Elderly Client Project, Essay Example

The client chosen for this project is a 76 year-old female with lower-back degenerative arthritis that is, according to X-Rays, considered to be severe.

This client first complained to her general physician (GP) during her 1997 annual physical.  She was referred to a well-known and respected physiotherapist, whom she visited two to three times a week for one hour sessions.  Any benefits that the client received during these sessions did not last throughout the night.  Consequently, her doctor added two registered massage sessions each week.  Since the client complained to her GP during her 1998 annual physical that her pain was getting worse, not better, an X-Ray was ordered, which showed mild to moderate arthritic degenerative changes in her lower back.  The doctor arranged for her to have two sessions a week in the hospital’s warm exercise pool.  She was prescribed various pills, but felt after awhile that taking extra strength Tylenol gave her greater relief.  Her doctor also recommended using topical medications; such as Traumeel ointment, hot and cold ointments and pain patches.  Her physiotherapist sold her a beanie bag to be microwaved and put behind her back periodically throughout the day.  In 2000, the client’s GP ordered another X-Ray.  This time it showed moderate to severe degenerative lower back arthritis.  Her pain was least when she sat in her soft chair with a heated beanie back behind her back, so she sat there a lot with the result that she gradually put on weight, which was explained to her could only make her situation worse since it put more stress on her back.  She was advised to exercise more, but to limit weight-bearing exercises.  Her right leg began to hurt, all the way down to her big toe.  She was referred to a couple of specialists.  In 2002 when another X-Ray was taken, it showed her pain as being severe.  She was sent to an acupuncturist and to a pain management clinic.

The client was also seen by a chiropractor who discovered that one of her legs was shorter than the other one.  He prescribed orthodics, with the heel of the left one to be built up so that her legs would be of equal length.  She still wears these most of the time, inserted in a rolling-type (recommended) running shoe.  Several years ago, the client received two pain injections, two months apart, at the local hospital, but when they failed to be of much help, she stopped.  Her GP then persuaded her to have pain injections in the X-Ray room at the hospital, with the doctor carrying out this procedure watching it carefully on X-Ray as it was taking place.  She did not have this procedure again.  Next her GP persuaded her to get injections every two months from a travelling pain management physician, using ultra sound as a guide..  These helped the most, but were very painful.  Finally, her GP referred her to an orthopedic surgeon who said that no surgical intervention was recommended at this time.

The medical care that this client has received is very comprehensive and in line with present research.  Newell (March 30, 2010) says that”many back and disc problems can be resolved with a multi-faceted and conservative approach.  This may include medication, physical therapy, and the use of back braces.” The client has been having medication and physical therapy, but is not yet in need of back braces.  Exercises to strengthen certain muscles and aerobic exercises to lose weight are also recommended (ibid.).  Mooney points out that an accurate diagnosis is essential saying that “the patient may have degenerative disc and bone spurs, but it is the  ostheoarthritis, in the facet joints that is causing the patient’s pain on motion.”Anti-inflammatory medications to relieve both inflammation and pain are also used.

Other than the discussed chronic condition, this client believes her health to be good.

References

Mooney, V.  Osteoarthritis complete treatment guide.  Retrieved on October 09, 2012, from http://www.spine-health.com/conditions/arthritis.

Newell, L. (March 30, 2010).  Discs and lower back problems.  Retrieved on October 09, 2012, From http://www.livestrong.com/article/99739-discs-lower.