Regular Articles
Shingle Bells Don’t Get Caught
Christmas is about family, having fun with grandchildren, singing carols, unexpected presents, laughter, and overindulgence. On Boxing Day, I felt a peculiar sensory tenderness around my left thigh. There was nothing visible, but the sensation was quite uncomfortable. Analgesics merely subdued the discomfort.
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 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.
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.
The Foot Health Practitioner
From time to time, those who have trained and established foot health services have faced challenges because, outside the HCPC, there is no register other than a submission to a voluntary FHP register RFHP. As a parallel argument for accountability, foot surgery developed by podiatrists caused an equal sense of rebellion from traditional medics, largely orthopaedic surgeons. When podiatrists felt an equal sense of injustice that a less rigorous course mimicked their three-year training and hard work, there was a certain irony. In the case of those known as podiatric surgeons, the HCPC provided a register of those annotated, affording not only standards that needed to be met but also accountability post-2015. The comparison between surgery, surgeons and FHPs ends there because the scope and risks are not in the same league.
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!
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.
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.
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
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