Removal of Painful Foot Callus and Corns for Diabetic Patient 15 Years of Suffering

TB: Yeah, it’s no fun for you always having the hard skin P: I know TB: But you know what? I think it’s not as bad as it was before P: Oh, yeah? TB: Because you’re wearing a better flip-flop at least What are you gonna do in the wintertime? TB: You just gonna put like a big sock over the Crock (shoe)? P: Yeah TB: A plastic bag? P: What I do is I wear socks during the wintertime TB: With the Crocs? P: With the Crocs, yeah TB: Socks with Crocs? P: Yeah! TB: That’s a fashion faux pas! Okay, I’m gonna put this foot down so I can get nice and close to this one. Okay, so you just relax Yeah socks with Crocs, huh? P: Yeah TB: So you never ever really wear shoes? P: Not anymore now not when this got bad like this. All these sneakers, I wear them Running shoes TB: You do? P: Yeah TB: Do you wear any sort of foot support, or gel insole like an orthotic or P: You know the one that you know you would you’re you know what that is sandals you mean? TB: No, in just a running shoe or any sort of shoe? Do you have any sort of foot support or orthotic? P: No, TB: Why not? P: I don’t know TB: So these kind of corns and calluses are caused by pressure, the way you’re walking. If we make you a good orthotic, it can help slow down P: What is it? TB: An insole, a custom orthotic where we take a mold of your foot P: Yeah, is that the one that you go and when you go into the stores they step on or something and they it decides which one you got it? TB: Yes, that’s not custom-made; that’s a customized. So what I would make for you is a custom-made insole or orthotic. So I take a scan of your foot a 3D scan and we make a shell based on the size and height of your arch so it’s gonna give you a lot more support P: Oh, you know I had that when I went to the first first chiropodist TB: Yes. Yeah, and it was too hard? P: He made it to made me one, but it didn’t help so much TB: It was too hard, right? P: Yeah TB: Okay, so the thing is, what I learned through my dad, is it has to be a little bit flexible; it can’t be rock hard and it has to be comfortable So all we need is a shoe that has a removable cushion and we can put an orthotic in that shoe P: So you can put it in any shoe that you wear? TB: As long as the shoe has a removable cushion P: Oh TB: If it’s a closed toe shoe, I can make different types of orthotics, if you don’t have a removal removable cushion But you really should be wearing something with all this hard skin that you have growing P: That’s what I have is a Sketcher running shoes TB: Yeah P: And that it helps because it has a cushion TB: And it’s soft. So the only thing that it’s missing is support because it does have cushioning but it doesn’t have support You have a very flexible foot so when you’re standing, it’s collapsing a little bit too much and it’s putting pressure in other areas of your foot that it shouldn’t be P: And that’s what will (cause the corn)? TB: Yes P: And how much does this cost? TB: A custom orthotic is five hundred dollars It takes two to four weeks to be made so normally we take a deposit for half the amount the day we do the scan When the orthotic comes in, you pay the remaining amount, and if you have insurance, we give you all the paperwork, my prescription, to submit to them P: Well I’ll talk to my husband’s insurance and see when I can be available to because I think they pay half TB: It all depends on the plan. Some pay the full cost, some pay for two pairs, some pay for half, it all depends on your plan P: Yeah. Yeah, I think they paid for half, and that was about four or five years ago TB: Oh, okay So you find out whenever you want, it’s here But what I would suggest is because it’s winter time coming up you’re gonna have to be wearing a closed toe shoe, P: Yeah, yeah, yeah TB: We make you that one even if it is for the Sketcher shoe, at least is better than nothing. Okay? P: Okay, I’ll call them and I’ll see how much they will carry of that cost TB: Are you wearing that same Croc at home? P: Yeah, yeah, yeah The only thing is for the closed Crocs that I have, TB: Yeah P: I’m getting more calluses on toes, the tip of the toes

because, you know, it pushes through the edge of the TB: Yeah, and all your toes are now really curled and clawed TB: Are you doing okay? P: What’s that? TB: Are you doing okay? P: So far TB: Any pain? P: What’s that? TB: Any pain? P: No, no, no TB: That’s no fun P: Oh at night? TB: No, with me doing this P: Oh no, no, no. There is nothing TB: That’s no fun P: Yeah TB: It’s too easy for you P: Which is good! TB: You just sit there look pretty, uh? You just relax! P: And then you do all the work, ay? TB: That’s why we’re here Do do any filing of the the hard skin? P: Sometimes TB: What kind of file do you use? P: I got it at Walmart, the one that has a blade in it, but I do it after after I take a shower This skin is soft TB: Tita, you gotta be careful with that P: Yeah, I’m careful of that, I don’t do too much Especially the middle portion because mostly I cannot do the middle portion because it won’t come off. It’s this side the toe side and this (?) TB: So I have a better file P: Okay TB: And you might want to think about. It’s very safe; it doesn’t cut into the skin P: I’d like to look at that TB: I’m gonna put the foot just like this, okay? You okay? P: Especially this part this toe TB: You okay? P: Sorry? TB: So how often do you file this down? P: How often? TB: Yeah P: Once a week probably TB: Okay. If you were to do this twice a week, it would make a big difference P: Oh, yeah? TB: Yeah P: Okay TB: And by having more support the foot won’t roll so much over on the side, and that will slow down how fast this comes back as well P: Okay TB: What kind of lotion or cream are using? P: I stopped using it for about three weeks now because I can’t get a chance to go to the store look for it. It’s it’s the creamy one? The one that they say you use for your foot while you are sleeping TB: While you’re sleeping? P: Oh it’s the Dr. Scholls TB: Okay So afterwards, I’m gonna put on a very very nice cream It’s not even a cream, it’s a foam and it’s a new technology that seems to be working very well P: Can you buy it at the stores? TB: No, only from health care professionals So this is something that I’ve been doing a lot of research on and I found a really really nice product P: So I buy it from you? TB: Yes, so what it does it’s non greasy and it’s a foam so it actually puts the ingredients into the foot, and it doesn’t sit on the surface That’s the problem with cream and lotion it just sits on the surface So there’s a lot of technology in this cream What happens it builds a barrier so it allows the moisture from the skin to stay there P: That’s good TB: So this is something we’ll put on afterwards and that’s really gonna help, okay? You got a little bit on this side You’re getting the works today, oh my gosh! P: Well, when was the last I was here? More than a month or two months, I think TB: A little bit more than two months, but I’m telling you compared to before, it’s a lot better P: What’s that? TB: It’s a lot better than before P: Oh, yeah? TB: Before used to be really heavy Heavy, heavy, heavy P: Heavy? TB: Yeah P: It looks good. Your efforts are helping a lot TB: And you and you because if you keep filing, you put this cream or lotion, it’s gonna slow, you get so orthotic, it’s gonna just slow down so it won’t be as much P: Okay TB: That’s the whole goal P: That’s what I like in you. You tell me good things to do. The other people where I go then just

keep on doing that and not telling me anything TB: I like seeing you,Tita, but I don’t want to see you no more I want you to be good, so you don’t have to see me I’ll see you at the Filipino parties instead! You’re making me some nice dinuguan P: Dinuguan, I love dinuguan! TB: Me too! With hot rice P: I know Have you tried this sauce? TB: Seafood City? Okay Seafood City I’ve never been to but something sweet though. I’ve never had the food I was in there recently and P: Their dinuguan is very good TB: Do they make it liquidy, or is it more more meat? P: I think it’s for meat TB: Because you know some are really liquidy, right? P: Yeah, yeah. I know TB: Okay P: This, this, um this toe, front toe, Jonathan TB: Yeah P: Sometimes it hurts and there’s TB: This one? P: Yeah TB: Because at the tip of the toe, right? P: Yeah TB: , Yes, and that’s because it’s a little bit clawed, and it’s putting too much pressure on the tip of the toe That’s why there’s a lot of hard skin It’s pressing into the ground Okay. We’ll put the foot up You okay, Tita? P: Oooh TB: Oooh? (laughs) You never fall asleep when you’re here, uh? P: Uh TB: One side done P: Okay TB: I’m gonna put on a new blade. Your skin’s so tough it dulled the blade. Look at that P: Okay TB: You’re rock hard Okay, you okay? P: Yeah TB: I’m not hurting you? P: No. Don’t worry. When I get hurt, I’ll shout! TB: You give me a kick! You throw something at me You’re diabetic? Or borderline? P: I’m what do you call that? TB: Borderline P: Borderline TB: It means you’re at the Filipino level Did you hear about Seafood City? P: No TB: it’s opening up or I think it’s open in Heartland P: It’s open and there are a lot of people going there TB: Of course P: And before you get in, you have to line up TB: Yeah, yeah P: And they said prices are not that great TB: They’re expensive P: Yeah It’s just like you remembered that Krispy Kreme, that one time? When people could not get in the store? TB: That was crazy. Yeah, people waiting all night P: It seems that it’s like that with this Seafood City. People are all so eager to see what it is Or what it’s like They said some people go in just to take pictures TB: So wait, it’s like a grocery store though, right? P: Yeah TB: With a restaurant in the back? P: Apparently there is supposed to be but it’s not open yet they haven’t started serving yet so they go to Something Street. That’s why Something Sweet gets so full every time TB: Yeah Something Sweet is nice P: Yeah, I know TB: They got halo halo in there P: Yeah, but so expensive, ay? More than five dollars TB: See but I never really ate Filipino food only a Filipino parties P: Have you tried (?) TB: What’s that? I only know what things look like P: it’s the one with peanuts TB: No P: Peanut and oxtail, no? TB: No, never P; Oh TB: Because you know my mom’s German P: Oh Yeah, and your dad doesn’t cook? TB: No he was busy working P: Oh TB: But my mom can make a good chicken adobo P: Oh that’s good, chicken adobo, yeah Well one of these days I’ll invite you to the party at home where you can taste all the different kinds of Filipino food TB: Lumpia, pancit, sinigang, how do you say it? P: What’s that? With that the P: Roux with the sauce with the TB: Beef it’s beef usually P: Beef sinigang. It’s water-based There’s like sabaw which is broth TB: So Tita, we had a little red spot in the middle of this corn P: Oh, yeah? TB: Yeah, it means there was too much pressure P: Yeah, because I could hardly walk with that TB: This side? P: Yeah TB: We’re going to make it as thin as we can, okay?

P: The very first time I went for my my foot TB: Yeah P:The guy, the chiropodist dug so deep into it TB: It hurt? P: Maybe about half an inch, because of the corn TB: Well, I’ll tell you now there’s a lot of hard skin, but it’s not deep deep deep P: Um humm TB: Today I gave you a little pinprick Did you feel anything? P: No TB: Okay, so afterwards, I’m going to put a little bit of an ointment and band aid to be safe Very very small little pinprick, okay? P: Okay TB: Because I’m trying to get everything out P: Thank you TB: You’re welcome It’s honestly not as deep as it used to be No pain here? P: Yeah TB: So do you mostly eat Filipino food at home? P: Yeah, oh well mother we’re staying with my son. He has this cookbook you know it’s all American or Canadian recipes TB: How often do you go to States again? P: What’s that? TB: How often do you go to the States? P: I don’t go there right now Before we go there six months for me and six months for my inlaws my daughter in-law But now they lessen it to three months each of us and that happen in a year TB: You split it up now. P: Um-hmm TB: But your kids are doing well down there aren’t they? P: What’s that? TB: They’re doing very well down there P: Well my my daughter is a doctor at the clinic TB: Wow P: She doesn’t want to come back because she wants to come back here with your retires, but right now she said I’m not gonna make the same money as I’m making here because the government you know the doctors here are so regulated by the government TB: Yeah, yeah P: And she said I will be able to recoup what I spent get school my studies here TB: Did she study here or down there in the States? P: What’s that? TB: Did she study in the States or in Canada? P: She studied in the States She took her BA her Bachelor of Arts here and then she went to the because we had a green card then so she was able to you know get the tuition fee of the immigrants TB: Mmm P: Not, not a student, so it’s not as much just you know Well I’m too happy with my kids because at least she’s a doctor, and then the next one is a teacher TB: Yeah, that’s good P: And the last one is a paralegal so. (Video was recut here) TB: No you’re living the typical Grandparent in retirement you gotta take care of the kids P: Take care of kids TB: You gotta take care of the kid’s kids P: And you get scolded if you spoil them too much you get scolded TB: Oh, you’re a bad Lola P: I know “Don’t do this! Don’t do that!” Like my my eldest granddaughter here in Canada, TB: Yeah P: She’s allergic to nuts eggs and all these kind of things right, but her mom is also dieting her and top of that and you know sometimes the kid wants to eat donuts almost everyday she didn’t want it maybe just every week once every week TB: And what are you doing? P: My husband sneaks them! (laughter) He sneaks in what they want And sometimes I get mad at him and I said, you know if the kid is already allergic and she gets diabetic then that is so bad TB: Oh my gosh! P: When I’m not here and he goes to the store, TB: Yeah P: He buys all kinds of sweets for the kids When I look at today in the TB: Fridge P: No the closet (pantry) there are all kinds of treats in there TB: Tita, you really scraped the tip of your toes, uh? P: I know TB: I gotta give you a better file so I have a file that’s safe especially for diabetics

Normal files and razors, they cut the skin This is a special file that has little bumps and the top of the bumps are flat So they pull just dead skin. They don’t pull the normal healthy skin P: Oh, that’s good TB: You know what’s the name of it? Angel Feet. P: Angel Feet TB: You know why I’m giving it to you cuz you’re an angel so you gotta have the angel feet P: Oh, thank you TB: I’m gonna show you afterwards how the file works. It’s safer for you because you know what, you get one little cut you don’t feel it too much, you’re in big trouble P: Yeah, yeah yeah, because I tried to hurt my toe before or my skin before and you know it’s really really bad TB: I’m making it rain. Look at all of this. P: Yeah TB: These ones I’ll file because they’re not too much. This is a hard one you okay? P: Yeah TB: Yeah, they’re not as deep as they used to be. I remember I used to be here a long time digging but today we’re taking our time P: That’s that’s those are the calluses that I really can easily pick on when I’m lying down or when I’m sitting home so that’s why I picked them TB: You’re a picker. P: Yeah P: I cut them with the sometimes with a what do you call this nipper? TB: Yeah TB: So this is the stuff that with a bitter file you can maintain and it’s not gonna bother you P: Yeah, that’s good TB: Okay, I’m just gonna dig out this corn and then we’re all finished, okay? TB: No pain? P: Yeah TB: Poor you. You got a lot of calluses, a lot of them P: I know that it’s really aggravating my condition too Because I told you I was diagnosed Parkinson. TB: Yeah. P: And sometimes I walk slow because of this feet it will hurt if I hurt you know TB: Okay. So this is the foam? P: Okay TB: You don’t need very much. I’ll show you P: When is the best time to do this? TB: Morning and night P: When you wake up and before you go to sleep? TB: Yep TB: I’ll put some on this foot P: So it’s on the foot not on the toes themselves? TB: You can put the toes this one you actually can go on the toes because it doesn’t leave it moist That’s the nice thing about this one. Normal cream and lotion you should not be putting in between the toes P: Because it’s oily, right? TB: Yes, this one’s non greasy There P: Okay, that’s good TB: This one you can’t find in the stores P: Okay, thank you Jonathan TB: You’re welcome. Okay. Let me put you down. You don’t jump off, Tita, you’re a wild one!