BACKGROUND
This week, a 43-year-old white male presents at the office with a chief complaint of pain. He is assisted in his ambulation with a set of crutches. At the beginning of the clinical interview, the client reports that his family doctor sent him for psychiatric assessment because the doctor felt that the pain was “all in his head.” He further reports that his physician believes he is just making stuff up to get “narcotics to get high.”
SUBJECTIVE
The client reports that his pain began about 7 years ago when he sustained a fall at work. He states that he landed on his right hip. Over the years, he has had numerous diagnostic tests done (x-rays, CT scans, and MRIs). He reports that about 4 years ago, it was discovered that
the cartilage surrounding his right hip joint was 75% torn (from the 3 o’clock to 12 o’clock position). He reports that none of the surgeons he saw would operate because they felt him too young for a total hip replacement and believed that the tissue would repair with the
passage of time. Since then, he reported development of a strange constellation of symptoms including cooling of the extremity (measured by electromyogram). He also reports that he experiences severe cramping of the extremity. He reports that one of the neurologists
diagnosed him with complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD). However, the neurologist referred him back to his family doctor for treatment of this condition.
Solution Preview
Assessing and Treating Clients with Hip Pain
Introduction
The patient is aged 43 and is of white origin. The patient has been presented to the health setting with the complaint of hip pain. He is using crutches and during the initial process of assessment of the patient, he indicates that the family doctor sent him to a psychiatrist because of the assertion that the pain was in his head. He points out that the family doctor has the assertion that he is making stuff up. He alludes that the issue of pain in his hip began 7 years ago when he had a fall. This paper helps in the assessment of the medication for this patient.
Decision Point One
The first option that is taken into consideration is to use Savella 12.5 mg orally once daily on day 1; followed by 12.5 mg BID on day 2 and 3; followed by 25 mg BID on days 4-7; followed by 50 mg BID thereafter. The reason for the selection of this decision is that it will help in working on the nerve endings with the production of analgesic effects as alluded to by Stanton-Hicks (2018). The use of the medication will help in the enhancement of the reuptake of the neurotransmitters in the brain. This helps in the reduction of pain.
The expected outcome upon using this medication is to help in the reduction of pain to a level of 3 on a scale of 1 to 10. The other thing is that the patient is expected to be able to walk. Upon returning to the clinic in 4 weeks, it is found that the patient does not use crutches anymore but is seen to be limping but minimally. He reports that he has more pain during the morning as compared to the other times of the day. The pain reported on a scale of 1-10 is 4. This shows that there is an improvement in the health of the patients….
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