CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 15 0000. ref SDS 13 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Meeting with...
040902 -
040903 - Doctor Nicole Reardon, DPM
040904 - Attending Podiatric Surgeon
040905 - VA Medical Center
040906 - 4150 Clement Street (112E)
040907 - San Francisco, CA 94121
040908 - 415 221 4810 ext 23925
040909 - nicole.reardon@va.gov
040911 - ..
040912 - Resident said there is a room available for treatment.
040948 - ..
040949 - Went into an examination room. The resident used a scalpel to shear
040950 - off the major part of callus on the big toe of the left foot. He also
040951 - removed a callus on the right foot big toe, but this was much smaller
040952 - and not causing problems.
040954 - ..
040955 - Doctor Reardon came into the examination room.
040957 - ..
040958 - She diagnosed calluses on the left foot are caused by large bunion,
040959 - shown by misalignment of the big toe, hallux valgus.
040961 - ..
040962 - We noted the big toe on the right foot also has hallux valgus, but may
040963 - be less severely out of alignment, since the callus on that toe is
040964 - much less severe, i.e., painful, than the callus on the left foot.
040965 - Equally, the right foot ring toe and little toe have no injuries.
040966 - This may reflect PRP treatment Doctor Gloria Tucker applied to treat
040967 - right foot hallux valgus during the procedure on 170816 1400,
040968 - ref SDS 5 IM7N, as set out in her letter the next day on 170817 0836.
040969 - ref SDS 6 9F5H Thus, if the left foot ligament is weaker, it may
040970 - yield to pressures hiking 11 - 15 miles over 3 - 4 hours, whereas the
040971 - right foot maintains alignment, resulting in fewer injuries - maybe.
040973 - ..
040974 - Previously, notified Doctor Tucker of evident response to treatment
040975 - for right foot hallux valgus, reported in letter on 170907 1604.
040976 - ref SDS 8 FJ46 Accordingly, might consider PRP treatment for left
040977 - foot hallux valgus.
040979 - ..
040980 - Blisters on left foot little toe and ring toe may further reflect
040981 - favoring left leg/foot during hikes. These toes are not blistered on
040982 - right foot. Left leg is favored during hikes in order to increase
040983 - strength, recovering from atrophy in a cast many years ago, explained
040984 - in the meeting with Doctor Tang on 141009 0900. ref SDS 3 FJ6O
040986 - ..
040987 - Examination of left Hoka Bondi 5 shoe shows the contact outer sole has
040988 - worn through to the softer outer sole cushion material, but has not
040989 - worn through on the right shoe. Imbalance in shoe wear causes the
040990 - left foot to tilt left, and so may be causing increased blistering
040991 - on the left foot - maybe.
040993 - ..
040994 - Before meeting with Podiatry today, ordered new pair of Hoka Bondi 5
040995 - Wide (2E) shoes for expedited delivery tomorrow. Hopefully, this will
040996 - help normalize pressures on both feet and thereby reduce blisters on
040997 - left foot, reported in another record on 171221 0910. ref SDS 18 SM4M
040999 - ..
041000 - Hoka is working on completing transaction to exchange 6-pair Hoka
041001 - Bondi 5 shoes, so there are 7 pair to rotate daily for a week,
041002 - reported in call to Hoka yesterday on 171220 0955. ref SDS 17 OH7L
041003 - This should enable shoes to last about 14 months hiking 60 - 100 miles
041004 - per week.
041006 - ..
041007 - Doctor Reardon commended wearing Hoka Bondi 5 shoes. She wears Hoka
041008 - shoes for long days standing at work in Podiatry, and implementing
041009 - recommendation by Doctor Tang. Mentioned discussing Hoka shoes with
041010 - Doctor Tang during a meeting on 140805 1030. ref SDS 1 1F50
041012 - ..
041013 - The doctor asked about socks?
041015 - ..
041016 - Pointed to socks on the floor next to the Hoka Bondi 5 shoes, and
041017 - explained these are Thorlos socks, recommended by Doctor Tang during
041018 - the meeting on 140904 0900. ref SDS 2 4M69 Bought 10 pair on 140909,
041019 - and another 10 pair costing $21.99 each, reported on 160424 1952.
041020 - ref SDS 4 EM6K These socks have been durable, so total investment of
041021 - $490 has been effective. Socks are rotated daily. There have been
041022 - periods when wear 2 pair. Socks are washed every 20 days.
041024 - ..
041025 - Doctor Reardon suggested trying Zensor compression socks.
041027 - ..
041028 - Wasn't clear during the meeting that compression socks were
041029 - recommended to protect against blisters that are a major problem
041030 - treated today. After the meeting, research on the Internet found...
041031 -
041032 - Amazon
041034 - ..
041035 - Zensah Tech+ Compression Socks - Running Compression Socks
041036 -
041037 -
041038 - https://www.amazon.com/Zensah-Tech-Compression-Socks-Running/dp/B00FFZHZU8
041040 - ..
041041 - Price................................. $26.27 - $78.58
041042 -
041043 - 1. Prevent Injury and Alleviate Shin Splints: Compression
041044 - helps to stabilize muscles and provide support to the shin
041045 - and calf area. By improving blood flow and providing
041046 - support to the lower leg, shin splints are able to be
041047 - relieved and calf cramping prevented. Whether suffering
041048 - from a calf strain or pain in the lower leg, the Zensah
041049 - Tech+ Compression Socks allow you to get back to your
041050 - favorite activity faster. Compression in the ankle area
041051 - helps to stabilize muscles to prevent injuries and provide
041052 - added support.
041054 - ..
041055 - 2. Superior Comfort: The compression socks feature a seamless
041056 - toe, which prevents chafing and blisters. An anatomical
041057 - fit means the socks are designed specifically for the left
041058 - and right foot to ensure a perfect fit. The compression
041059 - socks are made of Zensah Fabric, making them lightweight,
041060 - moisture wicking and thermal regulating. The Tech+
041061 - Compression Socks provide added arch support thanks to
041062 - ultra-zone ribbing. An elastic band goes around the foot
041063 - to help support your arches for added comfort and to
041064 - prevent fatigue. These are the best compression socks you
041065 - will ever try. We guarantee it.
041067 - ..
041068 - This indicates cannot simply put the socks on feet, but have to study
041069 - which sock for each foot. This is not always clear after numerous
041070 - washings.
041072 - ..
041073 - Amazon Product Description Continues...
041074 -
041075 - 3. True Graduated Compression: Graduated Compression means
041076 - that there is the most compression in the ankle area and
041077 - less in the calf area. This helps to promote blood flow by
041078 - pushing the blood back to the heart through the veins. Not
041079 - only does this prevent cramping and preventing swelling,
041080 - but also helps to improve muscle recovery time, as muscles
041081 - receive a greater amount of oxygenated blood they need to
041082 - recover. Use while running or working out to help take
041083 - your sport to the next level or while traveling to prevent
041084 - swelling.
041086 - ..
041087 - Improving muscle recovery time, may prevent severe pain for several
041088 - hours after hiking???
041090 - ..
041091 - Amazon Product Description Continues...
041092 -
041093 - 4. Who should wear Zensah Tech+ Compression Socks: Everyone
041094 - from runners, basketball players, fitness enthusiasts,
041095 - travelers, and those on their feet all day like nurses are
041096 - able to benefit from wearing compression socks. The
041097 - compression socks featured graduated compression to help
041098 - improve circulation and blood flow, reduce leg fatigue,
041099 - and support muscles.
041101 - ..
041102 - Hiking 11 - 15 miles per day have not noticed leg fatigue nor that
041103 - muscles need more support.
041105 - ..
041106 - Amazon Product Description Continues...
041107 -
041108 - 5. Made in Italy and Extra-Durable: The Tech+ Compression
041109 - Socks are made in Italy of Polyamide and Elastane blend to
041110 - ensure superior quality. The compression socks are also
041111 - engineered using a 200 needle count construction. This
041112 - results in a more durable and advanced compression sock to
041113 - provide you with the compression in the areas you need it
041114 - the most.
041116 - ..
041117 - Do we need another 20 pair of socks costing $500 - $1,000?
041119 - ..
041120 - Might try 1 pair of Zensah socks to experiment. Generally, wearing
041121 - socks over calves is not appealing.
041123 - ..
041124 - Turned out that 1 pair size medium costs $49.45, so will pass for now.
041125 - Could try wrapping calves with Coban tape to evaluate reducing
041126 - post-hike pain. Might wrap forefoot with Coban to reduce blistering.
041128 - ..
041129 - Asked about liquid naproxen presented in the letter to Doctor Tang on
041130 - 171207 1213, ref SDS 14 VT75, following up original request in an
041131 - earlier letter on 171201 1037. ref SDS 13 UX9K
041133 - ..
041134 - Doctor Reardon checked VA computer system. She found that liquid
041135 - (suspension) naproxen is not available for prescription in Podiatry at
041136 - VAMCSF.
041138 - ..
041139 - An aide (possibly student) used clippers to cut toenails on all toes
041140 - both feet. The clippers seemed industrial strength that make this
041141 - task faster and easier.
041143 - ..
041144 - The resident examined left foot little toe and ring toe. He applied
041145 - tube shield on the ring toe and another type of dressing on the little
041146 - toe (actually a simple bandaid, and then somthing that slipped over
041147 - the bandaid) to try hiking with this new line of protection. The
041148 - doctor also gave a roll of 1" white tape.
041150 - ..
041151 - Discussed PRP with Doctor Reardon. She was not comfortable with
041152 - results regenerating cartilage in metatarsals nor in knee joints. The
041153 - doctor did not cite studies to support her feeling that PRP injections
041154 - do not regenerate cartilage in feet and knees. She seemed to say
041155 - simply that this is hard to accompish.
041157 - ..
041158 - She may have investigated PRP for her father. She said he is 69, and
041159 - scheduled for knee replacement surgery.
041161 - ..
041162 - In the Welch case, MRI studies were done on both feet and both knees
041163 - before PRP injection treatments were performed in July and August.
041164 - Have scheduled to meet with Doctor Thuillier in Orthopedics next
041165 - Wednesday, on 171227 to consider post procedure changes 6 months after
041166 - PRP injections.
041168 - ..
041169 - Doctor Reardon has worked with Doctor Thuillier, possibly in
041170 - residency.
041172 - ..
041173 - Thanked Doctor Reardon for thorough, timely care today, and wished
041174 - her happy holidays.
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