Confidentiality Disclaimer - This essay uses patient initials only. No identifying features are included within this essay.
Patient: BA
Patient’s age: 63 years old
1. Medical conditions (active) :
After taking the patient’s medical history, I found out that the patient experiences several active medical conditions. She was diagnosed having rheumatoid arthritis, diabetes type II, sleep problem, high blood pressure and high cholesterol.
She got rheumatoid arthritis when she was 49 years old, and has been having this for 14 years. She will feel the pain at places involving joints like the hands, knees and hips. She also feels the pain in the area around her head and neck, which contributes to headache. This is actually a condition where our immune system which is supposed to fight infection, attacks the cells lining our joints, causing them to be swollen, stiff and painful, and in process, damaging the joint, the cartilage and our nearby bone1. The sharp pain she feels usually radiates from her heels to her hands. Walking is really painful for her due to the inflammation of the joints. This condition is worsened during hot weather and if she feels stress, where it triggers pain most. Not only that, she feels exhausted and tired easily after doing any activities and thus, she tends to sleep a lot due to this illness.
The patient also has a condition called fibromyalgia, which is a disorder that causes muscle pain and an extreme feeling of tiredness (fatigue)2. Patients will experience chronic fatigue syndrome and achy muscles, and this is treated with anti-inflammatory medications. Fibromyalgia affects her lifting ability, which limits movement and activities such as shopping. According to the patient, this bothers her ...
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9. National Heart, Lung and Blood Institute. What is COPD? [Internet]. United States : U.S. Department of Health & Human Services; 2013 [updated July 31]. Available from : http://www.nhlbi.nih.gov/health/health-topics/topics/copd/
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11. Cleveland Clinic. Occupational and physical therapy for arthritis [Internet]. Ohio : Cleveland Clinic; 2012 [updated September 17]. Available from : http://my.clevelandclinic.org/disorders/arthritis/hic_occupational_and_physical_therapy_for_arthritis.aspx
12. MedlinePlus. Type 2 diabetes – self care [Internet]. United States : National Institutes of Health; 2013 [updated October 31]. Available from : http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000328.htm
...health of a patient and a follow up check at the GP’s may be required.
A 61-year-old gentleman was admitted on 25/1/2016 to Letterkenny General Hospital with central chest pain after history of a fall. He also had drastic weight loss and loss of motor and sensory function. He walks with the aid of a walking stick as he has problems walking due to his lower limb weakness. The patient was a heavy smoker of 90 pack years (3 packs/day for 30 years) and stopped nine years ago. He stopped drinking seven years ago. He is married and lives at home with his wife. He works as a plasterer. He has a strong family history of ischaemic heart disease and type 2 diabetes mellitus. Two of his brothers had coronary bypasses and stents. His father died of a myocardial infarction. Two of his brothers are also type 2 diabetics. During
Fibromyalgia Syndrome (FMS) is a musculoskeletal illness (which causes chronic pain) and a chronic fatigue disorder. It can also change sleep patterns and cause the following: digestive disorders, chronic headaches, painful menstrual periods, temperature sensitivity, morning stiffness, numbness or tingling of extremities, and even cognitive memory problems. The name fibromyalgia comes from "fibro" in Latin meaning tissue, "my" in Greek meaning muscle, and "algia" (also Greek) meaning pain.(source 5)
Journal of Continuing Education in Nursing, 44(9), 406. doi:10.3928/00220124-20130617-38. Torpy, J. M. (2011). The 'Standard' Diabetes. Jama, 305(24), 2592 pp.
Diabetes Programs: The Scripps Whittier Diabetes Institute Experience. Curr Diab Rep Current Diabetes Reports, 14(2). Doi:10.1007/s11892-013-0462-0
International Journal of Epidemiology 36.6 (2007): 1229-234. International Journal of Epidemiology. Oxford University Press, 28 Sept. 2007. Web. The Web.
Dutton, M. (2012). Dutton's Orthopaedic examination, evaluation, and intervention (3rd ed.). New York: McGraw-Hill Medical.
P ICOT? Individuals with type II diabetes as well as their families and their healthcare professionals are impacted by this problem. The intervention identified as best practice focus on direct nursing support as the most effective management in diabetes patients. Interventions focused on management strategies prescribed by nurse practioners and medical doctors. The study results indicate that the use of direct patient support provided by nurse practioners were most effective for compliance and increasing management in diabetes
Richard G. Wilkinson, M. G. (2003). The Social Determinants of Health: The Solid Facts. Denmark: World Health Organization.
During my residency, I had the opportunity to work with the Rheumatology Rehabilitation team at the University of Alberta (U of A). I met passionate mentors in physical and occupational therapy dedicated to helping arthritis patients preserve and optimize joint function. There was one man with rheumatoid arthritis attending the program who said the most important learning point he wanted me to take away was how much his rheumatologist and the rehab team had changed his life. Prior to starting biologic therapy, he was completely debilitated in his day-to-day life and unable to perform simple activities such as picking up his young children. He now found himself not only with disease control, but also quality of life. I value the multidisciplinary approach in rheumatology and emphasis on treating the “whole” patient, rather than a single organ
Mayo Clinic Staff. (2011, May 2). Treatments and drugs. Retrieved Febuary 1, 2012, from Mayclinic: http://www.mayoclinic.com/health/rheumatoid-arthritis/DS00020/DSECTION=treatments-and-drugs
Journal of Diabetes Science and Technology: Self-Monitoring of Blood Glucose: Practical Aspects. Retrieved from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2864180/. Taylor, C., LeMone, P., Lillis, C., & Lynn, P. (2008). Fundamentals of nursing: the art and science of nursing care (6th ed.). Philadelphia, PA, Lippincott Williams & Wilkins, a Wolter Kluwer business.
World Health Organization, 3 September 2007. Web. The Web. The Web. 4 Apr 2011.
38 patients were enrolled, the demographics data as table 1. Most of AS patients were male(92.1%) mean age was 35.03 ± 11.57 years and duration of symptom was 9.29 ± 7.77 years. There were 15 patients had arthritis symptom (39.5%) and 11 patients had fatigue symptom (28.9%). Mean laboratory studies was 47.34 ±37.32 for ESR and 31.04 ± 46.62 for CRP. There was one patient who did not have CRP result in this study.
Medicine presents a myriad of complex puzzles waiting to be solved. Though not for the faint of heart, Internal Medicine allows for a daily dose of these complex diagnostic and treatment problems. During my Internal Medicine rotation, one of my most memorable cases was a 44-year-old who presented with shortness of breath, cough, night sweats, fever, focal neurological