Question

Despite her adversities and difficulties, Mrs. Fox did extremely well at Helen Hayes Hospital. She displayed...

Despite her adversities and difficulties, Mrs. Fox did extremely well at Helen Hayes Hospital. She displayed only mild impairments to short-term memory, was able to functionally communicate with others, and regained most of the function of her right upper extremity. Furthermore, she learned how to use her prosthetic limb to walk again without the use of an assistive device.

Mrs. Fox was finally able to return to her home in Stony Point. She was elated to see her family and the home environment and was immediately greeted by her golden retriever, Sonny. Occupational, physical, and speech therapy services continued on an outpatient basis for the next 3 months to address any unresolved impairments.

One day, Mrs. Fox drove her customized mini-van to the local high school. Her son Jeff was playing in the first soccer game of the season. As Jeff was running for the ball, he twisted his knee and immediately fell to the ground. In a panic, Mrs. Fox stormed down toward the field but caught her left foot on the bleacher step. With adrenaline flowing through her body, Mrs. Fox hoisted herself back up to check on her son. At the time, it was determined that Jeff had sustained a mild strain of his knee, and was out for the rest of the game (1). After visiting his provider (2), another consultant also found that Jeff had an itchy scaly bald spot on the back of his head, and another similar red scaly fungal like rash near his groin (3). He was treated for both rashes, which cleared while he was home recovering from his knee sprain. After checking with a specialist for his knee Jeff would be back to playing after a few weeks of rest and rehabilitation (4).

The following day, Mrs. Fox stepped outside to take Sonny for a walk. For some reason, Sonny wouldn’t walk, he wasn’t his usual active self. When Sonny suddenly stopped, Mrs. Fox kept walking and the abrupt tension on the leash caused her to firmly hit her left foot onto the ground. She immediately remembered that she had caught her left foot on a step the day before as she fell to the ground in pain. While on the ground she notice a red bull’s eye like spot on her left arm (5). “Maybe that’s why I’ve been feeling a little achier the past few days”, she said to herself. But her attention immediately returned to her left leg. As she made her way back into the house, Mrs. Fox realized that her artificial limb was damaged during one of her recent falls and needed to be repaired (6). She also noticed that Sonny had not touched his food or water. After his check-up (7), it was determined that Sonny had an upset stomach from which he recovered in a few days with treatment.

Mrs. Fox went to see her primary care provider, was given a prescription for antibiotics (8) for her rash and considering her extensive history was the given a name of two additional specialist (9a,b) if she needed more extensive follow-up of the bull’s eye rash Eventually she made it to her physician to take a look at her foot. X-rays (10) demonstrated that she had sustained a fracture and needed to keep weight off of the foot for several weeks. While waiting for her foot to heal, and regain her strength as advised by providers, Mrs. Fox spent most of her time reading, listening to music (11), watching movies with her family and playing with Sonny (12).

Six weeks later, Mrs. Fox returned to the outpatient rehabilitation facility for treatment of her left foot. She mentioned to her therapist that she had also been experiencing headaches (13) which increased in intensity when driving, watching television, and when eating/chewing (14). It was noted that Mrs. Fox’s posture had significantly changed for the worst since she was last assessed and a series of adjustments were considered (15). After further assessment, Mrs. Fox was referred out for further testing (16) as it appeared that changes to visual acuity (17) may have led to poor posture, and poor posture may have led to TMJ dysfunction (18).

Eventually and thankfully, with the input from her large patient centered team members, Mrs. Fox was back to feeling more like herself.

Other than the general categories of physical therapy, occupational therapy, physician, nurse, etc. There are at minimum, 18 specialty providers that might have provided services to Mrs. Fox and her family in this scenario.

Next to the situation or “clue” associated with each number in the scenario, name the specialist or care giver, that most probably was or logically could have been, involved in that step of the saga. For example, instead of physician, name the specialty, i.e. Cardiologist, Neurologist, or if a therapist name which type. Name at least 10.

Lower limb amputees are subject to secondary physical complications. Describe at least (2) Mrs. Fox has encountered. Why did they occur and how may they be decreased in the future.

Homework Answers

Answer #1

Mrs. Fox and her family has got services from the following specialists or therapist:

  • Orthopedic doctor
  • Skin specialist
  • Physiotherapist
  • Prosthetist
  • Gastero enterologist
  • Rheumatologists
  • An infectious disease specialist
  • Neurologist
  • Radiologist
  • Headache or migraine specialist
  • Ophthomologist
  • Chiropractor
  • Otolaryngologist

Mrs. Fox has the following secondary complications due to lower limb amputation:

  • The risk of fall-related fractures that has occurred as a result of low bone mass.
  • Postural changes.

Exercises can be performed to increase strength and flexibility. Because of the potential for a variety of secondary conditions related to muscular imbalance and insufficient bone mass, regular exercise following a change to correct improperly fitted prosthetic devices can lead to long-term health and the prevention of secondary conditions.

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