My name is Sheila O'shaughnessy and I've been coming to see greenand staff for six months. I saw him on Facebook awesome people liked him so I um made an appointment came I came because I new I was suffering from peripheralneuropathy and I had burning and tinglingmy hands and feet and
heating and burning went up to my elbows and my knees and I knew I had to do something about it and I knew if I didn't take care of it this issue that I would be very I would be immobilized as I got older I also came because I have avery foggy brain lo and behold
up to six months I do not have theburning and tingling up to my knees and elbows t's now onlymy feet and hands I found out I was allergic to gluten I found out I was allergic to lots of foods different foods.I changed my diet I change the way I think about how I need to improve my health I'm off
all mediions except for the supplements that Green has been giving me and I am more than thrilled about the way I feel today and peoplehave noticed the changme. I look forward to continuing on this journey with you and I look forward to continuing thisjourney with green and his staff until I feel like I am completely cured of all my ailments wonderful great
Athletes foot is a rash on the skin of thefoot and it's the most common fungal skin infection. Benjamin Wehrli of Desert RegionalMedical CenterPalm Springs, explains the symptoms of foot fungus. Foot fungus is something that's you know obviouslybeen around a long time and you hear the term athletes foot and what not but essentiallyit's all the same, you know what happens is you have normal colonization of fungus onyour skin; I mean it's aroundthe atmosphere, it's everywhere you go, when your feet sweator are you know don't allow to air out, sometimes that fungus can thrive and grow. If you haveany breaksthe skin whether it's from your
skin getting too wet we call it macerationor any other breaksthe skin that fungus can invade it and cause an infection. Itchy,burning feet that's a pretty common complaint, it can be flaky; a lot of people will startto itchbetween their toes and they just think it really itches and it doesn't go away,those are probably signs of fungus. Redness slight redness to the skin can be a sign offungus. It is contagious :you can get fungus from anybody but if you have athletes foot,they obviously you're going to have more fungus aroundthe environment. I tell people towear sandels if they're showeringcommunity showers, things like that to help preventit. Obviously sharing shoes and things like
that predisposes you to having a higher numberof fungusthere and increases your chance of getting it. Wehrli explains toe fungus.Toe fungus or onychomycosis when it starts to invade the nail we find typically comesinitially from a tinea pedis or an athletes foot or you know a foot fungus and so whathappens is it's there and it can start to colonize underneath the nail and into thenail. It can be very tough to get rid of but what we have is different treatments thatwe use, one is a topical antifungal that will help stop the athletes foot. There is pills,Lamisil Sporanox, multiple pills that you can take. They work pretty well, they're prettyefficientgetting rid of it, the down side
is that it can raise your liver function testand so it's something to be a little concerned with and watch. There's topical nail treatmentslike Pinlac or Formula 3 and then there's laser treatments. What we find is that wecan get rid of the fungus and once we kill it, it takes probably about nine months foryour nail to grow out and have a clean nail under there. The risk is that it reinfectsthe nail so I think a lot of the treatment that we talk about now are more on the preventativenature so I usually have somebody that has had nail fungus and we've cured it, do a topicalantifungal to kind of decrease the number of fungus that are there and then I have themdo a topical once a day treatment on their
nail and they just do that for life. At riskpatients could have compliions from toe fungus. With toe fungus or onychomycosis onething that we worry about is that the nail becomes very thick and it can become painful.Most people that don't have normal sensationtheir feet when they start to rub and causeproblems will know it and will stop wearing the shoes and seek medical attention. Diabeticpatients if they get thicknails and they have neuropathy where they lose sensationin their feet, when they start to wear thata shoe it'll rub, ulcerations underneaththe nail orthe back of the nail can predispose them to infections with bacteria, which aremuch more virulent and could be limb treatening.
So there's certain popluations of people thatwe're much more concerned about with causing problems and limb loss and diabetics or otherneuropathic or autoimmune deficient patients are people that are much rigorous on treatingthe fungus.
These are the instructions for evaluating perceptionof vibration. Use a 128 hertz tuning fork. SOUND Hit the tuning fork hardenough so that the sides touch. And make sure that the subjectknows the type of sensation. Do you feel this asa vibration or a buzzing? gt;gt; Vibration. gt;gt; As a vibration, very good.
Now repeat the procedurein the feet. Again, strike the tuningfork hard enough so that the sides touch andimmediately put the tuning fork on the distalinterphalangeal joint. Count the number of seconds. Ask the subject to tell youwhen the vibration stops. gt;gt; Now. gt;gt; It stopped now?
Good. And repeat the procedureto the opposite side. Again, the tuning fork goeson the distal interphalangeal joint. Make sure you strikethe tuning fork hard enough so that the sides touch. For evaluating deeptendon reflexes, with the subject seated,examiner should use the hand
to gently dorsiflex the footat about 90 degrees. Press upwards slightlyon the sole of the foot. Use a reflex hammer, preferablya longhandled reflex hammer. A tomahawk hammeris also acceptable. And strike the Achillestendon just behind the heel. Contraction of the gastrocnemiusmuscle will be both seen and felt. Repeat the procedurewith the opposite leg.
Have to do now is showthe discrepancy between the knee reflex and the ankle reflex. Many patients with HIVdisease have both central and peripheral nervoussystem disease. So one may see a mix ofhyperreflexia at the knee and reduced reflexes,or hyporeflexia or areflexia at the ankles. So now we'll attemptto demonstrate this.
So here first for the patellareflex, the knee reflex, this would be graded as a 3plus, there is hyperrefelxia and spread of the reflexto other muscles. In the same patient,ankle reflexes are reduced significantly outof proportion to knee reflexes. So these are the differentgradings for ankle reflexes. Absent means that with a strongpercussion of the Achilles tendon, there is no contractionof the gastrocnemius.