THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR PATIENT'S PROBLEMS THROUGH SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY EXPERTS WITH AN AIM TO SOLVE THOSE PATIENT'S CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUTS.
This is the case of a 55 yr old male who is suffering with neck pain since May 2024. By profession he had to ride bike daily for 1-2 hrs which aggravated his shoulder pain and had relief only when he lied on the bed. Day by day his pain increased and developed a stiff neck.
He used a cervical pillow and neck collar advised by a local physician. He found relief more when laying on bed. Slowly after 2-3 months he felt better.
Now again the patient is suffering with neck pain and uneasiness to move the neck freely. He is feeling imbalance while walking and pressure on his knees. At present the patient is under the medication of Blood pressure and cholesterol.
PA - Hatur ei point ekta pain hoy ja hatachola korle bare r siri othanama korte bises kore namer somoy
balance harie jay .sue thakle relief pay.
Translation - "There's a point in the knee where pain occurs, which increases when walking and
especially when going up and down stairs, particularly when coming down. Balance is lost during this.
There's relief when lying down."
[05-03-2025 08:07] PPM 1: Hater majher angul fold korte bes lagche ..
[05-03-2025 08:07] PPM 1: Ki korbe pl bolun..jodi kono test korte hoy bolben..
[05-03-2025 08:07] PA: Bes kichudin holo
[05-03-2025 08:07] PA: R gharer problem ta last June theke
[05-03-2025 08:07] PA: Oi somoy pray 15 days bed ridden chilo ,marattok kosto peyechilo
[05-03-2025 08:07] PA: Gharer collar r ekta spondylitis pillow use kore komechilo.orthopedic
dekhiechilen
[05-03-2025 08:07] PA: Pressure, cholesterol medicine khay r dry eye problems.
[05-03-2025 08:07] PA: Kajer jonno bike chalay khub
[05-03-2025 08:07] PA: Pither diker Reeb box r kache khub lagche .phone besikhon dhore rakhte
parchena
[05-03-2025 08:07] PA: Pressure r cholesterol medicine khay
"It's quite painful to fold the middle finger of the hand. Please tell me what to do, and if any tests are
needed, let me know. It's been a few days. The back problem has been there since last June. At that
time, I was bedridden for about 15 days and experienced severe pain. Using a collar and a spondylitis
pillow helped reduce it. I consulted an orthopedic doctor. I take medicine for blood pressure and
cholesterol and have dry eye problems. I ride a bike a lot for work. There's a lot of pain near the rib box
at the back. I can't hold the phone for long. I take medicine for blood pressure and cholesterol."
[05-03-2025 14:52] PA: He used cervical pillow and neck collar as per doctor's advise and almost bed
ridden for 2-3months. after he feels better and back in his normal activities.
[05-03-2025 15:03] PA: Now he feels again' neck pain and uneasiness to movement.Even he feels unstable when he steps ...
[05-03-2025 15:05] PA: He also feels that his knee twist when he walks.
[05-03-2025 15:06] PA: Now he takes cholesterol nd blood pressure medicine.
[05-03-2025 15:07] PA: What should he do pl suggest him
[05-03-2025 15:15] PPM 1: We need to see these films
Didn't we do any X-rays when he came here in our hospital?
[05-03-2025 15:16] PPM 1: To begin with, please add his immediate advocate here and ask him to share
his daily food plates and hourly activities
[05-03-2025 15:26] PA: No.
PA - Dinner at 10.09pm with rice aloo curry and pickle.
PPM 1 - 👍
[06-03-2025 06:56] PPM 1: Please do also mention the patient's hourly activities.
[06-03-2025 07:00] PA: He wakes up in the morning at 8 'O'clock then he takes a glass of hot
water. After freshening up he takes a cup of black tea with a thin arraroot or Marry biscuits.
[06-03-2025 07:03] PA: 8.30Am -He walks in his balcony or roof top and do light stretching exercises.
[06-03-2025 07:05] PA: Then he lies down on the bed for few minutes and after that he takes mobile or
read newspaper.
[06-03-2025 07:19] PPM 1: Did he feel any pain today or yesterday during the stretching exercises?
[06-03-2025 07:23] PA: Yes, little pain and confused that now he has to continue or stop for few days?
[06-03-2025 07:28] PA: After 9.15 he goes to bath and washes his everyday clothes. Then he carries
them up to the 3rd floor. Almost twice a week, he fills a bucket and washes with soap and even the
bedsheets, pillow covers,etc.,have to carry to the 3rd floor with that heavy bucket. After doing this he
feels tired.
[06-03-2025 07:28] PPM 1: Where and when exactly does he feel the pain during stretching? Can he
share a deidentified video of his stretching exercises and point to when and where does he feel the
pain?
[06-03-2025 07:29] PA: Ok, will share after few hours.
PPM 1 - Check out the deidentified video posted by one of our other patients here👇
[06-03-2025 07:31] PPM 1: That sounds like tiring work and should keep him physically fit. I also
gather he doesn't feel pain during that work.
[06-03-2025 07:35] PA: He is a very hard working man.
[06-03-2025 07:54] PPM 1: Would be interested to know how he became bedridden once earlier.
[06-03-2025 07:55] PA: Sharing his daily routine
[06-03-2025 07:56] PPM 1: Yes
Also need to know the details of these events👇
05-03-2025 08:07] PA: Bes kichudin holo
[05-03-2025 08:07] PA: R gharer problem ta last June theke
[05-03-2025 08:07] PA: Oi somoy pray 15 days bed ridden chilo ,marattok kosto peyechilo
[06-03-2025 07:56] PA: Yes
[06-03-2025 08:02] PA: At the end of April he felt neck pain, stiffness, leg calf muscle cramps,
abdomen problems like uneasiness, indigestion, bloating, constipation etc several times. He is good
human being but very short tempered with very loud voice ...
[06-03-2025 08:04] PA: Sorry, it is by the end of Feb 24
[06-03-2025 08:07] PA: But end of March he looks like very tired, it was starting of summer, very hot
weather.
[06-03-2025 08:07] PPM 1: Was he absolutely alright before that?
[06-03-2025 08:08] PA: Although he continues his daily work.
[06-03-2025 08:10] PA: Almost but he has a chronic anxiety problem and appetite problem throughout
the year. but that time he has no neck pain.
[06-03-2025 08:11] PA: His morning Tea
[06-03-2025 08:11] PA: Without sugar
[06-03-2025 08:17] PA: By the end of April his pains were increasing in different parts like
neck, back side, knee, at several times it was really irritating for him.
[06-03-2025 08:21] PA: Few days after that he was unable to do his daily work and
became bedridden due to stiffness of neck with severe pain.
[06-03-2025 08:24] PA: 1st week of May he lost his father and it
was a great loss to his family and then he was very upset.
[06-03-2025 09:00] PA: Oh! Sorry it was 9 th June he lost his father permanently. Few days after that
in his area someone organised a meditation workshop for 5days and luckily, he
attended this program and it was very effective for him from pain and stressed life.
[06-03-2025 09:23] PA: Then he practices Sudarshan kriya and meditation. At 10 am he eats rice with
boiled potato or curry. After that, he takes some rest and goes out on a bike for his work. Between
12.30 to 1pm he has black tea fried chola. Then at 2 pm he returns home and uses the toilet for second
time, and from 2.30 to 3pm he has lunch. Afterwards lies down on the bed, takes rest, spends time on
his mobile and listens to songs. At 5.30 pm,if there is any work, he goes out again and then has one
cup of black tea. If needed, he even rides his bike for 1-2hours .after that between 7.30 to 8 pm he has a
light snack with little puffed rice. Then at 9.30 he returns home, freshen up, and at 10 he has
dinner. After one and half hours, he drinks water and then watches Tv until about 11.30pm. Then, from around 12.30, he uses his mobile before going to sleep. Between lunch and dinner, he smokes one
cigarette or bidi otherwise he can't sleep or his energy drops. and he ends up getting a cold. He smokes
3-4times. At night, if he takes a long time to fall asleep or don't get deep sleep he has to use toilet 2-
3times.
[06-03-2025 09:28] PA: Now he suffers mouth sores (which called slesha gha due to deficiency of vit c)
on both sides of his tongue.
[06-03-2025 09:29] PA: He takes cholesterol and blood pressure medicine daily
[06-03-2025 09:32] PA: Last month he tested urine routine test for time taking urination and 2_3times
he has to urinate at night. or day during when he takes short rest.
[06-03-2025 09:32] PA: It was normal.
[06-03-2025 10:30] PPM 1: Please share his cholesterol medication image here.
That could be an important reason for his current symptoms.
If he has never had any heart attack or brain attack then that medicine may be stopped after confirming
with the local doctor who prescribed it
PA - Cholesterol and blood pressure medicine takes as per doctor's advice in 2023. After that he didn't
go for further but medications and continuing the above medicines.
[06-03-2025 12:28] PA: This is 21/9/24 dated blood reports, after one year taking those medicines.
[06-03-2025 12:30] PA: Pl tell me what should he do or need to do any test?
[06-03-2025 12:32] PA: Today he woke up at 8am. Then hehad a glass of warm water.
[06-03-2025 12:33] PA: After freshening up he took cup of tea and biscuit at 8.30am
[06-03-2025 13:02] PA: The patient had black tea and nuts.
[06-03-2025 14:46] PA: The patient completed his lunch with rice and curries.
[06-03-2025 15:44] PA: After lunch the patient takes some rest and listening songs.
[06-03-2025 16:41] PPM 1: Serial lipid profile report?
[06-03-2025 16:42] PPM 1: 👆Date?
When was the first lipid profile done?
[06-03-2025 16:43] PPM 1: 👆this tablet rosumep 5/160 can be stopped. It could be one of the possible
reasons for his symptoms
[06-03-2025 16:44] PA: All reports are 21/09/24 dated.
[06-03-2025 16:47] PA: Should he check once again before withdrawal?
[06-03-2025 16:57] PPM 1: Can.
[06-03-2025 16:57] PPM 1: Try sharing the profile that made his doctor start him on the
rosuvastatin and fibrate medicine
[06-03-2025 16:58] PA: Pl write down the patient for which test is needed
[06-03-2025 16:59] PA: Ok
[06-03-2025 17:00] PPM 1: Serum fasting lipid profile
[06-03-2025 17:00] PA: This is
[06-03-2025 17:01] PPM 1: 👆 need to see that lipid profile after which he was started on
the medicine
[06-03-2025 17:04] PA: After 1 year of starting rosumep.
[06-03-2025 17:05] PA: Rosumep
[06-03-2025 17:08] PA: When he started 1st time TG was 285 and after 1 year taking
rosumep it is 81(5 months ago)
[06-03-2025 21:38] PA: Patient had dinner at 9.30pm.
[06-03-2025 21:57] PPM 1: Can stop cholesterol medicine.
[06-03-2025 22:03] PA: Should the patient get done lipid profile test tomorrow?
[07-03-2025 08:24] PPM 1: Can get it fasting anyday.
[07-03-2025 10:49] PA: The patient woke up at 8am.
[07-03-2025 10:55] PA: After freshening up he got done test for lipid profile and fasting blood sugar.
After that drinks a cup of black tea with biscuit and then takes bath. Then he does meditation and eats
rice and takes rest and went for work.
[07-03-2025 10:56] PA: Patient had breakfast with rice, curry and dal.
[07-03-2025 14:52] PA: The patient had lunch with rice and vegetables.
[07-03-2025 14:53] PA: After back from work the patient had lunch and relaxed for some time.
[07-03-2025 15:47] PPM 1: Goes for own work? Please share what work activities he does.
[07-03-2025 19:30] PA: The patient is an insurance agent has daily tasks such as customer
service, collecting, payments submitting documents etc, also have to go out on a bike for his work.
[07-03-2025 19:33] PPM 1: Will be nice to know about his hourly activities during the 24 hours as to
when he's doing collections and when he's submitting documents etc
[07-03-2025 19:51] PPM 1: Seen the lipid profile.
Please ask him to stop the medicine
We can repeat the lipid profile three months later
[07-03-2025 21:08] PA: Ok
[07-03-2025 22:31] PA: Patient had dinner at 10.30 with rice, curry and dal.
[08-03-2025 07:46] PA: After he wakes up the patient takes a glass of warm water and then he takes a
Cup of tea with biscuit
[08-03-2025 10:01] PPM 1: Thanks this is his activities in general.
We need to know what he does in real time here hourly if possible.
[08-03-2025 11:01] PA: He takes lunch at 9.15 am
[08-03-2025 11:04] PA: At 9.30 he goes for own work from outside on bike.
[08-03-2025 11:05] PA: Almost the whole day he has to stay outside.
[08-03-2025 18:52] PA: The patient ate dosa and sambar in the evening around 4.30 pm.
[08-03-2025 18:53] PA: He takes black tea and chola at 6.50pm
[08-03-2025 19:56] PPM 1: Please share what he did hourly while outside the whole day
[08-03-2025 22:40] PA: Patient had dinner at 10pm with rice, dal and sabji.
[08-03-2025 22:54] PA: Whole day daily routine while outside.
[09-03-2025 08:15] PA: The patient wakes up at 8am. after that he takes a glass of warm water and then
a cup of black tea with biscuit.
[09-03-2025 11:30] PA: The patient takes his breakfast with 6 puris, 1 bowl of aloo dum and bowl of
sweet mihidana
[09-03-2025 11:31] PA: Breakfast completed10 am
[09-03-2025 12:00] PPM 1: Thanks
[09-03-2025 12:00] PPM 1: Another PaJR patient breakfast 👇
[09-03-2025 12:01] PPM 1: Another PaJR patient Sunday hourly activity log 👇
[09-03-2025 12:54] PA: Now, he takes black tea.
[10-03-2025 08:22] PA: Patient wakes up at 8 am and after that he takes warm water and then drink a
cup of black tea with biscuit.
[10-03-2025 08:26] PPM 1: Can avoid biscuits
[10-03-2025 10:32] PA: Patient had lunch at 10.24 am with rice, dal and sabji.
[10-03-2025 10.35] PPM 1: 👍
[10-03-2025 15.05] PA: Patient had lunch with rice, dal and vegetables.
[10-03-2025 19:42] PA: Can anyone suggest a medicine for mouth sore(ulcer)? The patient is suffering
since last 15 days. It is really painful while taking food ...
[10-03-2025 19:53] PPM 1: Zytee gel to be applied in the sore areas of the mouth
[10-03-2025 19:57] PA: Evening break.
[11-03-2025 07:34] PA: Patient had his dinner at 10 pm.
[11-03-2025 08:01] PA: Patient woke up in the morning at 8 am. after that he takes a glass of warm
water.
[11-03-2025 10:47] PA: The patient completed his breakfast with this plate.
PPM 1 - 👍
[11-03-2025 17.43] PA: The patient had his lunch at 4.30 pm with rice and vegetables.
[11-03-2025 22:18] PA: Dinner plate
[12-03-2025 07:54] PPM 1: Needs vegetables.
[12-03-2025 07:56] PA: Takes a glass of warm water.
[12-03-2025 08:03] PA: Patient takes black tea with nuts.
[12-03-2025 09:24] PA: The patient does daily stretching exercises for15min continuously and then
relaxes for some time.
[12-03-2025 09:30] PA: Take the bike out of the garrage everyday in the morning., then he takes rest.
[12-03-2025 11:29] PA: He washes regularly his clothes during bathing time.
[12-03-2025 14:47] PA: The patient had his lunch with this plate at 2.30pm
[12-03-2025 16:48] PPM 1: Maybe once in a while to get a pictorial idea of what a human being does as
daily activities hourly. It could be useful to get more activities data as sometimes humans find it easier
to share images around them and their activities rather than text about it
[12-03-2025 21.41] PA: Patient had puffed rice bhel.
[12-03-2025 23.16] PA: Dinner with rice and aloo sabji.
PPM 1 - 👍
[13-03-2025 09.52] PA: The patient had a glass of warm water and after a while had cup of black tea
and nuts.
[13-03-2025 14:58] PA: Patient had his lunch at 2.30pm with rice, vegetables and chutney.
[13-03-2025 22:54] PA: Patient had dinner at 10pm with rice, dal and aloo curry.
[14-03-2025 08:07] PA: Patient takes black tea in the morning.
[14-03-2025 08:36] PPM 1: 👍
[14-03-2025 11:12] PA: At breakfast patient had rice and aloo fry.
[14-03-2025 16.04] PA: Lunch with rice curry and chutney.
[14-03-2025 22.38] PA: Rice with sabji
PPM 1 - 👍
[15-03-2025 07:53] PA: In the morning the patient takes a glass of warm water
[15-03-2025 07:57] PA: He takes black tea
[15-03-2025 09:16] PPM 1: 👍
[16-03-2025 11.07] PA: The patient had breakfast with the above items.
[16-03-2025 13:20] PPM 1: No vegetables?
[16-03-2025 13:21] PA: Yes
[16-03-2025 13:22] PA: Sunday special tiffin.
[16-03-2025 16.09] PA: The patient had lunch with rice dal and vegetable curry
[16-03-2025 22.12] PA: The patient had dinner with rice dal and aloo sabji and chutney.
PPM 1 - 👍
[17-03-2025 08.21] PA: Patient had glass of warm water and black tea.
[19-03-2025 15.44] PA; Lunch with roti and sabji
PPM 1 - 👍
[19-03-2025 22.25] PA: Dinner with rice, vegetables
PPM 1 - 👍
[25-03-2025 10.14] PA: Breakfast rice dal and curry.
[25-03-2025 15.07] PA: Lunch rice with vegetables.
[26-03-2025 08.04] PA: Black tea in the morning.
[27-03-2025 10.10] PA: Breakfast rice dal and curries
[28-03-2025 10.31] PA: Breakfast rice and dal.
[28-03-2025 16.09] PA: Lunch with rice, aloo sabji
[28-03-2025 16:27] PPM 1: 👍
[28-03-2025 16:27] PPM 1: Hourly activities?
No comments:
Post a Comment