1 / 3

Mr Tom “44 year old 1,85 m /82,5 Kg Civil servant working 4h a day

Complex/ Uncertain. Complicated/ Knowable. Healthcare Regime Acupuncture Homeopathy Nutritionist. Examination Power good/ S1 reflex absent on L general health: impression of rigid skin and reduced muscle tone. Caffeine abstinence vs. CFS. Case History

russell-cochran
Download Presentation

Mr Tom “44 year old 1,85 m /82,5 Kg Civil servant working 4h a day

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Complex/ Uncertain Complicated/ Knowable Healthcare Regime Acupuncture Homeopathy Nutritionist Examination Power good/ S1 reflex absent on L general health: impression of rigid skin and reduced muscle tone Caffeine abstinence vs. CFS • Case History • Melanoma on upper back removed 2 years ago • Previous foot ball injuries to back • Presents with • LBP after twisting/ sitting badly on a sofa, with pain developing the next day • Agg: flexion, coughing, sneezing • Rel: lying flat, rest • Pain radiating into L post. calf Mr Tom “44 year old 1,85 m /82,5 Kg Civil servant working 4h a day reduced as previously diagnosed with chronic fatigue syndrome 1 year off work and just returned 1 month ago “loves being back” • Chronic fatigue syndrome • aetiology = not understood • Pathogenesis = unknown • Diagnosis of exclusion • Differential Diagnosis • Annular strain at L/S • Disk bulge at L/S Chaos/ Unpredictable Simple/ Known

  2. Complex/ Uncertain Complicated/ Knowable • Flags: • Yellow: • for CFS = indicator of chronisity • Anxiety not to cope • Going backwards = catastrophizing Time line of recovery Uncertainty of CFS in background altering outcomes Potential for crisis Uncertainty = feeling helpless / no agency Mr Tom “44 year old 1,85 m /82,5 Kg Civil servant working 4h a day reduced as previously diagnosed with chronic fatigue syndrome 1 year off work and just returned 1 month ago “loves being back” Beliefs Cause and effect ? “Diet helped the pain” Expectations “Going back to work soon as everything seemed going so well” Ambition “Miracle Cure” said with humour yet real desire! Work Leading position paid sick leading civil servant Chaos/ Unpredictable Simple/ Known

  3. 4 treatments over time Pain Function • Bio psychosocial healthcare • Integration of dysfunctions into big picture • Focusing on the person and their experience “no two back pains are the same” • BUT • If focusing only on “personal • beliefs” there is loss of the sense • for reality with its facts and • rationals • The quintessence must be “faith • and reason” • Critical reflection • Communication as important as TTT (esp. in multidisciplinary approach) • Treat the small picture with eager care in the context of the bigger picture • Always go back to first principles ie. Anatomy

More Related