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Prep 7/31

QuantiFERON appointment 9:40 AM

(Leave by 10:30 AM, try to get lunch)

 

11:15 AM START

 

12:45 AM Ortho Eval (no doc)

  • 78 y/o male

  • H/o cardiomyopathy, CHF (recent phase II monitored)

  • H/o trigger finger B

  • Neck and back pain radiating into the hand

Subjective:

- Hx of symptoms:

- Description of symptoms:

- Agg/ease?

- Headaches? (flexion rotation, muscle length)

- Weakness?

- History of neck or arm surgeries?

- Work

- PLOF

- Home environment + Roommates + R/L handed

 

Physical exam:

- Vitals

- Neck ROM

- Strength: C1-C8

            - C1-C2 neck flexion/extension

            - C3 lateral neck flexion

            - C4 shoulder elevation

            - C5 shoulder abduction/flexion

            - C6 Biceps (+ wrist extension)

            - C7-8 Triceps (+wrist flexion)

            - Thumb extension (C8/T1)

- Sensation C1-C8

- Cluster

- Rotation < 60 deg

- Spurling’s

- ULTT

            -

- Distraction

 

 

 

1:30 PM S/P L TKA, LBP

  • 1ST follow-up visit (possibly associated back pain)

  • Quad sets + ankle pumps

  • SLR with quad set

  • SAQ

  • Heel slides

  • LAQ

  • Kickbacks

  • Mini squats

  • Calf raises

 

2:15 PM L TKA f/u (document)

  • Manual therapy

  • Assisted ROM exercises

  • Strengthening – Split squat, lateral step ups (add foam to transition)

  • Dynamic balance – Lunge onto foam on step, single-leg DL, attempt BOSU?

 

3:00 PM – Finish documentation

 

3:45 PM LUNCH

 

4:15 PM – L Knee Pain

  • 22nd visit (!)

  • Leg press double and single leg, step downs, step overs, manual therapy

 

5 PM – R Knee

  • STM adductors (Stretching), stiff trunk, gait training without SPC

  • Lunges at bar, step ups

 

5:45 PM

 

6:30 PM

 

7:15 PM – R Knee

  • Manual therapy

  • Step ups, TRX split squats, step downs

 

- Prep for Tuesday patients

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