Bypass Surgery -Conventional AFO's with Double Action Joints

The patient was seen today for fitting of his bilateral conventional AFOs with double-action ankle joints attached to extra-depth shoes with custom inserts and Velcro closures on the shoes. Fit was appropriate today. On the right brace the medial upright was just touching the patient's ankle. We shifted this 1A inch medially. Fit was appropriate. On the left side, the calf band was touching the fibular head. We lowered this to the correct height. The patient is still recovering from bypass surgery and is still very weak. He was able to stand in the orthosis today. He has not begun therapy. His wife indicated that she will call to receive the therapy schedule once he receives the braces. She reported that he will receive therapy 3 times per week. I instructed the patient and his wife in donning, doffing, wear, and care procedures as well as weaning schedule and proper shoe wear. I emphasized the importance that she monitors the patient's skin for any areas of irritation lasting longer than 30 minutes each time she removes the braces from his feet. I also gave them written instructions to follow today. They should begin weaning into the braces 2 hours today and increase by 2 hours each day. The patient is not ambulating very much at home at this time. I instructed them to call us should they have any problems or questions, and to return for a recheck on the braces 1 week after he begins therapy. They will contact us to set up this appointment once they know when therapy will begin. Otherwise, we will see them back for adjustments as needed.