Monday, January 29, 2007

PAIN

Hello all!

I am curently in my musculo prac and have been dealing with a very challenging patient- but learning lots from him! A 61 year old male walked in on O2 as he has severe COPD and was in hospital last year with core pulmonale. He first presented with severe Lx pain limitimg all movements and bilateral neural signs ans sympotms down both legs as well as cauda equina S+S. (now don't worry this is all in conjunction with Dr's orders). Oh and did I mention he's severely obese.

SO as you can see he was highly irritable so I was unable to do PAIM's or place him in prone. So I treated him the best I could with some PIVM's (quite challenging for me and I'm not a weak girl!). Then sent him home with some exercises! He came back saying the back pain was getting better (as in a 8/10 instead of a 10/10!) but came with a second referal from the Dr to treat his severe pain in Cx and Tx limiting all movements as well as having bilateral neural S+S in his arms and hands! Sooooo (after another long inital assessment for this problem) I have been treating him each session for all of his spine!

This proves to be a great challenge as a student but also as it it very hard to treat him as position changes are very aggravating. I have learnt a great deal from this patient both in the theory part of it as well as seing him (and his fabulous wife) keep his sense of humour when he clearly has a very LOW QOL! Gives you something to ponder.....

Nic

1 comment:

Minh said...

I agree with you that some patients can be very inspiring. As physios, we pretty much are all able bodied, and I feel that we take this for granted at times. Back in my cardio placement, there was a patient with a complete C0-C1 complete transection of the spinal cord. Most of the nursing and PT staff thought saving his life may have been a diservice to him. That turned out to be huge mistake, becaue this patient remained extremetly positive throughout the course of his management. He learned to use a mouse with mouth and was emailing his friends everyday. The human spirit is absolutely incredible.