Hello again Dr. Blake,
First, I am truly grateful for your thoughtful diagnosis of my injury over the last couple of days. Your willingness to make time and accessibility were very gracious and generous. Moreover, I very much appreciated your prompt voicemail with both the radiologist's and surgeon's diagnoses, respectively.
I just wanted to briefly follow-up on a couple of items:
Exercise
- General daily getting around - while I am not planning to hike Mt. Tam anytime soon, what duration of walking with the crutches is sound?
- Reclined exercise bike - I believe that you said that it's o.k. As of when may I begin using it? I believe you said to keep the boot on my right foot and use it rather than isolating it and solely using my left leg. Please advise.
- Pilates - is that o.k. if I isolate my right from the exercises requiring that leg?
Logistics
- Would it be possible to get a letter for a temporary disabled mirror hang tag from the DMV? For example that would preclude several stories of steps at my Athletic Club. If not, would be possible to email me a letter stating my injury on your letterhead for the Club at a minimum?
Insurance
- To follow-up on that topic, I will be insured through a high deductible, individual Aetna PPO plan starting Oct.1, which is when my COBRA expires. While I am seeking a traditional job partially for this reason and ideally will have secured one by the the end of the year, I would ideally like to hold off on any high cost procedures until 2013 if feasible should that I not be traditionally employed by the end of the year.
Again, my sincere appreciation,
Sally (name changed)
Dr Blake's Response:
Sally, I will answer the questions in order, hope they make sense. The progression of going from crutches to no crutches is totally based on how the ankle feels. You gradually increase weight bearing with the crutches to a point you do not need them any more. There is normally a 5 day period where you are bringing the crutches with you, in case you need them in between the crutch and no crutch periods. Always 2 crutches, never one crutch--terrible for your back. The boot protects you so you can take the pressure of the stationary bike. Just listen to the ankle, avoid the pressure that gives more than level 2 pain. Normally, the seat is lowered since you can not bend your ankle, and alot of patients off weight the sore ankle on a stool and solely pedal with hardly no resistance to get a better cardio workout. Try both ways to see the benefits of both. Pilates and Yoga have so many exercises that you can do safely without the boot of course and without stressing the ankle. Do not place yourself in unstable environments, and listen as much to your good leg for the sensations of overuse. We need a good leg to stand on. I will mail you the DMV and you take in with $6. Sounds great insurance wise. Your 3 months of casting, plus 6 weeks of carefully weaning out of the cast gets us to March anyway. Rich
Dr Blake's Response:
Sally, I will answer the questions in order, hope they make sense. The progression of going from crutches to no crutches is totally based on how the ankle feels. You gradually increase weight bearing with the crutches to a point you do not need them any more. There is normally a 5 day period where you are bringing the crutches with you, in case you need them in between the crutch and no crutch periods. Always 2 crutches, never one crutch--terrible for your back. The boot protects you so you can take the pressure of the stationary bike. Just listen to the ankle, avoid the pressure that gives more than level 2 pain. Normally, the seat is lowered since you can not bend your ankle, and alot of patients off weight the sore ankle on a stool and solely pedal with hardly no resistance to get a better cardio workout. Try both ways to see the benefits of both. Pilates and Yoga have so many exercises that you can do safely without the boot of course and without stressing the ankle. Do not place yourself in unstable environments, and listen as much to your good leg for the sensations of overuse. We need a good leg to stand on. I will mail you the DMV and you take in with $6. Sounds great insurance wise. Your 3 months of casting, plus 6 weeks of carefully weaning out of the cast gets us to March anyway. Rich
Crutch pads are smooth enough to ensure pain free movements. Grip pads act as cushion for crutches and provide a lot of comfort with a sense of style.http://www.easeofmobility.com/best-transfer-boards-guide/
ReplyDelete