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CASE NOTES
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PROGRAMME INFO |
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Dr Mark Porter gives listeners the low-down on what the medical profession does and doesn't know. Each week an expert in the studio tackles a particular topic and there are reports from around the UK on the health of the nation - and the NHS.
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Contact Case Notes |
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LISTEN AGAIN Ìý30 min |
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PRESENTER |
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"I spend half my week practising medicine and the other half writing and talking about it as a GP in Gloucestershire. Working on Case Notes has been a boon for both me and my patients. One of the principal aims of the programme is to keep our listeners up-to-date with the latest developments in healthcare, and to accomplish that I get to interview a wide range of specialists at the cutting edge of medicine. A rare privilege that ensures our listeners aren't the only ones to learn something new."
Mark Porter
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PROGRAMME DETAILS |
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 Full programme transcript >>
Feet
They contain a quarter of all our bones. And produce up to half a pint of sweat a day.
Yet we rarely give our feet a second thought. Until, that is, something goes wrong with them … when it can be difficult to think of anything else.
In this episode of Case Notes Dr Mark Porter investigates your foot problems from ingrowing toenails and verrucas, to flat feet, Morton’s Neuroma and bunions, with podiatric surgeon Emma Supple.
Sweaty Feet
Mark talks to cosmetic medical practitioner Dr Eric Toni who uses Botox injections to provide long-term relief to patients with hyperhidrosis, or excessively sweaty feet.
The botulinum toxin blocks the transmission of nerve impulses to muscles and is used to treat muscle spasm in conditions like cerebral palsy, and melt away frown lines and crow’s feet in people worried about the ravages of time.
But it has a similar effect on the nerves supplying sweat glands – basically it switches them off for up to a year.
The injections are made into the surface layer of skin and around 15-20 are needed to "cover" the foot.
Dr Toni uses iodine and starch to reveal the location of the sweat glands and the treatment lasts on average around 7 months. It's not normally available on the NHS and costs around £500 per treatment.
Plantar Fasciitis
Plantar Fasciitis is the foot equivalent of tennis elbow and the most common cause of heel pain. But what is the best way to tackle it?
Often the condition gets better on its own or anti-inflammatory drugs are prescribed to ease the pain.
Podiatric surgeon Steven Kriss has a special interest in the condition – which affects around 10% of all the people he sees in his clinic at West Berkshire Community Hospital.
Steroid injections can be used to treat it - but he recommends that no more than 2 or 3 injections should be tried.
Other treatments can include putting the leg into plaster for a while to immobilise it, but often the pain returns once the plaster is removed.
If none of this works,ÌýSteven Kriss can carry out a fasciotomy, where the inside band of the fascia is cut.
There is a small risk of some collapse in the arch of the foot but he has not seen this in any of his patients.
Arthritis
We hear from Dr Tricia MacNair about an operation to treat her arthritic big toe, a condition known as hallux rigidus.
From x-rays her surgeon Anthony Sakellariou could see small bony spurs, which irritate the soft tissues in the joint.
In her particular case there was also arthritis within the joint - so the surgeon created tiny microfractures, which caused bleeding and clots, forming a "false" cartilage to cushion the joint.
Physiotherapy is essential after this type of operation - including putting up the feet, using ice packs and wiggling the toes.
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