I met with D.B. on Tuesday, October 27, 2015. We met at her home and reviewed her care plan and discussed a recent doctor’s appointment she had with her doctor. At this appointment she discussed her chronic leg pain and received a diagnosis. We also reminiscence her life from the years 20 through 40. This reminiscence is submitted as a separate document with this summary and evaluation. At this meeting, we renewed our relationship and each told the other what is new in our personal lives. Shortly after my arrival, the niece of D.B. stopped by and stayed about 10 minutes. She mostly just sat on the couch nearby and listened. D.B. has talked about her niece in the past and I think she stopped by just to see who this is that is visiting …show more content…
to get. It had been over a year since D.B had seen a doctor, and her leg pain did warrant an evaluation by a doctor. D.B. informed me that the doctor told her she has spinal stenosis. D.B. explained to me her understanding of spinal stenosis. She explained that it is a pinching of her leg nerves in her lower back as they run through her spine. She advised she discussed options with her doctor for relieving this pain and treatment. She made it clear that she would not have an operation or other procedure on her back as she believes this would only make things worse. She stated that she doesn’t see much she can do for her pain other than what she has been doing in the past. The things she has done in the past are using aspirin and walking to keep in shape. She explained that her doctor agrees with her …show more content…
told me about a new heated blanket she had bought. She explained that this blanket covers her bed ad she turns it on about 20 minutes before bedtime. When she gets into bed, it is not only comfortable, she feels it takes some of the cramps / pain from her legs as they are warmer now. I feel I chose an appropriate care plan for D.B. I was successful in getting D.B. in to a doctor for a successful diagnosis of her leg pain. While there was no offer by this diagnosis for pain relief, I do feel that knowing the reason at least gives some relief as I feel there is more stress involved in unexplained pain versus pain that is from a known cause. She now can feel empowered to know that she has made choices in how to deal with the pain she is experiencing. Another aspect of the care plan was exercise. Increasing exercise can have beneficial effect for her leg pain. While this benefit may not be immediate and hard to correlate to the exercise, I believe D.B. understands how many benefits she may realize from increasing her level of activity. D.B. is a former physical education instructor and knows about these many
Mary L Walsh is a 84 y.o. female who presented on 5/6/2017 with chief complaint of back pain and leg pain after a fall. Mary was tearful and reported feeling sad. Mary reported she was in significant pain and requested I asked her nurse for more pain medication. Mary reported she fell at home on Saturday but did not tell anyone until her son David came to the home later that day. Mary reported "I am just getting old and having lots of problems".
Page’s patient, P, suffers from back pain and he is determined to find the cause of the pain. To rule of the most lethal causes of back pain, some of the questions Page asks include “Did the pain wake him up at night? Was it worse when he was lying down? Had he recently lost weight?” (Page).
Jean Russell of Michigan Insurance Company referred this file for medical case management. Instructions were given to meet with Flavia Tocco and assist with coordination of appropriate and related medical care, and identify needs to facilitate recovery. INTERVIEW SETTING I met Ms. Tocco at the St. John’s physical therapy department. Ms. Tocco was open to providing me information on her current and prior medical history.
Samantha Quinones of Sherwood Oregon had a surprise hip surgery on August 25, 2012. While riding her bike at the park the pain in her hip was to strong to continue. Since Samantha’s pain is hard to manage that she went to the doctors to make an opponent and then went back to the park but Samantha started to cry from the pain.
First, I am going to introduce my Pt (patient) to you. Her name is Wendy Couch and she is my mother. Her D.O.B. (date of birth) is January 12, 1980, which would make her 37 years old today. Wendy was diagnosed with a chronic disorder called fibromyalgia when she was 20 years old. It took the doctor 5 years to diagnose her with this disorder because they said she was too young to be diagnosed with fibromyalgia.
She does ask for more pain medication, but states Ultram worked well for her. She tells me she was given one of these in the emergency room. I did give her a prescription for Ultram 50 mg one to two tablets every four to six 6 hours p.r.n. #20 given with no refill. I did suggest we could try physical therapy, but she states things are improving and thus she does not want to do this.
An orthopedic evaluation report from Anthony Esposito, DO (Physical Medicine & Rehabilitation), dated 06/08/2017, indicated that the claimant reported neck and low back pain rated as 8/10. He stated that pain was aggravated by bending, climbing stairs, reaching, lying down, coughing, and looking up. Continued chiropractic therapy and MRIs of the
The desired outcome for J.B. is that she will be free from falls while under my care. Interventions for J.B. include instructing her about the effect of exercise on the progression of osteoarthritis, obtaining a physical therapy order for strengthening exercises, collaborating with her primary care physician to develop a pain medication regimen for times when her pain increases, using cold therapy on her knee during flare-ups, exchanging her non-slip bath strips in the bathtub for a non-slip bath mat, and installing a raised toilet seat (Durham, Fowler, & Edlund,
18. In his letter of 29 May 2002, her local General Practioner (GP), Dr John O'Dowd described her as a very sprightly 80-year old that had a history of increasing intermittent claudication to her right calf. When advised that it was unlikely that anything could be done at that stage to improve her symptoms, she requested a specialist review.
Medications such as Baclofen and gabapentin as well as home exercise program are proving effective in improving pain levels, function and range of motion and overall sense of comfort. Pain/spasm is more severe after decreasing Baclofen dose. She also complains of cervical and bilateral upper extremity pain/parasthesias. On physical examination, there is spasm and tenderness on cervical exam. Motion is guarded due to pain.
Happeny (2015) stated “Physical therapists are the health care provider to see when you have musculoskeletal pain” (para. 6). Musculoskeletal agony is frequently created by harm to the bones, joints, muscles, tendons, ligaments, or nerves. Bury and Stokes (2012) said “where direct access was permitted, it was seen to have a positive bearing on the scope of practice of physical therapists in terms of assessment, diagnosis, and referral to specialists” (para. 18). As a result, patients with direct access can increase their healing process faster of any medical need compared to a referral and delaying the healing process of a medical problem. For example, Hawryluk (2015) suggested “if patients can manage chronic back pain with physical therapy rather than getting MRIs that lead to back surgery, therapists could make an even stronger case for direct access” (para. 29).
The research projects presented in the thesis are the results of my own original work with the guidance from my supervisor and the supervisory committee. The topic for my thesis work came from my interest in optimizing the management of individuals with low back pain (LBP), course work, and from my personal experience as a physical therapist and with my supervisor as a graduate student. The main contribution of this thesis is to optimize healthcare professional practices in chronic LBP management by implementing key components of Chronic Care Model. Identifying the barriers to the delivery of self-management support and the use of PROM scores in clinical practice may help clinicians integrate these two approaches into clinical practice.
Patients experience disabilities due to pain and intensity of pain determines the level of disability. Low back pain with sciatica is a disabling health condition with high costs for both individuals and the society. Nevertheless, with advances in science and technology and education there are now a wide range of interventions experimented in combating low back pain. The search for the most productive and long lasting treatment has become a focal point for many people and physical therapy is one of alternative used by many as a treatment for low back pain with
In Addition, another agreement of physical therapy being useful in pain treatment, is that it avoids surgery and strong medications. People have different perspectives on medical purposes as some may prefer drug medications as it beyond what they except to take while others take surgery offers for quicker results in reducing pain; “Surgery may not always be the best first course of action. A physical therapist, in many cases, can help patients avoid the often unnecessary risks and expenses of surgery”. (http://www.apta.org/ 2013) and medications can be unresponsive to the body movements causing other informalities; “Medications that impact the central nervous system and alter (slow down) they way our nerves think and our reflexes respond can put patients’ at risk during physical therapy and certainly at risk for falls”.