My feet are not my best feature. They hurt (for no apparent reason), I am prone to stress fractures, I have chronic athlete's foot, and all but one of the nails on one foot have been completely destroyed by fungal infection. Every few years I get disgusted with the situation and complain to my physician, and she refers me to a podiatrist.
This morning I visited my fourth podiatrist in this benighted town. I am convinced that most podiatrists are perverts and the rest are morons. (Some of them are both perverts and morons.) Consequently, I was relieved that this morning's "doctor" neither stroked my feet overlong nor breathed through his mouth. He also demonstrated a reasonable knowledge of statistics when presenting me with treatment options.
In my lifetime I have consulted with at least seven podiatrists. The worst of them we called "Dr. Magneto." Dr. Magneto had a thriving business selling magnets and practiced reflexology on the side. He had all kinds of interesting ideas about fungus (it's just toenail rotting in the skin!), and tried to sell me a magic potion (formulated according to his own special recipe) that was guaranteed to cure my toenails. He later lost his license for gross malpractice.
Of the seven, two (one being the gentleman I visited this morning) stand out as being completely normal and possibly even competent. With the exception of Dr. Magneto, I was referred to each of these "doctors" by my physician. Eliminating Dr. Magneto from the sample as a potential outlier, we can obtain an estimated "competence rate" of p = .33 (SE = .19).
My questions are thus:
- Who the hell are these people?
- What other profession tolerates a rate of competence less than 50% (besides psychology)?
- Why won't my own physician, when faced with an obvious fungal infection, take a nail for culture (they pull off easily, no surgery required), order a liver panel and write a script for Lamisil, instead of referring me to creeps who masturbate into shoes or need a roadmap to find my toes?
23 comments:
I have had recurring athelete's foot (although not as bad as that picture!). Not that this will necessarily help you, or that you haven't tried this already, but what works for me is taking off my shoes whenever I'm sitting at my desk (which, as a theorist, is most of the time). Also, I don't shower every day, and when I do shower I try to get very dry soon afterwards.
Be careful of the Lamisil. I wasn't able to finish my prescription...it has a lot of nasty side effects. I just kept the nail cut back and applied vinegar to it each day and it's all cleared up now.
I'll add a sample to your pool. I saw a podiatrist for recurring pain in my big toe. He diagnosed fallen arches or something, and ended up selling me some shoe inserts that cost about $300.
I later switched primary physicians. The new guy looked at my toe, harrumphed, poked my foot with his finger to see if I would scream in pain (I did.), and said, "You have gout."
I don't remember the podiatrist's name. I think it was Eric something or other, but that might have been the dentist that I visited when I was a child.
Vicks VapoRub will kill a fungal infection in your toenail. It works better than Lamisil, costs less, and has fewer side effects, too.
My toenails have been infected for 15 years. I've tried the bleach, the vinegar, Penlac, topical antifungals, and Vicks Vaporub (for two years). Please don't suggest other alternative treatments; I've tried them all.
It's Lamisil or ablation. The podiatrist did not recommend ablation.
You are referred to a specialist even in the face of an obvious explanation by the general physician for the same reason you would prefer an experienced nurse to inject you with a medication rather than doing it yourself even if you've had a lifelong experience of injecting yourself with stuff - when things go wrong, the nurse would know better than you how to deal with it. And she'd likely catch on to the fact that something might go wrong before it actually does, and she'd be better at this guessing game that you are.
Thusly, a specialist podiatrist is better suited to look into your 'obvious' fungal infection - just in case it is something obscure masquerading as something obvious.
It is a reflection of the fact that in a technologically developed place like the States, systems in place automatically choose to incur a higher price to better protect individuals from the outside chance that some ill might befall them. It's a sign of prosperity, I suppose.
I tried lamisil and it worked like a charm. No liver problems either.
I used Lamisil and it worked like a charm with no side effects.
What did the MD say when you asked for a culture, a liver panel, and drugs? You should also ( shudder) consider this: podiatrist can do surgery. With general anesthesia and a scalpel. Then, they get to write post op orders, including insulin, narcotics, and antibiotics. I know, I know, very weird. Don't let them cut you.
> What other profession tolerates a rate of competence less than 50% (besides psychology)?
You haven't met many software developers in your life, have you?
That's really weird. For something like that, my husband tends to treat it himself with the Lamisil (if Vicks or tea tree oil haven't worked first). He only refers to the podiatrist in town he trusts if it's a diabetic or Lamisil doesn't work. I wonder why you were referred so fast.
What other profession tolerates a rate of competence less than 50% (besides psychology)?
Peddlers of diets (for significant long-term weight loss).
What other profession tolerates a rate of competence less than 50% (besides psychology)?
You haven't met many software developers in your life, have you?
Or airplane pilots.
I have had mostly bad experiences as well.
Then I found utter competency and never looked back.
Try Dr. Guy Werkhoven in Minneapolis!
http://www.minneapolispodiatrist.com/
EEP! (Airplane pilots? I HOPE they're running at a better competency rate!)
Good luck with the foot thing. Sounds miserable. :(
Ok, I was going to give this story I saw on msn my "wtf of the day" award. But you actually might be interested in the oddity of it so have at it: http://www.msnbc.msn.com/id/25783483?GT1=43001
No, I haven't done it. And I don't like people touching my feet. Fishies however, maybe.
Dear Angry Professor,
Read carefully and believe (clap your hands if you need to.)
Doctor have good healing. You have sick, go doctor fast. Not slow. Doctor friend, you better, OK?
Sincerely,
Grandmother
What other profession tolerates a rate of competence less than 50% (besides psychology)?
How about Psychology rejects, aka "Life Coaches"?
Best of luck with the foot thing. If you lived closer to Georgia, I'd suggest my podi here in Small Town. He's great.
And yes, please do have the liver panel. Sometimes recurrent foot problems point to other medical conditions. Got my toes crossed for ya.
Get some Lamasil. I had bad athlete's foor and tonail fungus for 25 years. A 2 week round knocked it out and in about 3 months my tonails grew back. As an extra treat my feet quit stinking.
My family doctor prescribed it.
OMg! I am sorry for the state of your feet, but your post was so hillarious that I almost pissed myself.
My husband did use Lamisil to cure a rather nasty bit of toenail fungus, but it took to rounds at a month each.
Best wishes to your feet!
BTW, I don't know if you can calculate the competency rate of politicians, but it is a job that I think you can be fairly incompetent at in some respects and still get paid.
Actually, not all "obvious fungal infections" are fungal infections. Psoriasis and lichen planus are just two possible inflammatory conditions that can cause both skin and nail changes that can mimic onychomycosis and tinea pedis. Too many primary care providers and podiatrists jump right to oral antifungals without actually confirming the diagnosis. I'd recommend that you see a dermatologist. If I had a dollar for every "fungal nail" I have cultured +/or biopsied at the behest of a patient who was convinced he had "incurable fungus" after visiting three other clinicians who did not bother to investigate the real cause....
The cause of atheletes foot in men is roughly the same thing that causes a yeast infection in women. For the chronic sufferer, I would recommend cutting out the sugars like soda, chocolates, cheap fruit drinks, etc... and the other food item that is common in this matter is red meats. Cut out all red meats for just 2 weeks along with the sugars (fruits the exception) and I bet you notice a major improvement. The generic name of the disease slips my tired mind at this time, but I too have used this method several times and it works, now I cant even eat red meat without seeing an increase in itchy foot. IT is for real.
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