I saw this article the other day day and it struck me how I had never considered a situation like this arising.

Its amazing how much our everyday lives have changed and adapted throughout the varying stages of this covid crisis.

The last few years both our sons have transitioned to high school and each time were required to show evidence of their having been vaccinated. The list can be extensive, diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus influenzae type B (Hib), rotavirus, hepatitis B, measles, mumps, rubella, chickenpox, pneumococcal and meningococcal diseases, and human papillomavirus virus (HPV), some are required, while others remain optional. At each stage of their development we weighed up the pros and cons of these and based our decisions on the available research and real benefit versus risk.

A recent article I read discused the phenomena of “Tribilization” on the subject of vaccination for Covid 19 and how people can align themselves with one or other side of the debate and refuse to discus, investigate or more frighteningly even consider the conflicting notion. As difficult as it can be at times to remove fear and uncertainty from any decision making process its import to remember regardless which “tribe” we might fall into, we must continue to think and questioning. 

If our primary source of information comes from your search engine, be aware its primary goal is marketing. If you like dogs verus cats then all of the feeds from your search will actively stream more of what you "want", more dog pictures!. Thus its necessary and difficult to find non bias sources of data to broaden your perspective.

Our Staff have ALL been fully vaccinated for some considerable time now, we continue to perform our daily work observing full Covid in-office protocol. We do this because we have a large diverse patient group, some are not eligible for vaccination, some have significant systemic health issues and some choose not vaccinate. Aside from any personal reasons, our governing college has directed that these measures will continue for the foreseeable future.

For our staff this posses a considerable increase in physical and emotional strain so please remember the minor delays and inconvenience experienced during your visit or on the phone are aimed at your continued safety and protection.

Coming soon

This senario used to be a more common place occurrence in our clinics and emergency rooms across the country, thankfully of late, less so.

    Imagine you're suffering from the discomfort of a corn or a callous, browsing the isles of your local pharmacy you notice a product marketed as a "cure" for your corns. So, If it's sold on the shelves in the drug store its gotta be safe to use; Right?  Wrong!

Usually, somewhere further down on the box, in the unreadably small print, there is advice and qualifiers for the application of this medicated pad or liquid.  Needless to say much goes unread and unheeded. Normally these fall off, or wash off and with it some skin. This can bring some relief or little effect at all.  However, if left on for longer than intended, or applied to skin with poor sensation and/or poor blood supply the results can be catastrophic and in a blink of an eye.

This gentleman had applied corn pads to painful calluses under both big toes, seven days prior to his visit with us. Both came off after two days, one however had caused the tissue to ulcerate and subsequently he developed cellulitis (infection) in his forefoot thus requiring aggressive management. He noticed intense pain, oozing yellow discharge and swelling.

Fortunately when he called we happened to have a cancellation and a motivated receptionist (thanks Mel).

    He is in his 80s; diabetic, only one Covid-19 shot and thus very reluctant to visit the busy emergency department.  To boot, his first available doctors appointment wasn’t until late July.

Its easy to see from one foot to the other how dramatically different the effects can  be from the same medication on the same individual but different localized circulatory and sensory status.

Such lesions can be limb or life threatening if not managed properly and can take a considerable time to resolve completely.

These are difficult times so please check-in with those at risk and ask if they are worried about any health issues, even those that may seem minor or inconsequential.

Birthdays in the midst of pandemics dont really seam that much fun and its easy to get in a funk and try to let them pass quitely.

NOT HAPPENIN IN BRANTFORD!!!

This what I arrived to this morning. What a wonderful start to the day, and what a wounderful treat it is to work surrounded by kindness and caring. Thank you so much Mel and Nicole for the suprise and for lifting my spirits. Lots of delicious treats to try and get to if Melanie hasnt been too cruel with our schedule today.

The tibialis posterior, is a muscle found in the lower leg wrapping around the inside of the ankle and inserts into the medial aspect or the inside of the foot. It is one of three playing vital roles in postural stability, shock absorption and the structural integrity of the foot. Weakness in this muscle and its reduced ability to carry out its role,  is referred to as “Post Tib Disfunction”.

On occasion “Tib Post” may be congenitally absent, injured, ruptured, torn or plain old ‘overused’. The difficulty is that like a drowning victim, without help the situation predictable gets worse and ends in failure. Thus the urgent need for early detection and  identification to determine the source and extent of the injury. Without knowing the cause and extent we cannot advise an appropriate treatment plan.

Arriving in our offices the patients’ typically pinpoint the insertion of the tibialis posterior tendon as the focus of pain,  and the exact path of the tendon on the medial ankle or the generalized medial ankle and inside of the foot. Sometimes however they will be without pain and simply identify they have very flat feet or notice it has flattened over time.

Over the last 10 years we have seen a dramatic increase in juvenile and teenage cases of Post tib disfunction, often times in generally; healthy, average weight, well nourished, and active individuals. I mention the weight factor to illustrate that while yes obesity most certainly will be an additional complicating factor, it is not an identifiable cause for many in this group.

Physical examination, history taking and video gait analysis form the mainstay of identifying the condition.  The following image is of one of the simple tests we perform on potential cases where we ask the patient to stand on one foot while stabilized and rise up slowly onto the ball of the foot, for some this will be impossible or very challenging.

Treatment is often multifaceted with footwear advice and functional orthotic intervention being the essential components. Fortunately our clinical partners at Integrity Orthotics have come to our aid developing a custom orthotic devices capable of delivering the significant functional support these individuals require and doing so in a manner that is appropriate to the stage of development and severity of the disorder.

Many new clients suffering from this condition have sought treatment previously, arriving with collections of orthotics often times causing severe arch pain to be tolerable, or too soft rendering them completely ineffective.

To summarize, this condition is progressive and debilitating, reducing quality of life and affecting mental and physical well-being. The earlier a diagnosis is made, the more destruction and adaptation can be prevented.