Dear Dr. Carreira, An arthritic ankle so severely inflamed to the point of immobility sent me to an Orthopedic surgeon who recommended replacement or an ankle joint fusion. I wanted a 2nd opinion and found Dr. Carreira who suggested I keep my ankle elevated, using a lift or higher heels, avoid beach walking and impact exercise, or if necessary a steroid injection. It has been 6 years since my 1st visit with Dr. Carreira and following his advice with only 1 steroid injection after activity overuse. I am pleased to have found Dr. Carreira who directed me on a path to managing my ankle condition with no surgery or chronic pain. Thank you Dr. Carreira!   Regina O. Pompano Beach Fl.