THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: May 16, 2016 08:05 AM Monday; Rod Welch

VA Orthopedics Prosthetics measured right knee for brace and issued ankle braces.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Orthopedics Examination Diagnose Right Knee MCL Tear 150326 Re-injur                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
3003 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3003 -    ..
3004 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
3005 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
300501 - Follow up ref SDS 8 0000. ref SDS 6 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300507 -  ..
3006 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3007 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3008 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3009 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
300901 - On 160418, visitied VA Orthopedics and met with Doctor Patrick Curran,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
300902 - with Doctor Alexis Dang attending, who has experience with sports                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
300903 - medicine. ref SDS 8 SN98                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
300905 -  ..
300906 - At that time on 160418, Doctor Curran ordered metal brace for the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
300907 - right knee, ref SDS 8 QJ4H, which he feels will be more effective than                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
300908 - Futuro brace purchased from CVS on 160413 1500. ref SDS 7 A57V                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
300910 -  ..
300911 - On 160509 1400 during follow up meeting at Orthopedics the doctor said                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
300912 - that the Prosthetics Department is still working on the knee brace.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300913 - ref SDS 10 IQ6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300915 -  ..
300916 - Today, on the way walking from ROI on the 1st floor, to the Cafeteria                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300917 - on the ground floor, just beyond the doorway leading to stairs for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
300918 - descending to the ground floor, noticed a sign saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
300919 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300920 -        Orthopedics Prosthetics                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
300922 -  ..
300923 - Went into this department and met Natalie, reported in aother record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
300924 - today on 160516 1710. ref SDS 13 SR5K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
300926 -  ..
300927 - She found the order entered by Doctor Curran on 160418 for a brace on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300928 - the right knee. ref SDS 8 QJ4H  Natalie said to wait while she                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
300929 - prepares to measure the knee to build the brace.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
300931 -  ..
300932 - Explained there is a meeting scheduled with Doctor Hewitson with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
300933 - Biomechanics in Podiatry at 0830.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
300935 -  ..
300936 - Natalie said measuring for the knee brace will only take 5 minutes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300938 -  ..
300939 - After she completed this, she noticed the Futuro ankle braces.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
300940 - Natalie asked how they are working?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300942 -  ..
300943 - Explained the ankles are really okay.  The braces are intended to hold                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
300944 - wound dressing in place while hiking to enable Achilles' tendon injury                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
300945 - to heal and to protect against recurrence, explained in the record on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300946 - 160514 1145. ref SDS 11 G15O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
300948 -  ..
300949 - Natalie asked how well the Futuro ankle brace accomplishes this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300950 - requirement?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
300952 -  ..
300953 - Related exparience this morning, where could not walk 100 yards,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
300954 - before it failed, reported in another record this morning on 160516                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300955 - 0631. ref SDS 12 QT7J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
300957 -  ..
300958 - Natilie removed both shoes and examined Futuro knee braces purchased                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
300959 - from CVS on 160514 1145. ref SDS 11 FA6N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
300961 -  ..
300962 - She went to storage cabinets, and showed knee brace the VA provides                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300963 - to patients.  These have laces and several strappings that appeared                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300964 - to provide more secure positioning that would prevent the braces from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300965 - changing position with movement, as occurred this morning.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
300967 -  ..
300968 - Since time was short, asked about returning after meeting in Podiatry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300969 - with Doctor Hewitson.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300971 -  ..
300972 - Natilie agreed.  She said the Prosetics Department can only issue                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
300973 - ankle braces or other devices on a doctor's order.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
300975 -  ..
300976 - Explained would like to try on these VA ankle braces to evaluate, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
300977 - if they seem effective, will then try to find a doctor to place an                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
300978 - order.  This is odd, because the braces are not needed for the ankles,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
300979 - except to secure wound dressing in place.  Not sure if anyone in Wound                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
300980 - Care can order these ankle braces for that purpose.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300982 -  ..
300983 - Natalie said to return after meeting with Podiatry and she will                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300984 - faciliate trying on the ankle braces and discuss who might place an                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
300985 - order.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
300986 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
300988 -  ..
3010 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3011 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
3012 - 1105                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
3013 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
301301 - After meeting in Podiatry Biomechanics for past few hours, where                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
301302 - Doctor Hewitson entered an order for ankle braces, returned to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
301303 - Orthopedics Prosthetics Department.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
301305 -  ..
301306 - Natalie was helping another customer.  Another person on the staff                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
301307 - assisted.  He found the order Doctor Hewitson placed for ankle braces                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
301308 - during the meeting Podiatry Biomechanics the past few hours, since                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
301309 - meeting with Natalie this morning, per above. ref SDS 0 5T6G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
301311 -  ..
301312 - The staff person measured the ankles and decided size "large" might                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
301313 - work best.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
301315 -  ..
301316 - He applied the braces.  It turned out the size "large" was a good fit.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
301318 -  ..
301319 - That's all there was to it.  This took about 10 minutes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
301321 -  ..
301322 - Returned to Podiatry for Doctor Hewitson and the Biomechanics team to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
301323 - assess effect of ankle braces on corrected gait problems, and modify                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
301324 - the ankle braces accordingly.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
301326 -  ..
301327 - Walking 100+ yards in the new ankle braces provided by VA there was no                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
301328 - feeling the back panel moved up, nor bunched up the sock.  On reaching                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
301329 - the Podiatry Department, Doctor Hewitson and the Biomechanics team                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
301330 - evaluated affect of the ankle braces to correct walking gait problems                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
301331 - observed this morning, that resulted in the doctor ordering ankle                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
301332 - braces from the VA, per above. ref SDS 0 PQ8F  The team concluded the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
301333 - ankle braces made substantial improvement in patient biomechanics.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
301335 -  ..
301336 - After this, removed the shoes and found the ankle braces had remained                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
301337 - place.  There was no movement of the braces, nor the socks, nor the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
301338 - underlying Hydrofera Blue dressing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
301340 -  ..
301341 - This record supports using VA ankle braces to replace Futuro knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
301342 - braces purchased from CVS on 160514 1145. ref SDS 11 FA6N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301343 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301344 -            [On 140101 0600 ankle brace provided by VA worked well on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
301345 -            left foot during entire 9 mile hike - held dressing in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
301346 -            place to protect wound on Achilles' tendon; both braces                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
301347 -            together feel good - seem more stable. ref SDS 1 UTVT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
301348 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301349 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301350 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301351 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301352 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301353 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301354 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301355 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
301356 -