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So you may remember I've had issues with my foot for the last 18 months, an ulcer became infected, almost lost my big toe and the ball of my right foot, but didn't. Win for me, you may think... Except its kind of been a score draw at best, as despite going from having an 8 inch hole in my foot to the tiniest little nick, its that little nick the wont heal, or rather will heal for all of a week, 2 at most, before breaking down again. That's been the situation for the last year now and It's beginning to grate, because I'm not able to get out on the bike much, or do anything where I'm on my feet for long which is driving me mad, and making me fat to the point that I'm having to buy new clothes to save embarrassment.
I've been seeing the NHS podiatrists pretty much every week since the issue arose, and every week they do the same thing, take off any dead skin, pad up the bottom of my foot to offload the ball of it, maybe change my insole, and make an appt for the following week, or fortnight if I'm lucky. This can't continue. Is it worth finding a private podiatrist who can wave a magic, if pricey, wand to fix me and does anyone have any recommendations ideally in the Leeds area, or will they just do the same as the NHS, but charge me for the privilege?
If there was an option to cut the damn toe off, I'd take it, but now it's 'healed' they won't. (even more annoying, as it was my protestations that lead to them saving the toe at the time, the surgeons wanted to lop it off.)
A second, specialist opinion can't hurt would be my view.
choose your podiatrist well.
A second, specialist opinion can’t hurt would be my view.
Yeah, that's what I'm thinking.
Can I ask have been checked or do you have diabetes?
Only for the last 27 years 😉
Ah! Thought that might be part of it.
Yeah you could try a private provider, they may have a different idea for treatment but so would another NHS provider. If it was me and I was that pissed off I’d go private too.
YMMV. They lost my records lately so still waiting. I’ll spare you tales of the last 23 years of rubbish (non-)treatment. Following an accident and subsequent arthritis I lost a good portion of foot health and function, so much so that it has been disabling, career-ending. Also stopped me completing the MTB leadership qualification, and from taking driving lessons. I (was) pretty bitter about it. I did see a private podiatrist early on and they were amazing, thorough, yet couldn’t help at the time owing to severe inflammation. If could have afforded it later on I would have gone right back there. I learned a lot via self-care and physio instruction from youtube.
Best of luck, it seems a lottery on the NHS as much as I support it the service seems to have been (no pun) crippled by successive underfunding and messing about. Plan for success. Act soon. Buy good care if you can. Aren’t open wounds are a slightly different thing, surely you need specialist wound-care for that?
I would think you will find few private podiatrists with the necessary expertise - but having said that I find NHS podiatrists who we use for advice on that sort of thing very ritualistic and behind the times in wound care.
It cannot do any harm tho to try to find one.
Edit - I have used both. The private ones were not brutal enough in cutting back the dead skin to open up the blisters way deep, the NHS ones did not take as much care in getting a smooth finish! ( feet with huge amounts of callous and corns!)
There was a private podiatrist on here, based in Plymouth. Maybe he’ll be along and can comment.
I’ve recently had experience of private podiatrists.
My 10 year son had foot problems the nhs didn’t seem to be able to sort For months, 2 Private appointments later he’s fixed so I would say definitely worth making an initial appointment to see what they say.
I would think you will find few private podiatrists with the necessary expertise – but having said that I find NHS podiatrists who we use for advice on that sort of thing very ritualistic and behind the times in wound care.
It sounds like he’s struggling to find an NHS one with the necessary expertise. Certainly a lot easier to phone around and chop and change private provider until you do find someone who seems to have what you need. I’ve limited experience of private podiatrists and none of NHS ones, whilst Mrs P has minimal NHS ones and no private... if you can afford to go private it would be a no brainier for me. The two I have used in the last 15 years were previously NHS people who were casualties of cut backs but who can now spend longer per patient than a high throughput service is designed for.
So, update. Emailed a couple of private clinics and they don’t want to know, point to the NHS as soon as I mention ulceration.
My plan now is to simply start riding more regularly. My thinking is either the foot will cope and stay the same or get better, increased bloodflow and all that. Or it will get worse, and off it gets worse they will cut the bad bits off. I like riding my bike more than having 10 toes (I’m not lactose intolerant, y’see), so I’m fine with that.
I tell my podiatrist this and she dampens my enthusiasm somewhat by explaining that if any infection gets in and goes really wrong, or doesn’t get caught in time, they may have to amputate below the knee (!).
Meet my friends, Rock, and Hard Place. They’re dicks.
Is your podiatry thru the diabetic foot clinic? Any chance of a referral to a surgeon to " clean it all out" ? sounds to me its healing over underlying infection but not really my area of expertise
So the answer is no.
Hope you get something sorted though.
Is your podiatry thru the diabetic foot clinic? Any chance of a referral to a surgeon to ” clean it all out” ? sounds to me its healing over underlying infection but not really my area of expertise
Yeah.
Bin dun... Last surgery was to remove the joint, flush everything out and replace with antibiotic beads. Had numerous X-rays and MRIs since. Pretty sure there’s no infection there as it’s been 18 months since that surgery, with no symptoms.
Nowt else to suggest bar trying to find someone else with good wound expertise who might be able to suggest something in the way of dressings that might help
There are devices out there designed to promote healing of foot ulcers (CE-marked antibacterial gel/ light treatment, coated bandages etc).
These may help to get the nick to finally heal - and I would consider searching for a podiatrist prepared to use such devices beyond NICE-approved standard treatment.
(Disclaimer: Completely unqualified beyond writing clinical trial protocols and study reports in this area. And I see the NICE guidelines were updated just last week).