***Update***I recently wore these for several hours and was left in the worst pain I have experienced in some time. It is apparent that the insole in these is no match for my custom orthotics and that I will need to wear those at all times. I have tried to make my orthotics fit in this shoe but the shoes have too much depth and my foot is swimming in the shoe. Sizing down would not help as then my orthotics would not fit. It appears these were an expensive mistake and will be relegated for those times when I will not be active on my feet.This will be a long review but it is my hope this will benefit someone else with similar issues. I am a Registered Nurse and have been working for 17 years. Prior to that, I was a CNA/Med Tech in the nursing home setting for 3 years while working through nursing school. My feet are excessively arched and I have worked night shifts for more than 10 years. Working on concrete floors, as any healthcare professional will attest to, does a number on your feet, hips, back, and knees. I suffered with pain for many years in spite of trying different shoes, compression stockings, and so forth. I finally saw a podiatrist who diagnosed me with Morton's Neuroma in both feet. I was given a cortisone injection in each foot (painful to say the least) and custom orthotics. I struggled along and tried sclerosing injections (7 each in each foot!), another set of custom orthotics, and finally, had surgery. Developed a stump neuroma and then had an additional surgery to remove that. Another surgery on the other foot to remove the neuroma and here I am, a year later. I still suffer with metatarsalgia and the wrong shoes will leave me in pain for days. Sandals are hopeless as nothing will work with my custom orthotics. Did I mention I have ridiculously high arches? Google "banana feet" and you'll see what I mean. My feet would have made for a great career in ballet but not so much as a RN.My podiatrist made the following suggestion that all shoes I wear have a rigid sole to prevent any flexing of my foot in the toes and ball of foot in addition to wearing my custom orthotics at all times and never going barefoot. My shoe wardrobe consists mostly of boots in brands such as Dromedaris, Wolky, and Drew. Boots are great in South Dakota for most of the year but it is summer and while I cannot wear a sandal, I need something to let my foot breathe. I read the reviews for the Paloma and figured I would try these. They do accommodate my custom orthotics but would need another insole underneath as mine are not as full to bring my foot up to where it needs to be. I have worn the shoes as is with the insole and have found comfort. The wide toe box prevents any crowding of my toes and the back is secure for my narrow heels. The rocker footbed is firm and eliminates any flexing of my toes or ball of foot area. The leather was a bit stiff at first but is breaking in nicely. My feet feel supported and I have not had issues going without my orthotics. The pattern is subtle and the velcro makes for easy off and on.I chose a 36 as I have one foot that is size 5 with the other being 5.5. A 37, which is what I wear for other shoes, would have been too big. I have room in front for my toes, the heel fits securely, and I have space around my foot. I have feet that are on the narrow side as I wear a size 37 narrow in Dansko clogs. I prefer these due to the footbed and inability to roll my ankle. My Dansko clogs also do not provide enough arch support. I look forward to getting through the rest of summer in these and will try to branch out to other styles. Thank you Alegria for providing shoes that offer support, comfort, and ability to get on with work and family!