I have spoken with the home care nurse regarding the wound and the physical therapist and occupational therapist. The physical therapist recommended a front wheeled walker as his weight bearing activity was progressing, including his transfers and more independence. The occupational
On 9/23/16 I met with Mr. Russell at the Covenant Occupational Medicine. Mr. Russell said his pain level is at a 1 to 2 now. He is able to tolerate sitting, standing and walking more since starting physical therapy. He reports he is doing a home exercise program also. Dr. Eckstein said he would increase his work restrictions. He would like him to have 2 more weeks of physical therapy. He hopes at the next appointment to be released.
His dressings are removed along with the brace and his incision is a curvilinear laceration through the medial retinacular region. Extensor mechanism of the knee is intact and a straight leg raise is painful but normal. Range of motion is grossly limited in flexion secondary to pain but full extension is easily achieved. He is stable with varus and valgus stress testing at 0 and 30 degrees. Gentle Lachman's test does not demonstrate any gross instability. The ankle shows some dependent edema but no acute injury. Range of motion, dorsiflexion, plantar flexion, inversion, and eversion are all intact with adequate strength. Extensor hallucis longus, dorsiflexion, plantar flexion function of the ankle are all intact with 5/5 strength, L3-S1 sensory dermatomes are intact to light touch, though the patient does describe some mild periwound numbness. There is no streaking erythema. Wound is benign and shows no signs or symptoms of infection. Vascular tone is full and compartments are
Raney was experiencing any pain to the area and Mrs. Raney replied that the only pain is in the right shoulder. Mrs. Raney was able to supinate and pronate her right wrist 30-40 degrees. Her skin was dry. Dr. Mendelson replied that at this time Mrs. Raney no longer required to wear the wrist brace and she can use the extremity. Dr. Mendelson obtained x-rays of her right shoulder as Mrs. Rainey has limited range of motion. After reviewing this, Dr. Mendelson replied that Mrs. Rainey as tremendous arthritis in her shoulder. I inquired if it was traumatic arthritis and the result of the accident. Dr. Mendelson replied that it was not related directly to the accident necessarily but her shoulder was aggravated from the accident. Dr. Mendelson continued to state that symptomatically it will get better and at some point Mrs. Raney did have a glenoral crack. Dr. Mendelson inquired about how Mrs. Raney’s shoulder was prior to the accident and she stated that it was fine and she could raise her arm above her shoulder and head but now she can’t and has had limited movement since the accident. Dr. Mendelson assessed and evaluated her lower extremity and replied that Mrs. Raney’s left incision is now healed. Her right ankle is still healing, the wound is dry and her skin is consolidating over the area. Mrs. Raney has an avagus external rotation of her foot.
DOI: 1/23/2014. This is a 36- year old male relief driver who sustained injury while he was putting away the automatic tarper when he was struck on the right shoulder and got driven into the ground and twisted his right foot. Per OMNI, he was diagnosed with right shoulder strain, and back/neck/right foot fracture. As per office notes dated 6/3/16, the patient is complaining of numbness in all extremities specifically the bilateral feet, arms and bilateral elbows. He has had a flare-up of pain that past couple of weeks around lateral column of the right foot made worse with walking and standing. He has been taking Neurontin 300 mg thrice a day which is helping control his symptoms. He apparently had a bilateral upper extremity upper extremity
I spoke with Mr. Sutter several times since 3/2/17. Mr. Sutter moved his medical appointment from 2/23/17 to 3/2/17. I was not unable to attend nor was I able to find a co-worker to attend. I spoke with Dr. Olenyn’s office staff many times for updated scripts and next appointment time. Mr. Sutter has lymph edema to the right and left legs. He was supposed to elevated and also wears compression stocking. His legs are so big the stockings cut in. Dr. Olenyn told Mr. Sutter he must get the swelling down because that will affect the healing of the fractures. He is at high risk for infections from open skin. Some of the bones are healing but not all. Mr. Sutter continues to use a bone stimulator daily. I have spoken with Mr. Sutter and
On 3/20/17 I met Ms. Iversen at the office of Dr. Nwuso. Ms. Iversen arrived with a cam boot on the right foot and also with crutches. She was applying little weight to the foot. She reports that she has pain from the cam boot on her incisions. Ms. Iversen reported that she came back to see Dr. Nuswo about a week after her surgery because she felt her dressing were wet from drainage. There apparently was no drainage. Ms. Iversen had a list of questions for Dr. Nwuso. Her questions were confusing and Dr. Nwuso was getting frustrated. He told her from his stand point she can do anything she wants. She is not going to rip open the incision or do anything to the fractures. They are healed and stable. T
DOI: 4/10/2012. Patient is a 62-year-old male customer service representative who sustained a work-related injury to his left foot and low back due to cumulative trauma from repetitive duties. Patient is diagnosed with recurrent lumbar disc herniation at L4 to L5. He is status post right L4 hemilaminectomy, L4 to L5 microdiscectomy with removal of exterior fragment on 01/08/2014. He underwent an endoscopic left plantar fascial release on 05/04/13.
Based on the progress report dated 04/05/16 by Dr. Fieser, the patient complains of pain in the left knee, left ankle and left foot, associated with numbness and tingling in the left leg/foot, as well as weakness in the left leg. He describes the pain as sharp, cutting, throbbing, dull, aching, pressure-like, cramping, shooting and shocking with muscle pain and pins-and-needles sensation.
PHYSICAL EXAM: Examination shows comparing the right hand to the left, including the hand and wrist region, that there are skin scratches, very superficial, from activity. There is no tenderness. There is no soft tissue swelling. There is normal alignment. No deep tenderness to palpation over the fractures. No crepitus. No instability. Active range of motion is about 85% of the contralateral left side.
Per verification to the PT facility, the patient has attended 38 PT sessions for the back from 10/06/15 through 02/01/16.
DOI: 07/10/2012. Patient is a 67-year-old female licensed vocational nurse who sustained work-related injury to multiple body parts when she tripped over a cord and fell onto the floor while leaving a patient’s room. Per OMNI entry, patient is status post right total knee replacement on 1/10/2015.
The patient was admitted into the hospital. In the morning after admission was taken to the operating room where she under went open reduction internal fixation of her right ankle fracture. She had an uncomplicated post operative course and gradually returned to assisted ambulation, she was then discharged in good condition.
This surgery was performed three days following the accident, due to swelling of the affected limb.
I think he is very smart as he said in the interview for matriculation at Harvard University, “I’m fucking smart,” but his intention and attitude was too much wicked towards people who he bankrupted as a leader of a company. The neuropsychologist Ian Robertson at Trinity College, Dublin (2012), used Jeff Skilling’s case when he demonstrated the critical sample of addiction to power on his book. Professor Robertson described that testosterone is strongly boosted up after many leaders have experience of victory and power. Some are apt to be addicted to power if they continue to experience it. This status quo is called a winner effect. Mr. Skilling had a reputation for being arrogant and laid off the bottom 10 percentages of executives and staff members whose business results he evaluated. Moreover, he had ever shown even his middle finger to workers who lined up in the parking lot because of him, passing by them. He had sold his shares of Enron three years before Enron filed for bankruptcy protection. How wicked he is. When the professor researched on Jeff Skilling with a question of what he was when he was young, he found out that ironically, Mr. Skilling’s friends at Harvard remembered him as being common and nice. Mr. Robertson described that power is a necessary evil for a leader, but Mr. Skilling spoiled himself with addiction of power.