Today’s clinic day had a theme: lessons learned from cantharidin, shockwave, and the unexpected. After switching to a fresh batch of cantharidin, I was reminded that even small changes in potency can turn into weekend phone calls and hospital admits. It pushed me to rethink aftercare instructions. On the other end, shockwave patients reminded me how important it is to pair short-term pain relief with long-term biomechanical correction through orthotics. And of course, there were a few unique cases—a patient injured by aquasocks at an amusement park, a long-distance traveler seeking Onyfix, and even a pioneer of pickleball.

The through-line? Every product, protocol, and conversation shapes not only outcomes but also the flow of practice.

3 Takeaways for Colleagues:

• Be cautious when switching vendors or batches of treatment products (like cantharidin)—potency varies.

• Pair shockwave with orthotics to improve outcomes and reduce reinjury.

• Even routine cases (orthotic scans, fissure care, Onyfix follow-ups) are opportunities to streamline workflow and free up your schedule.

  
  

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Timestamps:

• 00:45 — Cantharidin complications and infections

• 04:10 — Shockwave + orthotics: combining pain relief with prevention

• 09:35 — The aquasock injury and lessons on footwear

• 14:20 — Ingrown toenail & Onyfix case from New Hampshire

• 20:05 — Neuropathy consult and Qutenza coverage struggles

• 27:40 — Shockwave for fracture nonunion

• 31:25 — Pickleball pioneer with tight Achilles