03/11/2014    Robert Bijak, DPM

Using Nitropaste to Increase Blood Flow (Wm. Barry Turner, BSN, DPM)

The PDR distinctly says "don't rub in", so Dr.
Turner instructs patients to rub it in! Game over!
Also, what defense is there for the unfounded
theory he is "breaking up calcium with a surge
effect." How unscientific and unproven. It makes
podiatrists look bad to talk this way. In my
opinion, this is dangerous, unproven advice. The
fact he tried it on a 90 year old 100 pound woman
speaks volumes. I don't care who he lectures to.

Here's what you need to know. Podiatrists need to
honestly determine if they are capable of
evaluating the cerebral and cardiovascular status
of a patient and concomitantly understand the
pharmacology of drugs these patients may already
be on, like calcium channel blockers, ACE
inhibitors, etc.

The danger is, you can cause a hypovolemic stroke
or MI by dilating the vessels and reducing the
blood pressure. Without prior sophisticated
vascular testing, like carotid or vertebral artery
Dopplers, you're just guessing how much the
pressure can be dropped before you kill or stroke
someone. Nitroglycerin is not an innocuous drug
with the co-morbidities these patients present. I
also do not believe a half inch strip is a low
dose for some patients. Rubbing into the calf or
behind the knee may even be illegal in some states
for a podiatrist to do!

I think Barry Turner's "RN credential", backed by
MDs in the hospital, has mistakenly led him think
he has a scope beyond that allowed a DPM. His
advice is anecdotal and should be followed at the
DPM readers own risk. Once again podiatry's
limited training and license places the
practitioner in a legally dangerous gray zone, and
their patients at risk.

Robert Bijak, DPM, Clarence Center, NY
rbijak@aol.com

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