001015 Mr. ___ [NAME] is a 49-year-old white male, a patient of Dr. ___ [NAME], with a history of right knee replacement x 4, secondary to a gunshot wound in ___ [DATE]. Left knee, he has had multiple surgeries, primarily on the ligaments and I understand the meniscus. Also has right hip pain. The hip is probably related to his difficulty with the right knee. He has chronic pain in the knees. He has a need for testosterone as his labs are very low. PTSD, (___) anxiety. Really here today to follow up on the testosterone. Lab was drawn; other results are not yet available. His non-fasting glucose today was 106 and the hemoglobin A1c that was done was 5.9. He does have some history of hyperglycemia, but I think there were primarily non-fasting, he may just have some glucose intolerance. Complains primarily of knee pain and right hip pain. He is having erectile dysfunction, was given Viagra, and when he saw the urologist he was told that he needed testosterone, as it was quite low at 1.8. …show more content…
Blood pressure is a little bit low at 84/68. Heart rate is a little bit rapid, but his knees positive (dorsi aling) both. Right is particularly bad, it is extremely loose. The left is also quite loose, but perhaps not as bad the right. There is a lump on the right hip. I do not know if it is not fitting entirely into the socket or if it is just swelling, but it certainly must be difficult for him to
History of cardiomyopathy. The most recent echocardiogram was done in 2014 showing improved ejection fraction at 55%. He feels asymptomatic, at this time. He did have recent testing with Dr. Dourdoufis. I will request those notes and review them when they arrive. He will certainly let myself or Dr. Dourdoufis know or seek care if necessary if his symptoms change acutely.
Oliver et al. (2014), exemplifies how some physicians may not be aware of their implicit bias that could be causing healthcare disparities. This study determines whether physicians’ implicit racial views of African Americans affect their decision making, regarding total knee replacement (TKR) as a treatment option for OA. They also assessed whether not, if the Racial Implicit Association test would impact TKR recommendations. In the study implicit bias was determined by the racial implicit association test (IAT) and explicit bias was tested using a questionnaire that asked physicians which race they preferred (black or white) using a 5-point Likert scale and 10-point thermometer scaled to grade physician’s feelings.
.) SP is an 84-year-old widow recently admitted to an orthopedic ward for a total hip replacement from the anterior approach. She is widowed, but has two adult children living nearby. SP has a familial history of cancer and heart disease, and she herself has experienced several different medical issues. When discussing cares, procedure options, and having general conversations with SP the health care team needs to be especially aware of her hardness of hearing, and need to use hearing aides. A communication barrier exists between the patient and the care team. This barrier exists because of both her hearing issues and her advancing age. Safety risks from improper communication related to these barriers can greatly increase her chances of experiencing undue harm from her hospitalization. An example of how this could occur would be improper communication of what hip needs to be operated on. At all times, the health
Having read the case and knowing the situation, I would say the patient damaged his patellar ligament and posterior cruciate ligament. The knee joint consists of five ligaments—the patellar ligament, fibular collateral ligament, tibial collateral ligament, anterior cruciate ligament, and posterior cruciate ligament. The patellar ligament helps extend the leg at the knee. The fibular and tibial collateral ligaments stabilize the hingelike motion of the knee (Drake pg. 303). The anterior cruciate ligament restricts anterior displacement of the tibia and the posterior cruciate ligament restricts posterior displacement of the tibia (Drake pg. 303). Most likely, the cause of the blue color in the patient’s leg and foot is from lack
The DDS proposes a fully favorable allowance for this claimant with an EOD of 07/01/2013. The evidence in file supports a later onset date.
Introduction: In case of advanced knee arthritis, Total Knee Arthroplasty (TKA) represents an effective and reproducible surgical technique. In the last decade, Computer-Assisted Systems (CAS) have been introduced in TKA to allow more accurate prosthesis component implantation via intra-operative anatomy-based data tracking of the tibio-femoral joint (TFJ). Particularly, these systems were expected to result in better post-operative clinical outcomes under loading conditions and longer implant survivorship than Conventional Instrumentation (CI). This is generally due to more precise targeted bone cuts and Mechanical Axis (MA) using CAS. Unfortunately, only a few studies have compared so far TKA via CAS and CI at a long term follow-up in terms of clinical outcomes, MA alignment and implant survivorship.
In a hospital I worked at recently, I was told in report that a patient I was taking was demented and didn’t know where she was or what her situation was. The patient admitted for a post knee replacement was 86 years of age, fragile, very hard of hearing and mute. The pain in her knee was excruciating and she often cried out asking for pain medication. Moving her in the bed also caused her pain, because she was said to have dementia no one explained to her what they were doing so, she fought the staff when they moved her or changed her brief. After I came on shift I assessed her, I attempted to take her knee immobilizer off to assess her knee and she cried out in pain and smacked my hand aside. I felt so bad for her, I decided to try to yell
ACTIONS AND USESNifedipine is CCB generally prescribed for HTN and variant or vasospastic angina. It is occasionally used to treat Raynaud's phenomenon and hypertrophic cardiomyopathy. Nifedipine acts by selectively bloking calcium channels in myocardial and vascular smooth muscle, including those in the coronary arteries. This results in less oxygen utilization by the heart, an increase in cardiac output, and a fall in blood pressure. It is available as extended-release tablets (XL).
3.) Psyllium (Trade Name: Metamucil) 1 tablespoon by mouth, twice a day; used for relief and prevention of constipation (Deglin & Vallerand, 2007).
If your knee is severely damaged by arthritis or injury, it may be hard for you to perform simple activities, such as walking or climbing stairs. You may even begin to feel pain while you are sitting or lying down.
Knee injury is one of the most common injuries in sports activities or events. Failure to detect it would jeopardize the athletes’ future. Knee image processing is studied for the development of an aided system to identify knee injury. However, medical experts analyze the MRI images using their naked eyes. This increases the possibilities for false analysis. To overcome the problem, this study aims to develop an intelligent system, which involves image processing system to assist the medical experts in making decisions to decide on the types of ACL knee injury. The end results in the identification of ACL injury is in the form of a classification based on crucial tear (CT), partial tear (PT), and normal classes. The analysis of results based
Joints and joint related problems are very crucial in human bodies which need to be treated perfectly by the best knee replacement surgeons from any well known hospital. Joint pains have always known to be the hardest pains ever when it comes to following the daily routines along with bearing those pains. The starting stages can be treated really well by medicinal courses or exercising routines or by physiotherapy sessions given by various well educated, well trained and well experienced physicians of the specific field. In case the before mentioned methods do not work out well and the patients are found to be suffering to the extreme
Knee replacement surgery is one of the most common categories of joint replacement surgery implemented in world, with more than 200,000 surgeries per year in the US alone. Many patients travel from United States of America and UK to get low-cost knee replacement surgery in India.
People undergo total knee replacement when arthritis or injury erodes the joint's natural cushioning to the point where it's hard to walk even short distances without severe pain.
Teaching the importance of activity and exercise has a huge significance to the patient especially she undergone surgery, left knee arthroplasty. Lack of adequate knee exercise after surgery will lead to various complications that are dangerous and life threatening such as deep vein thrombosis, stroke and pulmonary embolism. Another complication that is associated with inadequate movement of the limbs and extremities is muscle contracture (LeMone et.al, 2011 p 142). Patient has a high risk of developing these complications. We wanted to educate the patient about these so that we could lower her risk at some point. We believe that even when patient is lying down on the bed, she can do a lot of things to improved her health and prevent