|
|
|
Search
10/13/2021 Robert D. Teitelbaum, DPM
Recommendations for Nail Drill with Vacuum (Peter A. Ternus, DPM)
Peter Ternus' response to the belittling post from Estelle Albright concerning the "use of woodworking tools" in the treatment of fungus nails was excellent. I would like to concentrate on the "be the physician that you are" aspect of that post. I prescribe Terbenafine for onychomycosis in the following manner: I ask the patient if 1) he/she has ever had any form of hepatitis, or jaundice, 2) takes more than two pharmaceuticals everyday for any condition, 3) has ever been told by a physician that there were unusual liver enzyme tests on a routine blood work-up. If they pass this test, I prescribe the drug. I also like to prescribe it if the patient is 35 years old or younger. I have never had a problem with it, not to say that it could not happen.
What is strange is that much of the public somehow knows that Lamisil is a dangerous drug because of this liver toxicity. Just today, I had a new 67 year old, very healthy female patient who takes no medicines for any condition--but she doesn't want to take Lamisil "because it's dangerous". She said "I researched it". I performed my usual magic with various sizes and grits of sanding discs and rendered her nails about 75% better than when she arrived. I also dispensed Clear Nails Pro (I also have Formula Three and Clarus, depending on my whim). I was encouraged when she said that if this plan did not work out, she would consider a prescription for Lamisil. "Being the physician you are" is not easy in these times.
Some notes about the "tools" I use: I have serious micromotor drills, made in Germany, relatively heavy because of the decent magnets inside, and rated at 35,000 rpm, with a transformer that produces at least 25 and preferably 32 volts. These are not easy to come by and when they are inspected in the photographs of all sides of the transformer it is hard to visualize the voltage of the unit, but it can be done.
I graduated in 1976, so you can guess my age. Twice daily I'm asked by patients "You're not going to retire now are you?" I say no, and they day "Thank God". Sometimes I pull numbers out of the air, but I'm good at it, and I feel that 25% of this profession needs to figure out why these patients are saying "Thank God".
Robert D. Teitelbaum, DPM, Naples, FL
There are no more messages in this thread.
|
|
|
|