Fungal Nail Infection – 5 questions to ask anyone providing Fungal nail treatment

Blog, Fungal Nails, General Podiatry, Ingrown Nails

Fungal nail infection treatment options are wide and varied; there are several different options anywhere from prescription medication to over-the-counter paints and ointments and also several laser light treatments. In particular Thermal laser has become one of the gold standards for treating patients with fungal nail infections. Dr Brenden Brown, Podiatrist in Penrith, talks about fungal nail infections and 5 questions to ask anyone providing Fungal nail treatment.

Not all lasers are the same, and in particular, we are talking about Thermal laser. This laser uses both the laser light spectrum but more importantly, the temperature increase occurring in the nail bed, which is highly effective at killing both the live fungal infection and it’s smalls or eggs.

Fungal infection and spores cannot live when exposed to temperatures above 40°C Celsius.

Fungal-Nail-Infections-5-Questions-to-Ask-Your-Therapist

Fungal Nail Infections just love feet. Proper care needs to be provided to stop reinfection

Are Fungal Nail Reinfection Rates High?

An issue that occurs with fungal nails is the highly contagious nature of the fungal infection is meaning that it is both easy to contract and, despite having a successful treatment, easy to re-contract after your therapy – leading to high levels of reinfection without proper care and advice

Fungal spores are invisible and are not seen when living in nails. Any evidence of fungal infection on a toenail is the result of a past infection. What you are seeing when looking at the yellow or brown discolouration is the area that has essentially been attacked by the fungal infection.

Are Fungal Nail Spores Invisible?

The eggs that are produced by the fungal infection are completely invisible; they will often live in the other toenails and on the skin surrounding the nails with no evidence whatsoever. Be warned that if you do not treat these, they will simply wait till the treatment is completed on the nail you are treating and because the two toes are in such close proximity to will simply transfer across to the freshly treated nail

Is Thermal Laser advanced treatment the Answer for Fungal Nail Infections?

As a foot doctor or podiatrist with more than 24 years experience, this is one of the most frustrating conditions to deal with. Fungal Nail infections are notoriously difficult to beat.

In 2014 I travelled to the United States to investigate the emerging thermal laser treatment protocols. After this trip, I returned to Australia and introduced the thermal laser technology we now use in our clinics and now numerous others across Australia

As I am highly involved in this area, these are the questions I would ask before undertaking treatment with any clinic!

Here are 5 questions to ask any clinic before undergoing treatment for fungal nail infections.

1) Why is the clinic only treating one nail?

As I have explained fungal infection is are incredibly contagious and also riotously difficult to eradicate. The spores regularly live on at least 3 to 4 nails on each foot, despite the fact that these cannot be seen, it is estimated that there is a 97% chance that the other nails have live spores infecting them!

Treating one nail only that being the nail that has obvious signs of the past infection is most would suggest a guaranteed way of not successfully treating this condition

2) How does a patient treat the unseen fungal nail infection?

All clinics should address with the patients they see a number of after-care steps this includes eradicating the unseen spores that are living in numerous other areas, these include on your skin, in your shoes, in your socks, in your shower and living areas. Ask the clinic treating you how they suggest you Address these areas.

3) What system does the clinic have to keep the Fungal Nail Infection at bay?

It’s fine to treat the infection while you are there but what after-care is the clinic suggesting do they have a thorough after-care protocol for patients to undertake. This is a highly contagious infection and to think that it only resides on the nails is either misinformed or naive.

4) What treatment do they advise for current footwear?

It is almost 100% positive that patients with fungal nail infections will have spores living inside the shoes, that they have been wearing while they have a fungal nail infection. If a clinic does not suggest patients should treat footwear that the client has been wearing, I will put forward they do not entirely understand how to manage this incredibly contagious condition. Find another clinic!

5) Are all Fungal Nail treatments the same?

Since later therapy for fungal nails was introduced to Australia, there have been a number of clinics add this technology as a way of increasing clinical turnover.

Unfortunately, they do not completely understand the condition or understand how to reduce the very high reinfection rate.

There is no way to prevent reinfection completely; however, without a significant Plan put in place it is almost a certainty that after treatment, it will quickly return. For this reason, it is important to ensure the clinic that is treating you has a thorough understanding of how to reduce this reinfection rate and to assist patients in beating this nasty condition.

How can we help?

We have treated thousands of patients with fungal nail infections literally. As one of the first clinics to introduce thermal laser technology, we are pioneers in the field and with this extensive experience have developed treatment protocols to overcome many of the problems surrounding the reinfection of nails. Yes, we think we are pretty good at beating this!

Our Doctors all fully qualified Podiatrists have extensive hands-on experience treating fungal nail infection.

Where to from here?

If you are serious about beating fungal nail infection and then the quickest and most effective way is to call our clinic on 9673 2987 we are based in western Sydney, with patients travelling from all over New South Wales to have this treatment due to our team’s profession leading experience.

Our helpful front desk team have spoken to thousands of people with fungal nail infection and will help guide you through the suggested process and guide you to the best laser package for beating this.

Why you’re not getting better and what you can do about it

Blog, Fungal Nails, General Podiatry, Growing pains, Heel Pain, Ingrown Nails, Kids Feet, Shockwave

Why You’re Not Getting Better and what you can do about it

Have you ever wondered why you’re not getting better after seeing a therapist, and what you can do about it? Dr Brenden Brown, the Leading Podiatrist at A Step Ahead Foot and Ankle Care, Penrith, explains that it could be you, not the therapist.

It’s Father’s Day. I love my dad, and I’m sitting in the entertainment area of my childhood home after cooking my dad his Father’s Day breakfast. My brothers are here with their children as well, and we are discussing my parents impending trip to Europe, but more concerning in the discussion is the Back Pain that has my Mum currently in a wheelchair.

Mum has been to see a therapist. She’s been given exercises and a treatment plan that she needs to undertake. My dad says, “Oh well. I think from here it’s all up to Peter.” I look at him, and I ask, “Who is Peter.” My dad replies, “Your Mum’s therapist. It’s up to him whether or not your Mum will get to Europe. Let’s hope he can get her better in time.” Pardon?

My head twirled, my eyes roll, and I’m quite sure I probably became the colour of an orange. I reply with all the love I can muster, “This has very little to do with Peter and a whole stack to do with Mum.”

That’s right; It’s not Peter’s responsibility to get my Mum better! Peter has developed a treatment plan, and the biggest participant in that plan is Mum. Peter can show her what to do, tell her when to do it, but in the end, who is the person that is responsible – MUM!

I have no idea who Peter is as I’ve never met the guy. Still, I know from experience that this is a common expectation of patients that somehow it is the practitioners’ responsibility to get patients better. I’ve got to tell you that while Peter and I have our patients’ best interest in mind and as therapists work hard to help out our patients reach their goals. I think there is very little further from the truth than it’s “up to us” to get patients better. Dad… Mum… listening?

If I were to make a list of the most common reason that I see for people not getting better, at least half would be the laid at the feet of the patient themselves. Yes, I know this is a bitter pill to swallow if you are a patient and reading this blog is not going to make me at all popular, but them’s the breaks, so to speak.

So what is the on “The list”:

Not following your treatment plan – broadly speaking
Not completing your exercise program as instructed
Not Completing exercises as often as required
Not wearing the footwear your practitioner suggests
Picking and choosing the best bits of your treatment plan
Holding your practitioner responsible for your success

Now, of course, other reasons can contribute to your lack of recovery and yes, at times they relate to therapy or perhaps the diagnosis. Yes, practitioners get it wrong but so do patients! As humans, we seem pretty programmed to point the finger at others than recognize that we may be a contributor to our problems.

If you find following your therapist’s instructions difficult, let them know, SPEAK UP! Sometimes 13 different stretches in a day is too much. But equally, if they tell you that you need to do this to get better, you’ve two choices – 1. Get to it or 2. Get a second opinion. But that’s it! Choosing not to follow the plan and then blame a therapist for your lack of progress is like not taking your medication the doctor prescribes and returning to them complaining that you’re not getting any better.

Why you’re not getting better – Its not ME its YOU

To the therapist who is reading this: Stop being walked over! If your patient isn’t following their plan and you know it or they are negotiating not completing vital parts of the program, fricken speak up! Tell them straight! You are in no way helping either of you by following that course. The patient doesn’t improve, you look stupid and incapable, and that is a lose-lose for you all! That patient will see someone else and will bad mouth you to their friends, loved ones and the next therapist they see! I know because they see me!

Why You’re Not Getting Better – Its not me its you

Well, after my head stopped twirling like the cast of the Exorcist, I had to make sure my Mum had a clear understanding that Europe was not only physically thousands of kilometres away, but the same distance metaphorically. Unless she stuck to HER part of HER treatment plan, she was not going anywhere.

The result? My Mum is, as I write, jumping on and off buses in Europe enjoying her holiday!

Orthotic Fitting – making it easier and safer!

Blog, General Podiatry

Orthotic Fitting – Preparing the Orthotic Molds

Most likely you have noticed like we have, the large number of people out walking or exercising during this period. Making your orthotic fitting more important than ever.

To help increase your Safety and Decrease risk when picking up your orthotics, we have implemented the following steps Allowing you to have your orthotics fitted safely.

Place the shoes you intend to wear the orthotics in a plastic bag
NOTE: It is IMPORTANT to ensure the liner/insole originally in the shoe is also included – without this, we can not guarantee a perfect fit
Drop your shoes and insole to our clinic.
Our team are happy for you to drive into our driveway and meet you at your car door. NO, you don’t even need to get out of your car!
Leave your shoes and insoles with us.

You can either wait in the car, and our team will fit them to your shoes while you wait. OR drop them in, and we will call you through the day to let you know when the fitted orthotics are ready.

Online Orthotic fitting instructions:

We will then book a time for a quick online fitting appointment where one of our Podiatrists will run through the instructions with you.

Our admin team will arrange another online check-up in a month.

If you’re ready to get back to happy healthy and active, our team would love to help please call us on 96732987

Orthotic Fitting – Making Orthotics

Shockwave for Treating Heel Pain

Blog, General Podiatry, Heel Pain

Shockwave therapy for heel pain – Western Sydney

Heel pain is one of the most debilitating conditions that our doctors see every single day. Pain in the morning is common for people, first step and OUCH! Only to be relieved or Plateau and return later in the day! This is where Shockwave for Treating Heel Pain comes in.

Is Shockwave for Treating Heel Pain for Me?

Shockwave has become one of the gold standard treatments for heel pain. As one of the first clinics to adopt shockwave, we have seen a rise in its use across other clinics and sadly not always successfully. The reason is that often well-meaning practitioners who use this, use it as a stand-alone treatment and NOT as part of a treatment plan to beat painful heels!

Plantar Fasciitis, Heel Spurs and Achilles tendinitis will all respond well to shockwave however alone as a therapy shockwave will only provide part of a solution.

Heel pain requires a treatment plan that incorporates multiple areas to be addressed from Footwear to foot posture. Then to also treat both the soft tissue pain and the tissue strength to balance its recovery and get patients back to happy, healthy and active.

Sadly treating heel pain with shockwave alone will rarely see patient recover leading to more pain and frequently frustration!

Can we help?

Our doctors are all qualified and registered Podiatrists. That’s right, foot doctors! Unlike other clinics who look after toenails and callous or dry hard skin. Our team sees sports injuries like heel pain, multiple times a day!

If you’d like to beat heel Pain, we would love to help.

Our clinic is located in Western Sydney just off the M4 in Penrith. Our Doctors are registered with all major health funds. Health fund referrals are not necessary, please contact us for details.

Appointments are NOT BULK BILLED; however, you may be able to claim some money through Medicare if your GP refers you to our team.

If you’re ready to get back to happy healthy and active, our team would love to help please call us on 96732987

Fallen Arches or Flat Feet and what you need to know

Blog, General Podiatry

Fallen Arches or Flat Feet – what are they? What do they look like? And why should you care enough to bother reading this post at all? You’re busy after all, and there’s stuff to do right! Well, what if we told you if you’ve got this and you don’t your tendon will snap straight off the bone? Ahhhh, see now you’re interested!

“Fallen arches” is a bit of an old school term these days. Your Nan may have told you that if you didn’t wear the right shoes, you’d get “Fallen Arches”. Or an Elderly aunt told stories of arthritis and fallen arches. There were no iPhones back then, so you actually listened to people.

What do Fallen Arches or Flat Feet look like?

Fallen arches is most often the term to describe what feet look like when it develops a condition that sees your Tibialis Posterior (fancy muscle name) stop working as well as it should. It most commonly happens only on ONE foot at a time. This is the difference between fallen arches and flat feet.

Most commonly, we see the arch contour lowers, flattens or drops. You may also develop a bulge on the inside of your ankle. You may also note that the foot splays out particularly at the toes. This can happen very gradually over time. Which means it can sneak up on people on occasions.

After hearing all this, I mean who says podiatry is exciting!

What Do people with fallen arches or flat feet feel?

Most people who experience fallen arches at some stage will develop some pain. It’s most commonly aggravated by increased walking or exercise.

The pain is often in the arch of the foot or around the back of the ankle. However, this will vary in people.

Sometimes the Tibialis tendon will snap from the bone, and this tends to happen to people during activity. Interestingly when this occurs many times people commonly fall over. This leads them to think that they may have twisted an ankle in the fall, as the ankle becomes swollen and bruised. When presented to a GP and fitting the description, it’s often agreed that it’s a run-of-the-mill sprained ankle. It’s not until sometime later that the swelling resides and the lowered arch is noted that it’s realised it’s not a swollen ankle.

Now because I am a responsible Boring Podiatry type person, I have to make sure you understand that this is NOT super common. But is, of course, a risk!

What can you do about Fallen Arches or Flat Feet?

Fallen Arches or Flat Feet: You may see a bulge on the inside of your ankle.

There are stages or grades of these conditions; often this is referred to as, Posterior Tibialis Tendon Dysfunction or PTTD. It will depend on what stage the foot is at the time.

Exercise – Building strength in the muscles and tendon is important and will give value in most stages, BUT this will not suddenly return your arch to its former high arches glory!

Good footwear – Great supportive footwear will help support the foot. It is, of course, dependent on what stage the foot is. Again all stages will gain value from good footwear

Orthotics – Orthotics will support the arch of the foot. This may help the foot from further degeneration. These on most occasions, reduce or eliminate pain. This is again, stage-dependent! Custom orthotics at this stage are most likely to give the best result. Over the counter devices, May provide limited relief however often don’t provide enough support

Surgery – typically left for the end stages of PTTD or fallen arches; the times where this is at its worst or As described above has torn from the bone – oh Ouchie Mumma!

My suggestion is if you notice any symptoms, get to a foot doctor type person quickly. Prevention is oodles better than cure. My formula for success for most cases (stage dependent) is Footwear, Orthotics and muscle rehab to build strength.

All this leads me to suggest you probably Should have listened to your great Aunt Bess! She was in the know and while at the time the stories of her rheumatism weren’t illuminating they, if you ever go through this, will become stories you well and truly recall!

Written by Dr Brenden Brown Podiatrist aka DrFoot, Principal Podiatrist at A Step Ahead Foot and Ankle Care.

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Fungal Nail Infections

5 questions to ask anyone providing Fungal nail treatment

Are Fungal Nail Reinfection Rates High?

Are Fungal Nail Spores Invisible?

Is Thermal Laser advanced treatment the Answer for Fungal Nail Infections?

Here are 5 questions to ask any clinic before undergoing treatment for fungal nail infections.

1) Why is the clinic only treating one nail?

2) How does a patient treat the unseen fungal nail infection?

3) What system does the clinic have to keep the Fungal Nail Infection at bay?

4) What treatment do they advise for current footwear?

5) Are all Fungal Nail treatments the same?

How can we help?

Where to from here?

Fungal Nail calculator

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