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Robin



My experience is quite the opposite to your impression. SoCaP welcome new associate members and have the same use and access to facilities and benifits. (except for some voting rights) In my opinion you get more of everything and of a higher standard than other associations. Further education and CPD is more regular, more accessable, cheaper, CHEAPER, and of a higher standard,(and Cheaper) generaly speakers and lecturers are proffesors, doctors or consultants. Two Journals, Have you read BJC or Podiatry Today journals and compared them with with other magazines. Option to pay fees by direct debit, higher insurance cover. Kept well informed of coming events by Journal, mail and email. (and they are cheaper) I've said cheaper so many times it not even a word any more!!
The whole organisation is just much more professional. You should try it out.
You won't feel 2nd class unless you want to (your mind makes your world).
You can also subscribe to JAPMA without joining APMA. Have you read this journal? When you have compare it to your current publication and let us know what you think. Leave Smae, or not, but join SoCaP I think you'll be glad you did. Once you have done a LA course you can join as a full member provided you are HPC registerd, which also applies to the former.

Cheers Dave Smith

Just a small correction.

If you are on the HPC register you can become a full member you do not have to have your LA certificate any longer.

However you do get the opportunity to obtain it and as Dave pointed out CPD is cheap for example at Branch level in Kent at least you will pay £10 membership and you can attend 10 evening meeting a year for free and you get a siginifcant discount on already very reasonable day long courses of which we have around 6 annually. I am sure other branches are similar we are not profit making ventures.

Akbal

"If you are on the HPC register you can become a full member you do not have to have your LA certificate any longer."

Now you tell me, when I've just had 2500 cards printed with AChS.

There is another benifit of joining SoCaP and that is you can only get BUPA referrals if you are BUPA registered. One of their criteria for registration is to be a MChS.

When I was a Hyperbaric paramedic and life support technician I had very proficient training in LA and lots of other procedures involving inserting foriegn bodies and puncturing people, mainly divers, (however it doesn't count for podiatry purposes) but I didn't wish to make nail surgery a part of my service. I just refer to another practice. What percentage of your turnover is nail surgery that requires LA.

Cheers Dave

if you really want to join then join put your cards through a few doors 2500 will not go very far anyway the resulting business will pay for the new cards you have to print and probably your membership.

LA can be used for more than nail surgery and it does make other procedures more comfortable for your pt's.

It's up to you ultimately, I am certain you will make the right choice for you.

Akbal,

>>LA can be used for more than nail surgery and it does make other procedures more comfortable for your pt's.<<

I've just finished the 2nd yr of Pod degree and we have done LA's this year. Nothing has been mentioned re LA use for 'other procedures' and I am intrigued. Can you please tell me more?
Thanks

LA can be used for other minor surgical proceedures such as minor skin surgery, ie removal of VPs, skin tags, Neurovasc HDs, and is of course vital if you wish to go on to qualify as an FPodC (surg).
I am surprised that LA wasnt mentioned in conjunction with other surgery. It is a useful adjunct in clinical practice when used correctly.

LA can be used diagnostically where a 'mental health' issue may be considered to the cause of the pain. Also in the musculoskeletal fieds it can be used to 'disable' the nerve innveration to a muscle such as in peroneal spastic flatfoot to enable casting or to switch off a muscle that is causing an antalgic gait that is in itself pathological. There are courses that teach the above.

Phil

A better injectable drug used EXTENSIVELY in paediatrics to 'disable' innervation to specific muscle groups is Botox. You dont need to use as much. This is used especially in CP. where the patient may have a plantarflexed, foot with severe muscle tone, needing serial casting to extend the rear compartment (ie triceps surea). used with AFOs and plaster casting techniques.

This is the 'medical' use for Botox rather than the cosmetic use to 'treat' lines!!

Rob

Can we get access to Botox and is it evidence based?

Cheers

Phil

Robby & Phil

Thanks very much for answering my post. Basically we get taught digital blocks and that's it. I gather that if we want to be able to ankle block etc then we will have to gain that 'bolt on' after we qualify. No mention has been made re innervation or the other uses mentioned here. I can feel some research coming on :)
Thanks again.

Where can we obtain more information on the use of Botox, and who can we purchase it from?

Botox is more than evidencre based. It has been passed by NICE for years for use with paeds in the treatment of CP muscle spasm for serial casting. It is a standard treatment. The logevity of action means than it can be used in VERY small doses, the usual length of action on nevres is up to several months dependant on the dosage. VERY small doses last for much shorter time scales. The drug is licensed for use in this manner.

As pods we CANNOT buy this drug it is not on our standard list of POM drugs that we can use. However if we are working in a Musculoskeletal capacity as an EXTENDED scope practitioner then we can use other drugs not on our list under the 'supervision' of a consultant.
Kitos I was under the impression that ALL undergrad LA courses cover ankle and knee blocks as standard I certainly did when I qualified many years ago. We did both as part of our standard course.

Robby,

>>undergrad LA courses cover ankle and knee blocks as standard <<
Maybe they do at some Uni's but not down here. My mentors on placement were also suprised that we are not taught them either. Doesn't make sense to me I must say but until the Society gets their act in gear and suggests/dictates a standard course across the board .......!!

Thanks for the info re Botox...very interesting and such a change to hear it being used for something other than straightening out wrinkles.

Makes interesting reading in BNF. Thanks again for the info.
Kit

The NICE guidelines for Botox use only cover its use in CP not for any other podiatric use at the moment.
It does seem a good idea to use it for other conditions but until then, I think it is more appropriate to use LA's .

phil

Robby et al

In the past I have enquired with other SRCh SoCaP pods in the area to refer a patient for treatment for a neuro corn or other painful condition. Expecting them to use LA but they replied that they did not use it for these minor ailments. So obviously it is not common to do this.
I use an electronic local analgesia machine, which works well on some but not so well on others.

Dave

David, and others…

Before I started doing ankle blockade regularly I was hesitant to use LA to treat those painful NV corns… and I guess it would be the same for other Pods whose main experience is digital.

Tibial blocks hurt more if done incorrectly and have a higher failure rate… when I trained in ‘86 we were shown the ankle block but it was 2 years before I had a go myself – it failed! It took me a while to develop even half decent technique, which would have taken longer with an audience!!

Ian Reilly

PS – other uses of LA done within the last week:
A sinus tarsi block – pain relief
Differential diagnosis of ??? Morton’s
Peri-incisional neuroma post surgery (distension)

Botox is licensed for use in CP and also for the treatment of hyperhydrosis.

Hyperhydrosis commonly presents in Podiatry clinics, maybe we need to be looking to extend our POM's range to include Botox.

I will not go into other uses of LA as it has been covered already.

On the subject of converting to the Society of Chiropodists and Podiatrists, putting aside value for money which must be easy to see and has already been pointed out in a previous posting. The Society is the only organisation which neither commercially trains or at least promotes foot health ''professionals". Both the training or the promotion of this new separate "profession" is confusing to the public and negates the whole ethos of having a register, in particular when organisations claiming to represent podiatrists are, in effect, undermining them by overtly supporting a system which will eventually put the legitimate profession back to where it was before the advent of the HPC.Supporting such organisations is akin to professional suicide. May I assure those previously unregistered and eligible for Society membership that they will be welcomed and in no way treated as second class citizens as has been previously suggested.

Jack Golding