Health and Wellbeing, Our CommunitiesCommunity, Health Medicine Students 13 April 2023

How Peter's heart was saved, by a Podiatry student

by Tim Connell

Peter Bedford says he owes his life to a moment in his kitchen. Mr Bedford had been on his way out to work on his Central Coast property in June 2022 when a segment on local ABC radio caught his ear. It prompted him to book an appointment at the University of Newcastle Podiatry Teaching Clinic at Wyong Hospital. Some months and a quadruple bypass later, he remains breathing.

Video

Peter's story

“It’s all by chance. I happened to be walking through the kitchen and my wife had the radio on. I was heading to the shed. The presenter, Scott Levi, who I think is a fine broadcaster, was interviewing someone from the Wyong clinic,” Mr Bedford, 74, says.

“Had I not stopped and listened, I suspect I would’ve been dead within six months or a year.”

Levi’s radio guest that morning was University of Newcastle Podiatry Head of Discipline Dr Andrea Coda. The interview spurred Mr Bedford to volunteer at the clinic as a patient. He wanted to help podiatry students hone their skills, more than he was concerned about his health. He was also curious to see how it all worked. If nothing else, he would be practice for future podiatrists.

Peter being examined by Victoria and her supervisor at the Podiatry Teaching Clinic

The facility is a university teaching clinic within Wyong Hospital, where students practise under the wings of leading, registered podiatrists and clinical academics. It can accommodate 15 patients at a time, four days a week, without the need for GP referrals. The types of consultations span the breadth of podiatry including sport injury, paediatric, biomechanics, gait analysis, and lower limb dermatological assessments. Supervised students can also assess neurological and vascular indicators, pivotally in Mr Bedford’s case.

Mr Bedford’s appointment was with Victoria Bennett, now a podiatrist practising in Canberra but then a student in the final weeks of her degree commuting daily from Sydney’s inner west.

“He was a new patient, so we did the full vascular assessment. He had a small cut on the plantar aspect of his foot (heel), that he’d taken antibiotics for. Otherwise, he was generally quite healthy and he didn’t have any major red flags,” Ms Bennett says.

Ms Bennett’s supervisors, Kristy Darnell and Rebecca Gordon came to help and found similar results, at first. The teachers and student agreed it was strange their patient’s feet seemed otherwise benign. They followed the required vascular protocol and Mr Bedford’s toe brachial index (TBI) readings registered around a worrying 0.2 score. A normal score is 0.7. Both feet had low scores, but the foot with the small heel cut was worse – it was a ‘call a vascular surgeon’ kind of reading, recalls Ms Bennett. Such results are not unheard of, but typically belong to patients with a more complex medical history, such as smoking, heart condition, poorly managed diabetes or rest pain. The podiatry team immediately referred Mr Bedford for a duplex scan.

“There was no clear signs that his arteries would have been blocked,” Ms Bennett says.

Victoria outside Wyong Hospital — Graduate Victoria Bennett at the Podiatry Teaching Clinic, Wyong Hospital

Ms Bennett’s suspicions that day in the clinic triggered a series of tests that found two of Mr Bedford’s arteries were completely blocked, and a third was 80 per cent blocked. He also had “a dodgy aorta valve”, he recalls. A calcium score scan, ideally zero, came back with a dizzying figure.

Following a cardio angiogram on October 17, Mr Bedford was advised to stay in hospital. More tests would be needed, and he was down for surgery three days later. A cardiologist told him the results weren’t good, but 73 wasn’t particularly old to go through it.

The six-hour quadruple bypass surgery was a success. Mr Bedford is now well enough to work on his yard, pause in his kitchen, listen to the radio and wonder at the set of radio production coincidences, the skill of a podiatry student and her supervisors, the serendipity that all means he’s still here.

“I’m a pretty relaxed person, and it is what it is. I have a lot of confidence in the medical people. My only concern was for my wife. Things can go wrong and you’re looking at your own mortality,” Mr Bedford says.

“It was bad news then, but I think it was good news. Had I not been there, I would probably be dead now. I’m a lucky man. It’s been like winning the medical lottery. Had I not listened to that radio program, and acted on it, and had Victoria not been well trained, I would’ve lost my life. It all started that day at the Wyong clinic.”

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In retrospect, Ms Bennett is glad Mr Bedford was at the clinic that day. She also learned, she says, that her instinct to question her first impression, rather than assume she was wrong, was one to carry into her career.

“There is a misconception about podiatry, and its place in healthcare. Many associate it exclusively with superficial grisliness of the feet. But, as Mr Bedford’s ordeal illuminates, a cut heel can be the tip of a looming vascular iceberg. It shows that vascular screening is in our lane. It’s a podiatry thing,” Ms Bennett says.

“It’s one of those things that give you shivers down the spine. Everything was 100 per cent necessary. We had our suspicion that his blood flow might’ve been compromised because that heel fissure was taking so long to heal. But when you see feet on a daily basis that don’t have blood flow issues, it was surprising. As a student it was a great learning experience and has shown why it’s so important not to cut corners.”

As he recovered from his quadruple bypass surgery, Mr Bedford contacted the clinic to relay the series of events that unfolded following his podiatry appointment, but mostly, to thank Ms Bennett.

Victoria and Peter walking down the hall at Wyong Hospital — Victoria and Peter

Dr Andrea Coda, the radio guest whose advice spurred Mr Bedford to present to the clinic, considers it a heartening but unsurprising instance of podiatry working hand-in-glove with vascular surgeons, general practitioners and nurses.

“Podiatrists play a key role in early prevention and detection of significant lower limb pathologies, and Mr Bedford story is a clear example of how well prepared our students are and the positive impact that our teaching clinic has in the community,” says Dr Coda.

“I am very proud of the services that we provide to the community, such as our paediatric, biomechanics, sport injury, surgery, and the Buridja Aboriginal and Torres Strait Islander Podiatry Clinic. We also have recently introduced new technologies that may help early detection for those patients who are at risk of falls,” Dr Coda says.

“We can communicate to a GP that medication might be making a patient feel dizzy, or equally we can provide referrals to occupational therapists who can assess people’s homes for trip hazards. Podiatry is an integral part of multidisciplinary care.”

Four months after his quadruple bypass, Mr Bedford says he watches his cholesterol intake a bit more, still works on his yard and will continue his regular visits to the clinic.

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