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.
AVMs – How I Treat Them: Alcohol Wayne F. Yakes, M.D. Arteriovenous malformations (AVMs) constitute some of the most difficult diagnostic and therapeutic dilemmas in the practice of medicine. The clinical can range from an asympto-matic birthmark to life-threatening congestive heart failure. Attributing any of these varied symptoms to a vascular malformation can be chal enging to the
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