Patient Profile

QEP Scripts for Two Recordings – Audio for Musculoskeletal System; “OK, Team! We have a new patient in Room 3B who is being admitted with a progressive (gradual, advancing) decrease in mobility (movement) of his back and legs, and increase in pain located in the lumbosacral (lower back above the tailbone of the spine) area. The patient’s Primary Care Provider has sent along Computed Tomography scans (CT, a rotating x-ray emitter, detailed internal scanner) showing spinal stenosis (narrowing of the spine causing pressure on the nerves and spinal cord causing lower back pain.) and decrease of the normal lordosis (abnormal curvature lower spine, excessive inward curvature of the spine) in the thoracic vertebrae (upper and middle back). Lumbosacral

DOI: 08/29/2006. Patient is a 57-year-old male bookbinding operator/route salesman who sustained injury when he was startled by a cat while making a delivery and fell. Per OMNI, he was initially diagnosed with lumbar herniated disk. The patient is currently temporary totally disabled due to knee surgery in April 2013. Based on the progress report dated 03/21/16, the patient reports that his low back pain tweaked again, after making the bed.

An MRI was performed of the lumbar spine. The examination found no significant extra

Let us understand the facts about this disorder. Lumbar Disc

DOI: 8/15/2016. Patient is a 65-year-old male manager who sustained injury while he was lifting a tire that was lying flat on the ground when he slipped and felt a pull in his back. Per the procedure report dated 10/14/16, the patient had a lumbar trigger point injection. Based on the medical report dated 11/16/16, the patient complains of lower back pain which is sharp, dull and achy in nature. The lower back pain radiates to bilateral side, bilateral hips and bilateral legs.

Thank you for organising the MRI of Ms Mackintosh lumbar spine. I understand that she was recently refused assessment by the MSK team at Chelsea and Westminster Hospital. I appreciate that her symptoms are complex. However, they have worsened recently resulting in her reporting that sitting is painful so too is walking for extended periods, which have impacts on both her ability to work and participant in her hobbies. I am concerned as she requires multifactorial investigation and management she may get bounced around from one apartment to another.

DOI: 4/16/2012. Patient is a 29-year-old male technician who sustained injury when he was 25-feet up on a ladder when the ladder slid and he fell onto the pavement. He had an open reduction internal fixation (ORIF x 2) for a compound tibia fibula fracture and had hardware removal in 4/25/2013. MRI of the lumbar spine performed on 3/24/2016 revealed L5-S1 small right paracentral disc protrusion without significant spinal canal stenosis or neuroforaminal narrowing.

The patient is an 84-year-old female who had a history of a fall approximately 2 weeks ago. She was seen in the ED at St. Joseph 's in Wayne at which time she had right hip and pelvic x-rays and also a CT of the of the hip. There was some question as to whether she had developed a fracture or dislocation of a previous hip prosthesis. The patient was in excruciating pain and was having difficulty ambulating. Her medical history is significant for diabetes mellitus, hypertension, Alzheimer 's disease, right hip fracture surgery back in January 2014.

Difficulties from spondylolysis plagued me for years in my teens. When the discomfort first began, I presumptuously told myself I remained tough enough to continue to play baseball through the pain; however, the soreness worsened, I needed to wear a back brace, and required several months of rest to heal. The downtime proved almost as painful as the injury itself. I felt well after this recovery period, except just as physical therapy ended, the achiness returned; a CT scan revealed not one, but two unhealed fractures that needed to be surgically repaired. During the weeks after surgery, I relied on a walker, and my pessimistic attitude caused many mental obstacles, one of which questioned my capability to be the athlete I was prior to my injury.

The left upper extremity was found to be within functional limits, so no measurements were taken. She was also found to have decreased arthrokinematic joint mobility for her glenohumeral and talocrural joints. She

Initial diagnosis was birth defect in lower spine, post surgery diagnosis is damaged nerves caused by surgery b. Symptoms started 2 years ago, surgery happened 1 ½ years ago, move to California 1 year ago. c. Cause was determined to be birth defect then surgery mishap when screw penetrated nerves during surgery. d. Susie’s consequence of the disease is her loss of mobility and independence, intolerable pain and suffering. e. Susie believed her behavior had nothing to do with her medical condition and wouldn’t influence her Treatment and Receiving Medical

As per progress report dated 4/27/16, the patient complains of cervical spine pain with left shoulder/hand radiculopathy. Upon examination, there is tenderness to palpation in the left trapezoid. There is positive Spurling’s test noted. Left hand/shoulder examination reveals positive Phalen’s and Tinel’s syndrome. Cervical and left shoulder/hand motor muscle strength is 4/5.

9. Discussion There are different types of surgical method or techniques that have been developed in past years to achieve fusion and reduction for the deformity of isthmic spondylolisthesis, [52, 53, 59-62] but it is difficult to define the ideal surgical strategy for IS in adults based on the published data [65]. Each procedure has its own advantages and disadvantages; the basic principle of surgical treatment is decompression and stabilization. In various studies, some Surgeon [65, 66, 67] showed that in case of severe spondylolisthesis, it is better to fuse in situ then reduction procedure in the long bone. However, for slipped vertebrae extended at one or two level, usually fusion in situ is performed [65, 66, 68].

On September 3rd, I had a lecture on “Eliciting the Patient’s Experience of Illness” in Pharmacy Practice III. At first, I paid attention in the lecture because I had to write a reflection paper worth 20% of the grade. However, as the lecture went on, I realized that the purpose of the lecture was to highlight the changing landscape in healthcare, more emphasis on patient-centered care. Nowadays, when I walk in to a bookstore in the health section, I encounter hundreds of books that narrate the authors’ personal experiences on battling different diseases. These books are gaining in popularity because the society thirsts for more healthcare knowledge. People want to read about the narratives, the human side of medicine. As I was listening to

More severe cases may present with scoliosis and respiratory compromise. Few reports have