
Wedding & Portrait photographer | Washington, D.C.
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)
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78 y/o male
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H/o cardiomyopathy, CHF (recent phase II monitored)
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H/o trigger finger B
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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
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- Distraction
1:30 PM S/P L TKA, LBP
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1ST follow-up visit (possibly associated back pain)
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Quad sets + ankle pumps
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SLR with quad set
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SAQ
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Heel slides
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LAQ
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Kickbacks
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Mini squats
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Calf raises
2:15 PM L TKA f/u (document)
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Manual therapy
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Assisted ROM exercises
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Strengthening – Split squat, lateral step ups (add foam to transition)
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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
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22nd visit (!)
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Leg press double and single leg, step downs, step overs, manual therapy
5 PM – R Knee
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STM adductors (Stretching), stiff trunk, gait training without SPC
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Lunges at bar, step ups
5:45 PM
6:30 PM
7:15 PM – R Knee
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Manual therapy
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Step ups, TRX split squats, step downs
- Prep for Tuesday patients