(music) TB: That way we can see the full extent. So how much was it like this when you were a young? You can relax your feet, you can relax. How was it when you were a young girl? Was it this bad? Patient: Just the heels, initially and that’s when they sort of cut it up, and then I was limping around with a bandage around, I’m trying to recollect (remember) I don’t remember if it was the right or the left, but it was the heel I remember right away. TB: The heel? This one over here where it all started? P: Uh hum. TB: And goes all up the side. P: Now it’s everywhere. TB: And now it’s on your poor hands to, uh? P: Yeah, this is recent. TB: How long has it been on the hands now? P: I would say at least six eight months now. TB: have you ever seen a dermatologist before? P: No. TB: Both heels. So how much were you scraping it down yourself? P: As much as I possibly could. Like I said, sometimes I’ve harmed the good part of the skin and it bleeds, you know. TB: The problem with scraping yourself, because the tool you have isn’t precise, it just takes off everything. P: And then I buy those blades. TB: I know. Of course, blades can be dangerous. This is gonna be very hard for even a foot specialist like me to treat. So what we’re gonna do, I’m gonna spray a callus softener. Try to soften as much as we can and then I use my own scalpel and we try to remove as much of the dead skin as possible. P: So you call this a callus or a corn or what? TB: So callus is just hard skin that grows above the skin and that’s because of direct pressure. So anything that’s really sticking out like all this, this is callous. When we see circles of hard skin that go into the body, that is from pressure: pressure and turning. That’s what pushes the callus into the body and that is what a corn is. P: It’s like a little root. TB: Like a little root. P: I’ve done a lot of discovery (research) on my own. TB: Yes, so as you can see the majority of the hard skin is along the outside of the foot and the heel. These are weight-bearing areas. Yes, pressure points and that’s why the majority of is here. But for some reason, your body is producing hard skin faster than normal, and that’s why it’s having a very fast reaction to the pressure. P: I have thick skin! TB: You’re a tough girl! That’s why I knew it. You’re a tough girl, tough skin. That’s the only way to that… P: That’s why I have such hard skin! TB: That’s right! I don’t want to mess with you! So what we’re gonna do we’re gonna try our best to give you as much relief as we can, okay? And this is something that you have to do yourself. P: So you see the end of the big toe? TB: Yes. Yep. The problem is like you notice, if you didn’t walk at all, this much would come right back. So the goal is to again, soft shoes, as much padding and cushioning as possible. P: You see the kind of shoes I wear? TB: Yes. P: In fact, Giselle was teasing me. She’s known me for about 17 18 years now. She was teasing me when was with her last week. TB: Yeah. P: She said, “Oh your feet are not yet ready for Summer!” It was the nail polish! We were talking about nail polish. You ought to see the soles of my feet! TB: Well what did Doctor Giselle say about me? She said … P: She said your dad was… TB: Yes. P: And you used to sort of just hang around. TB: That’s right! I used to be that his shadow and now I’m my own person now. Okay, so what we’re gonna do, we’re gonna take down as much as we can, okay? We just got one more one more foot to do. I know it’s really sore even with the callus softener. Okay. One done. So here is this. So it’s very similar, oh my, I have to sign in. Hold on. Oh! Because it got age restricted from YouTube, YouTube won’t show it to people who are underage and I haven’t signed in. But if you look, this is it here, one solid piece. Yours is just little bits and pieces all over. So like I said his is the closest to your foot. P: And you did this just two weeks ago TB: No, I filmed it a while ago, but I posted it two weeks ago and 150,000 people saw it. P: Yeah, I see that. So we’ll keep spraying it to keep it we gotta keep this really soft. Get this soft. So that’s why I’m trying to get him to really scrape it down himself. It’s about constant care, so if you’re able to have the time to really scrape it down yourself. P: You didn’t put it on? TB: No, it’s not working. I can’t sign in because it’s age restricted. P: It’s not good at all. I got it now. TB: So this is the tough area again, I know I know. I’m sorry. Did you ever have a surgery? P: On one of the feet, I don’t know which one. And it was that area that was first one whether they said it was a corn, and they removed it. I don’t remember which foot though. It was so long ago. TB: The problem is normally callus is just dead hard yellow skin. The fact that it has all these little red dots and like looks like little vessels to me shows that it’s either scar tissue or we have that tissue from underneath that has been caught and stuck in the callus and that’s why it’s so much more sensitive than normal in this spot. It also could be just because of the amount of pressure on the heel that’s what’s caused the tissue to P: To make it more tough. TB: And more sensitive, and it’s hard for me to dig that out because you have more feeling or sensitivity in that area. P: Right. TB: You okay? P: Uh hum. That’s why we just take our time, and we we take out as much as we can. And I’ll write a note To Dr. Giselle, P: Giselle, yes. TB: To get a dermatology referral just to see if there’s something else. P: Going on. TB: Yes. At least for the hands too to see if they can give you something to stop that. P: It’s fortunately, fortunately it’s not so bad. Huband: But it might you know? P: Yeah but it could. Who knows? P: And again, it’s all around the palm. TB: All around. P: Not in the middle part. TB: No and it’s similar to the foot. It’s where you’re putting all the pressure. P: Right. TB: So what I’ll probably do is similar to last time: I go over everything once applying more of the callus softener and then go over everything again trying to take out all the way to the bottom. P: Uh hum. TB: No, I really appreciate your patience you’ve been here a long time in the office, sorry. H: No problem. H: She is so used to waiting for her healthcare, okay? It’s alright. (laughter) P: Why is podiatrist not included as part of OHIP? (Ontario Health Insurance Plan) TB: Podiatrists do have some coverage, actually. Podiatrists can claim I think $10 to OHIP. They have billing rights, but the problem is I’m a chiropodist and Ontario practices a chiropody model So after the year ’91, there has been no new podiatrist in Ontario. There’s only 45 around 45 podiatrist left in Ontario. So chiropodists do not have any billing rights. We’re not able to claim that $10 to OHIP. But even if you’re going to a podiatrist, they’re only covering $10. The rest would have to be covered by you. P: That’s what I was wondering why you don’t they don’t cover part of it because there are so many… H: (?) TB: No. It’s the same thing. H: It is very uncommon really. P: I’m not talking about my kind of thing, there are so many other things too. TB: It’s just the money. P: People who have knee problems.. TB: OHIP you know to fund and pay for all these services it’s very hard; they’re already very tight. TB: I’d rather they give it to Doctor Giselle than me. She can take it. P: The rest of Canada, do they have something similar to OHIP? TB: Yes. Yeah, every province has their own provincial plan, but everything’s a little different. P: Yep. TB: But it’s pretty much the same. I’m gonna put this here. TB: I think the spot here on the left foot is much worse up here. The other ones on the higher up, this one yes in another area. You okay? P: Uh hum. TB: This one’s a little sore or it’s okay? P: It doesn’t hurt; it’s okay. I know where you are working on even without looking. TB: Remember you don’t be shy with me. You tell me if something’s bothering you. This one’s a little sore, ah? Yes? P: It’s not it’s not hurting but it’s quite. TB: Sensitive? I can I can feel it. It’s just that top layer that’s really… TB: I’m gonna spray it a little more. TB: Change the blade. P: How long have you been doing this? TB: Me? P: When did you take over your Dad’s business, I mean? TB: I finished school five years ago. This is gonna be my sixth year in September. But as you know I’ve been watching my dad do this my whole life. P: Right. TB: So my job was to take off the shoes and socks. P: Yeah, I know Giselle mentioned that to me. TB: She knows my story; she’s good. P: She told me that. TB: Yeah, she’s been very, very good to me. Any foot problem her patient has she sends it right here. So yeah, it’s this is what I grew up watching and and learning and but I think the biggest thing that my dad taught me was how to how to socialize or talk to people. That’s something P: That’s important too, obviously. TB: Very much, so. How to treat people you know with respect and make them feel comfortable. Etiquette. Those are the people skills. That’s the stuff that you don’t learn in school. P: No, they don’t teach you. TB: Because anyone can learn how to cut toenails. P: And you tell him all your different cases? TB: He’s always asking all the time. He’s always asking what I’m doing? But the way I practice is very different than his. He didn’t do as many surgeries or injections or laser treatment all the stuff that I do. So that’s why, yeah, he’s very always interested. Because of course, technology has changed, the treatments have changed. What I’m gonna do… We tried to take as much hard skin as we can. Okay.