PodChatLive is the monthly live show for the ongoing professional development of Podiatrists as well as other people who might be interested in the range of topics that they cover. It is hosted by Craig Payne from Melbourne, Australia and Ian Griffiths from England, United Kingdom. The stream goes out live on Facebook and after that is later uploaded to YouTube. Each live episode includes a different person or selection of guests to discuss a unique area of interest every time. Questions are answered live by the hosts and guests during the livestream on Facebook. There is also a PodCast recording of each episode found on iTunes and Spotify and the other common podcast options. They’ve developed a large following which is growing. PodChatLive can be considered one of the ways in which podiatrists might get free professional development hours.
In episode eight, they talked about the developments in the pain sciences and the complexity of pain with the physiotherapist and pain educator, Mike Stewart. It became clear that it is crucial for us to understand pain better than we have historically and clinicians need to develop the skills to effectively communicate this to their patients. The discussion concluded that pain is a personal experience. It is an output of the brain in response to real or perceived danger which has the goal of protecting us and getting us to modify our behaviour. Pain is contextual and is influenced by numerous factors. Mike Stewart is a physiotherapist who works as a Spinal Clinical Specialist for East Kent Hospitals University Foundation NHS Trust in the United Kingdom. He works full-time as a clinician with over fifteen years of experience managing complex, persistent pain conditions. In addition, Mike is a dedicated practice-based educator committed to providing evidence-based education to a wide variety of health professionals, including podiatrists. He is currently undertaking an MSc in Clinical Education at the University of Brighton in the UK. Mike runs the Know Pain courses around the world.
Foot problems in those with diabetes is becoming more serious and almost reaching epidemic proportions. The reason for this high number of foot problems in those with diabetes is because the diabetes affects the nerves and the circulation to the foot. In the nerves there is reduced sensation, so that when damage is done to the foot it is not detected or felt. With regards to the circulation, this is quite substantially reduced in those with diabetes. Put these two together and it means that damage is not detected so it is generally much more severe by the time it is seen, and because of the circulation the healing from that damage is poor. This means that wounds and sores in those with diabetes easily get infected and can be quite severe. In the worst case this may even mean an amputation because the wound will not heal. Those with diabetes need to take considerable care of their feet to, firstly, prevent these problems and then, secondly, if a problem happens to detected promptly so it can be given attention.
In order to protect the foot those with diabetes need to have good fitting shoes so that damage is less likely to happen. They need to inspect the foot every day for any damage that has happened. It is also advised that those with diabetes regularly see a podiatrist to have the foot checked and any potential problems dealt with. There are a number of things that people with diabetes can do to check the sensation, such as the Ipswich touch test. The Ipswich touch test involves lightly touching the end of the first, third, and fifth toes to see if the finger touching the toe can be felt. If you cannot feel a finger touching the end of the toe, then you are considered to be at quite a high risk for the development of foot problems and need to put all the precautions in place to prevent these from getting any worse or happening in the first place.