Why my wart treatment got infected?

I recently got a new batch of canthrodin in the office and my wart treatments got infected 2 times. Hello, welcome to Podiatry practice mastery. My name is Don Pelto, I'm going to go over the $1,000,000 minute here. So I had a couple of patients recently. After we got some new canthrodin in the office, I used to have patients leave it on till the following morning. Now I'm starting to have them take it off in four to six hours because I got this big blister.

And I got a call this weekend and they sent me a picture and it had like pus underneath it. So they popped the pus and, and the infection went down. But I did have another gentleman that I put it on his wart and he actually had a, a bad infection from it and had to get admitted to the hospital. So like these are things that I think depending on the, the

quality of the products that we use. So I think the old Catherine got a little bit old and didn't wasn't as potent and this newer 1 is, is more potent for us or maybe just even the vendor. So I have to be be careful, be careful because that can, can ruin my day and ruin my weekend of getting those calls. They're concerned. It was easy to treat, but it's just, it's just a frustration.

OK, let's go into the day here. The, the most valuable patient today was a the shockwave patient, a 51 year old female. She had #4 out of 6 for Shockwave and then she was scanned for orthotics. What I, what I usually do is I tell patients that they're going to be scanned on the third visit. This was actually the fourth

visit. And the way I explain it is I explain the the shockwave is good at getting rid of the pain, but to help it not come back and help the mechanics of the foot is specifically high contouring orthotic on that thickened fascia can help reduce the re injury rate for the patient and that and that's kind of how I'm doing the the orthotic. So that was the most valuable patient.

Next patient was a this was a another cancer in this the second cancer in doing for this patient, 40 year old female. Next was a 46 year old man bilateral foot pain got X-rays. He he actually went to Six Flags, which is great America, one of the amusement parks here anywhere. He wore Aqua socks the whole day. And I've heard injuries due to flip flops.

I've never heard injuries due to Aqua socks, but he was wearing Aqua socks and his feet were really hurting, you know, but for the 46 year old guy with with he has a 2 year old daughter. He's just walking around too much and that's why his feet hurt And it took a couple weeks to get better, but now he's better. But I don't think he had anything else. Next was a 53 year old female with a left fracture follow up. She had a fibula fracture after PT.

She's out of the global so I was able to get the the office visit. She also had some fissures through her heels and I just reminded her of how to take care of the the fissures at my. My routine tends to be the sleeping heel socks at night and then during the day or in the morning the 40% urea cream with a pumice bar for that occasionally. Next was a 55 year old female. She came in because her carry flex fell off. You know, this would be least valuable patient, I guess.

I got an office visit out of it. Had to put the carry flex back on. She's a nice, nice patient, but those kind of glut the schedule a little bit and I'd like to get more of those on. Marjorie, my nail tech schedule for that. Next was a 76 year old female. She had a new patient. She had a left matrix on both edges. She's had a couple of ingrowns before in the past and she opted for that. She had had a couple of just I and DS before. Next was that plantar fasciitis #4 out of 6.

There was a lot of a lot of shockwave yesterday. So let me go. Might as well go through do all the shockwave here. So plantar fasciitis 4 out of 6. There was a Achilles tendonitis, a 60 year old female #2 out of 6. There was a 68 year old man with #4 out of 6 posterior tibial tendon. The other one was Achilles tendon. Next was a 38 year old female with left ankle pain.

She had number actually arch pain, arch pain. She had #1 out of 6. Now this is a funny one. I have some patients someone just always want a discount. And this was one, and this is one that would like had three phone conversations with Blue Cross Blue Shield wanted their shockwave to be covered and thinking it would be covered and this and that and oh boy, so this one, but these ones do also do Taekwondo with my kids. And so I wanted them to feel

like they're getting a deal. So I did both feet because she does have it on both arches and I did both and I only charged for one. I occasionally do that. I, I feel like it doesn't really take me extra time and I don't always double dip on these, these bilateral cases. Next was a 57 year old female and #3 out of 6 for Achilles tendonitis. Now there was a 45 year old female with left plantar fasciitis #5 out of 6. And those were the a lot of the the shock waves of the day.

Now I'm going to get back into that other stuff. Next patient was a 42 year old female with bilateral bunions and hammer toes. And she was wondering about doing if she had to do anything because her mom is a really bad hammer toe. So I really just talked to her about shoe changes, did X-rays. My shoe recommendations are usually anatomic shoes like lems, topos, ultras and I always say shoes 1st and then correct toes 2nd and then surgery after

after they try those things. Next was a 25 year old man. This gentleman I think he's a a medical student or a post doc or a PhD student. He had a little red, a little black line on his left 5th digit. He was concerned about like a mulatto Nikkia. I took a nail sample I think was more from rubbing. He also had a little mole on his right 4th toe. And I didn't even biopsy. It was just so small. I took pictures of him and I'm going to see him in a year.

Next was a 61 year old female. She traveled all the way from New Hampshire because she had ingrown toenails and she saw that we were like one of the only ones that actually did Ani fix. And so she came all the way for that now. Yeah, Mind you, these words were kind of curved toenails that were curved in on both edges of both Gray toenails. And I did the Onifix.

I do not do a ton of Onifix. I do it occasionally when they need it. This hers is really not getting never gotten infected, but they just bother her. So I put Onifix on bilaterally and then she'll come back when they fall off. That's when I I used to have them come in every three months and then I would apply another one proximately. But at this point I try to keep it on as long as it keeps on stays on and if it falls off, I don't charge them to put it on it.

I, I, I kind of guarantee it for three months. If it falls off, then I just charge an office visit for that one. Next was a a 64 year old female with a, a right a foot lesion. And I kind of did X-rays did offloading. She had a kind of a prominence on the extensor hallucis longus just proximal to the to the first met head. So I think she has rubbing and bow stringing of the extensor that's causing like an ulcer.

I think it's because she was wearing slip on shoes and then you're just pushing your foot in there and it was hitting on that area. So I made a little offloading pad. I felt like I was in school again with XM do a ton of padding. I did like some felt and offloaded it and stuck it on her foot with the elastoplast and put right and left on it. I felt so crafty. OK, next was a Q Tenza consult. This is a, this is a 72 year old man.

He has non diabetic neuropathy. You know, these ones are just like willing to do anything for the neuropathy. He was thinking about going to Columbia for stem cell injections. He has seen a number of different providers. He's doing some vibration plate. I don't exactly know what it is, some vibration plate where he pays $250 just to vibrate his feet.

He's considering a nerve stimulator and he was referred over from the nerve stimulation pain management at a hospital for us to do Q 10s of the problem is they didn't preface it that Q 10s usually isn't covered for non diabetics. And so I'm going to try to get it covered because he's on all these other medications and things like that. And he, he, he can feel. So it's like a non he, he has symptomatic painful neuropathy and so we'll see if that's

that's covered for him. I'm going to try, try to, we've had some patients, some insurances that cover that. Next was my oh, this is, I don't think I talked about this, but this isn't one of my favorite shock waves of the day. This is #4 actually #3 for the 4th digit fracture. This is a fracture non union that's been there for a year and a half that didn't get better. Really swollen digit after the first and second. She's already feeling better. She's she's on #3 for this focused only.

So when it's a fracture, it's a little toe come on, it's a small area. I'm not going to do radial on that. It's just too so. But she's doing focused only for that one. Next patient was a 40 year old female had 4 foot pain quite possible neuroma I she does have a lot of tight Aquinas and so I talked about anatomic shoes and she's going to do the the Pelto special at night, split foam rolling, morning stretch and

then see her in one month and see how she does. And the last patient of the day was a 82 year old male for a right right Aquinas as well. He had painful Achilles once again, foam rolling and stretching. This guy, he was great. He was a one of The Pioneers

with pickleball. So he's like got this pickleball shirt and I started talking about pickleball and he's like, yeah, Massachusetts. He was like 15 years ago, he started to play pickleball and he learned it from a guy that played it in Florida. And then he made his own little pickleball courts. Like they went to the rec center and asked them to do the pickleball courts. See anyway, he was really, I think the main issue is he was tight and he needs some help with that, with that tightness.

I did not do a night spin because he's not having any pain getting out of bed in the morning, but he's very, very tight. So I had to work on foam rolling, stretching, things like that. If it doesn't get better, then I will do probably physical therapy for him. OK, so that was the day. I hope you guys found this beneficial. I am putting together kind of a six month challenge for some people that are interested. If you want to learn more, you can go to podiatrypracticemastery.com.

There's, there's, I think there's going to be something up top that says challenge or it'd probably be back slash challenge to find that looking for some other practices that want to bring their practice to the $1,000,000 mark and beyond. And I was thinking, I think the best people for this are people that are, are already busy. I think there's two, I, I did a, a podcast recently. I think there's two groups of

people. The in terms of practices, not people in general, just practices, some that are they're supply constrained, meaning they don't have enough supply of patients. Those are harder to deal with. Those are harder to like, I don't know if you get the best benefit from from the mastermind because you're not busy enough, you don't have the the the number of patients that you can

optimize. If you're, if you're still trying to get in patients that that's your whole focus is like marketing is AdWords newsletter, getting referrals, everything else like that. Once you get to a certain amount of patience, then you're looking to go from like 600,700 thousand up to the $1,000,000 mark. And then so it's doing that

transition. Once you're totally busy and you don't have any more room for patience, then I feel like that's where that's a better area to help with to optimize, to optimize your practice production. OK, So those are those are things that would be the better people for this challenge. OK, Once again, hope you guys enjoy this. Have a great day, talk to you tomorrow.