03/14/2014    Wm. Barry Turner, BSN, DPM

Using Nitropaste to Increase Blood Flow (Robert Bijak, DPM)

In response to Dr Bijak's "slam" on my
nitroglycerin paste protocol, I am familiar with
his rude responses and judgmental behavior that is
so typical for him. I will try not to take it
personal.

I am fairly certain in my description of my
protocol using nitroglycerin paste, that I
presented both sides of the discussion using this
particular modality. I mentioned that the
medication had a dangerous potential and cited my
experience of using it on a 90-year old patient,
with low body weight.

I had a similar event of hypovolemia while
treating a patient when I was a cardiac nurse.
That incidence dosing was a full inch, applied
directly over the heart. That time was under the
direction of a cardiologist while I was working in
a Cardiac Cath Lab. The time I used it on that
"little old lady" in my office was in an attempt
to save her foot. She died shortly after the
amputation. That was over twenty years ago and yes
I learned from the incident. I have saved
literally hundreds of limbs using that technique
since then. Not one person has died.

I believe that I mentioned that I had tried to do
a study, but could not find any sponsors, so I
recorded my experience and presented it just as
that, "my experiences","my protocol".

I believe that I commented on hearing about a
study, but was unable to verify it.

This medication in your hands might very well
cause an MI or hypovolemic shock, but not by
anyone that uses the protocol I described. I used
a cardiologist to help me develop that protocol. I
doubt your cardiac vascular knowledge and
experience are in any way equal to mine. That is
why I put together a protocol.

As far as scope of practice, I practice in
Georgia. Dr. Bijak is correct what is legal in
Georgia may not necessarily be legal where you
practice. Regarding my practicing outside my
scope of practice, I am not. Did I mention I
served a decade on the Georgia State Podiatric
Board? How long did Dr. Bijak serve on his state
board? His statement regarding that the
prescription of nitroglycerin possibly being
outside the scope of practice of a podiatric
physician supports my doubts regarding his
knowledge of his own state's scope of practice
act. I am very aware of my state's practice act.
Did I mention I was the first podiatrist in
Georgia to be allowed to supervise and bill for
full body hyperbaric oxygen therapy when treating
lower limb pathology.

My critical care experience as a RN and my over
all medical background are extensive, starting
with my combat medic training during the Vietnam
War. I spent over five years working as a "hot
shot" agency nurse in South Florida. While I was
attending podiatry school, I worked in almost
every ICU/MICU/SICU/CCU in the Miami/Ft.
Lauderdale area. Using my knowledge to enhance my
podiatric training, is just that, enhancing my
ability to treat my patients within my scope of
training and my state delegated restrictions.

I do not remember telling anyone to practice
outside their scope of practice. Did your
residency teach you how to do ankle surgery, or
fix tibial-fibula fractures? Are you allowed to
perform those procedures in your state? Did having
the knowledge hurt you, even if you can not
perform these procedures in your practice?

I understand the need for verifiable studies. I am
a firm believer that testimonies are refutable and
need to be verified by studies.

How many lawsuits have you had? Hmm. I have never
been sued and I have practiced for over 24 years.
I have people come from all over for my wound
care, as I get some pretty impress results.

Do I sometimes push the envelope? Never without
doing due diligence; contacting various
specialist, review of literature and incorporating
knowledge with common sense.

I am unsure why your ego made you feel that you
needed to attack me in a less than professional
manner, but I have followed your writings in the
past and I am neither surprised or impressed.

Sir, when you are ready to give all to your
patients, you may some day become a physician for
your patients. I am willing to look outside the
"box" in my attempts to heal my patients. No
subterfuge. I am up front and tell them their
options. I encourage second opinions.

One final word, if I might provide Dr. Bijak with
a lesson in professionalism. When you disagree
with other professionals, it would be more proper
to contact them at their provided email address,
instead of being pompous and acting like you are
the moral authority of our profession. Dr. Bijak's
behavior is embarrassing for our profession, or
any profession for that matter.

Wm. Barry Turner, BSN, DPM, Royston, GA,
claret32853@ymail.com

There are no more messages in this thread.