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By Jason Howells
Podiatrist Claire O’Shea has a holistic approach to working with diabetic patients.
They just have no sensation; diabetics continuously walk around like they are under anaesthetic. As a result I have pulled glass, tacks, a nail, and stones out of a patient’s foot. I found a baby doll stuck inside a shoe once; the hand embedded into the end of a toe. I had no idea how the patient was fitting their foot in as well as the doll.
We are the Regional Diabetes Service, which is an outpatient facility which has been up and running for three years. We have patients coming from quite far. Once a patient is identified with neuropathy, the practice nurse will refer to a primary care podiatrist, and if a wound is not healing or there is further deterioration in the blood supply they send them over to us for a review.
" Patients quite enjoy the setting because it’s not a normal hospital..."
Patients quite enjoy the setting because it’s not a normal hospital. They visit frequently with foot ulcers and you end up building up a nice rapport with them. We have about 40 patients come per week.
Most patients will present with a wound and I will do an assessment. I’ll then debride any dead tissue and then clean the wound, and get the wound down; then I deal with the appropriate dressing and send referrals to whoever else is involved, such as district nurses. We work closely with primary care. We also do rheumatology two and a half days a week for high risk patients.
It’s a nice feeling to see good progress in a wound, but it’s the hardest thing telling someone they are going to end up with an amputation. The Waikato region has one of the highest amputation rates in the country, and also in recent years there has been an increase in diabetes across the board.
The multidisciplinary clinic is also up and running once a week for two hours. When I first got here there was nothing like that set up; now there are six health professionals working together, and it’s good to see that develop and become a good service for patients. You can’t just look at a patient and think they have got just one thing wrong with them, particularly with an elderly population.
I have specialised in podiatry for 11 years. I enjoy the medical aspect of the clinic because you’re not just treating a foot you are treating a patient holistically. I enjoy my job, we are a good team, we have worked together now for three years; we know how it works and we get the job done. I see myself doing this for a quite a while, it still has lots of potential.