu

An open interview with Wimbledon podiatrist Brunilda Agalliu.

Wimbledon and Earlsfield Podiatrist | South West Podiatry clinic | Relieving foot pain.

Brunilda Agalliu south west podiatry

What’s your name, age ( if that’s ok to ask!!) and how long have you been a Podiatrist?

·       Brunilda Agalliu

·       29 years old

·       I have been a Podiatrist since 2013 (5 years almost)

 

You have been qualified a while now, you hold a band 7 specialist podiatrist role within the NHS working within musculoskeletal medicine and high risk diabetes, but what made you become a podiatrist in the first instance?

·       From a very young age I always wanted to help people and was fascinated with medicine sciences.

 

That’s great so how long did you study for, was that full time or part time?

·       I studied a full time 3 year course at The University of Brighton. It was a challenging period as the course was very demanding and was taught in English which is not my maternal language. However, I thoroughly enjoyed participating in a wide range of learning activities both University based and during clinical placements.

 

What was the best thing you learnt at University ?

·       I grew up in Lamia, a small city in the midlands of Greece and moved to the UK in September 2009. I was accepted to study at the University of Brighton and enrolled into the course of BSc Physiotherapy. During my first year in Physiotherapy my interactions with other students sparked my interest into the field of Podiatry. I found Podiatric medicine fascinating as it combines a holistic treatment approach including surgical intervention and the use of many other technologically advanced methods for the diagnoses and treatment of foot pathologies. After completing my first year in physiotherapy I decided to dedicate 3 more years in studying BSc Podiatry. During this time, I equipped myself with numerous skills taught during the course. If I must choose one to highlight as the best, I must say it is the use of orthotic devices as they can have a life changing impact for the patients receiving the prescription.

 

So how did that influence you in your current specialist role now?

·       From the minute I took a scalpel on my hands and learnt how to use it, I felt that Podiatry was what I always wanted to learn and improve my skills within.  I was fortunate to find a job immediately after I graduated and had a mentor that had a big influence on my passion within the profession, which is musculoskeletal injuries, Biomechanics and human movement related problems. I stayed in this role for 3 years and cultivated my passion by employing cutting edge methods such as Video Gait Analysis, Pressure Plate studies and Biomechanical examinations.

    

You worked with a podiatric surgeon for a while, how did you find that?

·       It was amazing to work with someone that has over 28 years’ experience and been exposed to seeing so many different cases. Podiatry and podiatric surgery is an area that is still new in medicine but has such a big influence in peoples’ life and I am very grateful for the opportunity to work closely with a leading podiatric surgeon.   

 

I think you would be an awesome surgeon! But like Tom explained, it’s a lot of dedication and your interest is slightly different, specialising in orthotics, biomechanical examination’s right? 

·       Podiatric surgery did cross my mind in the early stages of my career but I changed my mind after a few years of working in the profession. As Tom has noted already, the MSc in Podiatric medicine requires a lot of time and dedication to complete the training. I’m certain that this dedication pays off in the end as surgery has a very important role to play in the management of foot pathologies and must be rewarding to practice. However, we should not disregard the need for non-invasive treatment options as often patients cannot or do not want to undergo surgery and seek for alternative treatment options. Personally, I find great satisfaction in practising biomechanics and also find that it suits my current priorities better as it allows me to maintain a good work-life balance.

 

What lead you to specialise in this field of podiatry?

·       I find that my specialisation is a less invasive treatment option that is impactful and effective. Especially when dealing with children and young adults the outcomes are outstanding as we are able to correct gait abnormalities seamlessly.

 

I bet you get this all the time, but I have heel pain ! what should I do ?

 

·       Heel pain! We see at least 1 in 5 people with heel pain.

·       Podiatrists are the people to see when you have heel pain.  If someone suffers from heel pain they should seek early intervention and immediate advice. A foot specialist can examine, diagnose and provide an effective treatment plan which may consist of strapping, stretches, loading programmes, orthotics, ESWT or injection therapy. Podiatrists carry out Gait analysis / Biomechanical examinations and at South West Podiatry, we are fortunate to have access to infra-red pressure analysis, a private gait lab and 3 D scanning. 

 

Ok so I clearly need to book in to see you but there is no way you are injecting my heel! Back to the interview, what was your first podiatry job and did you enjoy it?

·       My first Podiatry job was in a private clinic in London (3 years) and I truly enjoyed the variety of people I was seeing and treatments that I was able to offer to my patients.

 

What is the best part of being a foot specialist ?

·       That every day I meet someone I haven’t met before, I hear stories that are happy or sad and I can have some influence in people’s life or be influenced by them.

 

And the worst ? 

·       I agree with Tom about the unfortunate misconceptions regarding our profession. On the other hand, I am hopeful that this is slowly changing as our patients spread the word about the amazing results they have seen under our care. I think the worst part of the job is dealing with high risk patients that often seek our care too late and the pathology has progressed to the point where there is not much we can do to improve their condition.

 

And what are the worst feet you have seen?

·       The worst feet I have seen were not in Europe and did not suffer from 21st century problems. In 2012 I volunteered with a charity organisation and spend a month at the Lalgadh Leprosy Hospital in Nepal. Many of the patients I treated presented with severe wounds caused by the life threatening disease of Leprosy.

 

Jeeeeez, how did you manage those feet?  

·       That’s why we are unique at what we do and essential as a faculty within health allied professionals.  We are equipped with skills that allow us to calmly deal with circumstances that others find terrifying.

 

If you could change on thing about your job what would it be, and why ?

·       I do love my job. One thing I would love doing more is seeing toddlers and children as they truly brighten my day.

 

This question is for our current podiatry students or newly qualified podiatrists, just starting out, what’s the best advise you could give them?

 

·       Observe your teachers and colleagues closely, study meticulously and practice with a patient-centred thinking. It is also crucial to question and re-evaluate and improve our practices so ensure that you have packed with you a fresh pair of eyes.

 

You work within the NHS and Private sector.  To give the newbie podiatrists an idea, how do you find both sectors and what’s the difference?

·       In the private sector you will be faced with less limitations in resources in comparison to working in the NHS. You have to be at the top of your game and have the ability to act independently whilst factoring in the needs and the budget of your customers. On the other hand the NHS will provide you with experience in a large cohesive team that on a daily basis is focused on treating a long list of patients.

 

Which sector do you prefer?

·       I think both are enjoyable environments and I enjoy different aspects in each of them. I would advise newly qualified podiatrist to spend some time in the NHS before venturing in the private sector.

 

Just one more question, same question as tom, so you have a foot fetish right 😊 ?

 

·       Certainly not. That’s like asking an ENT specialist if he has a nose fetish!

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Wimbledon Podiatry Interview | Tom Walton | Podiatrist

Wimbledon Podiatry team member Tom Walton is interviewed and reveals the differences between Podiatry within the Private and NHS sectors.

Tom is an important member of the South West Podiatry team in Wimbledon.  Tom speaks openly about his life as a Dad and trainee Podiatric surgeon whilst also reflecting on his university days as a young aspiring foot specialist.

Tom Watson south west podiatry

What’s your name, age and how long have you been a Podiatrist?

o   Tom Walton

o   32

o   10 years

You’re a foot specialist Tom, with vast experience and working in a specialist role within the NHS, but what made you get into Podiatry in the first instance?

o   I have always been interested in biology and human science so when deciding what to study at University I was drawn to Physiotherapy at first but once I had researched into the various health professions, Podiatry seemed to appeal to me more, due to the varying specialities and differing caseloads.

o   I like the fact that Podiatry as a profession are specialists of the foot and ankle. As well as independent practitioners at south west podiatry team we work in a multi disciplinary approach with chiropractors, physiotherapists, orthopaedics and podiatric surgery. It is certainly better to work together and try to understand how other professions work, but for the foot and ankle, Podiatrists are well placed to provide assessment, diagnosis and management plans to treat all lower  limb pathologies.

That’s great that you work in an MDT privately and within the NHS, so how long is the undergraduate degree?

o   It is a full time Batchelor of science with Honours ( BSc HONS Podiatry) degree for 3 years or you can do it part time which will take 5 years.  You spend quite a considerable amount of time as an undergraduate within the NHS or, if your a pro active student, shadowing practitioners.  

Where did you study?

o   University of Huddersfield for my undergraduate degree and University of Brighton for my Masters.

I believe you have done some extra training ?

o   I have yes, I have completed courses for soft tissue and intra-articular joint injections for a wide range of foot pathologies as well as obtaining IRMER certification order and interpret diagnostic scans such as X-Rays and MRI’s.

o   I am also in my second year of training to become a Podiatric Surgeon.

So how long does it take to become a foot surgeon?

o   In order to become a Podiatric Surgeon you need to complete the undergraduate BSc HONS in Podiatry.  After a minimum of three yeas studying then you need a minimum of 2 years post graduate experience before enrolling onto a Masters degree which takes a further three years. It is encouraged to work within a surgical unit as a clinical assistant.  Once you have completed the passport to surgical training you are then eligible for Surgical training which is a 3-4 year pathway. Once you have completed this you are a Fellow in Podiatric Surgery and you need to work with a consultant for another three years to get your certificate of completion Podiatric Surgery training.

o   So in short 12-13 years.

That’s long, you get less time for murder! It must be hard work studying, working full time and raising your daughter, how do you do it? 

o   I won’t lie, it does take a considerable amount of dedication and a passion to learn.  You need a tremendous amount of knowledge, skills and experience to become a Podiatric Surgeon. You need to be organised and give up a lot of time for it. Thankfully, I have a very understanding and supportive wife and business partner so that helps.

So that’s where you are heading but where did you start.  What was your first podiatry job and did you enjoy it?

o   First Job was in Kilburn north London part of Camden NHS trust. It was great to be free from university and start earning money but scary at the same time. I learnt a lot in my first year as a Podiatrist.

What is the best part of being a foot specialist ?

o   The best thing is helping people, even if its just simple toe nail cutting on a person who is unable to do so, or treating painful MSK conditions of the foot that leaves people debilitated. Relieving people of pain is a great feeling and very rewarding.

And the worst ?  seriously, apart from sweaty feet?

o   Its is rare to get sweaty and smelly feet I must say, unless I have built up an immunity to smelling feet? The worst part would be the general publics perception and other health care professionals opinions / knowledge of what we do as a profession.  People and health care professionals believe we are nail and corn cutters. We do so much more than that, we are the specialist of the foot and ankle dealing with dermatological conditions, MSK conditions along with serious high risk disorders of the feet that if untreated can cause quite considerable mobility issues.  Liam has a strong opinion on this subject, so I will let him explain a little more in his interview!

Ok – Come on tell me, what are the worst feet you have seen?

o   For me it would have to be diabetic feet, ones that have circulatory problems as well, because these can go bad very quickly and you can usually smell them before you see them.

If you could change on thing about your job what would it be, and why?

o   As said before the recognition of our specialism with the wider public and healthcare professionals. As well as dropping and getting rid of the “C” word (CHIROPODIST)

This question is for our current podiatry students or newly qualified podiatrists, just starting out, what’s the best advise you could give them?

o   This profession provides a lot of opportunities to be a clinician but also a business person which will give you lots of career fulfilment.  Be pro active in shadowing people, learn as much as you can and don’t be afraid to ask questions. 

You work within the NHS and Private sector.  To give the newbie podiatrists an idea, what is the difference?

o   The NHS is great organisation with good values and morals, However, it has been widely abused by us as users of the service and professionals working with in it. Along with poor management it is a struggling service so cut backs mean that as a clinician we are constantly held back by budgets and a lot of red tape meaning the patient looses out. Privately you can manage and work in smaller services which means you are able to give more time and resources to the patient. Using equipment such as force plates, 3D scanning and imaging to help diagnose and manage patients in a more efficient way than possible in some NHS trusts. At South West Podiatry we have same day access to X rays, MRI, Ultrasound examination’s and lets say a patient wants a specific type of orthotic device, we can go out there and meet their expectation. We work with orthotic companies from Canada, Australia, Ireland and the USA. 

Which do you prefer, NHS or Private ?

o   Hard to say I love my NHS position I deal with a lot of complex foot pathologies which challenge me. But the private sector really allows me to treat and manage patients in the best way I can.

Just one more question, so you have a foot fetish right?

o   Ha ha ha most definitely not!!!!!! The feet I have seen and treated would put you off your dinner for life.

 

Tom Walton MSc BSc HONS MChs HcPC 

020 7164 6607

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