agnesian healthcare know & go friday, march 2017: podiatry & health shoppe
TRANSCRIPT
Presentation Outline Introduction
Robert Bertram, DPM Sarika Parikh, DPM
What is podiatry? Common foot and ankle issuesDiabetes and diabetic foot careAgnesian Health Shoppe Questions
What Is Podiatry? Podiatry, or podiatric medicine, is a
specialized area of medicine dedicated to the diagnosis, treatment and prevention of diseases and disorders of the foot, ankle and lower extremities.
Foot/ankle anatomy is complicated 26 bones, 33 joints, 100+ ligaments,
19 tendons Many areas that can become an issue
Common Foot and Ankle IssuesPlantar fasciitis (heel pain)Achilles tendonitisBunions/hammertoesFlatfeetArthritisDiabetic foot care (corns, calluses, toenails)
Plantar Fasciitis Most common cause of heel pain in adults Typically due to repetitive or excessive stress on the foot Symptoms
Gradual onset of pain at bottom of the heel Worse when taking first steps in the morning or after
prolonged sitting Conservative treatment: Shoe
inserts/orthotics, stretching, appropriate footwear, NSAIDs, rest, ice, other (physical therapy, injections, etc.)
Surgical treatment
Inflammation often caused by repetitive stress on the tendon
Achilles tendon runs down back of lower leg
Symptoms: Aching, stiffness, soreness or tenderness within
the tendonTreatment: RICE, physical therapy, stretching
exercises, orthotics, night splints/custom bracing
Achilles Tendonitis
More than just a bump Reflects changes in the bony structure Big toe leans toward second toe, misaligning the bones
Progressive - gets worse and bump is more prominent Symptoms
Pain or soreness Redness and inflammation Burning or numbness Difficulty wearing certain shoes
Treatment Conservative Surgical
Bunions
Hammertoes
More severe cases - open sores
Treatment Conservative Surgical
Abnormal bend in the second, third, fourth or little toe
Bend in the toePain/irritation when wearing shoesCorns and calluses Redness and inflammation
FlatfeetStructural abnormality leading to abnormal
foot alignment/positioningProgressive weakening of supportive structures
and gradual collapse of the archConservative treatment: orthotics, bracing,
functional supports, physical therapySurgical treatment: reconstructive procedures
to recreate arch of foot
Arthritis Most common in the mid-foot, big toe or ankle Inflammation of the joint - breakdown in joint
cartilage Symptoms
Pain and stiffness Swelling in or near the joint Difficulty walking or bending the joint
Treatment Conservative - shoes, boots, bracing, orthotics Surgical - joint fusion or joint replacement
Diabetic Foot CareElevated blood sugars damage nerves, blood
vessels, joints, skinVascular diseaseNeuropathyUlceration InfectionGangreneAmputations
Diabetic FactsNumber of people with diabetes has risen from 108 million
in 1980 to 422 million in 2014.Global prevalence of diabetes among adults over 18 years
of age has risen from 4.7 percent in 1980 to 8.5 percent in 2014.
Diabetes prevalence has been rising more rapidly in middle- and low-income countries.
Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
Why Screen the Diabetic Foot?15 percent of people with Type I and Type II diabetes will develop one or more foot ulcers in their lifetime.
10 percent of these will go on to have a major lower limb amputation.
Of all non-traumatic lower limb amputations, 85 percent are due to diabetic foot ulcerations.
Foot Care Tips Check your feet every day
Look at your bare feet every day for cuts, blisters, red spots and swelling
Use a mirror to check the bottoms of your feet or ask a family member for help if you have trouble seeing
Wash your feet every day Wash feet in warm, not hot, water Dry feet well; be sure to dry between the toes
Keep the skin soft and smooth Rub a thin coat of skin lotion over the tops and
bottoms of your feet, BUT NOT BETWEEN YOUR TOES
Foot Care Tips, cont.Wear shoes and socks at all times
Never walk barefoot Wear comfortable shoes that fit well and protect your feet Feel inside your shoes before putting them on each time to
make sure the lining is smooth and there are no objects inside
Make sure the shoe fits properlyTake care of your diabetes and try to be more active
Work with your healthcare provider to keep your blood sugar within a safe range
Plan a physical activity program with your healthcare provider
Footwear Tips Type of shoe Proper fit Shoe wear, patterns of
wear Lining wear Foreign bodies/objects Insoles, orthotics
Agnesian Health Shoppe How does podiatry work with the Agnesian Health
Shoppe? Diabetic/therapeutic shoes Compression stockings Over-the-counter shoe orthotics Walkers Crutches Roll about knee scooter Wheelchair Surgical shoes/boots
Services Sleep management Home oxygen Women’s health Mobility and home
access Diabetic shoes Retail DME shop
Wound care Re-supply program Repair and service Benefits Additional products
Sleep ManagementSleep Management Program
Respiratory therapists on-site Four full-time respiratory therapists Technicians on-call 24/7 Flexible schedules to meet patient’s needs
Patient education and exceptional compliance
Re-supply program for masks and supplies Direct mailing to patient’s home
with permissionRetail products, such as pillows
and wedges for sleep comfort
Home Oxygen Home Oxygen program consists of:
Respiratory therapists and certified delivery technicians Provide home delivery at set-up and 10
tanks per month Provide education on proper use of
equipment and supplies Our team has many years of experience and
have established relationships with our customers providing a sense of security and compassion.
Strive for same day service, on-call 24/7 Respiratory therapists available for
consultation with patients and their providers
Women’s HealthPost mastectomy supplies,
including: Breast prosthesis, bras, swimwear, fashionable
scarfs and head coverings, wigs
Mom and baby products Medela and Ameda Breast pumps and supplies Earth Mama Angel Baby skin care products
Compression garments Ready-to-wear and custom fitted (for both genders) Two certified compression and mastectomy fitters
with a licensed registered nurse on staff
Private fitting rooms - call for appointments
Staying Home SafelyFalls inside and outside are the number one
cause of injury among the elderlyStairs lifts assist in climbing the stairs
More access to your entire home Funding sources available
Wheelchair ramps provide access into your home or garage
Vehicle ramps provide easier transportsFree home assessments for safety, equipment
and home modifications
Mobility & Home AccessTwo nationally-certified assistive technology professionals
(ATP).Work with patients and providers to ensure proper
equipment is built to fit the patient’s needs, home and lifestyle.
High-end custom specialty mobility devices and equipment including:Power wheelchairsPower liftsScooters
Diabetic/Therapeutic ShoesComplete Dr. Comfort line of diabetic and
therapeutic shoes, inserts and socks.Full-time certified associates dedicated to
assisting customers with their orders for shoes and inserts.
Medicare and most private insurances will cover one pair of shoes and three
pairs of inserts per year for qualified diabetic
patients.
Lift ChairsFor patients who have trouble getting in and out of
living room furnitureAvailable in a variety of fabrics to complement décorProvides safety and independenceMattresses and covers for sleepWide range of styles, colors and priceDelivery and set-up providedHydro-lift product for any surface
Retail DME ShopDME specialists assist with in-home medical
equipment and supplies, and third party reimbursement for private insurances and Medicare Expanded cash and carry product lines Exercise equipment – Zone recommended Pain management products Dietary supplements & chiropractic recommended
products Podiatry orthotics and bracing
Ambulatory aids, bathroom & bedroom safety
Wound Care Registered NurseRegistered nurse on-site working with patients and
providers on wound care supplies and reimbursement. Answers questions Product education Liaison for patient as it relates to
reimbursement Works hard to find products that will be
covered Conveniently located next to the Agnesian
Wound Care Products delivered right to the patient’s home
Re-Supply ProgramRe-order program with trained specialists:
Place monthly reminders to patients for supplies for CPAP, ostomy, wound care, urological, enteral or incontinent products
Monthly and quarterly reminder callsNever call a patient without permissionNever ship product without speaking to the patient
Repair & ServiceOn-site maintenance of all rental equipmentRepair of purchased power mobility devices,
wheelchairs, lift chairs and motorized scooters