WEBVTT 00:00:00.000 --> 00:00:12.180 So welcome to our next episode of Medically Speaking. Today we have two special guests 00:00:12.180 --> 00:00:18.100 with us, Kelly Mandile and Alex Barnett. We're going to be talking about podiatry. These 00:00:18.100 --> 00:00:23.380 are our two podiatrists we have here in Greenwood, a new service line we just started about a 00:00:23.380 --> 00:00:27.980 year ago. And we'll start maybe with some introductions. So again, I'm Matt Logan, CEO 00:00:27.980 --> 00:00:34.740 of South Regional. Hi, I'm Kelly Mandile. I'm, I guess, the first podiatrist of Greenwood for a 00:00:34.740 --> 00:00:40.740 while. I just moved down here about a year ago, and we've been starting the podiatry program. 00:00:40.740 --> 00:00:46.420 Things have been going great. I'm originally from Ohio, and I'm happy to be local South Carolina 00:00:46.420 --> 00:00:52.760 native now. I'm Alex Barnett. I just started in August, so a new addition here, but originally 00:00:52.760 --> 00:01:00.160 from Sumter, South Carolina. And I just came from Fort Worth, Texas. Awesome. Awesome. So some people 00:01:00.160 --> 00:01:05.580 may not know exactly what a podiatrist does. So we'll just start with that. So let's talk a little 00:01:05.580 --> 00:01:10.340 bit about like, what is podiatry? Like what conditions do you treat? What are some common 00:01:10.340 --> 00:01:17.880 things that you guys may see in your practice? Well, podiatry is a pretty broad topic. Pretty 00:01:17.880 --> 00:01:24.780 much any foot and ankle problem is covered in the scope of podiatry so if you have problem with your 00:01:24.780 --> 00:01:31.800 skin problems with your ankles the ligaments the tendons the joints if you have hammer toes or 00:01:31.800 --> 00:01:37.200 bunions plantar fasciitis I mean foot and ankle where you're where you're go to I kind of second 00:01:37.200 --> 00:01:44.200 that you know podiatry is such a broad spectrum and we specialize in it so we're taught everything 00:01:44.200 --> 00:01:51.220 about the foot and ankle. We can do sports-related injuries. We can do fracture care, routine foot 00:01:51.220 --> 00:01:58.540 care, plantar fasciitis, flat foot, and different type of clubfoot deformities as well. The beauty 00:01:58.540 --> 00:02:02.900 of podiatry is that we can treat things conservatively from a toenail all the way to 00:02:02.900 --> 00:02:07.880 reconstruct a whole flat foot and give people an arch again. So it's a unique specialty because 00:02:07.880 --> 00:02:12.840 it's kind of a touch of a lot of different specialties all just in the same area. Sure. 00:02:12.840 --> 00:02:18.180 I think there's some confusion now just in general on what is a podiatrist? 00:02:18.180 --> 00:02:19.280 But then what's the training? 00:02:19.280 --> 00:02:20.500 Just talk about that. 00:02:20.500 --> 00:02:22.740 It's not just, oh, you just go be a podiatrist. 00:02:22.740 --> 00:02:25.180 I mean, walk us through what does it take? 00:02:25.180 --> 00:02:28.060 What is the background of becoming a podiatrist? 00:02:28.060 --> 00:02:30.720 So a podiatrist is a specialized medical degree. 00:02:30.720 --> 00:02:32.640 So it's a doctor of podiatric medicine. 00:02:32.640 --> 00:02:34.500 Instead of an MD, it's a DPM. 00:02:34.500 --> 00:02:39.600 So we go to four years of your undergraduate degree, and then we go to four years of specialized 00:02:39.600 --> 00:02:40.440 medical school. 00:02:40.440 --> 00:02:45.360 So the first two years of that medical school is just the same as any other medical school we do. 00:02:45.360 --> 00:02:50.520 Full body anatomy, you're taught to be a doctor first and then a specialist second. 00:02:50.520 --> 00:02:55.420 And then the second two years, it's more focused on just foot and ankle pathologies. 00:02:55.420 --> 00:03:02.720 But we do focus some of that education on different specialties that would be emphasized in the foot, 00:03:02.720 --> 00:03:08.660 like vasculature and rheumatology and different conditions that kind of pop up more commonly in the foot. 00:03:08.660 --> 00:03:13.940 and then after you finish your medical degree then you have to go on and do a minimum of a 00:03:13.940 --> 00:03:19.600 three-year residency program and that's for your surgical training so you go and you do specialized 00:03:19.600 --> 00:03:25.440 foot and ankle surgery for three years in order to be you know efficient and qualified in that 00:03:25.440 --> 00:03:31.200 and then some people go on and will even do a fellowship and even more specialized training 00:03:31.200 --> 00:03:37.940 after that whether it be trauma surgery or anything foot and ankle related so it it kind of 00:03:37.940 --> 00:03:43.680 mimics the MD program in that you still have to have a residency. Um, and it still takes quite a 00:03:43.680 --> 00:03:48.700 lot of years, um, and dedication, but, uh, at the end of the day, you know, you're going to be 00:03:48.700 --> 00:03:55.260 working on the foot. Yeah, absolutely. Well, um, yeah, so I guess that's just exactly what I wanted 00:03:55.260 --> 00:03:59.180 to say. And it's like, this is a, uh, it's a highly specialized field. You go through four 00:03:59.180 --> 00:04:05.160 years of college, four years of podiatry school, and then, and then another three years of residency 00:04:05.160 --> 00:04:12.440 minimum to really become a podiatrist. And so a lot of training and a lot of expertise in the 00:04:12.440 --> 00:04:18.480 foot and ankle. And so kudos to you guys. That's really awesome that you guys have done that. And 00:04:18.480 --> 00:04:25.800 we are so glad that y'all are here bringing that to Greenwood. When Kelly started, we weren't sure 00:04:25.800 --> 00:04:29.800 exactly how the service line was going to go. Within about a month, she's booked out like three 00:04:29.800 --> 00:04:34.160 or four or five months. And so we were so glad that Alex was able to just join us to try to get 00:04:34.160 --> 00:04:38.740 the wait times down uh for the community um because there's a lot of people with foot and 00:04:38.740 --> 00:04:46.580 ankle problems out there i am surprised i mean i kudos to you and self for realizing the need of 00:04:46.580 --> 00:04:53.180 the community and and getting us here and starting this whole program from the ground up and i'm i'm 00:04:53.180 --> 00:04:57.140 impressed with the leadership of the hospital and getting this whole thing started and all the 00:04:57.140 --> 00:05:02.900 administration has been wonderful in getting us what we need so we are fully equipped um basically 00:05:02.900 --> 00:05:07.460 to do everything we want now. Yeah. Numerous of my patients have told me they've been waiting 00:05:07.460 --> 00:05:12.980 four months to see me. So I'm very grateful to be here and treat those patients and provide the 00:05:12.980 --> 00:05:17.820 necessity that they need. So, yeah. Oh, well say, uh, certainly we're glad to have you guys too. 00:05:17.820 --> 00:05:22.340 Like what are the most common things that you may see in your office on a daily basis? 00:05:22.340 --> 00:05:28.840 You want to start with that one? Yeah. So, you know, it kind of varies, uh, has a wide range. 00:05:28.840 --> 00:05:33.080 One of the more common pathologies we see is plantar fasciitis, 00:05:33.080 --> 00:05:37.600 which is kind of inflammation of your plantar fascial band at the bottom of your foot. 00:05:37.600 --> 00:05:40.580 So that's pretty common. 00:05:40.580 --> 00:05:46.360 We can also see routine diabetic care, including just foot checks, 00:05:46.360 --> 00:05:49.520 making sure there's no new wounds or infections on the diabetic foot. 00:05:49.520 --> 00:05:55.680 And then sometimes we do get ingrown toenails or sports-related injuries, 00:05:55.680 --> 00:06:02.460 including ligament sprains, um, or tendonitis. Yeah. And then, you know, we'll have the patients 00:06:02.460 --> 00:06:07.000 that come in with the big bunions on the side of their foot that are hurting them. They want cut 00:06:07.000 --> 00:06:12.500 off. Um, you got the hammer toes that come in, um, people with arthritic joints, um, Achilles 00:06:12.500 --> 00:06:19.620 tendon ruptures have come in, walked through the door, unfortunately. Um, and so it really is a 00:06:19.620 --> 00:06:23.600 broad scope, but so day to day, you never know what you're going to get, but every day is an 00:06:23.600 --> 00:06:29.640 adventure. And one thing I really appreciate you guys helping out with too, is you guys know we 00:06:29.640 --> 00:06:34.380 have a pretty strong vascular surgery program here and the help that you guys have been doing 00:06:34.380 --> 00:06:41.300 in the limb salvage program. Could we maybe share a little bit about that? Yes. So that we, so with 00:06:41.300 --> 00:06:47.120 diabetic limb salvage and really just peripheral vascular disease in general down here, it's such 00:06:47.120 --> 00:06:52.180 a need and such a demand. It's the culture that it has that's kind of going against us. 00:06:52.180 --> 00:06:59.200 But the vascular program has been excellent. We have a really good working relationship with 00:06:59.200 --> 00:07:04.980 both of the vascular surgeons down here and the technicians to get patients seen quickly and 00:07:04.980 --> 00:07:09.020 efficiently. And if they need revascularization and then offloading with us, either surgically 00:07:09.020 --> 00:07:15.180 or just with orthotics, it's been a really pleasant experience. And I don't think I've 00:07:15.180 --> 00:07:20.240 ever worked at a program where you could just call someone and say you know hey i have this patient 00:07:20.240 --> 00:07:24.140 really needs to be seen and they do the best they can to get them you know in the door as quick as 00:07:24.140 --> 00:07:31.600 possible because at a lot of a lot of time with these pathologies time equals tissue and so if 00:07:31.600 --> 00:07:36.100 you can get that revascularized quicker then we don't have to amputate as much the whole goal with 00:07:36.100 --> 00:07:44.240 the limb salvage program is trying to save as much as you can without you know taking too much or 00:07:44.240 --> 00:07:50.520 leaving bad disease tissue behind and so previously i think a lot of options here were either 00:07:50.520 --> 00:07:57.880 amputation or you know a big foot amputation or a big leg amputation now we can kind of do other 00:07:57.880 --> 00:08:06.060 strategies to keep people active and keep their feet having such a close relationship with vascular 00:08:06.060 --> 00:08:11.920 surgery that we have at this hospital really helps to the advantage of the patient so as kelly was 00:08:11.920 --> 00:08:17.500 saying we're able to see stuff quicker, get it treated faster, preferably save the patient's foot 00:08:17.500 --> 00:08:24.400 and then save their limbs, save their lives. So I do want to also just say the wound center that 00:08:24.400 --> 00:08:29.140 we have here, it's kind of like the trifecta because you have the revascularization from 00:08:29.140 --> 00:08:33.660 peripheral or from the vascular surgery. And then you have the podiatrist that's coming in to make 00:08:33.660 --> 00:08:38.340 sure that if we have to amputate some, that we leave an appropriate amount so that you still 00:08:38.340 --> 00:08:42.680 function with the foot that you're left with. And then you have the wound center that makes sure 00:08:42.680 --> 00:08:47.700 that their hyperbarics, um, the hyperbaric chambers there and the wound nurses and the, um, wound 00:08:47.700 --> 00:08:53.300 PA, everyone works kind of all together and we're kind of updating each other constantly on how the 00:08:53.300 --> 00:08:57.860 patient's going. And, um, I think that that's a beautiful thing that we have that kind of perfect 00:08:57.860 --> 00:09:03.320 little group there to kind of save as many limbs as we can. Absolutely. And you know, that's really 00:09:03.320 --> 00:09:07.020 all about is keeping that patient in the center and us working kind of around them for their 00:09:07.020 --> 00:09:12.360 benefit, right? You know, certainly that's the goal for all of our service loans. And I'm glad 00:09:12.360 --> 00:09:17.720 to see you guys really doing a great job with that. That's awesome. I just feel like we came 00:09:17.720 --> 00:09:22.520 down here and we were just grandfathered into a great system. And so we're lucky to be able to 00:09:22.520 --> 00:09:29.140 offer our services. And they go so well together. Great. So one of the things we're going to be 00:09:29.140 --> 00:09:34.340 working on, particularly now that Alex is here too, is, you know, certainly want to meet the 00:09:34.340 --> 00:09:39.040 need in Greenwood, but as we're growing some too, um, particularly, you know, I think about 00:09:39.040 --> 00:09:43.500 Abbeville and that's one of podiatry is one of the services that we want to try to move over to 00:09:43.500 --> 00:09:49.460 Abbeville and, and, and provide a similar service over there. Um, talk to me a little bit about like 00:09:49.460 --> 00:09:53.720 your capacity to do that now. And like, where do you see that potentially going in the future? 00:09:53.720 --> 00:09:59.160 Um, I think the growth is important because there's need all over South Carolina. Um, 00:09:59.160 --> 00:10:00.580 and we're kind of in a podiatry desert. 00:10:00.580 --> 00:10:05.120 So the need is out there, and we're growing. 00:10:05.120 --> 00:10:08.420 Right now, my current schedule is still booked out about three months. 00:10:08.420 --> 00:10:12.560 So with the addition of Dr. Burnett here, 00:10:12.560 --> 00:10:17.460 we're able to see patients that are more emergent kind of quicker, 00:10:17.460 --> 00:10:22.460 and the goal is that we're each going to be seeing outreach patients at clinics, 00:10:22.460 --> 00:10:25.100 and we're growing to expand hopefully into Abbeville soon. 00:10:25.100 --> 00:10:27.080 We're already in Edgefield. 00:10:27.520 --> 00:10:32.200 We were in Edgefield, and then we kind of bounced back because the growth in Greenwood was just so high. 00:10:32.200 --> 00:10:38.320 We're going to be starting back in the next month out at Edgefield, and then Alex here is going to start in Saluda soon. 00:10:38.320 --> 00:10:44.520 So we're already trying to expand the scope or the horizon there, and then hopefully more to come. 00:10:44.520 --> 00:10:55.080 Yeah, I think the growth to smaller towns or outreach is very crucial for the population to get them the need that they require. 00:10:55.560 --> 00:10:58.740 I'm starting a saluta pretty soon, so I'll be seeing patients down there. 00:10:58.740 --> 00:11:04.100 And a lot of patients, you know, it's kind of a far drive to Greenwood to come see us. 00:11:04.100 --> 00:11:07.460 So I think having the outreach is going to be crucial for them. 00:11:07.460 --> 00:11:08.820 Yeah, absolutely. 00:11:08.820 --> 00:11:11.300 Well, certainly we're glad you guys are doing that. 00:11:11.300 --> 00:11:16.200 And so, again, super excited about the program and the development of podiatry here in Greenwood. 00:11:16.200 --> 00:11:22.540 Tell me about anything you all want to tell me about that you would like for the community to know about your practice, 00:11:22.660 --> 00:11:27.380 about you guys personally or really anything else you'd like to share with with the community that 00:11:27.380 --> 00:11:33.840 may hear this message you can go ahead and start well i just want to say thanks because i'm glad 00:11:33.840 --> 00:11:40.140 to be back in south carolina now i'm closer to family so that that's great um being within a car 00:11:40.140 --> 00:11:45.240 ride to family has been you know very appreciative of all that not having to catch a plane flight 00:11:45.240 --> 00:11:51.580 but i'm just happy to be here to treat patients a lot of them tell me they haven't seen a podiatrist 00:11:51.580 --> 00:11:56.860 in over years since the last one in Greenwood was here so I think us being 00:11:56.860 --> 00:12:02.260 here is definitely a pillar for the community and I'm just very happy to see 00:12:02.260 --> 00:12:06.160 everybody and like we were saying the spectrum that we treat is so broad 00:12:06.160 --> 00:12:10.940 includes pretty much anything foot and ankle related if you twist your ankle if 00:12:10.940 --> 00:12:14.620 you step something wrong kind of had arthritis pain that's been bugging you 00:12:14.620 --> 00:12:19.380 for a while there's normally a treatment that can help you out so I think just 00:12:19.380 --> 00:12:24.780 getting that message out to patients that to come see us even if they you know aren't having 00:12:24.780 --> 00:12:31.380 tremendous pain but kind of have achy pain that's been going on a while is key um yeah i'm gonna 00:12:31.380 --> 00:12:36.600 piggyback off that and just thank the community so much for the welcome that we've had down here 00:12:36.600 --> 00:12:41.740 so i'm not from the south originally and i really like a lot of aspects of the south including the 00:12:41.740 --> 00:12:47.700 weather the weather um that we have down here which is so much better than ohio um i'm the 00:12:47.700 --> 00:12:52.800 opposite so I like moved away from my family to come and start down here but with my husband and 00:12:52.800 --> 00:12:58.080 my daughter and we've we're growing roots down here and we we've kind of dug into the community 00:12:58.080 --> 00:13:03.140 we love it so far everyone's so personable and friendly and I don't think we went went to a place 00:13:03.140 --> 00:13:09.600 so far where we weren't engaged by somebody and it's wonderful and so so interesting to be in a 00:13:09.600 --> 00:13:16.140 smaller town because I'm used to living in bigger cities and so I think I was telling somebody 00:13:16.140 --> 00:13:21.740 earlier so my mom came down um for a wedding ceremony that we had and uh she was at a bakery 00:13:21.740 --> 00:13:27.440 and she was saying oh yeah my daughter she's having her ceremony and um she was saying oh 00:13:27.440 --> 00:13:32.400 what's your daughter do and she's oh she's a foot doctor and she's oh dr mandyle oh she's the 00:13:32.400 --> 00:13:37.140 picasso of feet and you know like it's just such a nice thing that the community kind of has heard 00:13:37.140 --> 00:13:41.380 about us and they're so welcoming and engaging about podiatry i have patients that come in and 00:13:41.380 --> 00:13:46.120 they're just excited to get their foot checked just to make sure things are they're okay and 00:13:46.120 --> 00:13:50.860 that's okay you know we want to see the feet we want to know that they're good and can you can do 00:13:50.860 --> 00:13:56.060 everything you want there shouldn't be pain when you walk there shouldn't be pain you know with 00:13:56.060 --> 00:14:01.540 every step you take there is something that can be done to alleviate a lot of those symptoms you 00:14:01.540 --> 00:14:06.120 know at least to make it so that you can do activities that you want to do a lot of times 00:14:06.120 --> 00:14:11.960 with arthritis even in people that thought like oh it's either surgery or nothing you know we can 00:14:11.960 --> 00:14:17.320 get you into a nice sturdy insert a good supportive shoe please this is to the community you stop 00:14:17.320 --> 00:14:24.920 wearing crocs um i can't i can't comment enough yeah um kids are okay kids feet are flexible but 00:14:24.920 --> 00:14:29.940 as we get older we just need a little more support a little better shoe wear um so i think greenwood 00:14:29.940 --> 00:14:35.660 needs a little bit of that but yeah the uh if if you just have pain in your foot and you want it 00:14:35.660 --> 00:14:40.520 looked at you might have to wait a little bit but we're happy to look at it I have some people that 00:14:40.520 --> 00:14:45.660 come in and they say you know I'm not I wasn't sure if I needed to come that's okay we're here 00:14:45.660 --> 00:14:50.520 to help yeah so pretty much if it hurts you're glad to take a look exactly if it hurts we're 00:14:50.520 --> 00:14:57.360 glad to see it that's great let's see here oh I did want to ask just real briefly just for the 00:14:57.360 --> 00:15:02.200 audience I'm just and I'm just curious myself too so like what are some of the procedures that you 00:15:02.200 --> 00:15:06.400 may do in your office versus something that you might need to go to an operating room for? 00:15:06.400 --> 00:15:10.480 And what are some common procedural type things that you guys do? 00:15:10.480 --> 00:15:16.940 Okay. So a lot of procedures that we do in the office are all the minimally invasive procedures. 00:15:16.940 --> 00:15:21.840 So we can fix a very flexible hammer toe in the office. We can take care of plantars, 00:15:21.840 --> 00:15:31.140 warts in the office, ingrown toenails in the office. If you can tolerate like a nice numbing 00:15:31.140 --> 00:15:37.200 solution. We can do a lot of little skin flaps and rotations if you have deep calluses and things in 00:15:37.200 --> 00:15:43.160 the office. If it's something that's a little more invasive or we couldn't numb you up appropriately, 00:15:43.160 --> 00:15:49.420 then it's usually a trip to the OR. And most of our surgeries, I would say the majority of our 00:15:49.420 --> 00:15:54.520 surgeries can be done under local anesthesia. So you're just kind of in a little sleepy state, 00:15:54.520 --> 00:15:59.960 you're asleep, you don't feel what's going on, and it's outpatient surgery. So a lot of people 00:15:59.960 --> 00:16:04.960 get a little nervous because they think it's the full intubation full general anesthesia and 00:16:04.960 --> 00:16:10.440 it's not it still comes with risks but it's outpatient and you're back on your feet you 00:16:10.440 --> 00:16:17.920 know a couple weeks after depending on the procedure um yeah i mean in office like dr 00:16:17.920 --> 00:16:23.740 mandel was saying we can offer you know injections sometimes a steroid injection will help out quite 00:16:23.740 --> 00:16:29.360 a bit uh where you don't need a big procedure uh so that's something to consider and like i said 00:16:29.360 --> 00:16:35.920 ingrown toenails kind of smaller procedures in the office if it does require a bigger procedure 00:16:35.920 --> 00:16:41.720 it does require to get to the OR but it's normally like a twilight phase a local anesthetic will do 00:16:41.720 --> 00:16:47.940 quite a bit to make sure there's no pain so the recovery process on a normally foot surgery 00:16:47.940 --> 00:16:54.500 you do it does require to stay off it depending on where the incision is but there's a bunch of 00:16:54.500 --> 00:17:00.660 good, uh, knee scooters and I walks that will help the patient, um, be compliant with that. 00:17:00.660 --> 00:17:06.480 Good. Excellent. I think, um, so I wanted to point to my foot here because it was, 00:17:06.480 --> 00:17:13.120 so it's interesting because so your body has 206 bones and your foot has 26 bones. So if you 00:17:13.120 --> 00:17:19.380 multiply that by two, you're at 52. So 25% of the bones in your body are in your feet. So that's 00:17:19.380 --> 00:17:23.300 impressive. That's a lot of little joints that can become arthritic and can cause you pain. 00:17:23.660 --> 00:17:27.840 So I like to emphasize that when people ask, like, well, why did you become a foot doctor? 00:17:27.840 --> 00:17:29.660 Because there's a lot to do down there. 00:17:29.660 --> 00:17:31.300 Yeah, there's a lot. 00:17:31.300 --> 00:17:31.620 Yeah. 00:17:31.620 --> 00:17:35.980 And so and and I think one of the things I want to highlight because I've noticed so 00:17:35.980 --> 00:17:40.600 much of it down here is flat foot, huge flat foot population down here. 00:17:40.600 --> 00:17:42.580 And I think a lot of people are just living with it. 00:17:42.580 --> 00:17:43.880 They're living with the pain. 00:17:43.880 --> 00:17:44.520 They're starting. 00:17:44.520 --> 00:17:46.840 They get to the point where they're walking on their ankles. 00:17:46.840 --> 00:17:52.020 And by then you need a big, huge reconstruction to fix that. 00:17:52.020 --> 00:17:53.840 And a lot of people don't want to do that. 00:17:53.840 --> 00:17:57.480 But if we catch it a little earlier and get you into the proper shoe gear and some inserts, 00:17:57.480 --> 00:18:01.220 then you save yourself that need for reconstruction down the line. 00:18:01.220 --> 00:18:04.800 If you do get to the point where you need it, then we're happy to help. 00:18:04.800 --> 00:18:07.060 It's one of the surgeries that we perform all the time. 00:18:07.060 --> 00:18:11.820 But that's a huge, I just feel like flat foot's really common down here. 00:18:11.820 --> 00:18:15.500 And I wanted people to know that you don't have to necessarily live with it if it's causing 00:18:15.500 --> 00:18:15.980 you pain. 00:18:15.980 --> 00:18:18.800 So what age should that start to be treated? 00:18:19.260 --> 00:18:24.380 I just ask, I actually had flat feet when I was like in, oh, probably seventh or eighth 00:18:24.380 --> 00:18:30.140 grade, and I had an orthotic insert in my shoe for a while, and it did help. 00:18:30.140 --> 00:18:30.860 It did make a difference. 00:18:30.860 --> 00:18:32.340 So what age should that be treated? 00:18:32.340 --> 00:18:36.700 So usually if you're starting to have pain, it's going to be kind of on the inside of 00:18:36.700 --> 00:18:42.060 the ankle region, and that's usually once your foot stops becoming as flexible. 00:18:42.060 --> 00:18:45.060 So late 30s, you might start noticing it. 00:18:45.060 --> 00:18:47.800 Into your 40s, you might start becoming a little stiffer. 00:18:48.180 --> 00:18:52.540 That's kind of, I think, the prime age to fix it if you can reconstruct the flat foot. 00:18:52.540 --> 00:18:57.200 I think also it's really key to catch them early before they start having pain. 00:18:57.200 --> 00:19:01.140 Even if you just have a flat foot, but you're not getting good support in your shoes, 00:19:01.140 --> 00:19:05.560 there's orthotics that can help out with that and prevent you from having pain later in life 00:19:05.560 --> 00:19:08.760 where you do require that procedure to fix the flat foot. 00:19:08.760 --> 00:19:12.240 So what ages do you guys treat? 00:19:12.240 --> 00:19:16.180 So right now we're seeing kids two and up. 00:19:16.180 --> 00:19:16.980 Two and up? 00:19:17.200 --> 00:19:24.380 Yeah. So, and a lot of times patients will come in, parents will come in and their kids are either 00:19:24.380 --> 00:19:28.580 walking on their toes or their toes are a little crossed or crunched and they're not sure like 00:19:28.580 --> 00:19:34.480 what's going to happen with it. And oftentimes those are self-limiting. So once the kid starts 00:19:34.480 --> 00:19:41.160 walking regularly, then they're good to go. Everything kind of stabilizes itself. It's kind 00:19:41.160 --> 00:19:45.860 of after the age of two is when you kind of notice, okay, this is sticking around, what's 00:19:45.860 --> 00:19:51.860 going on is if something can be done about it yeah I agree with that I mean most most times 00:19:51.860 --> 00:19:58.180 when you're uh two around two um adolescent a lot of times the foot will kind of solve itself 00:19:58.180 --> 00:20:05.980 as you grow gotcha so um just another question too so um you guys have talked a lot about some 00:20:05.980 --> 00:20:09.940 of the things you treat are there any things in the foot and ankle that may be like oh I'm not 00:20:09.940 --> 00:20:14.420 sure I may want to refer this one to somewhere else or are there any of those type cases that 00:20:14.420 --> 00:20:19.220 you see from time to time um so i think limb lengthening is one of the things that can be an 00:20:19.220 --> 00:20:24.560 issue um if you've had a osteosarcoma or some sort of bone cancer in the past or something 00:20:24.560 --> 00:20:29.860 had to be resected and they come in they can get problems in their feet problems in their ankles 00:20:29.860 --> 00:20:36.260 and that's something where they can like the orthopedic doctors um can kind of do procedures 00:20:36.260 --> 00:20:41.500 um in osteotomy so cut the bone and kind of lengthen and correct that so that you don't 00:20:41.500 --> 00:20:46.000 have the pain anymore because you equalize that length so that's something that we would definitely 00:20:46.000 --> 00:20:51.020 refer to ortho for yeah i agree i mean that's probably one of the few things that i think we 00:20:51.020 --> 00:20:56.120 would probably need to refer out um but besides that i can't really think of too many other 00:20:56.120 --> 00:21:04.120 anything at all that we'd refer out um neuropathy sensations that's another one we don't have a 00:21:04.120 --> 00:21:09.620 we don't have i don't think a lot of people have a great toolbox to attack neuropathy sensations 00:21:09.620 --> 00:21:14.920 i love to sit there and focus on the different sensations and tell the patient that you know 00:21:14.920 --> 00:21:19.240 what they're feeling is normal for small fiber neuropathy which we see all the time especially 00:21:19.240 --> 00:21:24.880 in diabetics um not that there's tremendous treatments for it but at least it helps people 00:21:24.880 --> 00:21:30.200 understand that it's not just them and that these sensations that they're feeling that usually they 00:21:30.200 --> 00:21:36.360 describe as kind of just weird like thickness of the foot feeling like cardboards on their foot 00:21:36.360 --> 00:21:42.780 little tingling little burning something squeezing your foot over in the toes wakes you up at night 00:21:42.780 --> 00:21:49.380 those are all small fiber neuropathy symptoms um and so people will come to us thinking it's foot 00:21:49.380 --> 00:21:54.840 problem it's a nerve problem and so you know we we do a lot of education on that to kind of inform 00:21:54.840 --> 00:21:59.700 them but that should really truthfully be more addressed by like the neurology team so that would 00:21:59.700 --> 00:22:04.500 be referred out. Also, we send lots of referrals to physical 00:22:04.500 --> 00:22:07.800 therapy. The physical therapy team that we have itself is 00:22:07.800 --> 00:22:12.420 wonderful. They have a treatment for the neuropathy, the anodyne 00:22:12.420 --> 00:22:15.720 laser therapy, which is a new more cutting edge therapy for 00:22:15.720 --> 00:22:20.380 neuropathy symptoms. But the physical therapists have been 00:22:20.380 --> 00:22:24.420 tremendously helpful in saving us from having to cut on people 00:22:24.420 --> 00:22:27.720 and preventing them that trip to the operating room, but also 00:22:27.720 --> 00:22:33.660 knowing that there's a limitation to that as well and sometimes things just do need to be fixed 00:22:33.660 --> 00:22:39.820 if a tendon is torn and you try to strengthen the other tendons erratic you try to do your 00:22:39.820 --> 00:22:45.000 stretching your strengthening and your flexibility but at some times you just have to go and repair 00:22:45.000 --> 00:22:50.580 it so there's a limitation to it but that's a huge referral source too and physical therapy 00:22:50.580 --> 00:22:55.120 is key about getting you know especially post-heart patients back to ambulating back to 00:22:55.120 --> 00:23:01.000 normal life, uh, good quality of life before like what they had before the surgery, um, without 00:23:01.000 --> 00:23:07.160 pain. So, so tell me real quick, how does someone get plugged into the podiatry clinic? Can they 00:23:07.160 --> 00:23:10.920 just call themselves or do they need their doctor to refer them? Just tell me how that works. 00:23:10.920 --> 00:23:16.480 So there's, um, two options. So you can have your primary care physician send a referral into us. 00:23:16.480 --> 00:23:21.460 Um, and if it's an urgent matter, if you have an infected ingrown toenail or, um, something that 00:23:21.460 --> 00:23:27.080 needs to be seen urgently, usually that's your quickest method. If you don't have that and you're 00:23:27.080 --> 00:23:30.880 just having kind of pain in the foot or you just want to be checked out, you can also self-refer. 00:23:30.880 --> 00:23:35.160 So you can give us a call and then we'll schedule you an appointment and we'll figure out what's 00:23:35.160 --> 00:23:41.480 going on. Oftentimes we need radiographs before the people are coming. And this is a huge learning 00:23:41.480 --> 00:23:45.700 curve, I think, for a lot of people that haven't dealt with podiatrists before. But most of the 00:23:45.700 --> 00:23:50.240 radiographs that we need have to actually be weight-bearing. So we'll get x-rays from the 00:23:50.240 --> 00:23:55.160 emergency room that are looking for fractures because they have foot pain and if you look at 00:23:55.160 --> 00:23:58.800 a non-weight-bearing x-ray and then compare it to a weight-bearing x-ray you see a whole different 00:23:58.800 --> 00:24:04.440 story of the foot um so that's something that we uh like to like to let people know the weight 00:24:04.440 --> 00:24:08.180 bearing x-ray is important for us so that we can see what actually is going on when your foot is 00:24:08.180 --> 00:24:16.040 functioning um so how's that flat foot now that's much better actually you know i had the orthotics 00:24:16.040 --> 00:24:19.740 for gosh i'll probably wear them for about 10 years i don't even wear them anymore and i'm good 00:24:19.740 --> 00:24:23.880 good no worries make sure you're wearing those nice supportive shoes you know you notice it now 00:24:23.880 --> 00:24:28.260 though right so like my son plays basketball and i'll see kids on their team without their shoes 00:24:28.260 --> 00:24:32.920 i'm like oh goodness gracious my friend you need some orthotics oh yeah i'll be walking around the 00:24:32.920 --> 00:24:37.960 stores and i'll point out to my husband you know oh they need they need a little ankle brace you 00:24:37.960 --> 00:24:43.240 know and you just you can't help yourself right exactly yep it's one of the pitfalls of being in 00:24:43.240 --> 00:24:48.100 medicine i think because you notice things other people may not see sometimes yeah yeah but good 00:24:48.100 --> 00:24:52.280 Well, awesome guys. Listen, I've really enjoyed chatting with you guys today. Thank you all for 00:24:52.280 --> 00:24:58.740 joining me on today's Medically Speaking episode. And again, everyone who's watching, we really 00:24:58.740 --> 00:25:05.500 appreciate you watching and two great podiatry physicians here with us and excited to have them 00:25:05.500 --> 00:25:08.720 in Greenwood. And thank you all for watching Medically Speaking today. Thank you.