Rachael attended the podiatry clinic. The podiatrist asked Rachael how her toes had been since the last visit and if she had required any antibiotics. He checked the circulation in Rachael's feet with an ultrasound system. He informed Rachael that the circulation around her bigger vessels was healthy but the microvascular vessels that bring blood to the skin are not working so well, which is the reason why she has cold feet.
The podiatrist asked Rachael about sensations within her feet. Rachael informed him that she can feel things but that she has no sense of whether it is a sharp or a dull touch.
He advised Rachael that the best thing would be for her PA to file her nails once or twice a week to a manageable level. This way the sides will grow a little bit longer than the top of the nail maintaining a straight edge which will stop them from further ingrowing. The podiatrist cut Rachael's nails and demonstrated how to file them.
He congratulated us on the general foot care regime, especially in attempting to keep Rachael's feet warm at all times by using heated slippers and socks etc. He also advised us to keep Rachael's shoes warm before wearing and ensure that her feet are warm before she goes to bed.
The podiatrist mentioned nail surgery again but did not feel that it was the best option at this stage.
The podiatrist offered Rachael the option of taking a referral application home to refer herself if required. An appointment with a referral would take one to two weeks whereas existing patients can expect to wait four to six weeks. Rachael said she would rather be a patient and use the drop in clinic if necessary. The podiatrist agreed and recommended to Rachael that if she books an appointment within twelve months he will be able to keep a check on her feet and her status will remain active on their system.