Foot in Diabetes UK (FDUK) have recently developed a COVID-19 Amputation Prevention Pathway with the goal of getting all Podiatrists and lower limb clinicians comfortable and confident calling out the two biggest risks for immediate amputation – severe infection and ischaemia – to help triage skills and knowing when to generate urgent referral requests. We were joined by Mike Edmonds (Consultant Physician and FDUK Honorary President), Martin Fox (Vascular Specialist Podiatrist), Paul Chadwick (Clinical Director of College of Podiatry), Naseer Ahmad (Consultant Vascular Surgeon) and Emma McConnarchie as a Private practitioner representative.
In this episode we welcome two titans of Maltese Podiatry, Professor Cynthia Formosa and Dr Alfred Gatt who talk to us about studying in Malta (which given the climate and the low fees seems like a very attractive opportunity) and showcase some of the huge research output they have been involved in concerning the diabetic foot (and why you may want to think about toe pressures rather than the ABPI, and also think about treating yourself to a thermal camera). Loads of great slides throughout this one so will work better as a video than a podcast! Let us know if the thought of a Masters degree from the University of Malta intrigues you and you want Cynthia or Alfred’s contact details.
In this episode we talked with Annette Davis and discussed what the evidence tells us (and doesn’t tell us) about footwear and falls, explains the role of the Podiatrist in screening for falls risk and how to communicate effectively regarding this (making a reasonably solid case for all individuals of a certain age to be risk assessed regardless of why they are attending clinic to see you) and also the talks about the reasons that older individuals choose certain shoes and the challenges this can bring to the Podiatrist-patient interactions.
About Annette Davis:
Annette is Podiatrist in Melbourne, Australia and is currently serving as a Project Manager at the Department of Health and Human Services, Victoria. She is currently completely her PhD on footwear and falls at Monash University.
In this episode we welcomed Dr David Armstrong, DPM, PhD and we talked about how the worlds diabetic population is third only to China and India, and that during the length of this episode alone 198 amputations would have occured worldwide, and 565 people would have died from complications associated with Diabetes. We talk about what we as Podiatrists can try to do about this, how we communicate with and educate our patients, David’s approach to neuropathic assessment, and how Diabetic foot ulcers are not unlike training load injuries.
About David Armstrong:
David Armstrong DPM, PhD is Professor of Surgery at the University of Southern California. David holds a Masters of Science in Tissue Repair and Wound Healing from the University of Wales College of Medicine and a PhD from the University of Manchester College of Medicine, where he was appointed Visiting Professor of Medicine. He is founder and co-Director of the Southwestern Academic Limb Salvage Alliance (SALSA). Daivd has produced more than 500 peer-reviewed research papers in dozens of scholarly medical journals as well as over 80 book chapters. He is also co-Editor of the American Diabetes Association’s (ADA) Clinical Care of the Diabetic Foot, now in its third edition.
In this episode we squeeze some real vascular gems out of Martin and Peta, and talk about what a vascular assessment should look like, the importance of doppler use (and common mistakes made), we listen to some doppler waveforms live (and appreciate how relying on our ears alone may not be ideal), and identify the importance of good history taking and screening in individuals with known risk factors (particularly given that 50% of those with PAD are asymptomatic).
About Martin Fox:
Martin works in a CCG-commissioned, community-based NHS service in Manchester; providing early identification, diagnosis and best clinical management of people with suspected peripheral arterial disease (PAD). Previous clinical posts have included NHS podiatry, high-risk foot teams and a leprosy street clinic in Kolkata. He has also worked on a professional executive committee for his NHS Trust, regionally in podiatry clinical effectiveness groups, nationally for Foot in Diabetes UK, the NICE Guideline Development Group for PAD, the College of Podiatry and he contributes to the All Party Parliamentary Reports on PAD. He presents at conferences and has written journal articles on various aspects of high-risk foot care and lower limb vascular disease.
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