Microsoft word - kristis_foot[1]

This is a description of the results of treatments for a bone fracture of my left foot. The treatments were performed by Hakan Lagergren using the ReeCept X7 laser in Stockholm, Sweden in May 2004. Because I experienced a fracture of the same area in my right foot about ten years ago in New Jersey, U.S.A., it has been interesting to compare the rates of recovery under different treatment. I am a 52-year old woman in History of the injury and initial treatment On Saturday, May 1, 2004, I broke the 5th metatarsal of my left foot. I was walking a dog and did not see that the edge of the street dropped off sharply. I stepped on that edge, the foot turned suddenly, and the bone snapped. There was some pain immediately, and I had to sit down. A small bump or swelling appeared on the outside edge of the foot, but the skin was not punctured. This experience was almost identical to another which happened to me some years ago when I fractured the 5th I could not put pressure on the foot and had to use two arm crutches to get to the hospital. At Danderyd’s Hospital Emergency Room in Stockholm, I was examined by Dr. Cecillia Enander, an orthopaedist, and had x-rays taken. I was given an elastic tube bandage for the foot, a prescription for a pain killer, and new elbow crutches. I was told to wear a sturdy shoe, to walk on the foot as soon and as much as possible, and to use ice packs for the swelling. This was the same treatment I was given for the previous injury in New Jersey. Healing, I was told, would take about six to eight weeks, but I should come back in four weeks if I was not doing well. I asked the doctor about a bone density scan because of the two fractures, and she contacted my The next morning the foot was very swollen, and I could not step flat on the floor without severe pain. I used two crutches to move around the house, and I had to sit in order to get up and down the stairs. I had a support shoe with Velcro closures and a water-pack ankle brace from the time of the previous injury and wore these for 12 days until a reduction in swelling allowed me to wear regular walking/training shoes. I did not fill the prescription for the pain killer because the pain was not unbearable as long as I did not put weight on the foot, and aspirin sufficed. I was not using any medications at the time. I had taken hormone replacement therapy for three years for menopausal symptoms, but discontinued it in summer 2003. I was taking a multi- vitamin supplement plus 400 IU vitamin E, 500 mg fish oil, and began taking a 600 mg calcium and mineral supplement. I used ice packs on Saturday and Sunday about every two hours for 10 minutes. On Monday morning and evening and Tuesday morning I used ice baths in 2 x 5-minute treatments. I slept with the foot elevated for On Tuesday, May 4 at 9:00 p.m., I met Hakan Lagergren and had my first treatment with the ReeCept X7 laser. It was recommended to me by a friend, Alexandra Kastrinos, a dancer with the Royal Swedish Ballet in Stockholm, who was being treated for a foot injury and had received relief from it. I drove myself to the appointment, accompanied by Ms. Kastrinos. I experienced occasional sharp pain when I pressed the clutch pedal with the left foot, but I was able to adjust for it by After the one-hour treatment, all three of us observed that the swelling had definitely lessened and that the normal features of my foot were slightly more visible. We scheduled treatments for Wednesday-Friday and for the following week. Mr. Lagergren said that he thought that “maybe” I could be walking on the foot at the end of the second week. When I remembered the weeks of using crutches after breaking the other foot, I was sceptical, but hopeful and curious because of his confidence. When I drove home from the first treatment, there was no pain when I used the clutch as there had been two hours before. Because of the immediate relief I had experienced, I began taking photographs of the foot with my digital camera to record developments. They are available for a day-to-day visual comparison. For two days after the accident I remained at home upstairs. On Tuesday morning, I scooted down the stairs on my bottom to take a shower and used a crutch to support myself there. On Thursday morning after two laser treatments, I could walk down the stairs one step at a time using a crutch on the right side and holding the railings on the left. I could stand flat on both feet in front of the sink. I was moving so well that I momentarily forgot myself and stepped into the shower with my left foot and put my weight on it. I immediately reached for support, but there was no pain. From Wednesday to Friday I used two crutches to walk outside the house on uneven ground but needed only one inside the house. Swelling decreased visibly each day. On the weekend, one week after the accident, I had no treatments. I was able to do housework such as clearing storage boxes from a closet and doing laundry in the basement without the support of crutches. I could walk up the stairs slowly but normally. I still walked down the stairs one step at a time holding the rails, but Over the second week I had one treatment per day, Monday-Friday. Swelling decreased steadily. Discoloration went from blue to black in the toes, the side and bottom of the foot and then began fading. (See photos) I began to wear regular lace- On Wednesday I sanded the floor and stairway of the entry hall of my home. (Photo) On Thursday I painted the area with lut (lye). On Friday I returned to Danderyd Hospital to pick up my records and x-rays, and walked without crutches from Orthopaedics to Radiology to Mammography – in effect, from one end of the hospital to the other - and back. The only pain I experienced during the week occurred if I suddenly twisted the foot or hit it on something, but not from walking on it. I did move slowly and consciously. After an active day there would be some stiffness. The heat of the laser treatments felt very good and gave almost immediate relief. Mr. Lagergren attended the machine constantly and made adjustments if I considered it too warm or if I felt a slightly uncomfortable “tingling” sensation as the laser passed over an area with less dense tissue, such as the toes. At all times I felt safe and that I Before the end of the second week I had certainly met Mr. Lagergren’s projected time for being able to walk. I had had 9 one-hour treatments in 11 days. On Friday, May 14, I was examined by Dr. Thomas Lundeberg, Professor of Orthopaedics, Karolinksa Hospital. He said that he would expect this level of recovery after 4 weeks of On the second weekend after the accident, I visited a friend, Mary Kalau, and was filmed by her walking in her garden and up and down stairs without crutches. That The third week we scheduled no treatments, but I was assured I could return if I felt it was necessary. I continued to be more active and in the evenings had some slight return of swelling and pain around the site of the fracture. This disappeared by morning after sleeping with the foot elevated. On Monday and Tuesday of the third week I began clearing large areas of the garden of weeds and loaded and took two car loads of building materials and garden rubbish to the dump. I cleaned and prepared the house for a visitor, Lone Stephenson, whom I showed around Stockholm for 4 days. I carried a cane with me at all times, but very rarely needed it. On Saturday, May 22, three weeks since the injury, we both noticed that I was walking almost normally with only a slight limp, just more slowly than Three and a half weeks after the accident there is some stiffness in the ankle and foot and tenderness at the site of the fracture. I wear sport shoes almost always for walking because the support they give alleviates this stiffness and tenderness, and I am still insecure about walking barefooted. When I fractured the left foot on May 1 and remembered my incapacitation following the fracture of the right foot 10 years ago, I assumed I would have to cancel all of my plans for May and June. For the right foot, using standard treatment with cold packs and elevation, I had to wear the special shoe for a much longer time because of the swelling and pain. I remember a great deal more pain and limitation in my movements. I slept on the sofa so I wouldn’t have to use the stairs and used two crutches for weeks - not days. I was teaching then and used a wheeled desk chair to move around the classroom, when I was finally able to get there. In New Jersey at my first follow-up visit to the doctor, perhaps two weeks after the first accident, I remember him insisting that I begin placing my foot flat on the ground, not just using the toe to balance, so that the bone would heal correctly. The pain I felt when doing so had made me think that it could not be a good thing to do. But during the ReeCept X7 treatments, I did not have the same level of pain to discourage me from putting weight on the foot, which I know encourages bone healing. I was able to do almost everything I had planned to do this month: renovations to my home, tours around Stockholm, gardening. On May 28 I am flying to England for 3 days – four weeks after the injury. On June 2 I will fly to the U.S. for a three-week visit. On May 1 I thought I would be doing these trips on crutches – This treatment experience has been exhilarating. My outlook changed from hopeless disappointment and resignation at having to accept limitation during a busy time, to fascination with watching the healing of my foot progress in visible stages daily. The series of photographs documents that physical process, but the emotional benefit was just as dramatic. If it seems that I might have pushed too hard, it was because I could! It was uplifting to find out what new thing I could do each day. The potential of this device to speed healing and alleviate suffering – mental as well as physical – must be enormous. My experience with it has been wholly positive. “Awesome” is truly an accurate description. I am exceedingly grateful to have been introduced to Hakan Lagergren and the remarkable possibilities of the ReeCept X7.


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