Mr. Barta continues to have a very slow recovery and pain. After discussion with physical therapist Bo and speaking with Mr. Barta a second opinion was explored. I made several calls and provided medical records to Orthopedic Surgeon Dr. Lilly. Dr. Lilly reviewed the records and recommended waiting for some time yet before exploring a second opinion. Due to my vacation, Denae Bennett attended the appointment on 11/2/17 with Mr. Barta and Dr. Goethe. Ms. Bennett was provided information regarding favored work to provide to Dr. Goethe. She was able to speak with Mr. Barta and also Dr. Goethe's medical assistant. Mr. Barta continues to report poor sleep due to pain and discomfort along with rating his pain levels at 2 to 6 consistently. …show more content…
Barta on 11/6/17. He reports that the change in physical was due to the physical therapist he was working with. He reports he felt like “repeating the same thing was like insanity”. He feels a change of location may help him to gain more strength and endurance. He reports both of his parents went to this location. He had his initial evaluation today and will start therapy on 11/9/17. Mr. Barta had questions regarding the favored work and compensation. I directed Mr. Barta to speak with the adjuster regarding that. Mr. Rider would be happy to provide further information. RETURN TO WORK ACTIVITY Mr. Barta is currently off work until the next appointment on 11/30/17. There is no projection for a return to work yet. Light duty work was requested at the last appointment and Dr. Goethe continued to keep Mr. Barta off work. A current work status was emailed to the employer along with an update on 11/6/17.. ASSESSMENT Mr. Barta continues to make very slow progress. He has resumed hunting for Deer and Turkeys taking his son hunting. He denied that he would try to pick up any animals during the hunt that it was his son hunting. Dr. Goethe continues to not speak with nurse case managers. It is hard to determine what is being said or recommended from the dictation and from Mr. Barta. Mr. Barta has changed physical therapy locations since the prior physical therapist recommended a second opinion of the shoulder. Mr. Barta claimed that his therapy was repetitive in the prior
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media,
In her personal essay, Dr. Grant writes that she learned that most cases involving her patients should not be only handled from a doctor’s point of view but also from personal experience that can help her relate to each patient regardless of their background; Dr. Grant was taught this lesson when she came face to face with a unique patient. Throughout her essay, Dr. Grant writes about how she came to contact with a patient she had nicknamed Mr. G. According to Dr. Grant, “Mr. G is the personification of the irate, belligerent patient that you always dread dealing with because he is usually implacable” (181). It is evident that Dr. Grant lets her position as a doctor greatly impact her judgement placed on her patients, this is supported as she nicknamed the current patient Mr.G . To deal with Mr. G, Dr. Grant resorts to using all the skills she
According to Michigan Physical Therapy Act(MPTA), “ consult with the health care professional who issued the prescription for treatment if the patient does not show reasonable response to treatment in a time period consistent with the standards of practice as determined by the
The aim of this essay is a reflective account in which I will describe a newly acquired skill that I have learned and been able to implement within my role as a trainee assistant practitioner. (T.A.P.) for Foundation for Practice. I have chosen to reflect upon neurological observations on patients that will be at risk of neurological deterioration. Before I begin any care or assessments, I should have a good theoretical underpinned knowledge, of the skill that I am about to put into practice, and have a good understanding of anatomy and physiology, in order to make an accurate assessment of a patients neurological status. I will be making a correct and relevant assessment to identify any needs or concerns to establish the patient’s individualized care, and make observations to determine an appropriate clinical judgement.
A couple of days after Abelino’s knee accident he and Holmes went to the urgent care clinic. Abelino ended up seeing several doctors and a physical therapist over the next several months, and he never had any translators proficient in Triqui. The urgent care doctor barely listened to Abelino’s description of what happened before he examined his swollen right knee. The doctor ordered an X-ray, which showed that no bones had broken but could not show anything of the soft tissue, tendons, bursa, and meniscuses. The report from the X-ray concluded that he had a “normal right knee” the doctor explained that Abelino should not work picking berries, emphasizing rest to let his knee recover. The doctor refused to give him an injection to subside the pain and instead referred him to physical therapy, an anti-inflammatory medicine, and instructions on icing his knee regularly. The physician also opened up a worker’s compensation claim. (Holmes, pg. 117) The next week Holmes accompanied Abelino to the clinic for his appointment, the original doctor was not available, so they had to see a different doctor. The new doctor looked at Abelino’s chart and briefly listened to Abelino as he tried to explain his knee problem. The doctor told Abelino that he could work “light duty,” as long as he didn’t bend, walk, or stand for long periods. The doctor also stated in Abelino’s chart that the cause of the injury as “while picking, he
Rockwell, P.E.,M.D. Director of Anesthesiology, Leonard Hospital, Troy, NY, U.S. Supreme Court, Markle vs. Abele, 72-56, 72-730, 1972. P.11
Instead, the doctor exclaims, “So this is the patella”, merely reducing to patient nothing but her injury. In contrast, the doctor that took care of my injury not only called me by name, but he also asked if he was pronouncing it correctly. I have an unusual name that is not often pronounced correctly. By taking the time to say it right, I felt as though I actually mattered to the doctor. Another difference between this story and mine is her doctor did not take the time to explain what was happening to her knee. Instead, he just spoke medical jargon to his colleagues. My doctor, on the other hand, explained that what he was about to do to my finger would be painful. Then he asked if I was ready for him to start. All while he was fixing my finger he was speaking very kindly to me. I can’t recall what he said, but I know it made me feel very comfortable. There are, however, some similarities to this story. The nurses and therapist that took care of the patient in this story acted in a similar manner to the doctor is this story. The patient talks highly of these people leading the reader to conclude that they had a big influence on the outcome of her injury. She concluded that the nurse who washed her hair made her feel much more
During the interview, the Physical Therapist I conferred with was very thorough and straightforward in his responses to the questions that were given. I decided to interview another one of my mother’s fellow co-workers, Mr. Stephen Chan, considering his new experiences in the Physical Therapy field. I met with Mr. Stephen Chan at the Kaiser Permanente Outpatient Orthopedic Clinic that is located in Union City. The essential subject matters that we discussed consisted of his Major and Minor in college, the Residency Program that he takes part in, variations of attitudes, and advantages in the workforce.
DOI: 4/24/2013. This is a case of a 59-year-old female customer service representative who sustained injury to her left ankle when she got up after her foot “fell asleep”. As per OMNI notes, patient underwent ligament reconstruction with Brostrom repair on 1/16/2014 and left knee arthroscopy on 10/8/2014. As per office notes dated 6/21/16, the patient returns for interval followup visit. The patient has been working more and is explaining to me that she is having exacerbation of symptoms. The patient admits to increasing neuropathic pain secondary to complex regional pain syndrome. It was mention that the patient has been on Topamax and tramadol which allow the patient to get some improvement. She admits 40% improvement in the pain and she also
Consult specialist sites, including the American Medical Association, the American Academy of Orthopedic Surgeons, and local
Mrs. Jones was born on November 1 from 1970. She has five primary complaints: pain when showering, brushing her hair, washing dishes, dressing and driving. Mrs. Jones, suffers extreme stiffness in her right shoulder and has low strength, she complains of pain when moving her shoulder and arm with limited coordination. Mrs. Jones stopped working, the problems of strength, reduced mobility, and the pain need to be
Prior to this appointment, Jim has undergone a home-based diagnostic sleep study through the Austin. This has revealed short sleep onset latency of 3.5 minutes with reduced sleep efficiency. There is severe obstructive sleep apnoea with an Apnoea-Hypopnoea Index of 84 events/hr. There was significant oxygen desaturation during the night with more than 50% time of total sleep time spent with a saturation of less than 88%. There were no notable periodic limb movements.
On 12/12/16 I met Mr. McClellan and his step dad at the office of Dr. Nzoma. The MRI was reviewed. There is a partial tear of the ACL. There is some popping but examination showed good strength and stability. Dr. Nzoma would like physical therapy to continue to help him wean out of the brace and to work on the popping. We discussed a return to work and restrictions were written.
While with my patient on the first visit we had set some goals. The goals were for her to walk more with the aid of her walker and for her to recall past events. From the first visit these I identified these issues as problems for the patient. I gave the patient the following nursing diagnoses. Impaired walking R/...
He maintained good attendance with four excused absences and no unexcused absences. He was absented from the CRP because of holidays and the CRP facility closed because of increment weather (01/15, 01/16, 01/17, and 01/18). Additionally, he practiced taking one break before the morning break of 09:45 am. No reports of excessively going to the bathroom and water foundation this review period.