Granny's gone and done it again

[Granny Hatchet]

'Open me up' never = a good time at the park IMHO.

Last time they 'opened me up' they jerked out my gall bladder.

I can sure sympathize with what you are going through, Granny. You are just to the point where you don't want to hurt any more, aren't you?

yes I am. But I meant open up the blockages. Not me.
My gall bladder is also MIA

 

[Granny Hatchet]

MC did you read my report on my hips? I even have cysts in my hip sockets.

 

[BigBlueHen53]

MC did you read my report on my hips? I even have cysts in my hip sockets.

Twist will say something like, That's why we call you "Cyster" Granny Hatchet....

 

[CapricornFarm]

Cap, is your dizziness any better? Hows your ears?

Better now i am not up on a ladder, thanks Granny. Ears are ok at the moment.
How are you today?

 

[microchick]

MC did you read my report on my hips? I even have cysts in my hip sockets.

No I didn't. I'll have to back track and see if I can find it.

They found one on my cervical spine MRI near my spine. Nobody speculated if that was causing me pain along with the degenerative disc disease and Arthritis.

No wonder you are in so much pain.

 

[Granny Hatchet]

Better now i am not up on a ladder, thanks Granny. Ears are ok at the moment.
How are you today?

Im ok. A little stiff but Ill take it. lol Nervous for tomorrow too

 

[Granny Hatchet]

Subjective:
Patient is here for evaluation and management of new onset Bilateral hip pain. Patient reports lateral sided and groin hip pain for several months. Patient reports previous treatments with anti-inflammatories and activity modification. Patient reports pain with ambulation beyond 100 feet. Reports pain especially that is worsened after sitting for long periods of time. They report difficulty with twisting of the hip to put on shoes and socks. Also reports difficulty with ascending and descending stairs. They have tried anti-inflammatories and rest with no improvement. Referred by Dr. Roman Trimba for bilateral hip pain not back pain. Continuing to have severe and unrelenting pain. She is looking for any and all options. Has a history of previous injections

Objective:
General: Well-developed well-nourished no acute distress
Psychiatric: Pleasant affect alert and oriented to person place time and situation
Gait: Abnormal antalgic bilaterally shortened stance phase
Neuro: Sensation intact to light touch distally on all four extremities, reflexes intact
Skin: Skin demonstrates no rash no signs of infection
Cardiovascular: Regular rate via peripheral pulse examination
Respiratory: Easy work of breathing no use of accessory musculature no audible wheezing
Lymphatic: No evidence of lymphadenopathy in bilateral lower extremities

Musculoskeletal: Focused examination of bilateral hip shows exquisite tenderness to palpation over the greater trochanteric bursa. Positive Stinchfield. Pain with internal/external rotation at the extremes of motion. Slow and antalgic gait with a hip flexion contracture gait. Positive cross adduction sign

X-ray: X-ray examination of the hip and pelvis shows evidence of hip arthritis throughout the femoral head and acetabulum consistent with joint space narrowing, osteophyte formation, subchondral sclerosis, and subchondral cyst formation.

Assessment:
Hip pain
Primary hip osteoarthritis
Hip stiffness

Plan:
I had a long discussion with the patient about the different options for the hip pain present. Patient has tried other conservative treatment options including anti-inflammatories activity modification. We discussed all the different options including but not limited to surgical intervention injections prescription strength anti-inflammatories physical therapy and advanced imaging studies. Patient would like to proceed with more aggressive treatment options to help control the pain. Because of the patient's size and concerning issues with possible avascular necrosis versus femoral head collapse I would like to proceed with a CT scan of the pelvis for evaluation of the bone quality and possible surgical planning for total hip arthroplasty. Patient understands the plan the risk benefits and alternatives we will proceed

here MC

 

[Granny Hatchet]

No I didn't. I'll have to back track and see if I can find it.

They found one on my cervical spine MRI near my spine. Nobody speculated if that was causing me pain along with the degenerative disc disease and Arthritis.

No wonder you are in so much pain.

so far all 3 surgeons want to do Something to me. I just want to start with the blockages. If she tells me they dont need fixing then I will go with the ablation then hips last. I will have to have help for the last one and rides for the others.

 

[CapricornFarm]

Im ok. A little stiff but Ill take it. lol Nervous for tomorrow too

It will be ok, no cutting tomorrow!

 

[Granny Hatchet]

It will be ok, no cutting tomorrow!

Right! Hope I wake up in time. Oh boy, here comes Tom again