Week 2.1 Entry

Upon initial thoughts of the referral letter and documentation this appeared to be another basic case of PFJ pain syndrome and Bec and I were expecting a fairly straight forward assessment…how wrong we were. The individual was a heavy set man, which apart from being a contributing factor for knee pain may also be a factor to consider for several other problems and health issues such as diabetes, hypertension, heel and hip pain and a herniated disc. The history taking was a long process as new issues were constantly being raised as we proceeded. I imagine as our experience builds we will streamline similar cases a lot more but at this point in time we covered every possible angle and still could have asked other questions. Despite all the other issues that were made apparent our main concern, as was pointed out by our supervisor was the knee pain as this was the most debilitating of the conditions and essentially why he was referred on. This was also reiterated as the main issue in the patient’s mind despite the fact that he didn’t show much frustration with how the issue was limiting him which was even more surprising given that he mentioned he had a suffered from depression only 2 years ago. The patient was very easy to communicate with but had to be kept on course repeatedly since the extensive nature of the questioning did not allow for long dialogues on every part of the subjective assessment. The objective part of the assessment was straight forward with the main emphasis being on his patella alignment and the issues associated with this.

With all the issues discovered it would have been easy to be startled with the extent of information given and what do to do with it all. We managed to take everything into account but still focus on the main problem at hand. With a few more patients like this we will learn to target out assessment towards the main problem but at the same time ensure that all areas are covered in case important information is presented. My filling in of the assessment form will need to be improved; with all the information my note taking was a bit scattered and may be hard to decipher by the next physio. Also taking note of the times of the onset of pains will need more attention. As mentioned the patient was a large man and next time I would like to suggest to him in the nicest possible way that losing some weight will go a long way towards reducing his pain. I very subtly mentioned this during this assessment, that he should “Try to attempt any form of exercise within his pain limitations…” Coming up with ideas for progressing his exercise program is required.

I was happy with how the assessment progressed and felt that the patient was comfortable with us. We worked through each aspect of the assessment smoothly and covered each aspect systematically, enabling us to gain a clear picture of what his problems were and how/if they were linked. Our understanding and subsequent explanations of his conditions appeared to make the patient pleased with our we were moving forward. Streamlining the process more and being systematic about the analysis of each condition would make the assessment process more efficient and effective. Ensure that we mention every joint that could be painful and ensuring the patient knows that we want everything and anything that has happened to them in the past to build up a clear full history.
The patient mentioned that he suffered from sleep apnoea. I will look into the details of this condition since he was using a face mask to help him breath during sleep. This has no bearing on his condition or recovery but would be good to know what it’s all about for next time we see him since it is appeared to be a major issue for him.