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Vascular Surgery/consult for a professional

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Question
I am a physical therapist working with a patient in a SNF. She has a right open TMA and a heel ulcer. The doctor said that we could weight bear as long as neither wound was effected. There is about a 3" span along the sole of her foot in which we were trying to problem solve making a makeshift darco boot to accomodate this. The doctor sent back a response requesting a "backless sandal" First of all I dont even know where to start to find one or if there even such a thing and, how will a TMA be able to hold a backless sandal on with no forefoot? Can you help?

Answer
an orthotist / prosthetist can make a custom walking 'boot" that off loads any weight bearing surface
in our clinic we'd make an order for
ambulatory consult to orthotist / prosthetist (these guys make artificial legs) for custom off loading footwear make sure the usual dressings are on the foot when she goes in, and make sure you do the on for 30 minutes then check for reddened areas and reapply for 45 minutes and so on until she can wear safely without causing pressure somewhere else....
the other problem can be that with one 'boot' she may feel her hips "off" a bit and may need one for other foots so she is able to walk correctly
best of luck lauri

Vascular Surgery

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Lauri Ordway

Expertise

I can answer your questions related to your circulation, your peripheral vascular system. This includes all arteries and veins except those inside the head and inside the heart. For example, neck (carotid), arms (carotid subclavian bypasses to Thoracic Outlet) belly (aortic aneurysm & occlusive disorders, renal artery stenosis), legs (iliac, femoral, popliteal, peroneal, dorasalis pedis, posterior and anterior tibial) arteries. Aneurysm & occlusive disease, atherosclerosis, leg pain, arterial wounds and gangrene, amputation prevention. Arterial Bypass, Reynaud’s, Buerger's disease (thromboangiitis obliterans), Thoracic Outlet and other circulation disorders. Vein disorders: Blood Clots (DVT), post-phlebetic syndrome, varicose veins, venous stasis ulcers. I can help with vascular wounds from diagnosis to treatments. I have worked extensively with VNUS Closure and EVLT (Laser) for varicose veins and can describe pre and post procedure expectations and describe the procedures themselves. I can't help with spider veins or cosmetic vein treatment, we don't do it. I have 15 years of wound care experience, arterial, venous, trauma and diabetic wounds for example. **I CANNOT answer questions about STENTS or STENTING, heart disease, blood pressure, brain aneurysm although I can help with questions about the arteries that go to and from those organs.

Experience

I am a nurse, I worked for 15 years with two terrific peripheral vascular surgeons, and one of them is also the inventor of very innovative wound care products and surgical instruments to make vascular surgery procedures better and faster. I wrote and manage the clinic website and field questions from patients all over the world. I am now working with another vascular surgeon and wound care expert, which has given me an opportunity to widen my horizons as I learn another excellent physician's preferences and benefit from his experiences in this amazing specialty.

Education/Credentials
I am an LPN, licensed in Minnesota

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