Mid-Wales Diary 2023

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Mid Wales Diary

David Holland

BSc(Hons) Pod-Med, CBiol, CSci, FFPM-RCPS(Glasg).

We grow garlic each year (we eat a lot of garlic), and have found that instead of buying garlic sold specifically to be planted, it is much cheaper to buy jumbo garlic from a market. The garlic is also better quality, being fresh, and as long as your soil is well-fed it is easy to grow. Of course, you can also plant supermarket garlic, but that tends to grow small bulbs. Hay-on-Wye Thursday market is recommended for good, fresh garlic, as is Ludlow market.

I was discussing - with a colleague - the early days (almost 50 years ago) of Chiropodists injecting local anaesthetic (LA) and carrying out minor skin surgery. Not many Podiatrists realise that in the 1970’s we almost lost the right to inject LA solution stronger than 1%. That would have put a firm hold on any thoughts of Chiropodists/ Podiatrists carrying out deep tissue surgery or bone surgery - which was the intention I believe.

In those days we had to be seen to be absolutely aboveboard when it came to hygiene, and aseptic technique. Before each nail surgery session, we (my practice partner and I) washed the walls, floor, and units down with a weak antiseptic solution. For the surgical session - as well as gloves and masks we gowned up with sterile gowns and caps. Drapes were autoclaved as well as instruments. Over the top? Perhaps.

On autoclaves, it was recommended that a pressure-cooker would do at a pinch, and that is what we used in 1975 and 1976, along with autoclave bags and indicator-tape (brown lines appear when the contents are “done”). An autoclave is really just an expensive pressure cooker of course. Please note - I strongly recommend you do not use a kitchen pressure cooker for sterilisation today. Degree updates for Chiropodists were introduced in the 1980’s. They allowed Chiropodists who were HCPC-registered onto a degree programme which - if the necessary grade was achieved - could be used as a stepping stone onto a Medical or Law degree, or in my case a PhD in Bioengineering which I started but failed to complete. I converted to a research MSc when the ups and downs of life got in the way (it often does with mature students) of doing a part-time PhD whilst holding down a full-time job. Speaking of research - do you know what our main weakness in Podiatry as a profession is? We have no robust research base. We must therefore hang on to our medical colleague’s (metaphorical) coat-tails for anything other than simple footcare. That was appropriate in the 1970’s - less so now.

We are, I believe, close to unravelling the biomechanics puzzle which has its’ origins in the Root et al paper from 1966. The use of established biological tenets helped, but both authors are or were also Podiatrists, and it is fitting that the peer-reviewed results - when they are published - become part of a Podiatric - not medical - research-base.