Common questions & brief summary

Please use this website to find out more information about foot problems please do note I am unable to see patients but podiatrists are available on enquiry who can carry out direct clinical examination. I will be happy to receive e-mail correspondence

What is the difference between local and general anaesthetics?

‘Anaesthesia and pain management is as important as the skill of foot surgery’

The choice between staying awake and remaining at a level of consciousness is the main difference for a local anaesthetic, often called a regional block in the foot. A general anaesthetic is where a patient would have no conscious state at all.

At Spire Little Aston I work closely with anaesthetists to ensure the best method is used for foot surgery. All our local anaesthetic patients can have some sedative relaxation. This is sometimes known as ‘twighlight anaesthesia’. The main benefit is lack of awareness of needles for phobic patients whilst being ‘numbed’.

Patients can ask about their preferred method and discuss this with my anaesthetist to help make the best choice.

Modern anaesthetics are much more refined these days so that fewer unwanted reactions arise. Most patients can return home safely after their foot surgery on the same day.

More information about anaesthesia can be directed at the Royal College of Anaesthetists’ website patient and relatives section.

When should bunions be treated?

As a rule we do not treat bunions unless there are definite concerns. There are some golden rules or indications that might be worth considering. Professional advice from someone who deals with this problem is important as some internet information may not be backed by professional expertise. Be very careful of false promises such as minimal incision surgery, or ‘lunchtime surgery’ often popularised by small incisions and performed with quick return to walking. Please look at Clinical Fact sheets on my website under Educational Information; Nos. 7,16,50,52,106

  • Where recurrent skin breakdown arises (ulcers, chilblains, corns)
  • A high chance of worsening in older age
  • Where secondary problems are likely e.g. dislocation of smaller toes
  • The foot is so broad that footwear is difficult
  • After foot growth has finished ideally
  • Where soft tissue problems such ganglia arise
  • Nerve pain compression often know as neurogenic bunion pain
  • Some medical conditions such as rheumatoid arthritis
  • Chronic Infections including osteomyelitis

All surgeries carry risks and these must be fully understood and explained to you before consenting for surgery. Treatment fact sheets

Be very careful of false promises such as minimal incision surgery, or ‘lunchtime surgery’ often popularised by small incisions and performed with quick return to walking. Refer to NICE guidelines an official site on surgeries for toes which are approved.

Fellows of the College of Podiatry (FCPodS) are qualified and regulated by the HCPC to perform foot surgery in the UK

Why is the private sector so expensive?

Unlike the NHS, all hospital services have to cover their outgoings without subsidy. This allows you more choice when you have treatment and also ensures we have staff to provide your treatment swiftly. Something that might take six weeks to arrange in the NHS can often be carried out in the same week at our hospital. The cost of healthcare in the UK has risen as people who perform higher risk treatment must meet ever increasing standards. Obviously this is correct and you will find under ‘quality assurance’ the type of activities we must include. This has pushed the cost of healthcare delivery up. I believe it is important to spend time with patients and this is included within the cost of delivery high quality consultations.

Why use podiatric surgery in the private sector?

Treatment and diagnostics can usually be carried out for your convenience by different departments in one location without the traffic of a large general hospital. Our rooms are of a high quality with en suite for day surgery or admission if required, quality food and nursing support. Spire has a high satisfaction record at Little Aston. Only experienced consultants perform surgical treatment and have to meet high standards of practise. Please refer to ‘Quality assurance’.

Do you guarantee success from treatment?

This is not possible as too many factors can affect the outcome. If you feel that the risks are too great you should not consider surgery for non urgent conditions

What tests might I need?

x-rays account for over 60% of patient investigations, urine sample tests 98% and ultrasound 22%. Many other investigations might be used for specific conditions. Blood pressure is taken before surgery treatment on all patients to ensure that your heart is sound. Local blood flow tests with doppler in clinic is used to make sure circulation is acceptable. Podiatric surgeons cannot provide you with a lesser service than any medical consultant.

I am very anxious about having surgery and do not want to be awake?

I work with an anaesthetist to ensure appropriate anaesthetic is provided. Please refer to ‘About’ section in the drop down bar on the home page and then ‘Working closely with other conusltants’

Part of our service and our role is to ensure you do not have undue anxiety during your treatment. My anaesthetist always discusses your care before treatment to put your mind at rest.

Will I have to have surgery for my foot problem?

No I will always consider conservative treatment first and discuss with you reasonable options. I never push patients to have treatment that they do not need. I am here to advise and support decisions.It is always worthwhile asking for a consultation to clarify which treatment options work and are safe.

Will my treatment be different to an orthopaedic surgeon?

No your treatment is not expected to be different as we hope a good outcome is expected in both cases. Podiatric specialists are able to use all their basic training as a podiatrist as well as advanced training in foot surgery. Podiatric surgeons will not suggest surgery without a medical consultation if your medical health is not stable. There are conditions that I would suggest you see an orthopaedic surgeon for if this is in your best interest. At Spire Little Aston Hospital I work closely with orthopaedic colleagues.

Should I see an orthopaedic surgeon?

No it is not necessary to see an orthopaedic surgeon as not all orthopaedic practitioners specialise in feet. Only those members of the British Orthopaedic Foot and ankle Society carry out regular foot surgery. Podiatric surgeons treat feet exclusively in both the NHS and in private practice. A podiatric specialist will have trained to assess, diagnose and treat feet for 13 years before becoming a consultant. Orthopaedic surgeons specialise in foot surgery toward the end of their long training.

Are you medically qualified?

Our formal education includes studying medical sciences and we are able to treat surgical problems. We do not call ourselves medical doctors. A podiatric surgeon is to feet very much like a dentist is to teeth; I am an independent clinician in my field. Please download there patient information leaflet under Quality AssuranceGood practice. These leaflets discuss standards that podiatric surgeons adhere to and provide more information about training.