The Physician’s Touch
The body, its organs and its muscular-skeletal system are all linked. If we help one, we help all. The clinical examination relies on a patient providing accurate information, which can be performed quickly using the principles of observation, good questioning techniques, and appropriate examination. For the average physician, time is vital, and the amount of information deduced and analysed can only come with years of practice, good education and mentoring. The next time you see a clinician, you may find that you are better informed.
The Physician’s Ear
Clinicians require a keen ear to absorb the information provided by the patient. Those short sentences contain the heart of the information that guides diagnosis and the following process, whether examination of the affected part or the need to seek investigations. The process is well established, and if you know what to expect, you can optimise your clinical visit.
The Physician’s Eye
The state of observation can only provide a suspected condition and is far from definitive. A clinical examination requires the patient to provide information, but the clinician will observe and listen to exclude the most obvious signs of disease before taking the all-important history. The chance of cardiovascular disease may well be suspected by facial colour, which includes the lips. The next time you see a doctor or specialist, you will be more aware of the fact that you are on show the moment you enter the room. Like a computer, he or she is processing you, gathering data and may have a diagnosis already!
Calories You and Your goal
Barney works in the leisure industry and so can see the efforts of people trying to keep fit and lose weight. Here he writes about the well known balance between effort in exercise and energy loss versus taking in energy as food. He has added some worked examples for those who want a bit more information
The Clinical Visit
Comprising three distinctive parts, the clinician uses the five senses to guide the process–one might take the humourous view of Sherlock Holmes or Poirot in determining evidence from visual observation and verbal questioning. I hope these small introductory articles provide some interest. The first in the series covers observation as in the Physician’s Eye.
Why Can’t You Make Ganglions Disappear?
Hitting any tissue is not recommended, and indeed, one should avoid using computer tablets and iPads in place of the Bible – that is, unless you are searching for information such as this site, then hit the keyboard instead.
Can an Ingrown Nail Kill?
You should not experience more pain than needed, as you would expect from dental treatment. If the clinician is unable to provide an anaesthetic, then ask to see someone who can provide this service. Only registered people trained as podiatrists or medically qualified people can provide local anaesthetics. All registered podiatrists have been trained in using local anaesthetics from 1988 onwards. Pain is the giveaway, tenderness to touch
Thick Toenails
After a sixty-minute walk in light trainer-type shoes, the fourth toenail of a man appeared dark and then went clear after a few weeks. He reasoned this was the cause of his pain, and indeed it was (Figure 2a). The nail is a solid structure made from three distinct layers to look like one. The third toe and nail are normal, but the darkness seen with the 4th toenail is blood under the nail.
How Long Does Bunion Surgery Last?
Fusion is a safer bet than most alternatives and offers better longevity. Third surgeries seldom come without loss of function. More surgery involves deeper tissue scarring, and even then, a joint-sparing operation could lead to limited joint movement. Minimal incisional surgery (MIS) appeals to many for obvious reasons, but the follow-up is not as well presented as other surgeries and is limited to specific criteria. MIS is available and has advantages. New screw systems allow surgical placement through keyholes under X-ray-guided control.
New Bunion Guide for Patients
This new edition is without doubt an extensive tour de force of all thing’s bunion.
David Tollafield wisely teamed up with Dr Tim Kilmartin bringing together two experts with 60 years’ experience of caring for patients and fixing bunions. It’s fair to say few, if any, will have contributed more to the development of podiatric surgery and bunion correction in the UK. And what a result, this book leaves no stone unturned in helping patients understand what a bunion is, how to manage the condition themselves before delving into the surgical options, surgical risks and complications.