Welcome to the Podiatry Arena forums, for communication between foot health professionals about podiatry and related topics.
You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members (PM), upload content, view attachments, receive a weekly email update of new discussions, earn CPD points and access many other special features. Registered users do not get displayed the advertisments in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!
If you have any problems with the registration process or your account login, please contact contact us.
Just to echo the above- I've had a couple of patients who've run about 10k distance within a day of needling treatment (not that this was part of the post op recommendations!) with no problems, so might fit into his training fine if it does become necessary.
Thuja, Banana skins, duck tape, garlic, walking around a yew tree widdyshins on a full moon, we've heard them all but my personal favourite told to me by an whithered old Russian woman with a face like slate hangers nail bag ... is:
1. count how many warts there are
2. get a piece of biodegradable RED cotton thread
3. tie granny knots in a piece of cotton thread - a knot for each wart
4. get a skinny twig and wind it the knotted thread around the twig
5. plant the bound twig in a flower pot
6. water regularly
7. warts disappear withing 30 days
As far as I can tell - it works as well as anything else!
MMMmmmm, I am sure this has all been said before - but why is one treating warts at all? OK, some hurt, and that might be a justification, but surely there is not valid rationale for treaing any other (Beneficence, Non-Maleficence etc)? Rob
__________________
Honorary Research Associate, Institute for Human Evolution, University of Witwatersrand
Adjunct Associate Professor (Human and Comparative Anatomy), University of Western Sydney
Fellow of The Centre For Human Biology, The University of Western Australia
"Please God, deliver me whole from Creationists......."
MMMmmmm, I am sure this has all been said before - but why is one treating warts at all? OK, some hurt, and that might be a justification, but surely there is not valid rationale for treaing any other (Beneficence, Non-Maleficence etc)? Rob
Rob:
When you have an athlete coming to you with a painful plantar wart under their 2nd metatarsal head preventing them from training or competing in their sport, what do you tell them, "I might be justified in treating your plantar's wart only if it ispainful"? What do you recommend otherwise for treatment since you said "that might be a justification". In my mind, pain is definitely a justification to treat this condition.
I know you are retired and not treating people any more, but remember, the term "beneficence" means "The state or quality of being kind, charitable, or beneficial." How is it being kind, charitable and beneficial to an athlete in pain when you tell them that their pain "might be a justification for treatment of their medical condition". To me, this type of language between the clinician and patient who is in pain when he or she wants to participate in the activity they love indicates an uncaring and arrogant attitude in the clinician, not beneficence.
By the way, Rob, when was the last time you were in podiatric practice??
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
When you have an athlete coming to you with a painful plantar wart under their 2nd metatarsal head preventing them from training or competing in their sport, what do you tell them, "I might be justified in treating your plantar's wart only if it ispainful"? What do you recommend otherwise for treatment since you said "that might be a justification". In my mind, pain is definitely a justification to treat this condition.
I know you are retired and not treating people any more, but remember, the term "beneficence" means "The state or quality of being kind, charitable, or beneficial." How is it being kind, charitable and beneficial to an athlete in pain when you tell them that their pain "might be a justification for treatment of their medical condition". To me, this type of language between the clinician and patient who is in pain when he or she wants to participate in the activity they love indicates an uncaring and arrogant attitude in the clinician, not beneficence.
By the way, Rob, when was the last time you were in podiatric practice??
I am not sure how to address this personal attack, especially by a member of the profession that I have long held in high regard.
Let us take each attack one by one. I last practiced in February, and am back at work again next week. My current work, apart from being a consultant to pod schools, is in psycho-geri - the sharp end of good.
In the pure dictionary sense, beneficence means: the doing of good; active, goodness or kindness; charity (a cut and paste from Dictionary.com). However, as we both well know, in the sense of medical ethics, it simply means "do only good"; and indeed, its anti-statement, "non-maleficence" means do no harm. But you knew that.
And, as I am sure you are aware, there is literature (though I am out of date) that provides evidence that "removal" of warts in kids removes from them the immunity that they may have derived from their natural progression. Again, I come back to beneficence and non-maleficence.
you may like to note that in my first statement, I made an exception for the person in pain, which, I guess, is making me wonder what the basis is for this personal attack? While I have commented on many occassions upon the ethics of treating asymptomatic warts, I have always made exception for that are symptomatic.
While tact had never been my strong spot, I do not retract my comments.
My final word is this, and I have alluded to it before; the Nurenburg defence is, sadly becoming more and more common. It is not a valid defence, and never will be.
Puzzled, Rob
__________________
Honorary Research Associate, Institute for Human Evolution, University of Witwatersrand
Adjunct Associate Professor (Human and Comparative Anatomy), University of Western Sydney
Fellow of The Centre For Human Biology, The University of Western Australia
"Please God, deliver me whole from Creationists......."
I am not sure how to address this personal attack, especially by a member of the profession that I have long held in high regard.
Let us take each attack one by one. I last practiced in February, and am back at work again next week. My current work, apart from being a consultant to pod schools, is in psycho-geri - the sharp end of good.
In the pure dictionary sense, beneficence means: the doing of good; active, goodness or kindness; charity (a cut and paste from Dictionary.com). However, as we both well know, in the sense of medical ethics, it simply means "do only good"; and indeed, its anti-statement, "non-maleficence" means do no harm. But you knew that.
And, as I am sure you are aware, there is literature (though I am out of date) that provides evidence that "removal" of warts in kids removes from them the immunity that they may have derived from their natural progression. Again, I come back to beneficence and non-maleficence.
you may like to note that in my first statement, I made an exception for the person in pain, which, I guess, is making me wonder what the basis is for this personal attack? While I have commented on many occassions upon the ethics of treating asymptomatic warts, I have always made exception for that are symptomatic.
While tact had never been my strong spot, I do not retract my comments.
My final word is this, and I have alluded to it before; the Nurenburg defence is, sadly becoming more and more common. It is not a valid defence, and never will be.
Puzzled, Rob
Rob:
No personal offense was intended and I am sorry that it came across that way especially to someone who has been a leader within the profession for so long.
I just thought that for you to say that treatment of a painful plantar wart might require treatment sounded rather like you meant that there is something else that an ethical podiatrist would otherwise consider offering this patient for this painful condition for his or her benefit and health. Since you said it only "might" require treatment, then this also means it "might" also not require treatment. I am puzzled, therefore, Rob, what are the other alternatives for the ethical podiatrist to consider for this patient in the way of treatment to try to eradicate this painful verrucae for him or her?
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
I too am puzzled, why do people get so aggressive, and so quickly online? Would you behave like that in conversation? How close to the surface is your boiling rage?
I too am puzzled, why do people get so aggressive, and so quickly online? Would you behave like that in conversation? How close to the surface is your boiling rage?
Whatever agression you may have seen, it is not mine. All cool, Rob
__________________
Honorary Research Associate, Institute for Human Evolution, University of Witwatersrand
Adjunct Associate Professor (Human and Comparative Anatomy), University of Western Sydney
Fellow of The Centre For Human Biology, The University of Western Australia
"Please God, deliver me whole from Creationists......."
I too am puzzled, why do people get so aggressive, and so quickly online? Would you behave like that in conversation? How close to the surface is your boiling rage?
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
I too am puzzled, why do people get so aggressive, and so quickly online? Would you behave like that in conversation? How close to the surface is your boiling rage?
Hi Elizabeth,
Not sure who you are addressing here, but I am genuinely pleased that you have decided to stick around. As I said before, the Arena has much to offer everyone. Personally, I have learnt a great deal from many practitioners here, which in turn has benefited my practice.
Your analogy of a conversation is a good one, presuming you mean face to face and in the same room. Now, I`m not trying to teach you anything new here, but remember that the spoken word is only a small part of effective communication. Much is conveyed through body language, gestures, facial expression, tone, etc, none of which are possible in text. I.E, when posts are written here, we do not have the luxury of inflection and short or precise posts can come across as curt, or even aggressive, when the posters only intention was to be direct. I know I`m guilty of this, probably from years of living with a South African who are notorious for their `directness` (remember Spitting Image)
I guess what I`m trying to say is that not all direct posts here should be perceived as aggressive or rude. Often the poster is being straight or maybe just short of time to construct a considered post. They may also write with the same conviction as you when you wrote;
Quote:
Originally Posted by Elizabeth Humble-Thomas
As I said a while ago, treating verruccae is all smoke and mirrors..
This could be taken as a sweeping statement without evidence at best or aggressive at worst and that is not a criticism of you by me, just an observation of how posts can be misread by the beholder.
MMMmmmm, I am sure this has all been said before - but why is one treating warts at all? OK, some hurt, and that might be a justification, but surely there is not valid rationale for treaing any other (Beneficence, Non-Maleficence etc)? Rob
Hi Rob,
I agree that the majority of painless VPs do not require treatment, particularly in children as evidence suggests that spontaneous resolution is relatively high in comparison to adult patients.
However, I would also consider intervention if the lesion(s) interfere with their quality of life (QOL), whether that be through pain, altered gait or even if the pt perceives their QOL to be compromised due to cosmetic embarrassment. That said, I always explicitly explain ALL treatment options, including no treatment and the risks and benefits of each.
I have never said anything which differs from all the latter comments; in any of my postings - right back to the MacDonald and Kidd paper (of about 1998, admittedly not about warts, but was about the ethics of intervention), we never said "you should not"; we merely asked the question "are you sure that you should?". There in lies the differences between the reflective and the non-reflective practitioner. While Dr Kirby quite rightly points out that I am now sort-of retired, that does not mean that I have laid down. Rob
__________________
Honorary Research Associate, Institute for Human Evolution, University of Witwatersrand
Adjunct Associate Professor (Human and Comparative Anatomy), University of Western Sydney
Fellow of The Centre For Human Biology, The University of Western Australia
"Please God, deliver me whole from Creationists......."
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
I have never said anything which differs from all the latter comments; in any of my postings - right back to the MacDonald and Kidd paper (of about 1998), we never said "you should not"; we merely asked the question "are you sure that you should?". There in lies the differences between the reflective and the non-reflective practitioner.
Indeed.
Quote:
Originally Posted by Rob Kidd
While Dr Kirby quite rightly points out that I am now sort-of retired, that does not mean that I have laid down. Rob
And I, for one, am glad you have not been put out to pasture. You are one of the practitioners to which I referred to as learning from and improving my practice.
Can I ask if anyone knows or has any experience of treating verrucas with cryo spray 59 ???
its a spray can with a long tube attached - the idea is to put semi compressed felt on the verruca, and then to apply one minute bursts of cold through the felt - six times according the the instructions
and if anyone know, or has used this product...do i have to anaesthesize the foot? ie is it too painful without
Yes I have used that system for a long time and I have to say the cryogen used is painful in application.
Mr Isaacs was at my surgery and ( as usual) keeps interfering with things he dosent know anything about because he works in the NHS who are not that advanced and picked up my cryo 59 and self tx his forearm.
For the next 3 days I got texts ( with pictures) of the blistering and moaning from him and suggestions "only vets use this its so strong"
BUT
yes it works no better or worse than any other cryogen ( when used properly) and if you want to give LA .....I dont personally because I want the patient to tell me when enough is enough to remove the chance of pereosteal burns / excessive tissue damage then that is your clinical judgement.
Hope that helps
Cheers
D
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
Re: Preferred Method for Treating Verruca
)
and picked up my cryo 59 and self tx his forearm.
Linear Mode
