Archive 12/18/2023

THE NARRATIVE: HUMANIZES YOU TO YOUR JUDGE, MAY LESSEN YOUR SENTENCE

YOUR NARRATIVE,

HUMANIZE YOURSELF TO YOUR JUDGE
THE DOJ HAS ALREADY TOLD YOUR STORY, THROUGH YOUR INDICTMENT
A WELL-WRITTEN NARRATIVE 👉 COUNTERS THE DOJ INDICTMENT OF YOU

This video covers why your NARRATIVE is critical in your defense. Why? To date, the DOJ has published your Story or Autobiography in the form of your INDICTMENT, which was released everywhere across the net, and if you do nothing – that is what your Judge will read and assume is the gospel truth.

If you don’t agree with 100% of your INDICTMENT, you have a choice: to tell your story through Your NARRATIVE. I hope this Video helps, and I am available for any questions.

I) Your NARRATIVE should be provided to your Probation Officer 1-2 weeks before your Presentence Interview to be included in your Presentence Report. It impacts STAKEHOLDERS you will meet,

  • Your Attorney: Aside from your charges, they will learn more about who you are. It may help in your defense.
  • Your Probation Officer: Following your interview and investigation, they will draft the official Presentence Report based on what they have learned from you. With no NARRATIVE, it will be skewed toward the version of the INDICTMENT. Please take the time to write your NARRATIVE and proofread it and your Presentence Report for accuracy with your attorney.
  • The Prosecutor will still likely want to convict you but may be swayed by your NARRATIVE.
  • The Courts /Your Judge usually already has a sentence in mind by the time you get to your sentencing hearing.
    • If your NARRATIVE was written and embedded within your Presentence Report, your judge likely would have read it, learning more about you than just what was in your INDICTMENT. Depending on your NARRATIVE, judges across the country agree that they want to hear from the defendants because crimes do not happen in a vacuum. Judges want to learn the why. After learning the why, do you take responsibility for your actions? And do you have remorse for the harm caused to the victims of the crime you have perpetrated?

YOUR SENTENCING HEARING: Your First and Only Opportunity  To Speak Directly With Your Judge

 What Can You Do To Stand Out?

 

Michael. Santos interviews Federal Judge Mark Bennett on the importance of writing Your Personal NARRATIVE and including it in Your Presentence Report.

In Title 18, Section 3553, these provisions state the various factors that judges must consider when determining the proper sentence for a given offense. Among the most pertinent considerations are the Nature and Circumstances of the offense itself and the offender’s Personal History and Individual Characteristics.

These factors help ensure that sentencing decisions are fair and just and that the punishment fits the crime. This is your opportunity to provide your Story, Autobiography, or NARRATIVE of your life and what brought you to this day. Accepting responsibility and Having Remorse for the Victims you Created.


Departure Factors (Woven into the Narrative)

E Factors:
E Factors refer to circumstances that may warrant a departure from the sentencing guidelines established by the United States Sentencing Commission. These factors include aspects of the offense or the offender’s background that the guidelines do not adequately consider. Some examples of E factors include:

    1. The defendant’s role in the offense
    2. The defendant’s criminal history
    3. The presence of substantial assistance provided by the defendant to law enforcement
    4. The defendant’s mental or physical condition
      • Mental Illness:
        Did this contribute to the crime? Was there a history of significant abuse or trauma growing up? Either way, have you been in therapy? Has your attorney requested that you be evaluated? If there is a current treating therapist, it is best for all if they appear as witnesses. Most judges would rather hear from a treating physician than a doctor for hire. This is not to put down experts, as they provide expert testimony that can only come from a select few.
      • Was substance abuse involved in your charge(s)? Did you start treatment before your indictment, the guilty hearing, Presentence Interview (PSI), or Sentencing?
        • All the better, AA, NA, GA, or Psychological Counseling should be included in your PSR and Sentencing Memorandum. Letters verifying either completion or ongoing treatment add credibility.
    5. The defendant’s acceptance of responsibility for the offense
    6. Any other relevant factor that justifies a departure from the guidelines

F Factors (Below Guideline Range Factors):
F Factors refer to circumstances that may justify imposing a sentence below the guideline range, even if a departure is not warranted. These factors are also considered under 18 U.S.C. § 3553(a) and include:

    1. The Nature and Circumstances of the Offense
    2. The History and Characteristics of the Defendant
    3. The sentence must reflect the offense’s seriousness, promote respect for the law, and provide just punishment.
    4. The need to afford adequate deterrence to criminal conduct.
    5. The need to protect the public from further crimes of the defendant.
    6. The need to provide the defendant with needed educational or vocational training, medical care, or other correctional treatment.

Your ALLOCUTION. During the judge’s conversation with you, in addition to covering the points below, he/she may want to know, in the end,  your REENTRY PLAN or what you plan to do when you get out to not re-offend.  This is a short, to-the-point video.

During Your Allocution, Judges Look For,

    1. A sincere demeanor
    2. Discuss what “taking full responsibility” means to the defendant.
    3. An acknowledgment that there are victims (e.g., even when the PSR indicates “no identifiable victim,” as it does in most drug cases);
    4. A more impressive Allocution details how the defendant’s criminal conduct affected the victims.
    5. An expression of genuine remorse.
    6. A plan to use prison or probation time productively.
    7. Discussing why the defendant wants to change his or her criminal behavior, perhaps most importantly, information that helps humanize the defendant and the defendant’s role in the crime.
    8. Tell their story, but don’t minimize the seriousness of what your client did.
    9. Judges will sometimes ask a defendant what he/she will do upon release to reduce their need to re-offend.
    10. Show his/her strengths and weaknesses.
    11. If you can show that you are on the same page with the court regarding the seriousness of the offense, the chances of accepting your other statements will increase.

II) Your NARRATIVE: these are some of the STAKEHOLDERS you have not yet met.

1. BOP Office of Designation, Grand Prairie, TX: As part of your Presentence Report, it will impact where they place you, yet you have never met them.

2. BOP Staff; Warden, Unit Team, Case Manager:

    • For case managers and unit teams, these are employees, and they see hundreds of inmates/people (if not thousands), so how can you differentiate yourself – demonstrate that you are staying out of trouble, doing your assigned job, attending FSA Classes, and doing other constructive work. Reading Non-Fiction, teaching a course, and documenting everything you do (these are ideas I learned from others). Are you an artist? That is important as long as you have constructive interest that can lead to a career after release.
    • There are few ways in prison to demonstrate an individual’s Personal Growth and Development that prepare them to reenter society as law-abiding citizens. However, using your time constructively is important, as BOP Staff will observe you daily.
      • Eventually, you will be released. Will you need to work? What are your interests? Is this too early or premature in your sentence to consider this question? Honestly -> No.
      • Are you a High School Grad?
        • No, then consider getting your GED.
        • Yes, Then get a College Degree with The Second Chance Pell Grant.
        • Already graduated College – Grad School, consider teaching a course and giving the credit to your case manager.
    • In the meantime, use your time constructively. Read to learn, which is Non-Fiction on any topic from painting to computers, History to Philosophy. And if you’re serious, which I hope you are, write down the parts that interest you for later use.

 

III) To Get Started With Your NARRATIVE

Call 240.888.7778 for a personal one-on-one call
to discuss your current issue or that of a loved one.

-Marc Blatstein

ADMINISTRATIVE REMEDY PROCESS

WHAT YOU CAN DO WHEN PRISONS (FEDERAL) FAIL 🥀TO PROVIDE MEDICAL CARE.

* LEGAL REPRESENTATION IS NEEDED – BUT JUSTICE MOVES SLOWLY


Should your client be denied medical care once they have either self-surrendered, were remanded, or are still incarcerated, do they know what to do? Was their medical background comprehensive when provided to their Probation Officer? While this hopefully is a rare occurrence – it does happen, as you have read in recent cases.

October 10, 2022, Judge[i] Holds Federal Bureau of Prisons in Contempt for Allowing Man To Waste Away From Untreated Cancer[ii]

  • In November 2020, Bardell filed a motion[iii] requesting a Compassionate Release. He followed up with a Second Motion in February 2021[iv], accompanied by an Affidavit from an Oncologist. Despite the government’s opposition, Judge Dalton ordered Bardella’s release, expressing disgust at the situation.
  • However, upon his release, The BOP brought Bardell in his wheelchair to the Dallas/Fort Worth airport in a van, only to drop him off without his wheelchair, bleeding and soiling himself.

 

September 23, 2023, 1 IN 4 INMATE DEATHS HAPPENED IN THE SAME PRISON. WHY?

  • …a 47-year-old with a family history of breast cancer discovered lumps in her left breast while in federal prison. Treatment was denied until it was too late to treat – a judge released her on compassionate release.
  • …a 70-year-old was denied care for so long that he lost an eye, and a judge released him on compassionate release.
  • …for 7 months, another begged to see a doctor until it was too late, and he died of cancer.
  • …a 50-year-old male complaining of headaches, but the doctors said he was faking it, was eventually diagnosed with a cancer tumor the size of an egg and died.

 

 

March, 2023, The New England Journal of Medicine,[v]

On a deeper dive into the availability of medical care in prisons, there is a real possibility that the minimum standard for inmate healthcare, which was established in 1976 by a Supreme Court ruling, could be Stopped-Overturned, using the same legal framework that caused the Overturning of Roe v. Wade in June.

  • Deliberately withholding treatment from prisoners with serious medical needs is considered “Cruel and Unusual Punishment⚖️” under the Constitution’s Eighth Amendment.

Call 240.888.7778 for a personal one-on-one call
to discuss your current issue or that of a loved one.

-Marc Blatstein


THE INMATE’S GUIDE TO ADMINISTRATIVE REMEDY REQUESTS IN FEDERAL PRISONS

BOP REGULATIONS (P1330.18)

 

FOR THE PATIENT/INMATE | LOVED ONES | AND THOSE WITH POWER OF ATTORNEY

Below, I review several methods for clients, now patients/inmates, to advocate for themselves and additional options for their loved ones, family members, and those with Power of Attorney.

This does not replace the need for Legal Representation. While the Eighth Amendment and BOP Regulations [P6031.04 Patient Care] state that medical care will be provided, its availability is sometimes in question. If a BOP Second Opinion Consult is granted, sometimes months to years later, allowed – the local prison Clinical Director is not required to implement those treatment recommendations (Program Statement P6031.04 (Pg. 20-21), that could keep the patient/inmate’s care “Within The Standard of Care” in their community.

Unfortunately, the cases provided are current examples (as of 10/2023). The only proactive step one can take is to provide an accurate and comprehensive background that includes any medical issues they may have. Once included in their Personal NARRATIVE and provided 1-2 weeks before the Presentence Interview to their Probation Officer, it increases the chances of it being included in their official Presentence Report.

  • Should, on a rare occasion, a medical issue arise before the PSI where the current treating physician feels that the BOP (taking into account staffing issues in the BOP in general or at their Federal Medical Centers, or for other medical reasons), other actions may be indicated.
  • According to the BOP Policy, the court cannot order the BOP to provide specific medications, which may include treatments; BOP National Formulary Part I, 2022. Page 4, #9. Further, they appear to recommend consulting with BOP Counsel for that Region – so does it make sense to get their input before sentencing rather than after incarceration?

Ensure your client knows the dos and don’ts of the environment they’re about to enter – for it’s another world with a different set of rules. 

  White Collar In BOP HOUR ONE – IS AN EMOTIONAL SHOCK

Understanding the importance of the Administrative Remedy is just a part of the Preparation and Knowledge ProcessKnowing what to expect in prison – before their first day contributes to reducing the fears they and their loved ones naturally are going through. Having been through this, please prepare them because it will benefit them in many ways.

Realizing that there are no guarantees, preparation provides them with the information needed to stay out of trouble as well as how to navigate and work to gain the maximum benefit from the First Step Act Programs (should there be enough support staff), RDAP, Second Chance Pell Grants for College Courses, and overall work on their personal development. All of this is helpful as they approach their early release date.

Not being personally prepared (I was also not a great client, as I was that deer in headlights) was a driving force that allowed me to be here with you today. Yes, I had a felony in 2006, but with colleagues’ support, my practice license was reinstated in 2010.

Transitioning from patient care to preparing those facing their life-altering event is my way to give back and is self-rewarding in its own right – a worthwhile career change.


BOP LEADERSHIP CONTACT LIST, 2023/2024[vi]

 I) MEDICAL CARE DENIED; ACTION STEPS THE PATIENT/INMATE CAN TAKE.

The Administrative Remedy P1330.18 Program Statement[vii]( ‘Factsheet’) – If the Person Is Capable and Has Their Strength.

These Steps consist of the,

  • BP: 8 (or Cop-Out), 9, 10, and 11[viii]. – what they look like, followed by
  • Title 28 USSC § 2241[ix],
  • The Pro Se Motion (Form) is what you send to your Federal District Court.
    1. The Bureau of Prisons (BOP) encourages inmates to utilize the Administrative Remedy Process to address grievances.
    2. It is advised that the patient/inmate maintain an accurate written timeline of events on a calendar and 
    3. Please keep four copies (and the original) of all relevant documentation for future reference. This practice will help keep track of important details and ensure all necessary information is readily available.
    4. Use email when available.
    5. ONLY ‘1’ COMPLAINT PER ADMINISTRATIVE REMEDY REQUEST IS ALLOWED, AND EACH BP 8, 9, 10, 11, AND 2241 MUST HAVE THE SAME COMPLAINT.

 

The patient/inmate is to include copies of all previously submitted documents in their current complaint, with Minimal need for changes in wording.

Keep 4 copies of all original documents for future use.

  1. Take copies of everything and keep the originals.
  2. Ensure to document all pertinent information about the incident, including the specific DayDate to whom you Have Spoken, and The Time → of The Incident.
  3. Not the date you are writing or filling out this form.
  4. You’re expected to try and resolve the matter through a simple conversation with your counselor or (case manager), the BP-8.
  5. ON EACH BP 8, 9, 10 and 11,

Include;
(1) THE DATE OF THE INCIDENT IN YOUR BP-8,
(2) THE NAME of the individual(s) with whom you spoke,
(3) WHY YOUR REQUEST is being made, and
(4) WHAT YOU’RE ASKING FOR.


Each facility has its own rules. To start the process, speak with your counselor (BP-8) first to learn how their process works.

  • When the counselor responds, remember what they tell you – with attention to detail, write your notes later and note the conversation’s date, content, and time.
  • Once the counselor explains the process, follow the process strictly. Write the date that the incident“Happened,” not when you filled out the form – unless it’s the same date.

Supplies to get started;

  • If you can access a copy machine, make 4 copies of everything (possibly in the library). You may need a pentablet with paperenvelopes, and likely stamps. If there is no copy machine, you can handwrite 4 copies of everything – written precisely the same to be used on future BP Forms if needed.
  • A Calendar is critical.
  • With No Response or Negative Responses – Keep Track of the Days For Each BP 8, 9, 10, and 11.

Deadlines are also critical; the BOP staff may be Late. You are not given that same grace period; if you are late, the staff may reject the complaint because the time to complain has expired.

  • Write down the day the incident happened.
  • Write down the day you made the informal complaint (which has to be within 20 days of the incident – or Sooner).

Although a person in prison must adhere to the deadline of [“#”] days, staff members are not required to respond, nor do they have to respond.

  • Nevertheless, you must show that you attempted to resolve the matter with an informal complaint.

Writing A Letter Can Substitute for a BP- 8, 9, 10, or 11.

If there is no counselor available, you should record that the counselor is unavailable and then write a letter requesting that;

  • The Warden treated the letter as a BP-9, Administrative Remedy Appeal, or
  • The Regional Director treated the letter as a BP-10, Administrative Remedy Appeal, or
  • The Central Office treats the letter as a BP-11, Administrative Remedy Appeal.

START Each BP with the date and time of your original informal complaint (BP-8, attached), then (BP-9, attached), etc.

The date of the 1st incident is located in the BP-8 (but not the Date the BP-8 was Written)

OPTIONS;

  1. You did not receive a response to your informal complaint. Write that no one responded to your complaint, and you filed the (NEXT BP # and Form IN SEQUENCE) to comply with deadlines.
  2. If you received an unfavorable response, 1) Reply that you disagree with the decision on the complaint. 2) This is why you’re filing the (NEXT BP # and Form IN SEQUENCE) for a formal administrative remedy request.
  3. If you’ve missed the deadline to file the formal complaint, you must explain the reason why. 1) For example, if you were sick or locked in the SHU, nobody provided you with a BP form. Do your best to comply with the deadlines because the BOP likes to Deny-Deny-Deny.

END Each BP Form by noting how you are submitting it.

  1. When submitting the form to the counselor, add or include their name, date, and time.
  2. If you are putting the form in the unit mailbox, indicate the date and time you put it in the unit mailbox.
  3. If you are in the SHU and have to submit it to a staff member, write down that person’s name and the date and time you hand the form to them.

WHERE APPROPRIATE, INCLUDE COPIES OF BOP POLICIES AND FORMS that validate your position. These should be available in your library: Medical, Dental, and Health Policy


Include;
(1) THE DATE OF THE INCIDENT IN YOUR BP-8,
(2) THE NAME INDIVIDUAL(S) with whom you spoke,
(3) WHY YOUR REQUEST is being made, and
(4) WHAT YOU’RE ASKING FOR.


 THE PROCESS STARTS

with the “Informal Complaint,” or BP-8, or Cop-Out, that one requests from their Case Manager. At best, this is an informal conversation with your Case Manager to resolve the issue.

With No Response or a Negative Response within 24 hours – The Formal Process Begins. The next day…


 

The Patient/Inmate Next Requests a BP-9 from their Case Manager, who “Logs” this for the Record.  This one goes to The Warden.

  1. A 20-Day Clock Starts – and keeping track of the Days is Critical – Because if Late, the STAKEHOLDERS May Choose to Use It’s Being Late To Deny Your Request.
  2. Include copies of everything previously sent (BP-8 or Cop-Out).
  3. With No Response or a Negative Response within 20 Days

 

The Patient/Inmate requests a BP-10 from their Case Manager, who “Logs” this for the Record. This one goes to The Regional Director in your Region.

  1. The 30-Day Clock Starts – and keeping track of the Days is Critical – Because if Late, the STAKEHOLDERS May Choose to use its Being Late To Deny Your Request.
  2. Include copies of everything previously sent (BP: 8 or Cop-Out, 9).

 

BOP Regional Directors[xi]

*Cross-check Regional Directors with the above list and include those names.


Regional Director / Mid-Atlantic Regional Office (Check against BOP List, if different, contact as many as possible.)

1. 10010 Junction Drive, Suite 100-N, Annapolis Junction, Maryland 20701, Certified – Return Receipt.

2. MXR Leadership: Chris Gomez, 302 SENTINEL DRIVE, ANNAPOLIS JUNCTION, MD 20701, MXRO-ExecAssistant@bop.gov, Phone: 301-317-3100, Certified – Return Receipt.


Regional Director / North Central Regional Office (Check against BOP List; if different, contact as many as possible.)

1. NCR Leadership: Andre Matevousian, Gateway Complex Tower II, 400 STATE AVENUE, SUITE 800, KANSAS CITY, KS 66101-2492, Certified – Return Receipt, Email: NCRO-ExecAssistant@bop.gov, Phone: 913-621-3939


Regional Director /Northeast Regional Office (Check against BOP List; if different, contact as many as possible.)

1. NER Leadership: Amy Boncher, S. CUSTOM HOUSE, 7TH FLOOR, PHILADELPHIA, PA 19106, Certified – Return Receipt. Email: NERO-ExecAssistant@bop.gov, Phone: 215-521-7301


Regional Director / South Central Regional Office (Check against BOP List; if different, contact as many as possible.)

1. 4211 Cedar Springs Road, Suite 300, Dallas, Texas 75219, Certified – Return Receipt.

2. SCR Leadership: Heriberto Tellez, US ARMED FORCES RESERVE CMPL, GRAND, PRAIRIE, TX 75051, SCRO-ExecAssistant@bop.gov, Phone: 972-730-8600, Certified – Return Receipt.


Regional Director / Southeast Regional Office (Check against BOP List; if different, contact as many as possible.)

1. SER Leadership: Shannon Phelps, 3800 Camp Creek Parkway, SW/BDG 2000, ATLANTA, GA 30331-6226, Email: SERO-ExecAssistant@bop.gov, Phone: 678-686-1200, Certified – Return Receipt.


Regional Director / Western Regional Office (Check against BOP List; if different, contact as many as possible.)

1. 7950 Dublin Boulevard, 3rd Floor, Dublin, California 94568, Certified – Return Receipt.

2. WXR Leadership: Melissa Rios-Marques, 7338 SHORELINE DRIVE, STOCKTON, CA 95219, Email: WXRO-ExecAssistant@bop.gov, Phone: 209-956-9700, Certified – Return Receipt.

With No Response or a Negative Response within 30 Days


 

The Patient/Inmate requests a BP-11 from their Case Manager, who “Logs” this for the Record. This one goes to The Office of General Counsel in Washington, DC.

1)The 40-Day Clock Starts – and keeping track of the Days is Critical – Because if Late, the STAKEHOLDERS May Choose to Use It’s Being Late To Deny Your Request.

2)Include copies of everything previously sent (BP: 8 or Cop-Out, 9, 10).

File your BP-11 at the following address: Bureau of Prisons, National Inmate Appeals Administrator (Check against BOP List; if different, contact as many as possible.)

  1. James Wills, AD/General Counsel, BOP Office of General Counsel, 320 First Street, NW, Washington, DC 20534, (202) 307-3198, Certified – Return Receipt.
  2. Rear Admiral Chris Bina, BOP Assistant Director, Health Services Division, 320 First Street, NW, Washington, DC 20534, (202) 307-3198, Certified – Return Receipt.

With No Response or a Negative Response within 40 Calendar Days



 

Pro Se Motion

“The Central Office has 40 calendar days to respond as of the date it is received, which may be extended for An Additional 20 Calendar Days.” (“FBOP Administrative Remedy Program – Washington, D.C.”)

  1. You can now draft Your Pro Se Motion – Form: Writ of Habeas Corpus Under 28 U.S.C. § 2241 to Your Federal District Court,
  2. This goes to your Federal District CourtCertified – Return Receipt.
  3. Include copies of everything previously sent (BP: 8, 9, 10, 11).


 

IF THE PATIENT/INMATE IS INCAPACITATED🥀 AND NEEDS SOMEONE TO ADVOCATE ON THEIR BEHALF: THEIR LOVED ONES OR SOMEONE WITH POWER OF ATTORNEY

 

 ** LEGAL REPRESENTATION IS RECOMMENDED


 

II.   MEDICAL CARE DENIED, ACTION STEPS YOUR LOVED ONES CAN TAKE.

The Administrative Remedy Program Statement ( ‘Factsheet’) – If the Patient/Inmate Is Not Able To Do This, 👉Do the following.

 First, 👉Maintain an organized file to keep track of your loved one’s conversations and care, including dates, names, phone numbers, and steps taken.

Request a written detailed description of the issue with contact information for further details. KEEP COPIES OF EVERYTHING.

  1. You could compose a respectful letter to the warden advocating for your loved one. Certified – Return Receipt.
  2. Present the facts, describe the issues, suggest possible solutions, and ask for inquiry, communication, and collaboration. Help is what you’re asking for, and you’ll “await” their reply (I look forward to hearing from you).
  3. If a loved one is in jail and requires medical attention, it is essential to take specific actions to ensure they receive appropriate care.
  4. Request a written response from the Warden concerning your loved one’s medical condition and proposed treatment plan.
  5. This will provide valuable insights into their health and the measures being taken to address any medical concerns they may have.
  6. It’s a good idea to contact your loved one’s treating family doctor for additional support.
  7. This could prove particularly beneficial if you have concerns regarding their current treatment plan or feel they aren’t receiving adequate care while incarcerated. The doctor could provide you with a letter to attach containing more insight into their condition and suggest ways to ensure they receive optimal care.
  8. By staying informed and advocating for their medical needs, you can help ensure they get the right care – but no promises.
  9. You’re creating what I call a Paper Trail, which lets all parties know that someone else is watching.

 


BOP LEADERSHIP – REGIONAL DIRECTORS[xi], 2023/2024[vi]

 

Send copies of your complaint letter to relevant officials, including the prison’s medical director, but if you cannot contact the prison, there is always a,

  • Medical Director, there is always The BOP Assistant Adm. addresses above) and your loved one in prison. Keep all originals for yourself. Check the BOP website and below for addresses.
  • Copy everybody.

👉Contact your member of Congress. To find your U.S. congressional representative, visit www.house.gov[xii] and enter your zip code. The name of your member will appear.

 

  • Call your congressional representative’s local office. Ask the staff member to whom you should send your letter.
  • Present the problem, stating the facts and your concern.
  • Describe the efforts you and your loved one have taken to resolve the problem and ask that your congressional representative investigate the problem. 
    • Ask your Congressional Representative (or Assistant to ask for you) to write your Warden directlyas you have been told that BOP Wardens pay attention to these emails. Have the Warden’s Name, Phone #, Email, and Address ready, and be specific as to what help you need your representative to ask for, or inquire about.
      • Congressional Representatives (you can provide a sample letter, if helpful),
        1. …from the writer’s district,
        2. …of the district where the prison is located,
        3. …office in Washington DC.
  • Then, follow up with a pre-set phone call, or appointment.  

 

Second. 👉File a Formal Complaint Directly with the Facility and look up the prison contact information.

1) Find Your Prison Warden, or Warden Assistant or secretary,

2) Search for a location:[xiii] Inmates → Find an Inmate, or Locations: List of Our Facilities

 

3) Include the Patient /Inmate Number and Location

4) You can both call and write respectfully.

  • Include that you’re concerned about your loved one’s medical needs and their lack of care, sending a letter to the Warden.
  • Attaching a letter from their physician (at home) to provide additional context may be helpful. Certified – Return Receipt.

5) The BOP is a vast government agency. The new BOP Director, Peters, is doing her best to change its culture, so continue your advocating efforts.


 

Third. 👉If the prison did not resolve your complaint, file a complaint with the Bureau of Prisons (BOP) Regional Office (Above) that oversees the facility.

This goes to the appropriate Region (above)

Include the Patient /Inmate Number and Location

  • If you’re concerned about your loved one’s medical needs and the lack of care, consider sending a letter to the Warden.
  • Attaching a letter from their physician to provide additional context may be helpful. Certified – Return Receipt.

 

Fourth. 👉If you cannot address your issue, contact BOP Headquarters or the Department of Justice – Office of the Inspector General.

GO HERE FIRST: To Report a Concern[xiv].

 

BOP LEADERSHIP CONTACT LIST, 2023/2024[vi]

 

Bureau of Prisons, Headquarters, or the Department of Justice – Office of the Inspector General (2 contacts)

  1. James Wills, AD/General Counsel, BOP Office of General Counsel, 320 First Street, NW, Washington, DC 20534, (202) 307-3198, Certified – Return Receipt.
  2. Rear Admiral Chris Bina, BOP Assistant Director, Health Services Division, 320 First Street, NW, Washington, DC 20534, (202) 307-3198, Certified – Return Receipt.

FAMM-VAP-Family-Visit Prison Guide


III.     WE ALSO HAVE OTHER RESOURCES – CONTACT US 

[i] https://reason.com/2022/10/10/judge-holds-federal-bureau-of-prisons-in-contempt-for-allowing-man-to-waste-away-from-untreated-cancer/#:~:text=Bardell%20had%20cancer%E2%80%94let%20alone,and%20instead%20immediately%20released%20Bardell.

 [iii] https://storage.courtlistener.com/recap/gov.uscourts.flmd.265888/gov.uscourts.flmd.265888.77.0.pdf

[iv] https://storage.courtlistener.com/recap/gov.uscourts.flmd.265888/gov.uscourts.flmd.265888.86.0.pdf

[v] https://news.harvard.edu/gazette/story/2023/03/supreme-court-may-halt-health-care-guarantees-for-inmates/

[vi] https://www.pprsus.com/wp-content/uploads/2023/09/BOP_-Leadership-2023.pdf

[vii] https://www.pprsus.com/wp-content/uploads/2023/09/1330.18_Administrative-Remedy-2014.pdf

[viii] https://www.pprsus.com/wp-content/uploads/2023/09/NACDL-bp-9-11-forms.pdf

[ix] https://www.law.cornell.edu/uscode/text/28/2241

[x] https://www.pprsus.com/wp-content/uploads/2023/09/Pro-Se-Handbook-Representing-Yourself-in-Federal-Court.pdf

[xi] https://www.pprsus.com/wp-content/uploads/2023/09/Regional-Counsel-and-Consolidated-Legal-Center-Offices.pdf

[xii] https://www.house.gov/

[xiii] https://www.bop.gov/locations/

[xiv] https://www.bop.gov/inmates/concerns.jsp

YOUR JUDGE ⚖️WILL ASK FOR YOUR PLAN TO NOT RETURN TO THEIR COURTROOM → 🕊️WHAT’S YOUR ANSWER?

Home Confinement Info Sheet

WHY A RELEASE PLAN?

“ARE YOU READY TO ANSWER YOUR JUDGES QUESTION?”
DO YOU KNOW WHAT YOU’LL SAY?

Release Planning should begin before your Presentence Interview if, for no other reason than at your Sentencing Hearing, your judge will ask you or want to know your plan to not return to their courtroom. In this video, I review why Release Planning should begin before your Presentence Interview if, for no other reason than at your Sentencing Hearing, your judge will ask you or want to know your plan to not return to their courtroom.

The Release Plan, Divided into ‘6’ Parts

Part I) Before your Presentence Interview (and is provided along with your Narrative to be woven into your Presentence Report), 


Part II) Before your Sentence Hearing (building and after giving more thought to your 1st Release Plan),


Part III) Once inside, here is where it grows – mostly by documenting your Personal Developmental Growth, which includes the FSA Programs and everything Constructive that you have been working on in areas of interest to you, including mentoring others or teaching classes.


Part IV) Before Release details what you will be doing once released. This can be started by following example forms developed by Rikers Island, the MN Dept. of Corrections – ‘The National Institute of Corrections Manual, or the Release Plan Prep Guide. All of this will, or should (as nothing is Guaranteed), make you appear a better candidate for a Halfway House. These beds are limited, and Residential Reentry Managers want to fill these beds with people who will reenter society successfully. Is this You? This video doesn’t cover everything, but I hope it provides some constructive insight.


Part V) After Release / Post-Incarceration Services

YOU ARE STILL UNDER THE CONTROL OF THE BOP 

  • For many in BOP custody until he/she completes his prison term (for sentences greater than six months).
  • You’re in a Residential Re-entry Center (halfway house) or working with the BOP’s Community Corrections Management.
  • If you’re eligible to be transferred to home confinement (the last six months or 10% of the sentence, whichever is less), your client will transition from the RRC or CSC with another set of rules and requirements.
  • Even after leaving BOP custody, he/she will start his supervised release period, which is often for three years.
  • Each of these is a different branch of the Justice Department, 
  • You Do Not Want To Get Disciplined or have any Infractions that Could Return You To Prison

Part VI) Supervised Release/Parole/Halfway House –

  • You think You’re Out/Done,
  • But You’re Still Under “Federal” Control,
  • This could be the Hard Part – No Mistakes – Don’t assume,
  • For Questions, Ask your Probation Officer or Residential Reentry Manager First and Often. Not hearing back is Not an OK To do what you want to do.
  • Some are harder to deal with if your charge is a State Charge – But Make This Temporary.
  • Supervised Release – Probation

Probation or Supervised Release is No Joke. Follow the rules, and all will be ok.  Probation Officers have huge caseloads; unfortunately, they are overworked and expect the worst. Be the exact opposite, and good things will happen.


Now, with a New Director of The BOP (Dir. Peters, there is reason for hope and optimism), The First Step Act, the Second Chance Act, and the Work You Do In Investing In Yourself Can Earn Your Way To Freedom. For more on your Mitigation steps, call me.


This is a document that will grow over time and will influence your STAKEHOLDERS.

WHO ARE ‘YOUR’ STAKEHOLDERS

Your Attorney • The Probation Officer Conducting Your PSI• The Prosecutor • Your Judge • BOP 1st) Designation Staff, 2nd) Your Case Manager, and 3rd) Unit Team • Residential Reentry Manager (RRM) • Probation Officer, • and Others You Have Yet To Meet

Call 240.888.7778 for a personal one-on-one call
to discuss your current issue or that of a loved one.

-Marc Blatstein


 

When writing your Narrative, Allocution, or Reentry Plan, read it through the Lens of YOUR STAKEHOLDERS: WHAT DO THEY WANT TO HEAR? Through their eyes, there are victims, and there was a crime, but without your narrative, all they have is the DOJ indictment of you – so you may appear like America’s “Most Wanted.”  Only you can change this.

It’s best started before your Presentence Interview and will continue to develop as you add to it during your stay in the BOP.


 

Writing Your Release Plan, Now Before Your Presentence Interview 

Attempting to write your Release Plan, you don’t need to have all the answers today! Start will the small parts (bites) that I have provided below. Like the rest of your plan, it will develop over time; I know because mine did. Remember: One bite at a time.

But, if you have a letter from someone willing to hire you when you are released based on your skills and character – that is a GREAT letter to include in your plan, your Presentence Report, and with your attorney’s Sentencing Memorandum at your Sentencing Hearing.


 

Your Reentry Plan addresses your STAKEHOLDERS

You must be Your Own Best Advocate – 

Your Judge: STAKEHOLDER. If your Narrative (with your Reentry Plan) is included in your Presentence Report, you now have your Judges attention because he/she, among other things, wants to know your plan to not re-offend.

  • What are you going to do?
  • In addition to expressing remorse for the victim(s), understanding their pain, suffering, and how it has impacted them, 
  • You have reviewed what your life brought you to this moment that caused you to do this – with no excuses. 
  • You have reviewed the FSA Risk Assessment Program Questions, which had you reflect on what you’ve done and read about the many available programs to learn from.

Your Unit Team, Case Managers, and Counselors are your STAKEHOLDERS. For all of your meetings, just like with your FSA Programs and Books that you are reading, document their name, date, time of day, and conversation topic to recall later. Consider it insurance.

If release plans are not required, then why do them – To reduce Your Time Incarcerated?

  • Without a Plan, why should your Case Manager and the BOP give you a reference to a Halfway House Residential Reentry Manager (RRM)
  • There are not enough halfway house beds in the country to house everyone who wants to use them.
    • Halfway House Residential Reentry Manager (RRM) wants to fill those beds with people who will use them to reenter their communities successfully.
  • Case Managers will Recommend you, which the Warden signs off, and your file then,
    • goes to the Residential Reentry Manager to determine who is best suited for their limited bed space, who needs that time, and who will succeed.
  • Residential Reentry Managers decide who can use the limited number of beds by evaluating your BOP file, including your PSR, Narrative, and release plan.
    • They’re also being judged, so they want to show success. Inmates writing release plans are a way that halfway house managers can make that judgment.

Start your plan before your PSIIt Can Include Parts of Your Narrative,

  • Once inside, give the credit for your plan to your Case Managers and their recommendations as they offered FSA Programs to you.
  • Offer that you researched for your Release Plan: National Institute of Corrections website.
    • This template covers Personal Identification, Housing, Transportation, Personal Needs, Employment, Recreation/Leisure Time, Chemical Dependency Treatment/Aftercare, and your Support System.
  • Write as you review your investigation, criminal charge, plea hearing, trial or guilty plea, presentence investigation, and sentencing process. You will see that preparation fulfilled as you develop a reentry/release plan to achieve a better outcome. 
  • QUOTING something like…: “Since my indictment and arrest, I had the time to think about everything I have done. Previously, I didn’t recognize how BAD my decisions were, But I realize it’s Not About Me. It’s about My Victims, What I did, and What I have to do – to make it right.
  • Referencing your PATTERN Score, address applicable points for either Men or Women.
  • If you learn you have a Detainer (hopefully before your Presentence Interview)
    • Last week, the BOP quietly issued a change notice to its Program Statement on applying for FSA credits.
      • Before sentencing (or as soon as possible), your attorney learns that there is a Detainer; when filing this form, with no response after 180 days, it goes away.

1) Followed With copies of your Social Security Card, Driver’s License (expired?), and Birth Certificate. Know where your originals are kept so you can get them, and where are they now if they were taken from you at your arrest?

2) Be Honest with how you fill out BOP forms and talk in prison. If you lie and it gets found out by your STAKEHOLDERS (Judge), you may have more significant problems. Don’t say you have a substance abuse problem – if you don’t. This can be held against you by the Judge or other STAKEHOLDERS.

  • Some of those you meet will be biased against you (try not to let it bother you, be polite)
  • Writing is good, But Showing That You Have Learned You’ve Done Is Wrong Is Where You Want To Be.
    • (The Anger Management Course)
    • DOCUMENTATION OF EVERYTHING YOU DO,
      • CLASSES YOU TAKE, BOOKS YOU READ, AND FSA PROGRAMS YOU HAVE ATTENDED;
      • Because even if your case managers forget to document your progress, at least your records are complete and
      • You CAN NOW VERIFY, AS IT IS IN ‘YOUR’ COMPLETE FILE

3) Who will be your Support Structure?

  • This includes those who care for you to ensure you don’t return to the judge’s courtroom. This can be family, friends, or others and can include a potential employer willing to rehire you following your release, all who have provided letters attesting to your character, and who are aware of your past criminal behavior.

4) Employment Opportunities?

  • Will you still be allowed to run your own business? Was your business part of your criminal arrest? If Yes – then-No.
  • It is possible, though, to work For Yourself With a great release plan – Yes,
    • Probation May let you work for yourself and travel.
      • Were you working for yourself before your arrest? Yes,
      • If working for yourself – was this job part of your criminal activity? If No, OK
      • What will you do–keep it separate from your criminal conviction?
    • Who’s the owner?
    • Does it need to be registered with the state, licensed, etc?
    • Be Organized: “While incarcerated, I want to plan to own my own business, and these are the steps I will need to take.”
    • Will you need employment? No, I’m retired but volunteer or care for A Relative.
    • How realistic are your employment opportunities? You’re a physician – at best, you’ll need to reapply to your board, get your CMEs, etc. DEA and Provider Numbers, Medicare and Medicaid, OPM, and HHS.

5) At this point, your Reentry Plan is much shorter than it will be at the end of your sentence.

6) The plan will changeKeep your Case Managers Updated on your REENTRY Plan

  • This is why I need either 1 year in a Halfway House (or Home Confinement) – here’s what I need to do as I prepare to get back on my feet.

7) After sentencing, especially if the Judge gives you a downward Departure, start thinking about your Reentry plan, add what you wish you had done differently, and add what the judge said at sentencing before you forget.

 

 

BY THE NUMBERS

  • If you have over 12 months of ETC, they could be applied to Halfway House or Home Confinement.
    • If You Have the Appropriate Resources and Reentry Plan
  • ETC in Halfway House: for example, if you have 11 months, the BOP may apply that to early release.
  • If you have 14 months ETC:
    • 2 Months in Halfway House
    • The 2nd Chance Act,
      • The 5 Factor Review: 8 mo. Halfway House, 6 mo. Home
  • Released to Home vs. Halfway House.
    • The BOP now sends inmates to the Halfway House, where they are evaluated for their plan.
      • It is up to the Halfway House to determine if the person meets the Eligibility & Appropriate criteria.
      • It is up to our REENTRY Plan to show why Home Confinement is needed.

HOME CONFINEMENT INFORMATION SHEET

USING EMAIL⌨ AND PHONES ☎️IN FEDERAL PRISON: A STEP-BY-STEP GUIDE

TRULINCS EMAIL

The Rules for Email are set in The BOP Program Statement P5265.13.

  • TRULINCS: email Sent From someone in the BOP.
  • CORRLINKS: email Received either by persons outside of prison, or with the Warden’s Permission, other inmates in different facilities.

 

“TRULINCS” is charged based on $0.05/ minute, with the funds removed from your Commissary Account. This includes all of your time “On The System;” no matter whether you are reading a message, typing, or printing (at 0.15 cents per page).

    • Your maximum time is 30 minutes, and then you must wait another 30 minutes before logging back on if there is a computer free.
    • Minutes are sold in lots ranging from 40 to 600.
    • Messages can be ~ 2000 words or 13000 characters (and you will see a “countdown timer” in case you lose track).
    • Everything is plain text, with no special symbols; nothing fancy.
    • There is No Message Forwarding, but you can send a message to multiple persons at one time. If you are found to be forwarding messages, at minimum you may have restrictions put on your usage of the system.
    • Printing messages cost 15 cents per page.
    • An inmate could be restricted from TRULINCS (the public messaging system) in the following circumstances:
      • The person has a history that threatens institutional security or the public.
      • A prisoner is under investigation for Disciplinary Violations related to TRULINCS, or Corrlinks abuse or misuse.
      • Disciplinary sanctions have restricted the person from emailing for a specific period.
      • When there are particular email or sexual offense criminal charges.

CORRLINKS: No forwarding any message to third parties!

USING TRULINCS

  • Is considered a privilege; therefore, the Warden or other authorized representative may limit or deny that privilege to any person.
  • Individual inmates may be excluded from program participation as part of classification procedures, where the Warden makes the final determination.
  • All incoming and outgoing electronic messages, including transactional data, message contents, and other activities, are monitored and retained. [FYI: all that you do is monitored in prison, please don’t try to outsmart them.]
  • BOP staff can reject individual messages sent to or from inmates using TRULINCS that jeopardize the institution’s interests.
  • Each inmate’ acknowledges, and voluntary consent must be documented on the Inmate Agreement for Participation in TRULINCS Electronic Messaging Program Form (BP-0934).

 

TRULINCS RESTRICTIONS

  1. When it is determined that their use would threaten the safety, security, or orderly running of the institution or the protection of the public and staff.
  2. A Public Safety Factor – Sex Offender, does not automatically exclude them from participation.
  3. Pending Investigation or Disciplinary Action for Possible Messaging (TRULINCS) Abuse or Misuse. A messaging restriction in this situation is discretionary to ensure the institution’s safety, security, and orderly operation, or the protection of the public and staff.

 

YOUR CONTACT LIST

  • Inmates may only exchange electronic messages with persons in the community who have accepted the inmate’s request to communicate.
  • Attorneys, “special mail” recipients, or other legal representatives on their electronic message contact list, with the acknowledgment that electronic messages exchanged with such individuals will not be treated as privileged communications and will be subject to monitoring.
  • Inmate to Inmate Communication. An inmate may be permitted to correspond via electronic messaging with an inmate confined in any BOP facility if the other inmate is either a member of the immediate family or is a party or witness in a legal action in which both inmates are involved. The following additional limitations apply:
    • The appropriate Unit Manager at each institution must approve in writing the correspondence if both inmates are members of the same immediate family or are a party or witness in a legal action in which both inmates are involved.
    • The Warden will be informed of any unusual circumstances about a request to correspond electronically for members of the same immediate family or for inmates who are a party or witness in the same legal action.

OUTGOING MAIL LABELS

    • Ordinarily, inmates are required to place a TRULINCS-generated mailing label on all outgoing postal mail.

ELECTRONIC MESSAGE MONITORING

  • Electronic messages sent or received by inmates at all security levels are subject to monitoring for content by trained staff.

TRULINCS Email Contact Request Form BPA1054

    • This form allows two contacts per page and is very detailed.
    • From prison, an email will be sent out.

 

CORRLINKS: email Received either by persons outside of prison, or with the Warden’s Permission, other inmates in different facilities.

 

CORRLINKS

  • You may or may not receive an email alert, that you have a CORRLINKS
  • So if you get to this part first, great.
  • As you see, you will need to Register.
  • Enter: Your email and create a password.

 

 

ON YOUR FIRST CORRLINKS LOGIN

  • You will see all of these choices below.
  • The only one that I believe we need to work on now is Mailbox.

 

 

 

THE REGISTRATION CONTINUES

  • It may not be exactly in this order, but fill out all of your information that is in RED.
  • You will also see that there is a space for an Identification Code.
    • When you get the alert that you have your first email, Do You Accept It?
    • If yes, there will be an IDENTIFICATION CODE (which may expire in “10 Days”),
    • Copy that code and enter it on Your Registration Form ⇓

 

YOU NOW CORRESPOND FROM YOUR PC,

YOUR APPLE DEVICE, OR

 

GOOGLE.

 

CorrLinks Guide: An Overview

  • CorrLinks is a reliable and convenient web-based email system that allows authorized users to communicate with inmates through secure email. To use this service, you need to create an account, purchase credit, and add inmates to your contact list. Once you complete these steps, you can send messages to inmates, who can conveniently receive and respond to them using a secure kiosk within the prison.
  • Forgotten your password on CorrLinks – don’t worry. The system has got you covered! Simply reset your password, it’s a quick and easy process. Please note that CorrLinks won’t be able to personally assist you with this, but rest assured that their system is designed to help you with password resets.
  • Your first email alert from your loved one. Upon receiving an alert that an inmate wants to add you to their account on CorrLinks, you simply need to accept the request to begin exchanging messages with them.
  • If you’re thinking about blocking an inmate on CorrLinks, it’s important to know that it’s not a decision to be taken lightly. Once you’ve blocked them, it can be difficult to undo the process. You’ll have to go through a lengthy process of sending a written request to the institution to remove the block. It’s important to note that the institution’s mailing address can be found on the Federal Bureau of Prisons website. Once the block is removed, the inmate will have to send you another invitation to add your email again. If you’re certain that you want to block an inmate, you can easily do so by selecting the “block contact from an inmate” option or “block contact from every inmate at a specific facility” option from the menu on CorrLinks. But remember, it’s important to think through your decision before proceeding.
  • CORRLINKS Customer Support.

PHONE CALLS

  • Inmate Phone Calls Are Recorded and Monitored
    • No three-way telephone calls are allowed and this will result in you being disciplined.
    • The hours may start as early as 6:00 a.m. and extend as late as 11:30 pm.
    • Inmates can make up to 300 minutes of prison phone calls each month, each for 15 minutes.
    • In most cases, inmates must wait one hour from the start of their last prison phone call before they can place another call.
  • When making a collect call, the recipient must agree to pay for the call.
    • $0.06 to $0.38 each minute for local calls and
    • $0.56 per minute when calling long distance.
  • Direct-dial telephone call costs are subject to change, taken from your commissary account, and are currently as follows:
    • Local calls: $0.06/minute
    • Long-distance calls in the U.S.: $0.21/minute
    • Calls to Canada: $0.35/minute
    • Calls to Mexico: $0.55/minute
    • Other international calls: $0.99/minute
  • In November and December, the prison Warden may authorize an additional 100 minutes, on top of the allowed 300 minutes.
  • Biden signs a bill to fight Expensive State Prison phone call costs, JANUARY 6, 2023
    • Incarcerated people pay about 5 dollars for a 30-minute phone call. A new bill wants to change that.

 

CELL PHONES

  • The new law makes possession or use of a cell phone or wireless device a crime punishable by up to a year in prison.
  • The law also covers the smuggling of cell phones into the BOP.
  • Good Time Credits and Earned Time Credits may also be lost, as well as possibly going to The SHU or triggering a change in prison.

Dr. Marc Blatstein | About

Marc Blatstein was born in Philadelphia, Pennsylvania, where he attended high school. He later went to George Washington University in Washington DC for his undergraduate degree, where he received a Bachelor of Arts in Psychology, all the while working a job on the side to help offset the high costs of a college education.

Marc later went to Ohio College of Podiatric Medicine, where he studied medical training and obtained his Doctor of Podiatric Medicine Degree. While studying there, he started the “Pink Panther Bartenders” along with his brother and two of his classmates to help with some of the costs of higher education. At one point, he was grateful to be asked to participate in a Gala for the Cleveland Opera, to which he agreed.

He then attended a surgical residency that covered Podiatric Medicine and Surgery, which was followed by a 31+ year career as a single practitioner. While in practice, Marc Blatstein incorporated a medically oriented shoe store, wound care, and physical therapy programs into his practice.

HOBBIES

Most of my joys have been spent on the water, while I have enjoyed power and sailing with my 1st mate, Bailey.

In the end, though, the peace of sailing is where I have spent most of my time.

 

 

EDUCATION | PRACTICE AND CONSULTING TIMELINE

George Washington Univ., BA in Psych. (’77),
Externship(s):
* Lutheran Hospital Baltimore MD. (’82),
* Atlanta Hospital & Medical Center, Atlanta GA (’82).
Ohio College of Podiatric Medicine, Doctor of Podiatric Medicine, DPM (’83),
Lawndale Community Hospital Surgical Residency in Podiatric Medicine & Surgery (’84)
1st Career: Podiatric Foot And Ankle Medicine and Surgery, License, 1985 – 2023
2nd Career: Physician Presentence Report Service, LLC., 2011

PRIVATE PRACTICE 1985 – 2023

POPULAR COMPONENTS OF MY PRACTICE

I. PLANTAR FASCITIS

According to Dr. Marc Blatstein, morning heel pain is the most common complaint he treats. Patients relate that it is pain upon standing first thing in the morning. While the pain initially is excruciating, with ambulating, the pain may subside, only to come back again with a vengeance after sitting and then immediately returning after standing up again.

The plantar fascia is a ligament attached at one end to the bottom of the heel (in a medial, central, and lateral band), then fanning out into the ball of the foot, thus acting as a shock absorber for the foot. As the foot impacts the ground, with each step, the plantar fascia stretches slightly. When these excessive pressures of pulling the plantar fascia on the heel occur over time, with an innocent step (like stepping on a marble or off a curb), they create small tears in the plantar fascia (the ligament on the bottom of the foot) resulting in a small amount of bleeding, pain & inflammation. Medical literature initially thought heel pain was due to a bone spur on the bottom of the heel bone (or calcaneus). We now know that the pain is due to excessive tension on the plantar fascia as it pulls on its attachment to the inside/medial aspect of the calcaneus (heel) bone.

In diagnosing heel pain, Dr. Marc Blatstein relates that over the years, patient care has demonstrated that not all bone spurs are painful, and everyone with heel pain (or plantar fascitis) does not necessarily have to have bone spurs. A complete history and physical exam play a large role in approaching this diagnosis, along with weight-bearing X-rays, which are useful in determining if a heel spur is present (fractured), or associated with other pathologies contributing to the diagnosis.

Initially, treatment by Dr. Marc Blatstein can start with a combination of one or all of the following: padding & taping of the foot in a supportive nature, taking oral anti-inflammatory medications, immobilization of the foot in a walking cast, physical therapy as well as implementing specific stretching exercises. Should additional treatment be necessary, cortisone injections and orthopedic functional foot orthotics may be prescribed. Should any or all of these treatments fail, and after a detailed review of X-rays and lab results with your physician, surgical intervention may be considered, and according to Dr. Marc Blatstein, it is very effective. Here, an Endoscopic Plantar Fasciotomy is one (of many) of the possible procedures that could be recommended. A plan is formed between you and your doctor for a successful outcome meant to add a full and enjoyable life to your years.

II. THE CIRCULATOR BOOT™

 

A major part of Dr. Blatstein’s practice is using The Circulator Boot™ as a method of treatment that helps with the core elements of lower extremity wound therapy: bacterial control, increased blood supply, moisture, and the removal of dead or damaged tissues to help the healing of healthy tissue. Along with other modes of treatment, surgical debridement of infected wounds, the use of antibiotic medications along with home care, and boot therapy in Marc Blatstein’s eyes may improve the blood supply and control the infection when standard methods of treatment are failing.

The Circulator Boot™(Mayo Clinic.org), from Dr. Marc Blatstein’s years of experience, the end-diastolic timing of its leg compressions (this FDA-approved non-invasive technology) provides benefits in preventing leg amputation. Poor circulation and infection are the leading causes of 90,000 diabetic amputations that occur every year in the United States.

The Circulator Boot™, “A leg with poor arterial blood flow, may be likened to a dirty sponge that is half wet. Squeezing such a sponge disseminates the water throughout the sponge. Soaking and wringing the water repeatedly from the sponge may help clean it. In like fashion, the heart monitor of the Circulator Boot™ is timed to allow each arterial pulse wave to enter the leg as best it can (to partially wet the leg “sponge”). Boot compressions provide a driving force to disseminate blood around the leg and, at the same time, press venous blood and excess tissue water from the leg. Patients with a pulse rate of 80 beats per minute might receive 4800 compressions an hour. Patients with severe arterial leg disease might receive 100 such treatments or close to a half-million compressions! Breakdown of the clot, re-channelization of blocked vessels, and forming small new vessels may help restore blood flow.”

For those who may be facing amputation, this may be an option. Dr. Marc Blatstein recommends learning more about The Circulator Boot™ as a Method of Treatment via The Circulatory Boot Service at the Mayo Clinic.

III. TARSALTUNNEL SYNDROME

Similar to Carpal Tunnel, Tarsal Tunnel Syndrome is due to the compression of a nerve called the Posterior Tibial Nerve. Dr. Marc Blatstein, a Podiatric Surgeon, explained that Tarsal Tunnel Syndrome occurs over time as the nerve becomes inflamed, resulting in symptoms such as burning, electric shocks, and tingling, as well as a shooting type of pain. Other factors that Dr. Marc Blatstein has found factors contributing to Tarsal Tunnel Syndrome come from either an overly pronated foot, which puts a stretch on the nerve, pressure on the nerve from soft tissue masses such as ganglions, fibromas, or lipomas that physically compress the nerve, as well as other insults to the nerve.
The diagnosis is usually quickly made by physical exam and the patient’s complaint history. Observation may reveal a slight swelling just on the inside of the ankle joint. As part of the physical exam, Dr. Marc Blatstein finds that gently tapping the inside of the ankle joint in the acute phase will result in a tingling sensation that may shoot up the leg and/or into the foot. Nerve conduction studies are another tool that will reveal if there is damage to the nerve.

Treatment of the Tarsal Tunnel involves many different components, some of which are correcting the abnormal pronation of the foot [which is accomplished with prescription functional foot orthotics]. Along with this, oral anti-inflammatory medications, vitamin B supplements, &/or steroids may provide some benefit but are rarely curative. Should a soft tissue mass compress the nerve, surgical removal of the mass may be necessary. Surgical correction of Tarsal Tunnel Syndrome has a good chance of success; at the same time, the overpronation of the foot still needs to be followed with functional foot orthotics.

IV. THE PAINFUL HAMMERTOE

According to Dr. Marc Blatstein, hammertoes appear with the toes bent in a clawing fashion. Hammertoes may be flexible or rigid; flexible infers that you can manually straighten the toes, while it is not possible to straighten the rigid toe. Because most of us wear enclosed shoe gear, the pressure caused by the shoe gear we wear causes the toes to become painful. On top of this, pressure forms hard corn, while on the bottom of the foot, the toe pushes the metatarsal bone down, forming a callus under the metatarsal head. Treatment of hammertoes can be approached in many ways. Dr. Marc Blatstein starts by recommending a combination of appropriate shoe gear and a functional orthotic prescribed as a shoe insert to help the hammertoes from progressing or getting worse. In the very initial stages, while the toe is still flexible, it can be tapped into its corrected position, utilizing a functional orthotic. This conservative treatment also consists of hammertoe and buttress pads, all available over the counter, and open-toe shoes.

With continued pain, correction of the deformity, while successful, depends on whether they are rigid or flexible. While the hammertoe is still flexible, a simple tendon release followed by taping it in the corrected position is usually effective. Then, a functional orthotic may be prescribed to help maintain this correction. With a rigid hammertoe, the surgical procedure consists of removing some skin and a small section of bone. Dr. Marc Blatstein told us that in cases of a severe hammertoe deformity, a pin may be used to hold the toe in its corrected position for several weeks & then it is removed. In all cases, following your surgeon’s after-surgery instructions is essential to get the best result.

V. INGROWN TOENAIL

Victoria Azaranka recently dropped out of a tennis match because of an ingrown toenail. Dr. Marc Blatstein tells us how to prevent ingrown toenails. Several people wait far too long to have the procedure, and they have more complications. 

Most people do not think an ingrown toenail will get in the way of their profession, but it did for one person. Victoria Azaranka, the world’s No. 1 tennis player, was sidelined due to an ingrown toenail in her right big toe. The toenail had become ingrown and made it so painful she had to sit out of a match against Serena Williams, a former world’s No. 1 women’s tennis player. The cause behind the ingrown toenail is a surprise, a bad pedicure.

PUBLICATIONS:

Nails Magazine, Contributor, through the 1990s

                                                                                                               

CREATIVE FOOTWORKS

Novelties, Business Supplies, and Gifts for those practicing Foot and Ankle Medicine and Surgery, 1986-1996.

 

        

             

                                                                     

 

 

 

 

SECOND CAREER

PHYSICIAN PRESENTENCE REPORT SERVICE, LLC. 2011

 

PUBLICATIONS:

 

 

Presentence Report

 

 

The Federal Lawyer, Co-authored, 2021

 

 

 

 

 

 

 

 

American Bar Association, Co-authored two Chapters in 2022