|"What I like most about the job is the biomechanics of how the body moves. I love working out why an Achilles heel is under stress or why a patient’s hip is giving them trouble."
Lorcan O'Donaille is a podiatrist who runs the Achilles Clinic in Cork.
A Typical Day
A typical day, starting at 8am, is a combination of chiropody – dealing with corns, calluses and ingrown toenails – and podiatry, working on bio-mechanical issues. A lot of the work is psychological. You’re trying to reassure people and help them. So I never look at just the foot: I treat the person as a whole.
People come in and bare themselves to you. They can be quite vulnerable. Reassurance is a big thing. I see a lot of people with chronic pain issues. There’s a gentleman I’m treating who has had pain for the past four years, throughout his legs and back. He retired recently and all the symptoms have got worse. No one has been able to help him. I believe we can.
If patients come in looking for cosmetic treatments, we try to make them understand that’s not what we do. You don’t go to your dentist to make your teeth look pretty.
We are getting busier because people are exercising more. Since the recession, we notice that people are running a lot more. It’s much cheaper than going to the gym. Running is generally good for your health but people embark on it while having muscular, skeletal or strength issues. They’re not strong enough and not flexible enough. We tend to see them when their issues become chronic.
When dealing with a patient for anything other than routine chiropody, we always email them a report. We want to educate the patient. Studies show that if you educate your patients, they’ll get a better outcome because they’ll be more compliant. That takes up a lot of time but it’s worth it. I like to go home knowing I did for my patients what I’d do for my own family.
People of all ages come into us. The youngest patient I’ve seen was six months old and the oldest was 96. In 80 per cent of cases involving kids under 10, it’s a case of just reassuring the parents that their kids’ feet are normal. In some cases, we might recheck the child 12 or 18 months later. Being a parent, I understand. You’re inclined to think the worst.
The 96-year-old patient had a sprained ankle. I asked him when he sprained it and he said it happened in 1932. I don’t know why all of a sudden he decided he wanted treatment. Because of the sprain, he had severe osteoarthritis in the ankle and foot. I gave him some stability, taking some of the force off with orthotics. The man also had some weak muscles in his lower leg so the physiotherapist got involved and gave him exercises. After two or three months, he was discharged.
I did all sorts of training while I was at college; even treating leprosy patients. Diabetes is a growing problem. There’s a statistic that says if you have a foot amputated as a diabetic, you have a 50 per cent chance of being dead in five years. Ella Fitzgerald had diabetes and didn’t look after herself and had both legs amputated. It also happened to Zsa Zsa Gabor.
What I really like is seeing a patient who hasn’t been in for a year or two. You know you can fix them. On the downside, there are the troublesome patients who have something else going on in their lives. I don’t like the administration side of the job either. I always knew I wanted to work at something medical. I kind of drifted towards podiatry. I was qualified for a year before I realised it was what I loved.
Fixing people gives me satisfaction. We seem to get what other clinicians haven’t been able to fix.
Full article published in The Irish Times; February 11th 2015