Podiatrist Personal Statement

The district nursing team were now to be responsible for the wound care of an ulcer on the sole of her right foot on her impending discharge. She had previously attended the practice nurse and a podiatry service based within her local clinic. Due to a change in circumstances, she was now clearly housebound for the near future due to mobility issues. Prior to an arranged visit, the patient had called the nurse to advise her that she was pyrexial and was experiencing a pain in her right foot that was different from her normal neuropathic pain, which was often problematic. She was also finding it difficult to mobilise and was disinclined for diet but was taking oral fluids.

As a young child, I witnessed underserved communities in India and America that truly needed health care, but were deprived of it, due to high poverty. I was a casualty of this situation when I moved to America. I lived in a neighborhood that was poor, and there was a lack of proper healthcare, especially if one did not have health insurance. The neighborhood had only one hospital in its vicinity, and the wait hours were long. My experiences were never pleasant, for the staff and doctors were often rude. These experiences made me realize that my passion for helping would be most helpful in a health care career. However, I knew that if I were to become a doctor, I had to maintain my grades, as it is a highly competitive field. This desire to become a doctor led me to take classes at a community college while attending high school.

For clinical week 9, I was assigned to the UMC Wound Care Clinic to view a different field of nursing. As soon as I arrived at the clinic the nurse told me that I could bounce around from patient room to patient room to view as many wounds and burns as possible. The first patient room that I went into was a young Hispanic man who had an infection on his right lateral thigh area that spread from the popliteal area to the greater trochanter. When I asked the patient what had happened he told me he was injured at work and the injury got infected, which he never went to the doctor to have it evaluated. So, basically the infection was eating away at his skin and muscles. The patient has to come to the wound clinic every day to get dressing changes.

I get to see various types of wound, from pressure ulcer of different stages, unbelievable edemas, arterial and venous ulcers, diabetic ulcers, and many other wounds of uncertain causes. I have never expected to see those kinds of wounds. I have seen different drainage amount, color, and odor, various shapes and location of the wounds, and amputated edematous legs. I have learned also the different types of dressings and antibacterial ointments used. I had given the chance to observe a client on their high-tech hyperbaric oxygen therapy which makes the wound healing even faster. The most important lesson I have learned from the team members was, “DO NOT GET

OrthoOklahoma is an orthopedic medical clinic with a physical therapy branch that provides outpatient physical therapy care. The facility has a staff of three licensed physical therapists and a physical therapy assistant along with four physical therapy techs. I was able to observe all three physical therapists, Megan Ripley, Joe Ogle and Ken Roberts. At OrthoOklahoma, the most common patients are post-surgery from repairs of muscles, bones or joints. While shadowing these therapists, I observed cases of total knee replacement, total hip replacement, ACL/meniscus repair, rotator cuff repair, frozen shoulder, labrum repair, and other ailments from wear-and-tear and aging. This experience allowed me to talk to physical therapists about the ins and outs of their job, learn about different exercises and routines for treatment of injuries, and really get an idea of the work it takes to become a well-respected physical therapist.

Truthfully, as an undergraduate I knew very little about the osteopathic profession. In 2013, however, I began working as a medical scribe with Dr. Ghaffari-Greene, DO, in the Sibley ER and she opened my eyes to the beauty of osteopathic medicine. Thanks to Dr. Ghaffari-Greene, and a number of other osteopathic physicians in the ER, I have come to understand what osteopathic medicine is all about. Three years after my first exposure to the osteopathic profession, I continue to be motivated to become an osteopathic physician for many reasons. These include the following:

HISTORY AND PHYSICAL EXAMINATION_______________________ Patient Name: Chapman Robert Kinsey Patient ID: 110589 Room No.: 322-B Date of Admission: 23 February ---Admitting Physician: Martha C. Eaton, MD, Geriatrics Chief Complaint: Admitted from Dr. Max Hirsch’s office due to deep ulcer on left toe. Admitting Diagnoses 1. Severe peripheral vascular disease, status post deep ulcer on left toe. Rule out thrombolysis. The patient was admitted to a regular floor. Condition is serious. 2. ALLERGY TO PENICILLIN, which puts patient into anaphylactic shock. 3. Continue with home medications. DETAILS OF PRESENT ILLNESS: Mr. Kinsey is an 87-year-old white gentleman with history of (1) Chronic atrial fibrillation, on Coumadin. (2) Chronic deafness,

These topics and my interactions with clinicians in our lab have driven my interest for pursuing the specific area of orthopedics. From back injuries, Tommy John surgeries, broken feet, and a prosthetic leg, my family has also had a lot of experience on the patient side of this specialty. The chance to rehabilitate athletes, such as my loved ones, is appealing, but I know that these injuries are not exclusive to this population, and my true passion lies in the opportunity to rehabilitate individuals in underserved populations. My time in Guatemala and Nicaragua has really grown my heart for people living in the impoverished countries of Central America. My first mission trip there largely contributed to my passions for becoming a doctor and since high school, my career goals have been aimed at building the skills necessary to serve those communities. Eventually, I would love to be able to marry my interests in global health and orthopedics, and incorporate my biomedical engineering background, to contribute to research aimed at optimizing care and medical technologies in low-resource settings. As the leader in global orthopedic initiatives, UCSF and the prospect of working with the Institute for Global Orthopedics and Traumatology stand out

The healthcare team honored the patients’ wishes as best as possible; the only time we bothered the patient was when we changed the dressings on the pressure ulcers located on the anterior portion of the left foot and right buttocks and when we provided the patient with PRN pain medications. Since this is a Medical Surgical floor, we were required to do one assessment, and that occurred during the time the health care team went in as a group to clump all of the care up and do it at one time. The only negative experience that had occurred was when the patient was expressing non-verbal signs of pain – and from that point, we worked quickly to give him his PRN pain medications to manage it.

It is estimated that 387 million people, globally live with diabetes (Phillips & Mehl, 2015). According to Medical News Today [MNT], diabetes is a metabolic disorder; which causes patients to be extremely thirsty and produce a lot of urine. Diabetes arises due to high blood pressure, due to the body not being able to produce enough insulin or because the body does not respond well to high insulin levels (MNT, 2016). There are four types of diabetes; there is the pre-diabetic stage, type 1 diabetes, type 2 diabetes and gestational diabetes. In 2014, 29 million people died due to diabetes. This equates to 1 diabetic patient dying every seven seconds due to preventable complications (including complications affecting lower limbs) caused by diabetes. It is said that 20-40% of health care costs are spent on the treatment of lower limb complications due to diabetes. The risk of a diabetic patient developing a foot ulcer is 25% and foot ulcers account approximately 85% of lower limb amputations. Diabetic complications that affect lower limbs are caused by both type 1 and type 2 diabetes (Phillips & Mehl, 2015). It is said that the World Health Organization described diabetic foot syndrome as including all possible complications in relation to the feet of a diabetic patient. Diabetic foot syndrome is defined as the ulceration of the foot, from the ankle downwards. Causes of foot ulceration include peripheral sensory neuropathy, vascular disease (ischaemia) and infection

While shadowing Dr. Julia Shuleshko, I enjoyed witnessing the osteopathic philosophy in her practice, and how it led her to heal wounds better. She often described healing wounds as if it were a puzzle, and the best place to start was with any underlying health problems such as diabetes or circulation issues. I found it eye-opening that her default was to address the patient’s overall health as much as the wound itself. Her treatments utilized products to encourage tissue growth, but largely relied on the body’s ability to self-heal. She also implemented preventative strategies whenever possible—either through education or therapeutic methods. Her forward-thinking approach, grounded in osteopathy, was amazing, and inspired me to pursue a career

Working in a setting with scientific applications whilst providing quality care to patients is something I feel very passionate about. As a podiatrist I will be providing preventative care and advice to individuals and community groups by increasing the awareness of healthy feet. Educating the public through the use of health campaigns such as ‘Feet for life,’ as discussed on the College of Podiatry website, is a brilliant platform to motivate the public by explaining the consequences of neglecting good feet care. Gaining work experience in a dental hospital made me understand how important it is for medical practitioners to keep a strong relationship with their patients.

The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.

Jones is a 64 year old well nourished man with a history of long-standing non-insulin dependent diabetes mellitus (NIDDM). He had an open heart -surgery bypass graft 7 weeks ago. The graft site got infected and had to undergo an emergency surgery to improve circulation to his left lower limb. Mr. Jones is relieved that his leg was saved and he is now being prepared for discharge. He wants to regain his strength so that he can start doing the things he loves. Currently Mr. Jones needs moderate assistance depending on his level of pain or fatigue and ambulates with a walker. Mr. Jones still needs help with activities of daily living. He has urinary and bowel control problems as side effects from multiple antibiotics. Mr. Jones is married and has 4 grown children that provide him with love, care, and support. The nursing staff is teaching Mrs. Jones how to perform sterile wound care for her husband as he will need dressing changes three times a day, blood glucose monitoring and a healthy diet. Social service is helping to keep communication channels open between Mr. Jones, his family and the nursing staff to maintain psychological and emotional health.

The diabetic foot disease is the leading cause of non-traumatic lower-limb amputation and results from three common pathologies: diabetic peripheral neuropathy, peripheral arterial disease, and infection. Late complications include foot ulceration, Charcot neuroarthropathy and amputation (Turns, 2013, p.422) though another specialist like, Iraj who wrote Prevention of Diabetic Foot Ulcer, added to the most common facts: deformities and minor