Constance Madsen, Foot Care Nurse

01/14/2026

🧠 Why a Podiatrist Is Essential Too
Foot care nursing is maintenance — but sometimes the cause needs correction, not just management.
A podiatrist can:
✔ Perform a complete biomechanical assessment
✔ Evaluate how you walk (gait analysis)
✔ Identify areas of pressure and deformity
✔ Prescribe custom orthotics
✔ Provide custom-molded silicone toe orthoses
✔ Treat more complex toe deformities or pre-ulcer conditions
✔ Order imaging or recommend procedural interventions if needed
When podiatry becomes important
A podiatry referral is recommended when:
Callus returns quickly despite regular care
Pain affects walking or shoe wear
Skin shows bruising, breakdown, or bleeding
Toe deformity or pressure spots are present
Offloading can’t be achieved with home treatments alone
The client has diabetes, poor circulation, or neuropathy

01/13/2026

🦶 Why Calluses Keep Coming Back — and What Actually Helps
Calluses on the toes are not a skin condition.
They are your body’s response to ongoing pressure and friction.
Even with excellent foot care, calluses will continue to return unless the pressure causing them is reduced.
🔍 Why this is happening
Common causes include:
Toe deformities (hammer toe, claw toe, bunion changes)
Prominent bone structure
Thickened or fungal nails increasing pressure at the toe tip
Narrow or shallow footwear
Abnormal gait or weight distribution
Your skin builds callus to protect itself from pressure — not because it’s dry or dirty.
✔️ What is already being done correctly
The following measures are appropriate and necessary:
Professional debridement every 4 weeks with blade
Urea cream to soften thickened skin
Regular nail care and thinning
⚠️ These steps control callus — but they do not stop it from forming.
❗ Why toe protectors often fail
Over-the-counter toe sleeves and caps:
Shift during walking
Create friction
Can pinch or restrict circulation
Do not address the direction of pressure
They often make symptoms worse rather than better.
🥇 The missing piece: Pressure offloading
To slow or stop callus buildup, pressure must be redistributed.
Best options:
Custom-made orthotics (podiatrist-designed)
Custom silicone toe orthoses
Toe crest pads (for hammer/claw toes)
Felt or foam offloading pads professionally fitted
⚠️ These must be customized — store-bought devices are usually ineffective.
👟 Footwear matters more than creams
Shoes should have:
Wide toe box (no taper)
Soft or stretch upper material
Adequate depth for thick nails
Cushioned or rocker sole if available
Avoid:
Narrow shoes
Seam lines over toe joints
Thin or hard soles
Even slippers can cause pressure if narrow.
🧴 About creams
Urea (25–40%) helps soften callus after debridement
Apply only to thickened areas
Creams do not remove pressure
Corn plasters or salicylic acid products should be avoided (ulcer risk)
🚨 When podiatry is essential
A podiatry appointment is strongly recommended when:
Callus returns quickly despite regular care
Pain affects walking
Skin becomes bruised, bleeding, or breaks down
There is diabetes, poor circulation, or neuropathy
In some cases, minor corrective procedures are the only long-term solution.
📌 Key takeaway
Callus is a symptom, not the problem.
Foot care manages it.
Offloading and orthotics address the cause.
Without pressure redistribution, callus will continue to return — even with excellent nursing care.

https://thera-ped.ca/

https://www.metrohealthservices.ca/pedorthics

01/11/2026

🦶 Did you know an injury from decades ago can resurface later in life?
Many people are surprised to learn that something as simple as stepping on glass years—even 30+ years—ago can still cause problems today.
Here’s how 👇
🔹 Retained foreign bodies— If a small piece of glass (or metal, wood, etc.) wasn’t fully removed at the time of injury, the body may wall it off instead of expelling it. This creates what’s called a foreign body granuloma — a chronic inflammatory reaction.
🔹 Why it can stay quiet for years:
The fragment can remain dormant for decades with no symptoms at all. Over time, changes like:
• repeated pressure (especially on the foot)
• aging tissues
• inflammation
• weight-bearing stress
can cause the fragment to migrate or irritate surrounding tissue, making it suddenly painful or visible.
🔹 Why it’s often misdiagnosed:
These reactions can look just like
• a plantar wart
• a corn or callus
• a “spur”
• a chronic sore
As a result, people may undergo repeated trimming, debridement, or antibiotics — which often don’t help, because there is no infection to treat.
🔹 Why antibiotics don’t work:
This isn’t a bacterial problem. It’s a mechanical and inflammatory reaction to a physical object. Until the foreign material is identified and removed, the issue often keeps coming back.
🔹 Yes — this is documented in medical literature— There are published medical cases showing retained glass in the foot causing symptoms 20–30+ years later.
📚 Want to read more? Here are reputable medical sources:
• Foreign body granuloma overview (ScienceDirect):
https://www.sciencedirect.com/topics/immunology-and-microbiology/foreign-body-granuloma
• Case reports of long-retained foreign bodies causing late symptoms (PubMed):
https://pubmed.ncbi.nlm.nih.gov/41461145/
https://pubmed.ncbi.nlm.nih.gov/37496526/
• Clinical guidance on managing retained foreign bodies (American Academy of Family Physicians):
https://www.aafp.org/pubs/afp/issues/2007/0901/p683.pdf
🔹 Important takeaway:
If someone has a chronic foot lesion or pain that keeps returning, especially with any history of stepping on glass or sharp objects — even long ago — a retained foreign body should be considered. Proper imaging (often ultrasound) and specialist assessment can make all the difference.
👉 Sometimes the body remembers injuries long after we’ve forgotten them.

01/08/2026

https://www.theglobeandmail.com/business/economy/article-clinic-chronic-pain-treatments-health-care-long-lasting/?utm_source=paidsocial&utm_medium=FacebookAd&utm_campaign=traffic_mkt&utm_term=accelerator&utm_content=economy&utm_id=1&kwp_0=2580363&kwp_4=7116863&kwp_1=3011820&fbclid=IwZXh0bgNhZW0BMABhZGlkAasujgQCt0xzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeEwFs6g3ZDxk_dAEUooFAT-QxAVdsICuzZmf3LzwnGDScTBunXgyPGLjlOn8_aem_z0YdUQ5BNR0hwmW4pASnHA

Excessive pain treatments harm patients and cost the province millions of dollars per year. Physician Zameer Pirani believes he has a better way

01/07/2026

👣 Feet reflect whole-body health. When blood sugar, hormones, circulation, or hydration are out of balance, the skin can’t repair itself or retain moisture. That’s why feet may look unusually dry and flaky right now — and it’s not just cold weather 🥶.

01/07/2026

https://www.facebook.com/share/p/17NB85L1jq/?mibextid=wwXIfr

Meet Samuel McGaw, one of our 2024 scholarship recipients and future N.B. doctor!

Hometown: St. Stephen, New Brunswick
Attending: Dalhousie Medicine New Brunswick, Class of 2028

Samuel is a second-year medical student attending Dalhousie Medicine New Brunswick. He holds a Bachelor of Science with Honours in Biochemistry and Minors in Chemistry and Biology from Mount Allison University. Upon Graduation he hopes to begin a residency in Family Medicine.

Samuel carries a lifelong passion for hockey having previously served as Captain of Team New Brunswick and his hometown Junior A Club. This passion has led him to promote the value of athletics through the Dalhousie Kid’s Run Club and Mount Allison’s Right to Play Canada Society. Outside of academics, Samuel spends his time exploring New Brunswick by whale-watching on the Bay of Fundy, hiking in Fundy National Park, or skiing at Poley and Crabbe Mountains.

“As a primary care physician, I aim to establish consistently reliable access to personalized medical care while realizing the fulfilment of offering hope to a rural community.”

-

We're proud to support the next generation of healthcare providers in New Brunswick!

Your gifts empower students like Sam with much-needed tuition relief and have a lasting impact on the patients and communities that benefit from their care in the decades to come. For more information or to make a donation, visit https://loom.ly/73-MBPY.

01/07/2026

Why Are So Many Feet Extremely Dry and Flaky Right Now? 🦶📉

👣 Lately I’ve noticed a significant increase in clients with very dry, flaky, and cracked feet — more severe than what cold weather alone usually causes. While winter does contribute to dryness, there are several systemic factors that make this problem much worse.
1. Elevated Blood Sugar & Skin Barrier Dysfunction
High blood sugar — even in people without diagnosed diabetes — can disrupt the skin’s natural protective barrier.
Research shows hyperglycemia impairs skin structure and water retention, leading to dry, flaky skin with impaired barrier function.

https://pubmed.ncbi.nlm.nih.gov/27846299/?utm_source=chatgpt.com

Studies reveal skin in high-sugar states loses hydration and normal epidermal function, meaning the outer layer can’t hold moisture well.

https://www.cdc.gov/diabetes/signs-symptoms/diabetes-and-your-skin.html

Advanced glycation end-products (AGEs) from elevated glucose can damage collagen and skin elasticity, worsening dryness and scaling.

https://pubmed.ncbi.nlm.nih.gov/29151267/?utm_source=chatgpt.com

📌 What this means: When sugar intake is high (like during the holidays), even people without diabetes can develop skin changes similar to those seen in diabetic skin conditions.
2. Insulin Resistance & Metabolic Health Show in the Skin
Insulin resistance — common with high refined carbs and sugar — alters how skin cells grow and shed.
Animal models show altered keratinocyte (skin cell) behavior in high glucose conditions, leading to abnormal skin layers and dryness.

https://internationalmedicaljournal.org/index.php/ijmhsr/article/download/362/372?utm_source=chatgpt.com

📌 Feet are often the first place you see these effects because they have thicker skin and less natural oil.
3. Hormones (& Especially Menopause) Affect Skin Hydration
Hormonal changes, especially lower estrogen in perimenopause and menopause, make skin:
👣 Thinner
👣 Less elastic
👣 Less able to hold moisture
Estrogen supports collagen and oil production, and decreases in it are linked to significantly drier skin.

https://skinintegra.com/blogs/skin-facts/cracked-heels-during-menopause-why-they-happen-and-how-to-heal-them

📌 Women in their 40s+ may particularly notice flaky, cracked skin — especially on the feet.
4. Poor Circulation & Nerve Function (Especially in Metabolic Conditions)
Long-term elevated blood glucose can impair circulation and nerve function, reducing sweat and oil production on the lower legs and feet — which normally help keep skin moist.

5. Lifestyle Factors That Make It Worse
In addition to sugar and hormones:
✔ Indoor heating + low humidity → moisture loss
✔ Alcohol → dehydration
✔ Sedentary habits → slower circulation
✔ Nutrient deficiencies (omega-3 fatty acids, zinc, vitamins) → poorer skin repair

https://www.healthline.com/health/menopause/menopause-skin-care-diet

👣 Feet reflect whole-body health. When blood sugar, hormones, circulation, or hydration are out of balance, the skin can’t repair itself or retain moisture. That’s why feet may look unusually dry and flaky right now — and it’s not just cold weather 🥶.

01/02/2026

🚨 Self referral:
Access to a nurse practitioner or physician by appointment only.

12/31/2025

✨ Happy New Year! ✨
As we step into a new year, I want to wish all of my clients within the Charlotte County community a happy, healthy, and prosperous New Year.
Thank you for trusting me with your foot care this past year. It has been a privilege to support your health, comfort, mobility, and independence—one step at a time.
May this year bring:
👣 Healthy feet
🌿 Improved mobility
💙 Continued wellness
✨ And many steps forward with confidence
Here’s to another year of compassionate care, education, and putting your best foot forward.
Wishing you and your loved ones a safe, joyful, and prosperous New Year!

12/24/2025

✨ Merry Christmas & Happy New Year! ✨
As the year comes to a close, I want to take a moment to say thank you to all my wonderful clients and families for your trust, kindness, and support throughout the year. It’s truly a privilege to be part of your care and well-being.
Wishing you a holiday season filled with health, comfort, warmth, and peace, and a New Year that brings happiness, good health, and many reasons to smile.
Thank you for allowing me to do what I love — caring for feet and supporting your overall wellness. 💙👣
🎄 Merry Christmas and a healthy, happy New Year! 🎆

12/23/2025

https://www.facebook.com/share/17bmkjBd7V/?mibextid=wwXIfr

📢 Exciting news for Charlotte County!

We’re thrilled to announce that a new home has been identified for the expanded Charlotte County Collaborative Wellness Centre! 🏥✨ Introducing the St. Stephen Family Health Team! Check out this sneak peek of the new sign, coming soon!

📍 Location: 210 King Street, St. Stephen
(former Sobeys building)

Space planning and renovations will begin in the new year, and once complete, will open as the new St. Stephen Family Health Team. The new site will offer roughly 12,000 square feet of clinic space and allow the team to:
◾ Expand services
◾ Recruit more health professionals
◾ Onboard more unattached patients
✅ Important note: The existing clinic at Charlotte County Hospital will continue to operate as usual, with no interruptions, while renovations to the new space are underway.
We look forward to sharing more updates as this exciting project moves ahead!
___
Want more details? This announcement is a follow-up to the news we shared last month that the Charlotte County team received $3.6 million in government funding to establish a new clinic space. This funding and new clinic space will allow the team to further expand access to primary care for area residents. Read the full story here: https://horizonnb.ca/news-releases/charlotte-county-collaborative-wellness-centre-expands-primary-care-team-improving-access-to-area-patients/

📢Bonne nouvelle pour le comté de Charlotte!

Nous sommes heureux d’annoncer que de nouveaux locaux ont été trouvés pour la bonification du Centre collaboratif en matière de mieux-être du comté de Charlotte! 🏥✨ Voici l’Équipe de santé familiale de St. Stephen! Jetez un coup d’œil à l’affiche de la nouvelle entité de soins qui sera bientôt mise en œuvre dans la collectivité!

📍 Emplacement : 210, rue King. à St. Stephen
(ancien Sobeys)

L’aménagement de l’espace et les rénovations commenceront en 2026. Une fois les travaux terminés, on procédera à l’ouverture de la nouvelle Équipe de santé familiale de St. Stephen. Les nouveaux locaux offriront environ 12 000 pieds carrés d’espace clinique qui permettront à l’équipe :
◾ d’améliorer son offre de services;
◾ de recruter d’autres professionnels de la santé;
◾ d’accueillir un plus grand nombre de patients sans fournisseur de soins.

✅ Note importante : La clinique actuelle de l’Hôpital du comté de Charlotte continuera d’opérer normalement et sans interruption pendant la rénovation de ses futurs locaux.
Nous avons hâte de vous présenter d’autres mises à jour sur l’avancement de ce projet emballant!
___
Vous voulez plus de détails? Cette annonce fait suite à une nouvelle que nous avons partagée le mois dernier au sujet d’un financement de 3,6 millions de dollars promis par le gouvernement à l’équipe de soins du comté de Charlotte pour la création d’un nouvel espace clinique. Le financement et le nouvel espace clinique annoncés permettront à l’équipe d’améliorer l’accès aux soins primaires pour les résidents de la région. Pour lire la version intégrale de l’histoire, cliquez ici : https://horizonnb.ca/fr/communiques-de-presse/centre-collaboratif-en-matiere-de-mieux-etre-du-comte-de-charlotte-bonification-de-lequipe-de-soins-primaires-et-amelioration-de-lacces-aux-soins-pour-les-patients-de-la-region/

12/23/2025

https://www.facebook.com/share/p/1DoyCAsB3R/?mibextid=wwXIfr

Make the right call.

Whether it’s an emergency, a road update, community support, or health advice, there’s a number for every situation:

• 911 – Urgent emergencies
• 511 – Road information
• 211 – Community and government supports
• 811 – Non-emergency health guidance

Know your numbers and stay prepared.