| January 11, 2000 To Whom it May Concern: RE: Geraldine Parsley and Margie Pulkrabek Geraldine Parsley was seen for painful Achilles tendon that resulted form a partial tear. Conservative treatment failed to give her any relief. As a result I referred her to Dr. Gale for a second opinion and I provided Dr. Gale with her history indicating that all conservative options had been tried without any relief and surgical approach was appropriate at this time. As far as the second patient, Margie Pulkrabek, she had plantar fasciitis and tarsal
tunnel syndrome. Her problems were treated conservatively again with very minimal
improvement. As a result I referred her to Dr. Gale for a second opinion and surgical
correction if he deemed it appropriate. Once again I provided Dr. Gale with information
indicating that conservative treatment was tried with very minimal improvement and to my
knowledge, he has operated on several patients with tarsal tunnel release and I believe at
the same time the surgery for the plantar fasciitis and the surgery for the tarsal tunnel
should be done at the same time and to my knowledge she did very well after surgery and
she had immediate relief. So in both cases conservative treatment was done mainly by me
and in both cases conservative treatment provided either no relief to very limited relief.
That is why the referral was made to Dr. Gale for surgical correction. If you have any questions, please do not hesitate to contact me. Thank you. Sincerely,
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