Dysphona And Self-Esteem Case Studies

I noticed that Mrs. Lewis who was quiet when we entered her room upon seeing me approach her bed started to groan loudly and turn her head from side to side (this made me feel worried as it was obvious to me that she didn’t like me). The patient was also licking her lips and coughing up mucus and she appeared to me as if she were choking. My mentor informed me that this was normal for Mrs. Lewis but it added to my anxiety as I had not seen a patient in Mrs. Lewis’ condition before and it alarmed me.

Most people face self esteem problems at different levels. At some point in life people face this problem without realizing it. In the essay The Trouble with Self-Esteem written by Lauren Slater starts of by demonstrating a test. Self esteem test that determines whether you have a high self-esteem or low self-esteem. The question to be answered however is; what is the value and meaning of self-esteem? The trouble with self-esteem is that not everyone approaches it properly, taking a test or doing research based of a certain group of people is not the way to do so.

No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,

Mrs. Newman has been experiencing hoarseness and a change in her voice, but she did not seek medical help until she began to have difficulty swallowing. After being seen by her healthcare provider, she is scheduled for outpatient surgery for a direct laryngoscope to obtain a culture and take a biopsy.

No scalp lesions. Dry eyes with conjunctival injection. Mild exophthalmos. Dry nasal mucosa. Marked cracking and bleeding of her lips with erosions of the mucosa. She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft palette. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. SKIN: She has some mild ecchymosis on her skin and some erythema, she has some patches but no obvious skin breakdown. She had some fissuring in the buttocks crease. PULMONARY: Clear to precussion and auscultation, bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, non-tender, protuberant, no organomegaly, and positive bowel sounds. NORALOGIC EXAME: Cranial nerves ii – xii are grossly intact, diffuse hyporeflexia. MUSCULAR SKELETAL: Erosive destructive changes in elbows, wrist, and hands consistent with rheumatoid arthritis. Has had bilateral total knee replacements with stovepipe legs and perimalledal pitting edema 1+. I feel no pulse distally in either leg. PHYCIATRIC: Patient is a little anxious about these new symptoms and there significance. We discussed her situation and I offered her psychiatric services, she refused for now.

PHYSICAL EXAM: Temperature 98.6, Blood pressure 140/90. Pulse 110. Respirations 26. Her lungs are clear, showing mild signs of distress. Heart sounds are normal, irregular rhythm and bradycardia noted. No edema noted in extremities. Patient skin is cool to touch, slightly clammy. EEG shows prolonged QRS wave, with ischemic ST changes and PVCs. Chest radiograph clear.

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

Lung function tests have revealed normal spirometry, gas transfer and static lung volumes. There appears to be a fall in pre-bronchodilator FEV1, but not so FVC and TLCO comparing back to 2007??. Maximal respiratory pressures are reduced indicative of respiratory muscle/diaphragm weakness. This is consistent with what has previously been observed and the previous diagnosis of mild left hemidiaphragm weakness. I note from Tony Dortimer’s most recent letter that the coronary angiogram

History of Present Illness: Per patient report, he was in his usual state of good health until 2 days ago when he started feeling a throbbing throat pain. The pt denies pain in any other part of his body. The sore throat is al most constant and states feeling a throbbing sensation. Aggravating factors are swallowing and talking. The patient feels some short relief when he takes lozenges or eats something cold. Pt states awakening at night due to the throbbing throat pain. Currently, the pain level is 7/10 in a numeric scale (0-10). Denies any other associated symptoms such as headache, fever, chills, drooling, problem swallowing, hoarseness, sneezing, runny

Moving forward, if Lysbet's heart scan is clear, another possibility for the chest tightness and shortness of breath is that of asthma. She had normal lung function tests with us, but I have suggested that if the heart test was clear, she could trial some Ventolin to see if she has any symptomatic benefit and if so, perhaps even an extended trial of an inhaled corticosteroid.

History of Present Illness: Ms. Johnson is a very pleasant 66-year-old woman who was previously evaluated in this office by Elvira Aguila, MD for the diagnosis of asthma. She was last seen in January 2015. She states that overall, she has done well. However, over the last two to three weeks, she has noticed increasing shortness of breath as well as productive cough, rhinorrhea and postnasal drip. She states that she has been using her rescue inhaler above and beyond what is normal for her up to 10 times a day yesterday and she states that she has had some improvement in her symptoms with her short acting bronchodilator. She denies any fevers or chills.

At today’s visit, she is awake, alert, oriented. She was evaluate by hospice and was appropriate for admission but she refused admission and states that she wanted to continue with palliative care for the next 2 weeks. I am here to follow up for her disabling dyspnea. She is noticeable dyspneic on my arrival. She states that she continues to have chronic dyspnea/shortness of breath and that she does not want oxygen but is willing to try medication. She complains of a new onset cough, intermittent, clear secretion. She does not feel it is associated to her Lisinopril. She complains of GERD. She states that she would like to try morphine for her shortness of breath and if it is not effective then she will elect hospice

You may be surprised how many times you swallow throughout the day -- every time you eat or drink something, you have to swallow multiple times. You also swallow salvia throughout the day. The condition where one has difficulty swallowing is referred to as dysphagia or the swallowing disorder. Use this guide to better understand what your loved one is going through, and how a qualified speech pathologist can assist them.

* Prior to performing A.’s physical assessment, I gathered information over her diagnosis tonsillectomy, adenoidectomy, and vitiligo and any passed medical problems to be aware of. I then introduced myself to A. and her family and asked her if she wanted her grandparents to stay in the room during her physical assessment. I then explained the process of starting at her head and working downward to her feet by providing privacy throughout the whole assessment. First I started, by observing her appearance and behavior and how well A. communicated with me, A.’s behavior was calm, cooperative and appropriate for her age. I assessed PERRLA in both eyes, her pupils were a 3, equal, round, reactive to light and accommodated. I assessed her mucus membranes which were pink and moist along with assessing her throat by looking at the back of throat and checking for bleeding , whitish area, and odor. I then asked her if she had any frequent swallowing and trickling of blood in her throat. A. stated she did not have any frequent swallowing or blood in her throat just some soreness and discomfort in her throat. A.’s throat had white areas on both sides where the tonsils were removed with no bleeding. I auscultated her heart and lungs, and heard S1S2 and her