CONTACTS
SUBJECTS
VA Podiatry Review Metatarsalgia Pain Balls of Feet Enable Physical
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 43 0000. ref SDS 40 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Background
0409 -
040901 - Meeting Doctor Tang in Podiatry on 140805 1030. ref SDS 26 NU4G
040902 - Progress Notes for meeting on 140805, call for return to clinic after
040903 - receiving FFO. ref SDS 26 IJ4G A few days after meeting on 140805,
040904 - received letter from VA scheduling follow meeting today on 140820
040905 - 1000.
040907 - ..
040908 - On 140828 meeting with Doctor Kevin Daun and later with Doctor Mihara,
040909 - attending developed solution to blister on inside of big toe on left
040910 - foot, ref SDS 34 W74O, that required stopping 11 mile hike after 8
040911 - miles and calling for a ride home, shown in case study on 120101 0900.
040912 - ref SDS 2 BO6F
040914 - ..
040915 - On 140904 0900 meeting with Doctor Cynthia Lieu and Doctor Tang,
040916 - attending. ref SDS 37 AK6J Doctor Tang said orthotics can be trimed
040917 - to fit a smaller shoe size, if necessary; he has scheduled a meeting
040918 - after orthotics inserts are received. ref SDS 37 4M3H
040920 - ..
040921 - On 150115 0845 meeting with Doctor Tang and Doctor Goodman, the doctor
040922 - ordered a 2nd set of orthotic inserts to recover from and prevent
040923 - recurrance of metatarsalgia. ref SDS 42 BG6I
040924 -
040925 -
040926 -
040927 -
040929 - ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Agenda...
041302 -
041303 - 1. Examine feet for dryness caused by dehydration due to
041304 - medications explained in case study on 140101
041306 - ..
041307 - Discussed with Doctor Simpson in Cardiology on 151014 0900.
041308 - ref SDS 44 9G44
041310 - ..
041311 - Dehydration causing blisters reported on 150809, in case study
041312 - on 140101 0600. ref SDS 6 GH3G
041313 -
041315 - ..
041316 - 2. Treat blisters and calluses both feet.
041318 - ..
041319 - Doctor Tang cut the blisters and calluses down on big toes both feet.
041321 - ..
041322 - He applied a thin plastic adhesive wrap today for the big toe on both
041323 - toes. He wants to try this to prevent shear from causing further
041324 - blister problems.
041326 - ..
041327 - These wrappings should be cut in half so that one unit is enough for
041328 - both big toes. This is an experiment to see if they will stay in
041329 - place during hikes and prevent blisters.
041331 - ..
041332 - The doctor provided interim supply, and placed order for pharmacy to
041333 - ship regular supplies.
041334 -
041336 - ..
041337 - Agenda continues...
041338 -
041339 - 3. Little toe and toe next to little toe on left foot only.
041340 -
041341 - Using cuffs on these toes for long hikes.
041342 -
041344 - ..
041345 - 4. Metatarsalgia - Prolab orthotic inserts, ibuprofen medication,
041346 - and Thorlo socks, all prescribed by Doctor Tang at the VA, and
041347 - further combined with Hoka Stinson Lite shoes have, since the
041348 - end of October, 2014, restored ability to hike 11 miles per
041349 - day, 300 miles per month, including 22 miles per day on
041350 - consecutive days, shown in the agenda for the meeting submitted
041351 - with the letter on 150113 1049. ref SDS 41 F497
041353 - ..
041354 - Past month or so, e.g., on 151024, have increased hikes to 15
041355 - miles per day, shown in case study on exercise, diet,
041356 - medication and vitals on 140101 0600. ref SDS 6 A26M
041358 - ..
041359 - Doctor Tang asked about hills/inclines?
041361 - ..
041362 - The 11 mile route has 2 long hills. On clockwise route 1st hill is
041363 - about .75 miles. The 2nd hill is slighty steeper and only .5 miles.
041364 - Additional 4 mile loop on 15 mile hikes has 2 more hills: 1st hill is
041365 - about 1 mile and steeper than hills on 11 mile route; the 2nd hill is
041366 - only about .4 miles, but steeper than 1st hill.
041368 - ..
041369 - Agenda continues...
041370 -
041371 - Mileage spreadsheet shows Podiatry has worked well the past
041372 - year...
041373 -
041374 - F:\05\00003\SM\CC\BNKG\120216cc\130101cc\hiking_miles_3.xlsx
041376 - ..
041377 - Date Miles Minutes Source
041378 - Jan................... 242 3687 ...... ref SDS 6 TSYW
041379 - Feb................... 256 3941 ...... ref SDS 6 VYVP
041380 - Mar................... 189 2941 ...... ref SDS 6 WUTU
041381 - Apr................... 240 3698 ...... ref SDS 6 XVVR
041382 - May................... 230 3485 ...... ref SDS 6 PPXS
041383 - June.................. 233 3571 ...... ref SDS 6 QZ6J
041384 - July.................. 230 3559 ...... ref SDS 6 RSVY
041385 - August................ 142 2241 ...... ref SDS 6 SVPP
041386 - September............. 212 3658 ...... ref SDS 6 TVQP
041387 - October............... 323 5337 ...... ref SDS 6 TVQP
041388 - November.............. 77 398
041390 - ..
041391 - Totals 2395 36878 average 15.7 minutes per mile
041392 -
041394 - ..
041395 - 5. Why does left foot cause continual problems metatarsalgia and
041396 - right foot never hurts, shown by example on 151011, in case
041397 - study patient history on 140101 0600. ref SDS 6 Z86F
041399 - ..
041400 - Doctor Tang suspects the left foot is fore some reason now longer
041401 - than the right foot.
041402 -
041404 - ..
041405 - Agenda continues...
041406 -
041407 - 6. Good news - past week or so, metatarsalgia left foot has been
041408 - less severe, reported most recently 2 days ago on Wednesday,
041409 - 151111, in case study. ref SDS 6 WUWU
041410 -
041411 - Since begnning extended endurance hikes of 11 miles per day,
041412 - 300 miles per month have noticed following health
041413 - improvements...
041414 -
041415 - 1. HDL 30 increased to 70, enabling regression of
041416 - atherosclerosis.
041418 - ..
041419 - 2. Strength and vitality have increased.
041421 - ..
041422 - 3. Pain in neck and shoulders has subsided, no long occurs.
041424 - ..
041425 - 4. Pain in lower back has subsided, no long occurs.
041427 - ..
041428 - 5. Pain in left hip has subsided, no long occurs.
041430 - ..
041431 - 6. Pain no longer occurs from degenerative arthritis left knee
041432 - from surgery that removed cartilage to recover from 40'
041433 - fall in pump station in 1973, and provided take Glucosamine
041434 - Chondroitin before 11 mile hikes, and before and after 15
041435 - mile hikes.
041436 -
041438 - ..
041439 - 7. Have there been any new designs or treatment theories for
041440 - orthopedics that prevent and resolve feet injuries from
041441 - extended endurance exercise?
041443 - ..
041444 - Doctor Tang made referral to podiatry specialist.
041446 - ..
041447 - The front desk may have made a mistake scheduling the meeting with
041448 - Doctor Tang instead of the specialist.
041449 -
041450 - Date/Time: Tuesday 15 Dec 2015 0845
041451 - Clinic: Podiatry Tang, Follow up
041452 - Location: Building 200 Ground Floor Module 3
041453 - Telephone: 415 379 5673
041454 - Provider: Tang, Robert E
041456 - ..
041457 - Did not notice the name when the schedule clerk submitted the letter
041458 - dated today.
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