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  Leader

The

  Medical & Surgical

in

Care of the Foot & Ankle
\\ NEWS //

Covid-19 Corona Virus

 

We are open during this Covid-19 / Corona virus outbreak, but with sharply limited hours.  We are also only seeing urgent patients--such as those with at risk with diabetic wounds, infections, and those with severe pain.  For those with more routine complaints, we will ask you to postpone those visits.

To diminish exposure for everyone, please bring as few people into the office to accompany the patient, and whenever possible, we will bring only one person in the treatment room. 

You will be asked to wash your hands before being seen and to wear a mask if you have one.    

And of course, if you are feeling ill, with symptoms of a cold, flu or fever, please stay home.   

Welcome Dr. Hyowon Choi! 

We are most pleased to

announce that we have

added a new podiatric

surgeon to our practice,

Dr. Hyowon Choi.

Dr. Choi is a native of BC,

having grown up just

across the Fraser River

in Coquitlam. 

Dr. Choi is a 2010 UBC
graduate
in microbiology

and ecology.  Her medical

training was performed at the Rosalind Franklin University of Health Sciences in Dr. Schumacher's hometown of Chicago.  She has just completed her surgical residency at Presence St. Joseph Hospital, also in Chicago, and she will practice in both Bellingham in Washington State, and in our Surrey office.

Dr. Choi will help us expand our hours by holding regular clinical hours on Fridays and Saturdays.  She'll also provide surgical hours, and she will cover our office hours when Dr. Schumacher is attending or speaking at a medical conference.  

Dr. Choi is kind, empathetic, talented and highly trained.  She is also fluent in both English and Korean.  We're very luck to have her!

Statistical Update on the
Abbotsford Regional Hospital
Renal Foot Project


Patients with end-stage renal disease have significant foot issues, ranging from infections and gangrene to significant wounds and ulcerations.  These have significant ramifications on the patients quality of life and mortality. 

 

From 2013 through 2019, Dr. Schumacher was the staff podiatrist in the Department of Nephrology at Abbotsford Regional Hospital, working in a pilot study on the effects of podiatric intervention in this patient population.

 

The data surrounding the Abbotsford Regional Hospital Nephrology Department Foot Project has come in, and the results are promising. 

 

For instance, the rate of leg amputations performed on dialysis patients is 36% lower than before the podiatric intervention was introduced, and the rate of leg amputations to total amputations is 53% lower.

Further, the days saved in hospitalizations resulted in significant savings in fewer hospitalized days, not even considering the savings in fewer leg amputations performed, fewer prosthetics required, less rehabilitation, fewer presentations to the ER, less imaging and lab work, and less antibiotics. 

Better outcomes for less money!  What's not to like?

The Abbotsford Hospital Renal Foot Project

in the News

 

On January 09, 2018, Dr. Schumacher's work in the Renal Department at Abbotsford Regional Hospital was featured in the Globe and Mail newspaper.  Here's a link.  

 

Dr. Schumacher's work with complex wounds in the dialysis community was featured earlier in both the Vancouver Sun and Vancouver Province newspapers.  The story was picked up by newspapers across Canada, from Alberta, Saskatchewan, and Manitoba to Ontario and Quebec.  Here's a link.

 

        MAPLE has sprouted!

 

In the Spring of 2017, Dr. Schumacher founded an organization for the education and advocacy for patients with neuropathic wounds, who too frequently do not receive the care they deserve to close their wounds and keep them closed. 

Our group is called the Canadian Medical Alliance for the Preservation of the Lower Extremity, or MAPLE

 

The MAPLE website, still under construction, can be found by clicking here. We hope one day every diabetic and neuropathic patient with an ulceration, or at risk for an foot ulcer, will be given a link to our site for a better understanding of their condition, and how to treat it.

Speaking Engagements, Conferences & Advocacy Meetings
 

Dr. Schumacher has attended and spoken at conferences across Canada, the US, the Caribbean, Europe, Asia, and Africa. 

 

 

In 2019 Dr. Schumacher traveled to Washington, DC to attend the Diabetic Limb Salvage conference and the International Forum in the Hague, Netherlands for the Diabetic Foot conference and Association of Diabetic Limb Surgeons and the Diabetic Foot meeting in Brisbane Australia. 

Dr. Schumacher gave two talks at Wound Canada's annual conference in Niagara Falls.  

In September 2018, Dr. Schumacher spoke on the diabetic foot at the BCPMA conference in Vancouver.

 

 

 

 

In September 2018, Dr. Schumacher attended the Wisconsin Podiatric Medical Association conference. 

 

 

Dr. Schumacher traveled to Washington, DC for the Georgetown Diabetic Limb Salvage Conference held April 4-7, 2018.  This is one of the pre-eminent limb salvage conferences in the world. 

 

 

Advocacy On January 19, 2018, Dr. Schumacher met with the Health Minister to discuss the need for MSP coverage for diabetic and dialysis patients throughout the province.  Other than for Dr. Schumacher's work at Abbotsford Regional Hospital's Renal Foot Project, the vast majority of podiatric services in BC are now paid out of the patient's pocket.  We're trying to change that for diabetics, renal patients, and other "at risk" feet.

 

If you wish to help, contact your local MLA and ask that podiatric care be covered by MSP for diabetic and other "at risk" feet.

On November 9-11, 2017, Dr. Schumacher was in Venice, Italy at the 3rd annual conference of the Association of Diabetic Foot Surgeons, of which Dr. Schumacher is a member.  The A-DFS meeting hosts some of the top surgeons in the world of diabetic limb salvage. 

 

 

 

On November 9 and 10, 2017, Dr. Schumacher and Dr. Francis Chan presented a poster, “Foot Ulcers Treated by Multidisciplinary Team” at the Patient Health Experience Summit at Fraser Health. This submission presented statistics and case examples from Dr. Schumacher's work with dialysis patients at Abbotsford Regional Hospital.
 


 

​On May 27, 2017, Dr. Schumacher presented two lectures and two hands-on workshops at the national meeting of the Canadian Association of Foot Care Nurses in Saint John, New Brunswick.

 


 

On May 04, 2017, Dr. Schumacher was in Amsterdam, Holland presenting the lecture "The Effects of Podiatric Intervention on Dialysis Patients" to the European Wound Management Association (EWMA), a group in which Dr. Schumacher is a member.  Afterwards, Dr. Schumacher toured wound-care facilities in Brussels, Belgium and Paris, France.


 

On April 22, 2017 Dr. Schumacher spoke at The College of Podiatric Physicians of Alberta conference in Edmonton.  Topics he presented included:

 

  • The Importance of Wound Care

  • The Medical Management of the Neuropathic Foot

  • The Effect of Podiatric Intervention on Dialysis Patients

  • The Visual Effect of Hyperglycemia on Wound Healing

  • Biomechanical  Considerations in Amputation Surgery 

  • The Total Contact Cast 
     

  
 

 

On October 07, 2016, Dr. Schumacher spoke on the "Clinical Perspective of the Abbotsford Hospital Nephrology Foot Project" at the BC Kidney Days Conference at the Four Seasons Hotel in Vancouver.  


 

Advocacy  Many areas of British Columbia are underserviced for foot care, and BC desperately needs more podiatrists.  To help address this issue, on September 8, 2016, Dr. Schumacher joined the Podiatric Residency Genesis Committee to meet with the Vice-Presidents of the Health Authorities of BC to discuss podiatric surgical residency genesis.

 

 

 


On May 26, 2016, Dr. Schumacher spoke on "Wound Care Interventions in the End-Stage Renal Disease Patient" at the Fédération Internationale des Podologues (World Congress of Podiatrists) in Montreal, Quebec. 
 

From March 31-April 2, 2016, Dr. Schumacher was in Washington, DC for the Georgetown University Diabetic Limb Salvage (DLS) Conference.  This is a unique conference that incorporates approaches from both the vascular surgery and podiatric surgery--including hands-on surgical procedures.


 

Advocacy On March 14, 2016, Dr. Schumacher and the Canadian Diabetes Association were in Victoria to meet with dozens of MLAs, the Liberal Health Minister, and the NDP Health Critic for discussion on the need for more podiatric coverage for at-risk patient populations.

 


On November 22, 2015, Dr. Schumacher presented the lecture "Diagnosing and Treating a Diabetic Wound" at the Live Well With Diabetes conference in Vancouver. 
 

From October 23-24, 2015, Dr. Schumacher participated in a hands-on surgical workshop in Milwaukee, Wisconsin with the American College of Foot and Ankle Surgeons (ACFAS).  ACFAS is an educational society devoted to surgery of the foot and ankle, and Dr. Schumacher is a fellow with the organization.  



From August 14-16, 2015, Dr. Schumacher was in Stellenbosh, South Africa at the  annual conference of the Podiatry Association of South Africa (PASA).  He later toured medical facilities in Cape Town, Port Elizabeth, and Johannesburg.
 

 

 

On June 12, 2015, Dr. Schumacher spoke on the "Abbotsford Regional Hospital Foot Project" at the annual British Columbia Podiatric Medical Association conference in Kelowna, BC.


ABOUT DR. SCHUMACHER


Dr. Schumacher is the founder and director of the Achilles Foot Health Centre, a facility devoted to medical and surgical care of the foot and ankle.

Dr. Schumacher is Board Certified by both major certification boards of his profession.  He is a Board Certified Founder and Emeritus Diplomate with the American Board of Podiatric Medicine.  Dr. Schumacher is also Board Certified in Foot Surgery with the American Board of Foot and Ankle Surgery.  In fact, Dr. Schumacher was just recertified in foot surgery in 2019. 

 

Dr. Schumacher is the only practitioner in the province of British Columbia with both certifications.

 

Dr. Schumacher is also a Physician Certified in Wound Healing (CMET).  And he was certified in shockwave medicine by the International Society of Medical Shockwave Therapy.

To learn about his areas of specialization in surgery, diabetic and neuropathic wounds, designing custom orthotics, braces, and shoes, extracorporeal shockwave therapy and regenerative medicine, the treatment of chronic, non-responsive arch, heel and ankle pain, and musculoskeletal sonographic imaging, click here.

ABOUT OUR FACILITY

​At nearly 4,000 square feet, the Achilles Foot Health Centre is the largest podiatric facility in western Canada. 

Our state-of-the-art facility has a multiple treatment rooms and a self-standing surgical centre, which allows us to perform surgery on site, without a wait.

​We are the only podiatric facility in British Columbia to have on-site ultrasonographic imaging (to image soft tissues like tendon and connective tissues), and the only facility with on-site fluoroscopy (a form of live, moving x-ray to visualize bone). 

We also offer several unique treatments for chronic, difficult-to-treat conditions found in few other facilities--treatments like true, focused, piezoelectric Extracorporeal Shock Wave Therapy (ESWT), Platelet-Rich Plasma injections, and Radiosurgery.  Learn more on these technologies here

We provide vascular testing--ABI (Ankle Brachial Indices), Doppler, and photoplethysmography--for diabetics and others with dysvascularity.

We provide neurological testing for
diabetics and other neuropathic
patients.

We provide diabetic and neuropathic
foot examinations and perform
comprehensive wound care, including
surgical debridement and offloading
with all manner of devices including
total contact casting.

We make custom orthotics, custom
foot and ankle braces, and custom
shoes to accommodate, correct,
and control foot dysfunction and

deformity. 

We also carry diabetic wound supplies, 
off-the-shelf orthopedic shoes, night
splints, bandages and a variety of
other foot products. 

And we have a fully-functional

surgical suite that allows us to

perform surgical procedures on a

convenient out-patient basis, with no wait.

The Achilles Foot Health Centre provides for all your medical foot care needs.

What You Need to Know When Considering Foot Surgery

It's difficult to know what to look for when you
need medical advice.  How do you know if the
advice is correct for you?   

 

First you need to know something about

your doctor.  You might want to consider

how long the doctor has been in practice. 

 

You might want to know if your doctor is a

specialist in surgery of the foot by having

obtained board certification in foot surgery. 

 

Not all foot specialists are board certified.  Fewer still are certified in foot surgery.  The process of certification is lengthy, and involved successful completion of appropriate surgical training during residency, demonstration of surgical skills through a review of dozens of procedures in a variety of categories, a written examination and an oral examination.  The one surgical board recognized throughout the podiatric profession is the American Board of Foot and Ankle Surgery (ABFAS), and Dr. Schumacher has been a board certified Diplomate with that organization for nearly two decades.  (Click here to learn about Dr. Schumacher's other credentials and here to learn about his areas of specialization.)

Dr. Hyowon Choi, are newest team member, recently finished a 3-year surgical residency program in Chicago, one of the best teaching programs in North America.  She has been trained in the most recent advances in foot surgery.

Having faith in your doctor is even more true when you're considering surgery.  In addition to asking if your doctor is board certified in foot surgery, ask yourself,

  • Does your doctor give you enough time to ask all your questions?  Or do you feel rushed?

  • Does your doctor explore non-invasive alternatives to surgery with you? 

  • Does your doctor discuss when is the right time for surgery?  Can it be delayed, or is there some urgency? 

  • Does your doctor go over various surgical options with you, to help tailor your procedure to your specific needs?

  • Does your doctor welcome second opinions?


If you are ever uncertain when it comes to an elective surgical procedure, there is never any harm in having a second or third opinion.

What You Need to Know About Diabetes, Neuropathic Feet, and Ulcerations

Diabetes affects nearly one person in ten in Canada, and the majority will develop some type of neuropathy (abnormal nerve function) as a result.  A variety of other conditions--alcohol abuse, compressed nerves in the back, kidney disease, dialysis, liver disease, infections, chemical toxins and so forth--will develop neuropathy as well.

Up to a quarter of diabetic and other neuropathic patients will, at some point in their lives, develop an ulcer, or hole in the skin.  This leaves them susceptible to infection, amputation and shortened lives.


Frequently patients are not referred for foot screenings or proper foot treatment once symptoms develop. 


Podiatrists have a unique skill set when it comes to treating these patients.  We're foot specialists, medially trained, biomechanically trained, and surgically trained. 

Every patient at risk for neuropathy should be seeing a podiatrist, both for screening and for treatment.  And whenever possible, look for a podiatrist with a diabetic foot specialty.  Dr. Schumacher is a diabetic foot specialist with certification in wound healing.  He is a certified fellow with the Academy of Physicians in Wound Healing, and a member of the Association of Diabetic Foot Surgeons. 

For more information on diabetic wounds and how to treat them, visit www.CanadianMAPLE.org.  This is the website for the Canadian Medical Alliance for the Preservation of the Lower Extremity, an organization Dr. Schumacher founded for education and advocacy in the treatment of at-risk, diabetic and neuropathic feet. 
 

What You Need to Know When You Need Orthotics, Foot Braces or Custom Shoes


A true orthotic is a medical device.  It's a custom-made appliance designed to treat a medical problem.  It may be designed to change a biomechanical abnormality causing pain in your foot, leg, knee, hip or back.  Perhaps it's meant to redistribute weight from a painful area.  Or maybe it's needed to offload pressure and decrease friction from a diabetic ulceration prone to limb-threatening infection.   

As a medical device, it's no different than a custom-made brace designed to improve a musculoskeletal or neurological abnormality, a custom-made shoe designed to address a deformity, or custom-made glasses to correct your vision.

Whatever your medical issue, your problem is important.  You need the right fix.  And as these can be expensive devices, you don't want to invest your money poorly.

 

But did you know that in British Columbia, there is no minimum standard of training required to design and make an orthotic?   In fact, you, yourself, could open up an orthotic store with no training whatsoever.

 

The result of this lack of regulation is that a variety of individuals sell orthotics and similar devices and purport themselves to be experts. 

 

  • This includes health providers, whose field of study and training have little to nothing to do with the foot or biomechanics, who have made a business decision to go into the orthotic business.   

 

  • This includes storefront retail operations who have hired simple sales staff making your health care decision.  Many patients have spent $300, $400, $500 or more on an over-the counter devices that can be purchased in a catalog for as little as $15 or $20. 

 

  • This includes many shoe stores who are effectively diagnosing your medical condition and prescribing a correction.  Would you go to a sunglass store and have the sales staff examine your eyes and prescribe corrective lenses?  Or would you rather have a doctor do it?

  • There are large, retail stores selling such devices. 

  • There are even people selling orthotics door to door, or showing up at a business to examine everyone there "for free."  When everyone they examine ends up with an orthotic costing hundreds of dollars, that free exam doesn't end up quite so free.  This makes extended health insurance plans less likely to cover you when you do need a real orthotic appliance. 

These providers might have people walk across a pressure plate, get a quick computer scan, or step into a foam box, and that's it!  You're diagnosed and assessed! 

 

Others even sell pre-fab devices, "adjust" it in some minimal fashion, and label it as "custom"--because now the off-the-shelf device is deemed "custom-ized" or "custom fit."  But that's far different from "custom-made," with the wording misappropriated to mislead the consumer. 

Compounding the problem are medical doctors who know little about the biomechanics of the foot, and often make referrals to inappropriately-trained individuals.

Medicine is rarely so simple.  The wrong orthotic, brace or shoe can be, at best, a waste of money.  They may also make your problem worse.

  • We recently had a dialysis patient who had a custom brace made that caused three new ulcerations (holes in the skin) on his left foot.  They became infected and required 6-weeks of hospitalization with IV antibiotics.  The current cost of a hospitalized day in BC is $1060 per day, plus the cost of antibiotics--not even considering the effect on the patient for being away from home and family.

  • Another patient recently spent over $2000 on custom-made orthotics and shoes for a deformity in his foot.  They didn't do anything to address the deformity, and they were unwearable.  The shoes and orthotics had to be remade, and the $2000 initially invested was lost.

  • A patient with a Charcot deformity and a foot ulcer was referred to a storefront operation for offloading footwear and was dispensed a $2,400 brace and a separate $700 orthotic, neither of which offloaded the foot or were appropriate for her affliction.

  • We recently saw a woman with went to a shoe store complaining of foot pain.  The cause of the pain was poor circulation, but the store told her she had plantar fasciitis and made an inappropriate orthotic.  The orthotic created a hole in her foot known as an ulceration.  This became infected and the patient passed away.  A case could be made that the orthotics literally killed her.

So how do you know who to trust?

First, start with your extended plans.  Many extended plans require a podiatrist to make the appliance in order to reimburse you.  

If your plan doesn't specify who should make the device, ask the person making the orthotic or brace if they are licensed to diagnose you.  Or do you have to get a prescription from a doctor who is licensed to diagnose you?  If the maker of your orthotic is not licensed to diagnose your condition, do you want them designing your treatment plan? 

When you need an orthotic, brace or shoe, ask what level of training the health provider has.  Do they have a doctorate level of training?  Or do they have a bachelor's degree?  Or perhaps just a foot course of a few weeks duration?  As a patient, what level of training would you prefer?

If your provider has a doctorate, is that degree in a field specifically specializing in the foot and leg?  Or is the doctorate in some other unrelated discipline?

If they're making orthotics with a quick computer scan, but don't know how to make custom braces or custom shoes--that, too, is a flag.  Is the level of expertise you want in your provider someone who simply holds a computer imaging device at your foot? 

Podiatrists in BC are foot specialists with a doctorate-level of training, with extensive training in biomechanics (foot and body function).  Who better that that to understand your foot complaint and make your orthotic? 

In Dr. Schumacher's case, he has further distinguished himself by going a step beyond, as a practitioner board certified in this field by the American Board of Podiatric Medicine, specifically in the field of podiatric orthopedics and the biomechanical function of the lower extremity and human body.

If you wish to be seen by Dr. Schumacher, or get a second opinion, contact us at 604.589.5234.

Achilles Foot Health Centre
Suite 102
10190 - 152A Street

Surrey, British Columbia
Canada  V3R 1J7

To Schedule An Appointment

Call 604.589.5234

www.DrSchumacher.ca