• toenails (equipment for thinning, trimming and filing)
•  hard skin reduction or removal eg callous, corns, cracked heels       

• Neurovascular assessments,  including:
• doppler ultrasound (listening to/viewing waveforms of foot/ankle arteries) *see Extras
• up to 6 different levels of nerve sensation may be tested 
• ankle/ toe brachial pressure index if indicated * see Extras
• Privately or Publicly funded treatment (see below)
• Foot care education
• High Risk Feet are not just restricted to people with diabetes; history of heart issues and strokes are another major risk factor

• Assessment of how you walk, and how it may relate to foot and leg pain

• Activities of daily living: how do the repetitive movements in your day affect your muscles and joints?

• Shoe recommendations; yes I have many on display in my Rangiora clinic; no I do not sell any of them! Recommendations to suit your budget and favoured shopping area                   
• If necessary modified off-the-shelf orthotics, or fully customised orthotics.                                                     
• Off-the-shelf orthotics stocked in multiple brands in multiples styles; grinding room on-site in Rangiora for customisation including additions        
• Fully customised orthotics are casted on-site, and manufactured in an Auckland lab

• Not just miniature adults!                        
• Is this normal for my child's age? Is this something that will be outgrown, or does it need attention?                        
• Does this need treatment, or just monitoring?                                                
• Will my child have my foot problems?

• Pegasus High Risk Foot Provider
• Waitaha High Risk Foot Provider (formerly Rural PHO)

(the above two require referral from your GP or Registered Nurse if you meet criteria)

• NZDF Veterans Service Provider

(requires referral from your case manager)

• Southern Cross Easy-Claim Affiliated Provider  (on the spot claiming)             
• No ACC sorry... I have chosen to give up ACC work

available if required;

•  simpler treatments may fix the issue first. Many different factors affect this; I need to have a close look and a discussion with you about other options first

if nail surgery is required, a separate time is made; 

• partial and total nail avulsions with nail matrix cautery are available at both clinics.
• I often find these procedures are quite different to past stories you have heard which are worrying you! Another reason to get advice on your particular situation

A thorough explanation as to the cause of your problem and likely outcome; what can you expect from various treatment options? Or from choosing no further treatment? Practical options, day to day tips and tricks to help.

If it is a long standing problem you have seen a podiatrist for before, is there any other changes we can make to stretch out your time between appointments? eg deflective insoles for corns under the feet, stretches/strengthening to slow down the clawing of your toes? Could seeing a health specialist in a different field potentially help you more?

Immunochromotography: on-the-spot dermatophyte (fungal) test. Properly clearing a fungal toenail requires considerable time and effort; how about we actually determine if the nail is fungal, or the nail thickening has been caused by something else? The nail may have been fungal in the past, but no longer be so. There are many reason for a thickened or discoloured toenail which do not include fungal infections. However, often they are obvious, and this test will not be routinely offered in this case. The charge is an extra $30, which is cost price.

Doppler ultrasound: unfortunatley uncommon in Canterbury. These occupy the testing space between simply feeling a pulse  to extensive hospital tests.  We can either be reassured more extensive testing is not required- or that it is definitely required ASAP! Let's listen to how healthy your foot and ankle arteries are. This is done during a standard appointment time at no extra charge

Ankle Brachial Pressure Index (ABPI) or Toe Brachial Pressure Index (TBPI)- (*requires an extra appointment)

taking either the blood pressure of your ankle/s or big toe/s, and comparing them to the blood pressure or your arm.

I mainly perform these if there is a question mark over whether your foot/leg pain is due to lack of fresh (arterial) blood flow, or possibly due to another issue, and there isn t yet enough evidence to get the extensive hospital testing performed. Also, if your doppler ultrasound above had an unexpected result.

They are also routinely performed in NZ by nurses before pressure stockings being issued. In Australia I performed these frequently on at-risk or high risk patients; which is not so commonly done here. It is a skill taught at university but often not used after graduation, so the lack of confidence, prohibitive cost of equipment, time consuming nature of the assessment and lack of public funding generally rule it out.