ONTARIO’S PODIATRISTS TIPS FOR WINTER FOOTWEAR

It’s that time of year again. Winter arrives with a vengeance and the first thing you want to be sure is you have invested in proper winter footwear.

Here is some basic advice –

• Choose a pair of boots with a cushioned, removable insole and a deep heel cup.
• Choose a pair of boots with an insole that is thick and cushioned that will provide support for arches and heels – a bonus for people who suffer from plantar fasciitis or flat feet.
• The benefit of the removable insole is it allows you to use custom orthotics or more supportive insoles if required.

Frequently Asked Questions:

What size snow boots should I buy?

You should be able to stick to your everyday shoe size. Many snow boots are designed to just slip on because, more often than not, the sole of the boot and the boot upper are made from the same piece of hardened rubber. This ensures maximum waterproofing and protection against any hidden obstacles or debris.

They’ll likely also have a neoprene, leather or waterproof textile collar too for added comfort. Because they slip on, show boots are generally made slightly larger than other types of footwear to allow you to get your foot in comfortably.

How loose should my snow boots be?

Loose fitting snow boots are a big no-no. Due to the change in how you walk when wearing snow boots, oversized boots are a potential tripping hazard. Any added unsteadiness is definitely not needed when it comes to winter weather. A one-finger width gap down the heel of the shoe is the maximum wiggle room you should leave. The same rules apply for fitting kids’ snow boots, too.

How Should Snow Boots Fit?

Snow boots should hug your foot comfortably, providing both support and insulation. A looser fitting boot will offer greater warmth and comfort but will cause problems when walking longer distances. Snow boots that are too tight will lead to circulation issues and problems walking.

To find the right balance, always fit snow boots while you’re wearing appropriate socks (as in the socks you’ll be wearing when you wear the boots). Make sure you have enough room to wiggle your toes comfortably.

The American Podiatric Medical Association shares tips on Warm & Cozy Feet

APMA offers some advice for keeping feet healthy in common winter scenarios:

• Winter is skiing and snowboarding season, activities enjoyed by millions of active North Americans. Make sure your boots fit properly; you should be able to wiggle your toes, but the boots should immobilize the heel, instep, and ball of your foot. You can use orthotics (support devices that go inside shoes) to help control the foot's movement inside ski boots or ice skates.
• Committed runners don't need to let the cold stop them. A variety of warm, light-weight, moisture-wicking active wear available at most running or sporting goods stores helps ensure runners stay warm and dry in bitter temperatures. However, some runners may compensate for icy conditions by altering how their foot strikes the ground. Instead of changing your foot strike pattern, shorten your stride to help maintain stability. And remember, it's more important than ever to stretch before you begin your run. Cold weather can make you less flexible in winter than you are in summer, so it's important to warm muscles up before running.
• Boots are must-have footwear in winter climates, especially when dealing with winter precipitation. Between the waterproof material of the boots themselves and the warm socks you wear to keep toes toasty, you may find your feet sweat a lot. Damp, sweaty feet can chill more easily and are more prone to bacterial infections. To keep feet clean and dry, consider using foot powder inside socks and incorporating extra foot baths into your foot care regimen this winter.
• Be size smart. It may be tempting to buy pricey specialty footwear (like winter boots or ski boots) for kids in a slightly larger size, thinking they'll be able to get two seasons of wear out of them. But unlike coats that kids can grow into, footwear needs to fit properly right away. Properly fitted skates and boots can help prevent blisters, chafing, and ankle or foot injuries. Likewise, if socks are too small, they can force toes to bunch together, and that friction can cause painful blisters or corns.

Finally—and although this one seems like it should go without saying, it bears spelling out—don't try to tip-toe through winter snow, ice, and temperatures in summer-appropriate footwear.

Ontario’s Podiatrists remind you: Good Health Feet First!!

Markham lawyer dies after being discharged from hospital with foot infection

Man should not have been released during coronavirus pandemic, friend says.

Michael Pierce was sent home from Scarborough Health Network's Birchmount site with a foot infection. He died hours later. Now family and friends are wondering what happened. - Photo by Paul Koziorowski

For Michael Pierce, criminal law was his charity. He got into it for the right reasons and he lived that reality each and every day.

“He would drive to clients' homes at 1:30 a.m. if they needed him, he would work on cases 60 hours in three days, only closing his eyes for a few hours – even if clients burned him and didn’t pay him, he’d still work hard for them,” said Mustafa Sheikh, Pierce's grieving law partner.

But it wasn’t just his work ethic or huge heart that left Sheikh in daily awe. Pierce was also a genius who put his Christian faith front and centre.

Unfortunately for Pierce, according to Sheikh, he may not have been given the same respect in death as he gave to those around him in life.

That’s because, as Sheikh tells it, Pierce died only hours after being sent home from Scarborough Health Network's Birchmount site, a place he went to seek help.

Now, Sheikh said, the Pierce family are looking into a wrongful-death suit against the hospital, alleging that even with COVID-19 rules in place, Pierce should have been kept in hospital – and if he was, he might still be here.

Pierce's condition began in early March when the lawyer, who resided and worked in Markham, developed a nasty foot infection from split skin at the back of his heel.

“There was pain and discomfort and it was affecting his walking,” Sheikh said.

After the courts shut down at the end of March, the 38-year-old, who was five feet nine inches tall and weighed around 300 pounds, decided to go into hospital.

“They told him, ‘It’s bad and not healing,’ and gave him antibiotics,” Sheikh said, adding they further diagnosed Pierce with diabetes and scheduled an appointment with a specialist.

Between that day and April 14, Pierce's condition worsened, including a loss of vision, severe pain and hallucinations, according to Sheikh.

On April 14, Pierce's mother, Patricia, drove him back to the Birchmount hospital, but because of COVID-19 rules she was not allowed inside.

Pierce was discharged later that day and was visited by a nurse at his Markham home around 7 p.m., Sheikh said, at which point he was given an injection.

One hour later, his heart stopped beating.

Sheikh added that Pierce's family has been told it will take between 10 to 12 months for a report on his death.

“He was young, he had issues, but nothing that should have caused his death,” Sheikh added. “He went to the hospital a second time because it wasn’t working. He was in so much pain, there’s no way he should have been discharged.”

He added that he believed without COVID-19 rules, the hospital would have kept him in the hospital for observation.

“Why would they send a nurse two hours later?" he asked. "It doesn’t make any sense."

Since Pierce's death, Sheikh has put his law partner's mother in touch with some personal injury lawyers and has encouraged them to seek damages as part of a wrongful-death suit against the hospital.

In response, Leigh Duncan, the communications representative for the hospital, cited patient confidentiality as far as releasing any information about why Pierce was released or just how bad his condition was.

“Our hearts go out to Mr. Pierce’s family and we are sorry to hear of his passing,” she wrote in an email to Yorkregion.com. “We are unable to comment on this specific case out of respect for patient privacy. We are committed to supporting a patient’s transition out of the hospital and discussing what recovery may look like so they know what to expect. We are committed to exceptional care and safety for all of our patients, at all times.”

As for his own pain, Sheikh said he continues to struggle through it.

“I lost my best friend. He was such a good soul, I’m devastated,” he said. “I feel like I lost a little piece of myself. There’s all these what-ifs – I just feel as though this could have been avoided. He was so innocent.”

He said what has remained with him since Pierce’s passing is the idea that a man can die in this way in Canada in 2020.

“They say our medical system (in Canada) is so good,” he said. “But this is about someone falling through the cracks. It’s hard to see someone of his calibre not get the medical attention he deserved.”

Dr. Jim Hill, president of the Ontario Podiatric Medical Association, said that he's been trying to convince the Ontario government for some 20 years that hospitals should have access to a podiatrist, yet the province is so behind the rest of the world – and even other parts of Canada – that the profession isn't even taught in Ontario. That means doctors at Scarborough Health Network, like all other hospitals in Ontario, do not have a podiatrist with whom to consult.

WHAT YOU NEED TO KNOW ABOUT NOVEL CORONAVIRUS (COVID-19)

Feb 26 2020 | Sinai Health Foundation

Ontario has only had a few confirmed cases of novel coronavirus (COVID-19) but the amount of media on the topic would suggest we should be worried.  Can you provide some perspective?

As this is a new virus, it takes some time for scientists to learn about the symptoms it causes and how it spreads. It’s understandable for people to experience worry in a situation like this where we don’t have all these answers right away.
However, public health experts continue to advise that at this time the risk in Canada remains low. It’s also important for people to know that health care providers are well prepared to deal with this situation and are now taking additional precautions.  For example, hospitals already have screening in place for respiratory illnesses such as influenza. Additional measures have been added to quickly and safely screen, isolate and test patients as recommended in guidance documents provided by the Ministry of Health in Ontario.

What can I do to protect myself and my family from getting novel coronavirus (COVID-19)?

Coronaviruses spread from person to person in tiny droplets of moisture expelled when someone who is infected coughs or sneezes. The best way to protect ourselves and others is with the same steps that help prevent the spread of colds or influenza:

• Clean your hands often either with soap and water for at least 20 seconds or use alcohol-based hand rub.

• Avoid touching your face.

• Cough or sneeze into a tissue or your elbow and clean your hands after.

• Stay home from work or school if you are feeling ill to avoid spreading infection to others.

Should I avoid travelling altogether, or only to certain countries?

For the latest travel advisories, visit the Government of Canada’s website to help inform any decisions about travel.

Read Full Article

MINISTRY OF HEALTH MEMO ON CORONAVIRUS

JAN 10

READ THE MEMO

BIENNIAL FOOT AND ANKLE SYMPOSIUM 

April 17-18, 2020 - Metro Toronto Convention Centre

The Biennial Foot and Ankle Symposium is Canada’s largest surgical Foot & Ankle meeting. Not only does it provide a centralized forum for practising orthopaedic surgeons to stay current, it allows for an opportunity to meet face to face. Biennial Foot & Ankle Symposium is the yearly hub for the Canadian orthopaedic community. 

2020 Hot Topics include: 

• Minimally invasive forefoot surgery
• Use of minimally invasive surgery for deformity correction in Charcot
• Salvaging complications of the Ring Fixator
• Deformity correction and TAR; Salvage of failed TAR
• Cartilage- transfer/transplant – why aren’t we doing better
• Lesser toe mtp oa salvage
• Perceptions vs reality in forefoot surgery
• Small Quality improvement initiatives and where to start

Additional details can be found at https://www.cpd.utoronto.ca/footankle/. 

OPMA ANNUAL MEMBERS' MEETING

At the Canadian Podiatry Conference 2018 | Delta Hotel Airport

October 19, 2018

During a celebratory opening session Thursday, Rep. Brad Wenstrup, DPM (R-OH), the first podiatrist to serve in the US House of Representatives, congratulated APMA members on the passage of the VA MISSION Act, including APMA’s VA Provider Equity Act.  

“This was not only about pay,” Rep. Wenstrup said, referring to the bill, which placed podiatrists in the same authority as their allopathic and osteopathic colleagues at the Veterans’ Health Administration. “It was about leadership. And it was important for our veterans. Our veterans so often have comorbidities. And that’s what we do as podiatrists.”  

He cited statistics showing a startlingly large number of podiatrists working within the VHA compared to orthopedic surgeons. “We’re the ones doing the work.” 

Rep. Wenstrup reminded the attendees of “the power of advocacy and building relationships,” detailing the hard work he and his colleagues accomplished alongside APMA staff and members as they addressed opposition from orthopedists, building relationships with them and with other members of the legislative and health-care communities. 

He encouraged members to maintain the momentum of this important legislative victory. “Invite your representatives to your office. Get to know their health-care staff. Invite them to your hospital or surgical center and let them see what you do; let them meet your patients.” 

Seeing firsthand the good that podiatrists do will make an impression, Rep. Wenstrup said. “We need to make our case. We have never asked for something we haven’t earned and trained for.” 

Rep. Wenstrup also spoke at length about the many opportunities podiatry has afforded him, saying he wouldn’t have had the opportunity to serve his country were it not for podiatry. “Podiatry afforded me the opportunity to take part in the defense of our nation and to serve with heroes.” He remembered fallen heroes who sacrificed all for their country and their peers, including a reservist who volunteered for a dangerous mission so that two of his fellow soldiers who had children would be spared. He was killed by a sniper during that mission. “Two families have fathers today because of him,” Rep. Wenstrup said. 

He recalled two recent situations in which his podiatric training as a physician and combat surgeon allowed him to help people in critical need. Last summer, during a congressional baseball team practice, a shooter opened fire, severely injuring Majority Whip Stephen Scalise (R-LA). Rep. Wenstrup was able to treat Whip Scalise on the field. Earlier this year, he was called to action again when the Amtrak train on which he was riding struck a truck. Rep. Wenstrup treated victims on the scene of that incident, as well. 

“Any time you have the opportunity to make life better for others, you do it,” he said. “If you fail to do so, you’re wasting your time on earth,” he continued, paraphrasing Roberto Clemente.  

He strongly encouraged podiatrists to keep up their work, focusing on their service to patients. “I don’t want Washington to tell me if I’m doing a good job. I want my referring doctors to tell me. I want my patients to tell me,” he said. “You do a lot of good. Remember that whatever you do, you’re representing podiatric medicine.”

APMA Announces New Benefits at Opening Session 

During the opening session Thursday, APMA President Dennis R. Frisch, DPM, announced two exciting new benefits of APMA membership: the APMA MIPS app and an APMA electronic health record.  

The APMA MIPS app will be free of charge to members, offering the ability to track a provider’s MIPS score in real time and see how changes in activities would affect that score. It also will be an important adjunct to the APMA Registry, allowing users to submit MIPS data to CMS via the APMA Registry regardless of which EHR they use. Visit the APMA booth (#633) to learn more. 

APMA is beginning work to develop an EHR in collaboration with Darena Solutions. The EHR will be designed for podiatrists based on feedback from members. It will be fully integrated with the APMA Registry and 2015 ONC-certified. APMA and Darena Solutions plan to offer other vendors the opportunity to resell the APMA EHR, meaning you could enjoy the benefits without changing service providers. Watch for an opportunity in the near future to sign up for an early beta version.

Ask a Podiatrist Hotline: We need volunteers

On Saturday, May 26, 2018, during the final week of Foot Health Awareness Month, the CPMA will be opening an Ask A Podiatrist Hotline: a temporary 1-800 number where the general public can call in to speak directly to a podiatrist. We did successfully this in BC a few years ago, and we are now rolling the program out nationally. To do this, we need volunteers.

During each two-hour window, the line will be picked up by a CPMA member who has volunteered to answer foot health-related questions. To do this, we will be acquiring a temporary toll-free VOIP number which will forward to a pool of designated phone numbers matching participating Podiatrists on duty for that window.

For each time slot, we will need five podiatrists to comprise that pool.

We are looking to cover a window that spans 9am to 5pm in each time zone (12 hours total). Ideally, we would have people in the East covering the earlier part of the day, and have podiatrists in the West close out the schedule.

Please visit: https://goo.gl/RUvGVs to select a time slot that works best for you.  We encourage your participation!

Amputations due to diabetes can be prevented
Diabetes patients urged to take simple precautions to help save their feet during Foot Health Awareness Month and beyond

Windsor, ON, May 8, 2018 – Taking a minute or two every day to inspect your feet and observing a few simple rules can make the difference in sparing diabetes patients from a preventable outcome of the disease – a foot amputation.

“Of all diabetes-related complications, a serious foot ulcer and subsequent amputation might be the most preventable with proper care, which means vigilance in checking the feet at least once a day for small cuts and other abrasions,” says James Hill, DPM, FACFAS, President of the Canadian Podiatric Medical Association. “Even those with good control of their blood sugar can experience foot ulcers, especially if neuropathy, a frequent diabetes complication, has caused decreased feeling on the bottom of their feet.”

Loss of sensation inhibits the body’s normal pain response. As a result, walking can apply repetitive, unfelt pressure to a wound, making it larger and deeper. Left untreated, diabetic ulcers lead to serious infections, which may result in amputation.

James says foot and ankle surgeons use a variety of surgical and non-surgical methods to heal diabetic ulcers, but stressed early intervention yields the most favorable outcomes.

“Daily self-exams are the best protection. Too often, patients fail to check their feet for small cuts or punctures that over time will ulcerate and become infected,” he says. “If you have diabetes and see anything suspicious on your feet, consult a foot and ankle surgeon for diagnosis and treatment. Even a few days can make a difference in preventing serious foot problems from developing.”

An estimated seven in 10 diabetes patients have nerve damage that impairs feeling in their feet. Fifteen percent eventually will develop a foot ulcer. Among those with ulcers, one in four will lose a foot. Each year more than 86,000 amputations are performed as a direct result of diabetes, and studies show that half of those who have one foot or leg amputated will lose the other within five years. Proper diabetic foot care, says James Hill DPM FACFAS, prevents foot loss.

In some cases, amputation might be the preferred option. If vascular and podiatric surgeries can’t improve blood circulation and foot function, resolve infection, or restore foot function, amputation may be the only solution that enables the patient to heal. Today, advances in prosthetics make it possible for patients to return to an active lifestyle, a necessity for keeping diabetes under control.

Foot problems are not an inevitable consequence of diabetes. The risk can be lessened significantly by following a few simple precautions:

For more information on diabetic foot conditions, contact the Canadian Podiatric Medical Association office at 1-888-220-3338, or visit our website: www.podiatrycanada.org 

On Friday, April 20, 2018, OPMA President James Hill attended the Midwest Podiatry Leadership Breakfast in Chicago, Illinois, on behalf of the CPMA and OPMA. 

"The APMA Board of Trustees sponsored a leadership breakfast with APMA representatives, Region Five executive directors, presidents and chief delegates. APMA President, Dennis Frisch, DPM and other APMA board members were in attendance. I was honoured to meet and speak with Congressman Dr. Brad Wenstrup.  Dr. Wenstrup is a current member of the US House of Representatives and is also a Doctor of Podiatric Medicine. 

Last year he introduced the Veterans Affairs Provider Equity Act (HR 1058) that would grant Podiatrists the same supervisory roles and pay scales as other VA doctors in Veterans' hospitals. The Bill has passed the House of Representatives and has been referred to the Senate, where it has been read twice and is now before the Committee on Veterans Affairs"

Jim Hill, DPM, FACFAS

Dr. Brad Wenstrup & Jim Hill

OPMA PARTICIPATES IN HEALTH FAIR AT 

ONTARIO LEGISLATURE

Legislative Assembly of Ontario Hansard March 21, 2018: Hon. Helena Jaczek (Minister of Health and Long-Term Care): 

       "I’ve just been informed that we’re joined by David Shaw and Peter Stavropoulos.            They are from the Ontario Podiatric Medical Association and they will be at the health fair today".

Good Morning,

I would like to thank you and your organization for being part of Health and Wellness 2018.  The Health Fair was a success. The feedback received was very positive.  The participants found the event very engaging and interactive. They were also pleased with how your organization interacted with them and provided them with valuable information.   Please pass my thanks to your staff for taking time out of their busy schedules to be part of this day.  This event would not be a success without all of you.  I am very grateful your assistance, hard work, enthusiasm and participation. Hope we can work together for future events.  Thank you again and take care.

Thank you very much.

Daryl De Pala,  RN

Occupational Health Nurse, Health Services

Legislative Assembly of Ontario

OPMA Submission to Minsitry

On March 7, 2017, the Ministry of Health and Long-Term Care released the Health Professions Regulatory Advisory Council's (HPRAC) Chiropody and Podiatry: Regulation of the Profession and the Model of Foot Care in Ontario. 

The Ministry held a 45-day public consultation on the report and recommendations.

The OPMA made a submission to the Ministry on April 21, 2017. Click the picture below to read the submission. 

The College of Chiropodists of Ontario also made a submission to the Ministry on April 21, 2017. Click the image below to read the submission.

Click here for more on the submission

INNOVATION

PODIATRY DEVICE TAKES TOP PRIZE AT NORTHEAST OHIO INNOVATION CONTEST

A team of Kent State researchers took top prize at the Burton D. Morgan Foundation’s LAUNCHTOWN SOARTM Competition, held at Baldwin Wallace University in April, beating teams from Case Western Reserve University, Cleveland State University, and the University of Akron.

Their winnings ($7,000) will allow the team to further develop a device which could solve an age-old problem for diabetics.

The device, called a “Shear Force Mat,” represents a breakthrough for physicians seeking to understand the formation of plantar ulcers — one of the most prevalent and dangerous problems facing diabetic patients.

Click Here to Read Full Article 

DERMATOLOGY OF THE LOWER LIMBS SYMPOSIUM

The Order of podiatrists of Québec and the Université du Québec à Trois-Rivières are happy to work together in preparation for the next dermatology symposium. It will take place at the UQTR campus in Trois-Rivières on Saturday November 17th 2018.

Dr. Ashfaq A. Marghoob, a reputable American dermatologist whom specializes in dermoscopy will cover the following topics: dermoscopy evaluation of the nails and of the plantar aspect of the foot.

Dr. Bernard Cohen, an exceptional dermatologist specialized in pediatric dermatology will discuss the following subjects:

• Emergency pediatric dermatology
• Pediatric nail pathology
• How the approach rashes and skin flares in the pediatric population

The OPMA and its members salute the B.C. podiatrists for taking proper foot health care to the public. 

Free foot care pilot project in Abbotsford, B.C. showing positive signs for patients.

OPMA President Jim Hill presents MPP Cristina Martins with Award for Bill Prohibiting Mandatory High Heels in the Workplace

"Putting Your Best Foot Forward Act" Cristina Martins, Toronto MPP.

Follow the "Putting Your Best Foot Forward Act".

Toronto MPP Cristina Martins (Davenport) tabled her “Putting Your Best Foot Forward Act” today, October 17, 2017, in the Ontario Legislature. The Bill will make changes to the Occupational Health and Safety Act and “prohibit employers from requiring an employee to wear footwear that is not appropriate to the protection required for their work."

The President of the Ontario Podiatric Medical Association, James Hill stated: “Clinical evidence demonstrates that wearing high heeled shoes causes a much higher incidence of bunions, musculoskeletal pain and injury than those who do not wear high heels.”

OPMA applauds this Private Member's Bill  for advancing workers' foot health in Ontario.

Click image to view full news

Tej Sahota on CH Morning Live Promotes healthcare.

Hartley Miltchin, DPM,  on behalf of The Ontario Podiatric Medical Association appeared on TORONTO’S NUMBER ONE MORNING SHOW, BREAKFAST TELEVISION on CITY TV to promote FOOT HEALTH AWARENESS MONTH.

Dangers of Pedicures

CBC INVESTIGATES | Worker with open sore, reuse of disposables among recent problems found at Manitoba nail salons

Follow the full story at CBC.ca

Learn more about the growing dangers of pedicures and some helpful "Stay Safe" tips in an installment of CTV's "Customer Alert".