{"id":15191,"date":"2020-07-27T02:15:31","date_gmt":"2020-07-26T20:45:31","guid":{"rendered":"https:\/\/tijusacademy.com\/?p=15191"},"modified":"2020-07-27T02:15:31","modified_gmt":"2020-07-26T20:45:31","slug":"ms-lord-ellison","status":"publish","type":"post","link":"https:\/\/s420.previewbay.com\/tijus\/ms-lord-ellison\/","title":{"rendered":"Ms Lord Ellison"},"content":{"rendered":"

Reading-5 minutes<\/span><\/p>\n

Writing- 40 minutes<\/span><\/p>\n

 You are a Public health nurse in Boomsgrave health centre in Walsgrave CV2 4HF<\/span><\/p>\n

Patient Name<\/span>:      Mr Lord Ellison<\/span><\/p>\n

DOB<\/span>:                       20\/04\/1976<\/span><\/p>\n

Address<\/span>:               36, New Avenue road<\/span><\/p>\n

                               Marcion<\/span><\/p>\n

                               CH2 3 DP<\/span><\/p>\n

Occupation<\/span>:         builder since 10 years<\/span><\/p>\n

History<\/span>:                Regular patient in Boomsgrave health centre in Walsgrave CV2 4HF<\/span><\/p>\n

                               occasionally present with lower back pain and takes anti-inflammatory<\/span><\/p>\n

                               had spinal x-ray 2 years ago – some narrowing of L3- 4, signs of osteoarthritis<\/span><\/p>\n

                               type -II DM controlled by diet and exercise<\/span><\/p>\n

18\/03\/2018<\/strong><\/p>\n

                              Sudden onset of lower back pain while working.radiating to left side and then to the down          <\/span><\/p>\n

                               left thigh. Took ibuprofen which settled pain but worse this morning. <\/span><\/p>\n

                               Didn’t go for work due to the pain.<\/span><\/p>\n

                              Tenderness around the lower spine, walks slowly.SLR positive on left side at 45 <\/span><\/p>\n

                               degree.normal strength on both legs.pain inhibiting flexion and extension.<\/span><\/p>\n

Assessmen<\/strong>t:     possible disc prolapse<\/span><\/p>\n

Treatment<\/strong>:       Proper bed rest -3 days,paracetamol; 1 g, NSAIDs, hot water bottle on back, follow -up in 3 days.<\/span><\/p>\n

21\/03\/2018<\/strong><\/p>\n

                             no change, neuro obs – normal<\/span><\/p>\n

                             complaints of pain but no worsening<\/span><\/p>\n

Assessment<\/strong>:   No change in symptoms<\/span><\/p>\n

Treatment<\/strong>:     Continue treatment as before.NSAIDs increased to 4x daily, follow up visit after 3 days.<\/span><\/p>\n

24\/03\/2018<\/strong><\/p>\n

                            Back pain, radiating pain in legs, especially at night. urine test- glycosuria 2 plus(NAD)<\/span><\/p>\n

                            walk slowly, difficulty in movement, Random blood glucose-14 mmol<\/span><\/p>\n

Assessment:<\/strong>  symptoms worse .inactivity making diabetes symptoms worse<\/span><\/p>\n

Treatment:<\/strong>     Code\u00efne phosphate 30-60 mg x 4 hourly.diet modification recommended- diabetes<\/span><\/p>\n

27\/03 \/2018<\/strong><\/p>\n

                            Urgent visit to the patient’s home. Pain increased overnight in the back and left leg. Pain <\/span><\/p>\n

                            uncontrollable by oral medication.numbness on the left leg.<\/span><\/p>\n

                            Unable to get out of bed.no ankle reflexes, decreased toe extension, pinprick sensation <\/span><\/p>\n

                            decreased. blood glucose- 16 mmol<\/span><\/p>\n

 <\/span><\/p>\n

Assessment<\/strong>:  uncontrollable y medication.? for nerve root compression and disc prolapse<\/span><\/p>\n

Treatment<\/strong>:    Arranged ambulance transport to Watford hospital emergency department, arranged an <\/span><\/p>\n

                           orthopaedic assessment through phone.<\/span><\/p>\n

 <\/span><\/p>\n

Write a letter to Dr Koshy Sandik, Watford Hospital, Watford, Cv2 4DX<\/span><\/p>\n

 <\/p>\n

 <\/p>\n

27\/03\/2018<\/p>\n

Dr Koshy Sandik
\nWatford Hospital
\nWatford
\nCv2 4 DX<\/p>\n

Dear Dr Sandik<\/p>\n

Re: Mr Lord Ellison, DOB: 20\/04\/1976<\/p>\n

I am writing to transfer Mr Ellison to your facility for urgent hospitalisation and further orthopaedic assessment since he is suspected to have nerve root compression and disc prolapse.<\/p>\n

Mr Ellison is a builder who has had narrowing of L3-4 and signs of osteoarthritis for two years, and his occasional back pain was managed conservatively. On 18\/03\/2018, he presented with sudden onset of severe back pain on his left side, which was radiated down to the back of the left thigh. On assessment, he had symptoms suggestive of the above-mentioned condition, and he was treated with symptomatically.<\/p>\n

Last three days of consecutive visits showed that Mr Ellison had no change in his pain; however, it is not worse. He had difficulty in movement and walked slowly. He was received the same medication with an increased frequency of anti-inflammatory. In addition, he was recommended for diet modification since his inactivity leads to worse diabetic symptoms.<\/p>\n

Today, Mr Ellison was visited urgently because his affected leg became numb, confined to bed, and the pain was uncontrolled by the prescribed medications. Examination revealed that decreased toe extension and decreased pinprick sensation with no ankle reflexes. Along with that, his blood glucose level increased to 16 mmol.<\/p>\n

In view of the above, kindly provide immediate evaluation and intervention at the earliest.<\/p>\n

Please contact me for further queries.<\/p>\n

Yours sincerely<\/p>\n

Public Health Nurse
\nBoomsgrave health centre
\nWalsgrave
\nCV2 4HF<\/p>\n

 <\/p>\n

 <\/p>\n

 <\/span><\/p>\n

 <\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Reading-5 minutes Writing- 40 minutes  You are a Public health nurse in Boomsgrave health centre in Walsgrave CV2 4HF Patient Name:      Mr Lord Ellison DOB:                       20\/04\/1976 Address:               36, New Avenue road         […]<\/p>\n","protected":false},"author":1,"featured_media":14121,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[122],"tags":[],"class_list":["post-15191","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-oet"],"acf":[],"_links":{"self":[{"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/posts\/15191","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/comments?post=15191"}],"version-history":[{"count":0,"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/posts\/15191\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/"}],"wp:attachment":[{"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/media?parent=15191"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/categories?post=15191"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/s420.previewbay.com\/tijus\/wp-json\/wp\/v2\/tags?post=15191"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}