CONTACTS
SUBJECTS
VA Podiatry Review Metatarsalgia Pain Balls of Feet Enable Physical
1303 -
1303 - ..
1304 - Summary/Objective
1305 -
130501 - Follow up ref SDS 41 0000. ref SDS 35 0000.
130502 -
130503 -
130504 -
130505 -
130506 -
130508 - ..
1306 -
1307 -
1308 - Background
1309 -
130901 - Meeting Doctor Tang in Podiatry on 140805 1030. ref SDS 25 NU4G
130902 - Progress Notes for meeting on 140805, call for return to clinic after
130903 - receiving FFO. ref SDS 25 IJ4G A few days after meeting on 140805,
130904 - received letter from VA scheduling follow meeting today on 140820
130905 - 1000.
130907 - ..
130908 - Wound on left big toe looked infected, and may account for elevated
130909 - WBC 12.8 on recent lab performed at Martinez VA on 140814 1530,
130910 - ref SDS 29 RP4N
130912 - ..
130913 - On 140819 Doctor Sandhu, Primary Care Martinez VA Clinis examined the
130914 - wound and ordered follow up lab. 140819 0800, ref SDS 30 318I
130916 - ..
130917 - On 1408, 140827 follow up lab showed WBC 13.8 increased. ref SDS 32
130918 - RP4N
130920 - ..
130921 - On 140828 meeting with Doctor Kevin Daun and later with Doctor Mihara,
130922 - attending developed solution to blister on inside of big toe on left
130923 - foot, ref SDS 33 W74O, that required stopping 11 mile hike after 8
130924 - miles and calling for a ride home, shown in case study on 120101 0900.
130925 - ref SDS 2 BO6F
130927 - ..
130928 - On 140904 0900 meeting with Doctor Cynthia Lieu and Doctor Tang,
130929 - attending. ref SDS 35 AK6J Doctor Tang said orthotics can be trimed
130930 - to fit a smaller shoe size, if necessary; he has scheduled a meeting
130931 - after orthotics inserts are received. ref SDS 35 4M3H
130933 - ..
130934 - On 140910 1553 receive Prolab orthotic inserts ordered by VA to
130935 - resolve metatarsalgia pain side effects of endurance exercise physical
130936 - activity treatment to lower CVD risk by reression of atherosclerosis.
130937 - ref SDS 37 AK6J
130939 - ..
130940 - On 140911 1529 letter to VA notified Podiatry received Prolab orthotic
130941 - inserts. ref SDS 38 AK6J
130943 - ..
130944 - On 141008 1349 letter to VA submit agenda for meeting on 141009 0900,
130945 - ref SDS 40 AK6J; advised orthotic inserts orderedby VA were not
130946 - received in time for Half Dome, ref SDS 40 ST60; suffered pain that
130947 - prevented reaching top of Half Dome, but likely not related to delay
130948 - receiving VA orthotics. ref SDS 40 ST60 Advise VA Prolab custom
130949 - orthotic inserts significantly reduce metatarsalgia pain compared to
130950 - other measures. Enables hiking up to 3 days in a row; may support
130951 - hiking 300 miles per month, which has proven effective controlling CVD
130952 - risk by reducing atherosclerosis, based on lipid labs. ref SDS 40 ST68
130953 - Switching inserts between shoes causes debilitating injuries.
130954 - ref SDS 40 ST79 Therefore to maintain level of effort, would like to
130955 - order 3 more sets of VA Prolab orthotics so that all 4 pair of Hoka
130956 - Stinson Trail shoes have separate inserts. If there is a cost
130957 - consideration, I can pay for the work. ref SDS 40 ST92
130958 -
130959 -
130961 - ..
1310 -
1311 -
1312 - Progress at 0900
1313 -
131301 - Podiatry Meeting Review Metatarsalgia Orthotic Inserts
131302 -
131303 - Follow up ref SDS 41 AK6J, ref SDS 35 AK6J.
131304 -
131305 - After getting a blood draw, Kathy and I had lunch in the cafeteria.
131306 - Considered trying to see Karen in Cardiology to say hello and follow
131307 - up prior discussions on standard of care testing response to treatment
131308 - for atherosclerosis with coronary CTA and calcium score, reported on
131309 - 140805 1030. ref SDS 25 0082 Further considered requesting emergency
131310 - care in Podiatry for treatment of persistent blister on left foot and
131311 - new blister on right foot that occurred hiking yesterday on 141020,
131312 - reported in case study on 120101 0900. ref SDS 2 6H3L
131313 -
131315 - ..
131316 - After meeting with Karen in Cardiology, reported on 141021 1226,
131317 - ref SDS 43 0082, walked to ROI on 2nd floor building 202, and received
131318 - the report for the lab earlier morning on 141021 1150. ref SDS 42 X45G
131320 - ..
131321 - Walking down the main hallway returning from ROI, knocked on the door
131322 - of Podiatry, rather than check in at the Module 3 counter, and request
131323 - a meeting.
131325 - ..
131326 - The main Podiatry secretary, Laura, listened to the explanation of
131327 - treatment by Doctor Tang and Priya last week on 141009 0900,
131328 - ref SDS 41 EL3K, and that yesterday had more problems with same
131329 - blister on left foot, and new problem on big toe of right foot,
131330 - reported yesterday on 14102 shown in case study 120101 0900.
131331 - ref SDS 2 6H3L
131333 - ..
131334 - Laura checked her computer and found the record of recent treatment
131335 - last week on 141009 0900. ref SDS 41 AK6J She left her desk to find
131336 - and consult with Doctor Tang.
131338 - ..
131339 - About 2 minutes later she returned and said the doctor agreed to
131340 - provide emergency care. Laura created a record in the medical chart
131341 - setting up immediate treatment.
131342 -
131344 - ..
131345 - Meeting with Doctor Robert Tang and Priya Patel
131346 -
131347 - Follow up ref SDS 41 LS9T.
131348 -
131349 - Objective is removing more hardened tissue since the prior meeting on
131350 - 141009, along the length of blisters on the inside of both big toes,
131351 - that act like a knife cutting into softer underlying tissue after
131352 - hiking 4 miles or so. This causes severe injury and pain over the
131353 - next 7 miles. Doctor Tang was disappointed that rework is required
131354 - today, less than 2 weeks after treatment on 141009 0900. ref SDS 41
131355 - LS9T This occurred, because successful Podiatry care for metatasalgia
131356 - enabled hiking to increase following a periord of significant decline
131357 - due to metatasalgia, shown in patient history...
131359 - ..
131360 - Mileage 2014
131361 -
131362 - Follow up ref SDS 41 V15F.
131363 -
131364 - 130902....Aug................. 297 4916 ...... ref SDS 2 554N
131365 - 130929....Sep................. 225 4305 ...... ref SDS 2 419J
131366 - 131103....Oct................. 373 5757 ...... ref SDS 2 6F9N
131367 - 131201....Nov................. 172 2899 ...... ref SDS 2 XRPV
131368 - 131229....Dec................. 234 3324 ...... ref SDS 2 XXQY
131369 - 140202....Jan................. 347 5393 ...... ref SDS 2 YWST
131370 - 140302....Feb................. 234 3681 ...... ref SDS 2 PYWS
131371 - 140330....Mar................. 207 3313 ...... ref SDS 2 RXPR
131372 - 140427....Apr................. 310 4402 ...... ref SDS 2 RXVV
131373 - 140601....May................. 322 5338 ...... ref SDS 2 SXWV
131374 - 140629....Jun................. 156 2337 ...... ref SDS 2 ZW4N
131375 - 140803....Jul................. 81 1023 ...... ref SDS 2 I37G
131376 - 140831....Aug................. 140 1998 ...... ref SDS 2 236I
131377 - 140928....Sep................. 136 2855 ...... ref SDS 2 XWUY
131379 - ..
131380 - Successful care of blisters today, combined with resolving
131381 - metatrsalgia pain that began at the end of June, enables resuming
131382 - physical activity hiking 300 miles per month that yielded significant
131383 - improvement of lipid management toward regression of atherosclerosis
131384 - to lower CVD risk, planned in the meeting with VA on 140519 0800.
131385 - ref SDS 10 YM5N
131387 - ..
131388 - Priya used a scaple to shave more crusted tissue from blister on
131389 - inside of big toe left foot, continuing prior work on 141009 0900.
131390 - ref SDS 41 EL3K
131392 - ..
131393 - This effort resulted in a smoother surface with less noticable
131394 - crusted remaining tissue.
131396 - ..
131397 - Priya did the same procedure to remove crusted tissue from the new
131398 - blister on the right foot.
131400 - ..
131401 - Doctor Tang issued several pair of protective cuffs that can be worn
131402 - during hikes that increase pressure on these areas.
131404 - ..
131405 - The doctor will submit Geri-hydrolac 12 Urea lotion that will soften
131406 - these blister areas to aid recovery.
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