55F Back Pain 6 Years Telangana Pajr
This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.
Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.
Our patient is 55 years female who is suffering from back pain and legs pain. She shared that she Feels high back pain while getting from bed. Sometimes feels pain in shoulder and neck. She also mentioned that she Gets Pain during folding of legs.
She told us that once she was fallen in bedroom after head bath by skids 9 years back
And she fell from horse during Srinagar visit 5 years ago
She also shared that had been suffering from corns on both foot
(For information please)
The PHR, patient journey record PaJR transcripts below reflect the therapeutic uncertainties around the patient and their resolution through team based learning :
[8/7, 10:06 AM] PaJR Coordinator: Please kindly start posting current symptoms
[8/7, 10:06 AM] PaJR Moderator: Describe how she feels in the morning immediately after getting up from bed
Please kindly describe her daily routine from getting up in the morning hour by hour
[8/7, 10:06 AM] PaJR Coordinator: Since when?
[8/7, 10:06 AM] Patient Advocate : For last seven years
[8/7, 10:06 AM] PaJR Coordinator: Can you share her hourly daily routine before seven years when she was presumably living a normal life?
Let me share some examples in links below to demonstrate the structure of information, slotted into hourly slots we would need to proceed further in our evaluation 👇
Example 1 normalcy illustrated in another patient:
6.30 am : woke up and got prepared for morning Walk
7.30 am : came home and went to bath
8.00 am : students came of class 9 & class 7 and studied, drank cow milk with Protinex
9.15 am : had lunch with rice, dal , mixed sabji and omlet curry
9.30 am : did some household work
10.00 am : went to school
2.00 pm : returned home and slept
3.30 pm : ate ruti , 1spoon jaggery with milk and slept again
5.00 pm : woke up, students came and studied
7.30 pm : went for tuition to teach drank milk tea without sugar and 2 biscuits
8.45 pm : went for rehearsal of drama.
10.00 pm : came home and had dinner, rice , fish , dal , sabji
10.15 pm : did some work
11.30 pm : slept
Another backache patient's hourly activities:
8.00 AM - wakeup time
8-8.30 AM - freshup
9.00 AM - breakfast (2 idly + 2 vada + chutney)+ one cup tea
9.30 - 1 PM - client work on system
2 PM- lunch ( chicken biryani approximately 300 grams)
2.45-4.30 PM - sleeping
4.45-5.30 PM - went out on a casual walk of approximately 1.5 km
5.45 PM - 2 muffins + one cup coffee
6. PM- 9 PM - system work
9.20 PM - dinner (chicken biryani approximately 200 gm)
Note- the pain he had in the lower back on the left side area seems to have returned and is bothering in the same way like it did a week ago . Faces pain / discomfort in that area on deep breath and also when stretching body.
https://userdrivenhealthcare.blogspot.com/2024/02/pajr-telugu-guidelines-for-sharing.html?m=1
[8/7, 10:06 AM] Patient Advocate : Daily routine
7:30 Am wake-up light exercise
8:00 drinking water 2 glass
8:00 eat dry fruits walnut 4 or almonds 6 or sunflower seeds and pumpkin seeds occasionally
9:00 drinking tea or coffee
10:00 preparing breakfast for 30 mins standing in kitchen
10:30 to 11:00 break fast idli 3or dosa2 or pesarattu1
12:30 to 13:00 drinking of water 1.5 glass
13:00 cooking of lunch for an Hour standing in kitchen
14:00 to 14:30 Lunch rice with dal/ veg. curry
or egg weekly or chicken occasionally
16:00 to 17:30 relaxing / sleeping
18:00 drinking water 2 glass
Eating snacks sometimes
18:00 watching TV or drying of clothes on terrace by climbing steps
20:30 light dinner
21:00 watching TV or domestic work
22:30 sleeping
( before 23:00)
[8/7, 10:06 AM] Patient Advocate: This is recent routine
[8/7, 10:06 AM] PaJR Coordinator: Was this yesterday's routine or is this an average routine of last 7 years?
[8/7, 10:06 AM] PaJR Coordinator: If yesterday's then please tell us in which of these hourly slots, did she experience pain
[8/7, 10:06 AM] Patient Advocate: She feels pain complete day it is high during standing for one hour or more and during forward bending, walking, sittings and standing
[8/7, 10:06 AM] PaJR Coordinator: If recent then please tell us in which of these hourly slots, did she experience pain
[8/7, 10:06 AM] Patient Advocate : Pain is high while lifting heavy items
[8/7, 10:06 AM] PaJR Coordinator: Yesterday in which hours did the pain become high and how long was it high?
[8/7, 10:06 AM] PAJR moderator: So is the pain not fluctuating but remaining constant every day?
[8/7, 10:06 AM] Patient Advocate: Unable to discriminate the pain as you asked
[8/7, 10:07 AM] PaJR Coordinator: We need to see her recent X-ray of lumbo sacral spine lateral view and AP view along with sacroiliac joints.
If it's done already, please share here if possible
[8/7, 10:07 AM] PaJR Coordinator: Had to delete the documents to protect the patient's privacy
Please remove all identifiers before sharing anything online
[8/7, 10:07 AM] patient advocate: Ok sir
She has been taking Telmisartan & Chlorthalidone 40+12.5mg one tablet in the morning for BP ( for information)
[8/7, 10:07 AM] PaJR Coordinator: We need to see the x-ray films and not just the reports
Also please share the x-ray of her sacroiliac joints if available
[8/7, 10:07 AM] PaJR Coordinator: Medication was not given prior to X Ray
[8/7, 10:07 AM] Patient Advocate: Report of this X Ray ls not available, only print outs was seen by Dr.
[8/7, 10:07 AM] PaJR Coordinator: Wondering what those white fluffy opacities are in the pelvis! Let's hope they are artifacts but it will be very difficult to believe that till we can repeat and confirm that they were indeed artifacts!
Only the radiologist who supervised the x-ray at that time can confirm or we may need to repeat
[8/7, 10:07 AM] Patient Advocate: : Thank you very much sir
[8/7, 10:07 AM] PaJR Coordinator: Please share the report of this x-ray! Was any medication given prior to this procedure? Medication such as barium sulfate?
[8/7, 10:07 AM] Patient Advocate: Please suggest type of tests or X Ray required for investigation and confirmation of artifacts
[8/7, 10:07 AM] Patient Advocate: Can you please guide X Ray operator on phone for better results
[8/7, 10:07 AM] PaJR Coordinator: Ok sir
[8/7, 10:07 AM] PaJR Coordinator: 👆Ask your local radiologist to repeat the x-ray in this view
[8/7, 10:07 AM] PaJR Coordinator: Report being sent
[8/7, 10:07 AM] PaJR Coordinator: The name that is visible on the x-ray, is it of the doctor or the patient?
[8/7, 10:07 AM] PaJR Coordinator: Appears to be a paraspinal muscular pain
Can you test her trunkal muscle flexion as instructed in this video linked below and take a deidentified video of the patient's trunkal muscle test and share it in your own link here?
Standard trunkal/back muscle power testing👇
https://youtu.be/H3AxTxLP7zE?feature=shared
[8/7, 10:07 AM] Patient Advocate: Good Idea but the patient needs to cover the entire face and head for deidentification perhaps
[8/7, 10:07 AM] PaJR Coordinator: Excellent work @Pajr_member 👏👏
@PaJR Coordinator @pajr_member please hire him as our trainee volunteer if he agrees.
He has the potential to be a great patient advocate to many more patients one day.
The videos and the event timeline that you finally shared for us has made it so much easier to nail the diagnosis for her backache!
It's likely to be due to lumbosacral strain, which is often exacerbated with injury and muscle weakness along with spondylotic changes.
So to reverse her current issues we need to work on her back muscle strengthening as well as prevent further back injury.
Wish her videos could be shared widely if not for our patient deidentification clause as the videos are showing her face although again if the patient provides signed informed consent we can prepare the case report accordingly.
@pajr_trainee is our top case reporter who is also likely to embark on a PhD in "user driven healthcare" soon. It's a name we have given to this entire process. Can check her work in her learning portfolio here:
https://24fpatientblog.blogspot.com/?m=1 and if you agree she can guide you as to how to prepare your patient's case report.
Hope to see your patient improving her muscle function with guided physiotherapy and a good end point will be when she's able to reach Grade 5 (more here: https://www.physio-pedia.com/Manual_Muscle_Testing:_Trunk_Flexion?utm_source=physiopedia&utm_medium=related_articles&utm_campaign=ongoing_internal)
and lose her pain too!
[8/7, 10:07 AM] Patient Advocate: Sir
Trunkal muscle test carried and found that she unable to perform great3 test
However she could lift her head as in great2 test
[8/7, 10:07 AM] PaJR Coordinator: Ok
[8/7, 10:07 AM] Patient Advocate: Drinking 2 glass of water
[8/7, 10:07 AM] Patient Advocate: 600ml water
[8/7, 10:07 AM] PaJR Coordinator: 👍
[8/7, 10:07 AM] Patient Advocate: Drinking coffee
[8/7, 10:07 AM] PaJR Coordinator: Would be nice if you could provide informed consent to @PaJR Coordinator @Pajr_trainee through this form which you can download and sign from here: https://medicinedepartment.blogspot.com/2020/05/informed-patient-consent-and.html?m=1 so that she can prepare her case report. Please check the other case reports in her portfolio
[8/7, 10:07 AM] PaJR Coordinator: పండ్లు మరియు కూరగాయల కంటే చాలా ఎక్కువ తృణధాన్యాలు ఉన్నట్లు కనిపిస్తుంది.
సలాడ్లు ఎక్కువగా వేసి తృణధాన్యాలు తగ్గించవచ్చా?
Plēṭlō paṇḍlu mariyu kūragāyala kaṇṭē cālā ekkuva tr̥ṇadhān'yālu unnaṭlu kanipistundi.
Salāḍlu ekkuvagā vēsi tr̥ṇadhān'yālu taggin̄cavaccā?
The plate appears to contain a lot more cereals than fruits and vegetables.
Can we add more salads and reduce the cereals?
మన శరీర బరువు పెరగకుండా మరియు మన పొట్ట పొడవు 80 సెం.మీ కంటే తక్కువగా ఉండేలా మన ఆహారం ఉండాలి. ఏమి తినకూడదు? చక్కెర మరియు పిండితో కూడిన ఆహారం పూర్తిగా నిలిపివేయబడింది. బిస్కెట్లు మరియు బ్రెడ్ పిండితో తయారు చేస్తారు, కాబట్టి బిస్కెట్లు మరియు బ్రెడ్ తినడం మానేయండి. నెలకు 500 గ్రాముల కంటే ఎక్కువ నూనె వినియోగించరాదు. ఏమి తినాలి ఫుడ్ ప్లేట్లో 40% వివిధ ఆకుపచ్చ కూరగాయలు మరియు 10% వివిధ రంగుల పండ్లు. మిగిలిన సగంలో బియ్యం, గోధుమలు మొదలైన తెల్లటి గింజలు మరియు దుంపలు (బంగాళదుంపలు) ఉంటాయి.
Our diet should be such that our body weight does not increase and our stomach length is less than 80 cm. What not to eat? Sugary and starchy food is completely stopped. Taya with biscuits and bread flour ( translated by Google)
Mana śarīra baruvu peragakuṇḍā mariyu mana poṭṭa poḍavu 80 seṁ.Mī kaṇṭē takkuvagā uṇḍēlā mana āhāraṁ uṇḍāli. Ēmi tinakūḍadu? Cakkera mariyu piṇḍitō kūḍina āhāraṁ pūrtigā nilipivēyabaḍindi. Biskeṭlu mariyu breḍ piṇḍitō tayāru cēstāru, kābaṭṭi biskeṭlu mariyu breḍ tinaḍaṁ mānēyaṇḍi. Nelaku 500 grāmula kaṇṭē ekkuva nūne viniyōgin̄carādu. Ēmi tināli phuḍ plēṭlō 40% vividha ākupacca kūragāyalu mariyu 10% vividha raṅgula paṇḍlu. Migilina saganlō biyyaṁ, gōdhumalu modalaina tellaṭi gin̄jalu mariyu dumpalu (baṅgāḷadumpalu) uṇṭāyi.
https://medicinedepartment.blogspot.com/2023/10/healthy-harvard-plate-in-telugu.html?m=1
మీరు మీ రోగి యొక్క రోజువారీ గంట కార్యకలాపాలను దిగువ స్లాట్ చేయబడిన పద్ధతిలో పంచుకోగలరా? 👇
నవీకరించబడింది
Can you share your patient's daily hourly activities in the manner slotted below? 👇
Updated
8.30 AM - మేల్కొనే సమయం
Time to wake up
8.30-9 AM - ఫ్రెషప్
Freshup
9.30 AM - అల్పాహారం (6 వడ + చట్నీ)+ ఒక కప్పు కాఫీ
Breakfast (6 vada + chutney)+ a cup of coffee
10 AM - 1 PM - క్లయింట్ కాల్స్
Client call
1.45 PM- మధ్యాహ్న భోజనం (3 కప్పుల అన్నం + చికెన్ కర్రీ సుమారు 300gm)
Lunch (3 cups of rice + chicken curry approx 300gm)
2.15-5.30 PM - క్లయింట్ పని కొనసాగుతుంది
Client work continues
6 PM - 2 మఫిన్లు + ఒక కప్పు టీ
2 muffins + a cup of tea
6. PM- 9PM- సిస్టమ్లో క్లయింట్ పని
Client work in the system
9.30 PM - రాత్రి భోజనం (2 కప్పుల అన్నం + చికెన్ కర్రీ సుమారు 200gm)
Dinner (2 cups of rice + chicken curry approx 200gm)
గమనిక- దిగువ ఎడమవైపు నొప్పి రోజంతా ముఖ్యమైనది. అతను తరచుగా విరామాలలో వేడి నీటి సంచితో స్థానిక హీట్ అప్లికేషన్ చేయడానికి ప్రయత్నించాడు. ఈ రోజు ఉదయం నిద్ర లేవగానే కొంచెం బెటర్ అని చెప్పాడు, బహుశా నిన్న హీట్ అప్లికేషన్ వల్ల కావచ్చు.
Note- Lower left side pain is significant throughout the day. He tried local heat application with a hot water bag at frequent intervals. He said he was a little better when he woke up this morning, maybe yesterday
https://userdrivenhealthcare.blogspot.com/2024/02/pajr-telugu-guidelines-for-sharing.html?m=1
[8/7, 10:07 AM] patient advocate: Drinking 2 glass of water
[8/7, 10:07 AM] patient advocate: Had tee after eating walnuts
[8/7, 10:07 AM] PaJR Coordinator: Get review of X ray report w.r.t. SI joints and L5-S1
[8/7, 10:07 AM] PaJR moderator : @PaJR Coordinator We couldn't get to collate the entire previous transcripts here (which may contain the review of the investigation desired by @~डॉ गणेश मुक्ता अरुण जोशी ) into a case report by @Lajrupa Bhadra as informed consent from the patient is pending?
[8/7, 10:07 AM] PaJR moderator: Consent was forwarded to pajr_coordinator, he said he will share mail id for sending again, wating for mail id please
[8/7, 10:07 AM] Patient Advocate: Sir,
signed copy of consent and Authorization letter mailed for information
[8/7, 10:07 AM] Patient Advocate: Shal I share in the group
[8/7, 10:07 AM] PaJR Coordinator: 👆 Please share her hourly routine as previously shared on 13/7/24
[8/7, 10:07 AM] Pajr_moderator: Personally sent to me by @PaJR Coordinator
[8/7, 10:07 AM] PaJR Coordinator: Near Vizag
[8/7, 10:07 AM] PaJR Coordinator:
Conversations with patients, health professionals and meta AI to understand pharmacological efficacy in backache
https://userdrivenhealthcare.blogspot.com/2024/08/udlco-meta-ai-driven-ebm-support-to.html?m=1
[8/7, 10:07 AM] Patient Advocate:
Drinking 500ml water and 300ml lemon honey water
[8/7, 10:07 AM] Patient Advocate: Drunk 1.5 glass of water
[8/7, 10:07 AM] patient advocate: Rajma and tomato curry
[8/7, 10:07 AM] patient advocate: With curry leaves powder
[8/7, 10:07 AM] patient advocate: Drinking 2 glass of water and eating dates, kismis
[8/7, 10:07 AM] patient advocate: 👆
[8/7, 10:07 AM] patient advocate: Daily routine
7:30 Am wake-up light exercise
8:00 drinking water 2 glass
8:00 eat dry fruits walnut 4 or almonds 6 or sunflower seeds and pumkin seeds occasionally
9:00 drinking tea or coffee
10:00 preparing breakfast for 30 mins standing in kitchen
10:30 to 11:00 break fast idli 3or dosa2 or pesarattu1or upma
12:30 to 13:00 drinking of water 1.5 glass
13:00 cooking of lunch for an Hour standing in kitchen
14:00 to 14:30 Lunch rice with dal/ veg. curry
or egg weekly or chicken occasionally
15:00 to 16:00 cleaning and arranging in kitchen
16:00 to 17:30 relaxing / sleeping
18:00 drinking water 2 glass
Eating snacks sometimes
18:00 watching TV or drying of clothes on terrace by climbing steps weekly twice
20:30 light dinner
[8/7, 10:07 AM] patient advocate: 21:00 watching TV or domestic work
22:30 sleeping
( before 23:00)
[8/7, 10:07 AM] patient advocate: Review morning stiffness and pain. Relief with hot water bath
[8/7, 10:07 AM] PaJR Coordinator: Thanks!
Please share at which hourly slots did your patient experience back pain and how long did that last yesterday?
[8/7, 10:07 AM] patient advocate: She feels pain throughout the day. However pain is slightly high during wake-up from bed and standing for longtime.
[8/7, 10:07 AM] PaJR Coordinator: Far away perhaps🫥
[8/7, 10:07 AM] patient advocate: Yes
[8/7, 10:07 AM] PaJR Coordinator: We are nearer but even we haven't met her!
[8/7, 10:07 AM] Patient Advocate: With Nuvvula karam podi
[8/7, 10:07 AM] PaJR moderator: 👆In this daily routine how much is her daily walking distance?
[8/7, 10:07 AM] Patient Advocate: 👆@PaJR Coordinator
[8/7, 10:07 AM] PaJR member: Please send me the previous information of this group
MMT grade 2
MMT grade 3
[7/17, 6:15 PM] +patient advocate: Videos with mask for privacy
[7/17, 6:19 PM] patient advocate: Sir
Please check videos with mask and delete earlier videos as required
[7/17, 8:25 PM] PaJR PHR Moderator: Good Idea but the patient needs to cover the entire face and head for deidentification perhaps
[8/2, 11:59 AM] +91 94250 07641: Get review of X ray report w.r.t. SI joints and L5-S1
[8/2, 12:27 PM] PaJR PHR Moderator: @PaJR Coordinator We couldn't get to collate the entire previous transcripts here (which may contain the review of the investigation desired by @~डॉ गणेश मुक्ता अरुण जोशी ) into a case report by @Patient Advocate as informed consent from the patient is pending?
[8/2, 12:37 PM] +91 94907 33744: Consent was forwarded to Sateesh garu, he said he will share mail id for sending again, wating for mail id please
[8/2, 12:40 PM] Patient Advocate: Shal I share in the group
[8/2, 12:56 PM] PaJR PHR Moderator: Thanks!
Please DM it to the case reporter @Patient Advocate
The case reporter needs to ensure that the informed consent is signed by each of their logged patients and emailed to this address: informedconsentpajr@gmail.com asap and ensure that s/he gets a reply to that email
The signed informed consent needs to be emailed along with the patient's signature, their name and complete contact details along with signature and contact details of witness along with the case report and PaJR link in that email else the people who are archiving this data will not be able to correlate who's it is.
Please find more details about the PaJR workflow here 👇
https://userdrivenhealthcare.blogspot.com/2023/12/pajr-checklist-for-inpatient-interns-in.html?m=1
[8/2, 1:24 PM] patient advocate: Sir,
signed copy of consent and Authorization letter mailed for information
[8/2, 2:04 PM] patient advocate: Near Vizag
[8/2, 2:05 PM] patient advocate: Get his direct opinion
[8/2, 2:05 PM] patient advocate: Personally sent to me by @PaJR Coordinator
[8/2, 8:15 PM] PaJR PHR Moderator: 👆 Please share her hourly routine as previously shared on 13/7/24
[8/3, 8:21 AM] patient advocate: Drinking 500ml water and 300ml lemon honey water
[8/3, 8:38 AM] PaJR PHR Moderator: Conversations with patients, health professionals and meta AI to understand pharmacological efficacy in backache
https://userdrivenhealthcare.blogspot.com/2024/08/udlco-meta-ai-driven-ebm-support-to.html?m=1
[8/3, 12:59 PM] patient's advocate: With curry leaves powder
[8/3, 1:00 PM] patient advocate: Drunk 1.5 glass of water
[8/3, 3:14 PM] patient advocate: Rajma and tomato curry
[8/3, 6:12 PM] +patient advocate: Drinking 2 glass of water and eating dates, kismis
[8/4, 9:30 AM] PaJR PHR Moderator: 👍
[8/4, 3:19 PM] patient advocate: Daily routine
7:30 Am wake-up light exercise
8:00 drinking water 2 glass
8:00 eat dry fruits walnut 4 or almonds 6 or sunflower seeds and pumkin seeds occasionally
9:00 drinking tea or coffee
10:00 preparing breakfast for 30 mins standing in kitchen
10:30 to 11:00 break fast idli 3or dosa2 or pesarattu1or upma
12:30 to 13:00 drinking of water 1.5 glass
13:00 cooking of lunch for an Hour standing in kitchen
14:00 to 14:30 Lunch rice with dal/ veg. curry
or egg weekly or chicken occasionally
15:00 to 16:00 cleaning and arranging in kitchen
16:00 to 17:30 relaxing / sleeping
18:00 drinking water 2 glass
Eating snacks sometimes
18:00 watching TV or drying of clothes on terrace by climbing steps weekly twice
20:30 light dinner
[8/4, 3:27 PM] +91 94907 33744: 21:00 watching TV or domestic work
22:30 sleeping
( before 23:00)
[8/4, 4:31 PM] PaJR PHR Moderator: Thanks!
Please share at which hourly slots did your patient experience back pain and how long did that last yesterday?
[8/4, 4:52 PM] patient advocate: She feels pain throughout the day.
However pain is slightly high during wake-up from bed and standing for longtime.
[8/4, 4:54 PM] patient advocate: Far away perhaps🫥
[8/4, 5:28 PM] PaJR PHR Moderator: Yes
[8/4, 5:29 PM] PaJR PHR Moderator: We are nearer but even we haven't met her!
[8/6, 12:13 PM] PaJR PHR Moderator: 👆In this daily routine how much is her daily walking distance?
[8/6, 8:53 PM] Patient Advocate: Please send me the previous information of this group
[8/6, 8:58 PM] PaJR PHR Moderator: 👆@PaJR Coordinator
[8/7, 10:03 AM] PaJR Coordinator: Ok sir sending
[8/7, 10:45 AM] Patient Advocate: Got it
[8/10, 10:49 AM] patient advocate: Drinking 2 glass of water at 8:30am
[8/10, 10:50 AM] patient advocate: Breakfast with coconut chutney
[8/10, 2:10 PM] patient advocate: Lunch rice with dal, goru chikkudu curry and carrot pickle
[8/10, 2:10 PM] patient advocate: Lunch rice with dal, goru chikkudu curry and carrot pickle
[8/11, 10:37 AM] patient advocate: Drinking 2 glass of water at 8:30am
[8/12, 8:21 AM] patient advocate: Drinking 300 ml warm water with lemon and honey
[8/12, 8:42 AM] patient advocate: Drinking 500ml water
[8/12, 9:16 AM] patient advocate: Drinking coffee
[8/12, 11:45 AM] patient advocate: Eating apple as breakfast
[8/12, 2:11 PM] patient advocate: Lunch with rice, dal and bottle gourd, carrot pickle
[8/13, 9:15 AM] patient advocate: Drinking 300 ml warm water with lemon and honey at 8:30am
[8/13, 10:47 AM] Patient : Idli with ground nut and roasted bengal gram chutney
[8/13, 2:26 PM] patient advocate: Lunch with capsicum and potato curry
[8/13, 2:30 PM] PaJR PHR Moderator: 👍
[8/14, 8:23 AM] patient advocate: Drinking 500ml water
[8/14, 8:29 AM] PaJR PHR Moderator: 👍
[8/14, 8:40 AM] patient advocate: Eating dry fruit
[8/14, 9:06 AM] patient advocate: Still she feels back pain
[8/14, 9:06 AM] patient advocate: Still she feels back pain
[8/14, 10:49 AM] patient advocate: Mark the severity of pain here as on date. This will be used in future.
[8/14, 10:49 AM] patient advocate: Does pain wake up from sleep?
[8/14, 11:03 AM] patient advocate: Breakfast dosa with chutney
[8/14, 2:52 PM] patient advocate Lunch, Rice with tomato and egg curry
[8/15, 11:04 AM] patient advocate: Breakfast poha and cashews upma
[8/15, 2:17 PM] patient advocate: Lunch, rice with dal and tomato curry
[8/15, 5:06 PM] patient advocate: Ok sir
[8/17, 9:19 AMpatient ADvocate: Drinking 300 ml warm water with lemon and honey at 8:30am
[8/17, 9:19 AM] patient advocate: Drinking 500ml water
[8/17, 11:26 AM] patient advocate:
Breakfast Vada with chutney
[8/19, 9:28 AM] patient advocate: Drinking 600ml water at 8:40
[8/19, 9:29 AM] +91 94907 33744: Eating pumpkin and sunflower seeds
[8/19, 10:55 AM] patient advocate: Breakfast
[8/19, 2:19 PM] patient advocate: Lunch, rice with boiled chana, bachali Kura pappu
[8/19, 2:20 PM] patient advocate: Curd with carrot, keera salad
[8/19, 8:50 PM] patient advocate: Dinner
[8/19, 9:48 PM] PaJR Coordinator: Really nice
[8/20, 8:27 AM] patient advocate: Drinking 200 ml warm water with lemon and honey
[8/20, 8:41 AM] patient advocate: Eating dry fruits
[8/20, 8:43 AM] PaJR PHR Moderator: 👍
[8/20, 10:58 AM] patient advocate: Breakfast
[8/20, 2:14 PM] patient advocate: Lunch
[8/20, 2:16 PM] PaJR PHR Moderator: Daily 1 egg per person not 2
[8/20, 2:51 PM] patient advocate: Carrot, keera salad with curd
[8/20, 4:41 PM] patient advocate: Sir, can we take 2 eggs per day and three days in a week
[8/20, 6:38 PM] PaJR PHR Moderator: Alright
[8/20, 8:41 PM] patient advocate: Light dinner
[8/20, 8:42 PM] patient advocate: With curry leaves powder and Kandi powder
[8/21, 10:27 AM] patient advocate: Drinking 600ml water at 8:40
[8/21, 11:15 AM] patient advocate: Breakfast, upma with carrot and groundnut
[8/21, 2:34 PM] patient advocate: Lunch, rice with egg curry
[8/21, 10:04 PM] patient advocate: No dinner today
[8/22, 8:29 AM] patient advocate: Drinking 300 ml warm water with lemon and honey
[8/22, 8:30 AM] patient advocate: Eating dry fruits
[8/22, 11:01 AM] patient advocate: Breakfast, fermented curd rice with chana
[8/22, 2:41 PM] PaJR PHR Moderator: Daily activities?
[8/22, 5:18 PM] PaJR Coordinator: What were the daily activities
[8/22, 5:30 PM] patient advocate: Same routine
[8/23, 9:52 AM] patient advocate: Drinking warm water with honey at 8:40 am
[8/23, 9:52 AM] patient advocate: Eating dry fruits
[8/23, 9:53 AM] patient advocate: Had Cup of tea
[8/23, 10:00 AM] PaJR PHR Moderator: And other hourly physical activities?
[8/23, 10:37 AM] patient advocate: Breakfast, Dosa with chutney
[8/23, 2:32 PM] patient advocate: Lunch, Rice with dal palak tomato coriander , chana with carrot, keera curd salad
[8/23, 8:59 PM] +patient advocate: Light dinner
[8/24, 8:45 AM] PaJR Coordinator: How is patient how is patient pain Today
[8/24, 10:18 AM] patient advocate: Drinking warm water 500ml at 8:20am
[8/24, 10:19 AM] patient advocate: Eating dry fruits
[8/24, 11:07 AM] patient advocate: Breakfast, Poha with cashew nut upma
[8/24, 2:10 PM] patient advocate: Lunch, Rice with donda Kaya Kura and groundnut
Curd with carrot keera salad
[8/24, 8:56 PM] patient advocate: Dinner, sweet corn
[8/24, 9:52 PM] PaJR PHR Moderator: It's a cereal and every healthy plate needs it's cereals to be balanced with fruits, vegetables (half of the plate)and pulses (1/4th)
https://nutritionsource.hsph.harvard.edu/healthy-eating-plate/
[8/25, 9:49 AM] patient advocate: Drinking 600 ml water
[8/25, 9:49 AM] patient advocate: Drinking 600 ml water
[8/25, 9:49 ] patient advocate: Eating dry fruits
[8/25, 10:32 AM] PaJR PHR Moderator: Water intake and it's volume needs to be driven by thirst
[8/25, 10:55 AM] patient advocate: Breakfast, carrot and groundnut upma
[8/25, 2:32 PM] patient advocate: Lunch
[8/26, 8:38 AM] patient advocate: Drinking 300 ml warm water with lemon and honey
[8/26, 9:01 AM] patient advocate: Drinking 600 ml water
[8/26, 9:01 AM] patient advocate: Eating dry fruits
[8/26, 11:05 AM] patient advocate: Breakfast, dosa with coconut chutney
[8/26, 2:27 PM] patient advocate: Lunch, Rice with cabbage moong dal curry and coconut chutney and curd
[8/26, 8:40 PM] patient advocate: Light dinner
[8/27
, 9:54 AM] patient advocate: Drinking of 300ml warm water
[8/27, 9:55 AM] patient advocate: Eating dry fruits
[8/27, 10:51 AM] patient advocate: Breakfast, pesarattu
[8/27, 2:21 PM] patient advocate: Lunch, Ragi sankati with potato batani curry and carrot curd salad
[8/28, 8:51 AM] patient advocate:Drinking 300 ml warm water with lemon and honey
[8/28, 8:51 AM] patient advocate: Drinking 600 ml water
[8/28, 8:52 AM] patient advocate: Eating pumpkin and sunflower seeds
[8/28, 11:20 AM] patient advocate: Breakfast, Samia upma with carrot and cashew nuts
[8/28, 2:33 PM] patient advocate: Lunch, Rice with chana dal, omlette and carrot, cucumber curd salad
[8/28, 8:38 PM] +91 94907 33744: Dinner, cucumber chana dal with karivepaku Powder
[8/29, 10:56 AM] +patient advocate;Breakfast, Idli with ground nut chutney
[8/29, 2:31 PM] patient advocate:Lunch, Coconut Rice with beens potato chana and curd
[8/30, 2:35 PM] patient advocate: Drinking 300 ml warm water with lemon and honey at 8:40am
[8/30, 2:36 PM] patient advocate: Drinking 600 ml water at 8:50am
[8/30, 2:37 PM] patient advocate: Eating dry fruits At 9:00am
[8/30, 2:37 PM] +patient advocate: Breakfast, Idli with ground nut chutney at 10:40am
[8/30, 2:40 PM] patient advocate' Lunch, Rice with moongdal curry boiled egg , groundnut
And carrot curd salad
[8/30, 10:43 PM] PaJR PHR Moderator: 👍
[8/31, 10:44 AM] patient advocate Drinking 600 ml water at 8:50am
[8/31, 10:45 AM] patient advocate
Eating pumpkin seeds and sunflower seeds at 9:00am
[8/31, 12:06 PM] patient advocate: Breakfast, 2 banana
[8/31, 2:08 PM] patient advocate: Lunch, Rice chapathi with Rajma tomato curry and carrot curd salad
[9/1, 2:46 PM] patient advocate: Drinking 600 ml water at 8:50am
[9/1, 2:50 PM] patient advocate: Lunch with curd
[9/1, 8:53 PM] patient advocate: Dinner
[9/2, 10:45 AM] patient advocate: Eating dry fruits at 8:50am
[9/2, 10:57 AM] patient advocate: Breakfast, upma with cashew nuts
[9/2, 2:26 PM] patient advocate: Lunch, Rice Babbarlu, dal with Ponnaganti tomato Kura cucumber, carrot salad
[9/2, 2:40 PM] PaJR PHR Moderator: Very nice
[9/2, 7:24 PM] patient advocate: Thank you sir
[9/3, 9:21 AM] +patient advocate: Eating dry fruits at 9:00am
[9/3, 11:07 AM] patient advocate: Poha upma with cashew nuts
[9/3, 2:24 PM] patient advocate: Lunch, Rice with tomato kakara Kaya curry, dal and kabuli chana
Patient advocate: [9/4, 8:47 AM] : Drinking 600 ml warm water with honey
[9/4, 8:48 AM] +patient advocate: Eating pumpkin and sunflower seeds
[9/4, 11:09 AM] patient advocate:Breakfast, Samia upma
[9/4, 2:15 PM] patient advocate: Sir, her cold under control, however she got throat pain and lost smell sense.
Kindly suggest treatment
[9/4, 2:21 PM] +patient advocate: She is suffering from cough with out flem
[9/4, 2:24 PM] patient advocate: Lunch, Rice with egg curry
[9/4, 4:57 PM] +patient advocate:Wheezing sound observed from throat
[9/4, 7:27 PM] PaJR PHR Moderator: Cab take paracetamol for the throat pain
Others will subside on their own
[9/4, 7:59 PM] +patient advocate: Thank you sir
[9/5, 8:40 AM] patient advocate: Drinking 600 ml water
[9/5, 8:41 AM] patient advocate: Eating dry fruits
[9/5, 9:30 AM] PaJR PHR Moderator: 👍
[9/5, 11:17 AM] patient advocate: Breakfast, idli with ground nut chutney
[9/5, 1:30 PM] patient advocate: Sir
Can we have curd while suffering from cold
[9/5, 2:17 PM] patient advocate: Lunch, Rice with cabbage chana dal and boiled pesarlu
[9/5, 2:19 PM] PaJR PHR Moderator: Can be taken in moderation
[9/5, 2:40 PM] +patient advocate: Thank you so much sir
[9/5, 8:20 PM] patient advocate: Dinner
[9/6, 8:07 AM] patient advocate: Drinking 600 ml warm water with honey
[9/6, 8:08 AM] +patient advocate: Eating dry fruits
[9/6, 8:28 AM] PaJR PHR Moderator: 👍
[9/6, 10:22 AM] patient advocate: Breakfast, dosa with chutney
[9/6, 2:12 PM] +patient advocate:Lunch, Rice with Dosa Kaya Pappu and boiled chana
[9/6, 6:05 PM] patient advocate: Sir
She is suffering from coughing and wheezing sound from throat
[9/6, 6:10 PM] patient advocate: She was using aerocort inhaler earlier in situations like this , she got asthma
[9/6, 6:10 PM] +patient advocate: Request for treatment
[9/6, 6:29 PM] +patient advocate: She is using inhaler, still wheezing continuing
[9/6, 6:29 PM] PaJR PHR Moderator: Aerocort is not a rational combination in the step wise management of Asthma.
I shall try to explain her necessary treatment in a simple language but please let me know since when she has been found to be having this intermittent coughing and wheeze? When it begins how long does it last?
[9/6, 6:36 PM] +patient advocate: She was suffering from last 4 days initially it was cold then developed to coughing, you adviced cetrizine and paracetamol
[9/6, 6:37 PM] patient advocate: The cold was controlled then coughing and wheezing developed
I can here her wheezing
[9/6, 7:45 PM] PaJR PHR Moderator: How many years has this been noticed?
How many times in a year she gets these symptoms?
[9/6, 7:49 PM] patient advocate: She was suffering from asthma from childhood
It was cured at the age of about 20 years
[9/6, 7:51 PM] patient advocate: She suffers from cold and then it developed to asthma due to climatic changes
[9/6, 7:52 PM] PaJR PHR Moderator: From the age of 20 years to her current 55 years, is this the first episode of her cough and wheeze?
[9/6, 7:52 PM] patient advocate: Asthma remains for about a week. She recovers after treatment
[9/6, 7:53 PM] patient advocate: She gets effected once or twice in a year
[9/6, 7:54 PM] +patient advocate: Asthma is effective followed by cold
[9/6, 7:55 PM] PaJR PHR Moderator: So from age of 20 years till now 55 years she has had asthma episodes 35-70 times?
[9/6, 7:57 PM] patient advocate: Not sure sir
[9/6, 8:30 PM] PaJR PHR Moderator: Let us know her respiratory rate. @PaJR Coordinator can help you to check out YouTube videos showing how to check her respiratory rate.
Can discuss with your local doctor to obtain
Asthalin (salbutamol rotacap) 200 mcg to be taken with a rotahaler three times a day for wheezing for 2 days
Budecort rotacap 200mcg twice a day for 2 days
Just sharing this technical reference for others here: https://www.nature.com/articles/s41533-023-00330-1/figures/5
There appears to be strong traction for track 1 in the figure these days but we would prefer track 1
[9/6, 8:31 PM] PaJR PHR Moderator: @Pajr_trainee Would be good to update this new issue with the conversations above into her case report
[9/6, 9:28 PM] patient advocate: Sir
I measured respiratory rate manually is 25 per minute.
Measurement is done by placing stethoscope at throat to listen inhale/exhale and counted rate for one minute
[9/6, 10:03 PM] PaJR PHR Moderator: Let us know how it is after the medicine
[9/6, 11:53 PM] Pajr trainee: I'll update it
[9/8, 11:39 AM] PA: Drinking 600 ml warm water with honey at 9:30am
[9/8, 11:41 AM] PA: Breakfast, pesarattu at 11:00am
[9/9, 11:00 AM] PA : Drinking 600 ml warm water with honey at 9:00am
[9/9, 11:01 AM] PA: Eating pumpkin and sunflower seeds at 9:30am
[9/9, 11:06 AM] PA: Breakfast, Carrot upma
[9/9, 2:30 PM] PA: Lunch, Rice with drumstick tomato curry, Babbarlu with Carrot keera salad
[9/10, 9:23 AM] PA: Drinking 300 ml warm water with lemon, honey at 8:30am
[9/10, 9:27 AM] PA: Eating dry fruits at 9:00am
[9/10, 9:28 AM] PA: Had Cup of coffee at 9:15am
[9/10, 9:29 AM] PaJR PHR Moderator: 👍
[9/10, 11:20 AM]PA: Breakfast, boiled chana and banana
[9/10, 11:53 AM] PA: Sir
She is inhaling asthalin and budecort rotacaps for last two days, wheezing still exists and respiration rate not improved
Request for your guidance please
[9/10, 2:58 PM] PaJR PHR Moderator: How many times is she inhaling asthalin?
Please share her respiratory rate hourly
[9/10, 3:00 PM] PA : Asthalin 3 times in a day
[9/10, 3:01 PM]PA: And budecort twice in a day sir
[9/10, 3:02 PM] PA: I counted one inhale and exhale as one count sir
[9/10, 3:06 PM] PA: She inhaled for two days, and stoped today as your recommendation
[9/10, 4:36 PM] PaJR PHR Moderator: She needs to continue and the dose needs to be increased and if required we need to move to the next step and add another rotacap such as:
Foracort 200 which contains Formoterol (6mcg), Budesonide (200mcg)
[9/10, 4:37 PM] PaJR PHR Moderator: That's right but it needs to be repeatedly checked every hour or every two hours and shared here
[9/10, 4:45 PM] PaJR PHR Moderator: Another additional monitoring device such as this 👇
https://m.indiamart.com/proddetail/mini-wright-peak-flow-meter-5374638762.html
will help us to decide the treatment better
@PaJR Coordinator can help you to procure and operate it
[9/11, 9:20 AM] PA: Drinking 600 ml warm water with honey at 8:45am
[9/11, 9:21 AM] PA: Eating dry fruits
[9/11, 10:45 AM] PA: Breakfast, dosa with ground nut chutney
[9/11, 2:27 PM] PA: Lunch, Rice with eggs curry
[9/12, 8:34 AM] PA: Drinking 300 ml warm water with lemon, honey
[9/12, 8:35 AM] PA: Eating pumpkin and sunflower seeds
[9/12, 10:58 AM] PA: Breakfast
[9/12, 2:46 PM] PA: Lunch, Rice with brinjal dal chana and carrot cucumber curd salad
[9/13, 8:48 AM] PA: Drinking 600 ml warm water with honey at 8:30am
[9/13, 8:49 AM] +PA: Eating dry fruits
[9/13, 11:02 AM] PA: Breakfast, poha upma
[9/13, 2:09 PM] PA: Lunch, Rice with tomato dal, Babbarlu and carrot cucumber curd salad
[9/14, 10:59 AM] PA: Drinking 300 ml warm water with lemon, honey at 8:30am
[9/14, 11:03 AM] PA: Eating dry fruits at 8:45am
[9/14, 11:03 AM] +PA: Had a cup of tea at 9:00am
[9/14, 11:14 AM] PA: Breakfast
[9/14, 2:25 PM] +PA: Launch, chapathi with Rajma tomato curry
[9/14, 5:03 PM] PaJR PHR Moderator: 👍also mention her hourly activities
[9/15, 11:02 AM] PA: Drinking 600 ml warm water with honey at 8:30am
[9/15, 11:02 AM] PA: Had a cup of coffee at 9:00am
[9/15, 11:13 AM] PA: Breakfast
[9/15, 2:44 PM] PA: Lunch
[9/15, 7:20 PM] PaJR PHR Moderator: 👍
[9/16, 10:52 AM] PA: Drinking 300 ml warm water with lemon, honey at 8:30am
[9/16, 10:53 AM] PA: Eating pumpkin and sunflower seeds at 8:45am
[9/16, 10:53 AM] PA: Had a cup of coffee at 9:00am
[9/16, 10:55 AM] PA: Breakfast, papayya fruit
[9/16, 11:28 AM] PAJR DOCTOR : This is a good diet. How is the back pain compared to before starting this group?
[9/16, 12:56 PM] PA: Sir
She is unable to discriminate the improvement
[9/16, 12:57 PM] PAJR Doctor: Okay. What is she taking for pain relief?
[9/16, 1:02 PM] PA: Sir
Not taking any medicine for pain relief
[9/16, 2:18 PM] PA: Lunch, Rice with Ponnaganti Kura dal, boiled pesarlu and carrot cucumber curd salad
[9/16, 2:26 PM] +PAJR Doct: 👇🏻
[9/16, 2:26 PM] PAJR doct: 👆🏻
[9/17, 10:54 AM] PA: Drinking 300 ml warm water with lemon, honey at 8:30am
[9/17, 10:55 AM] PA: Eating dry fruits at 9:00am
[9/17, 10:55 AM] PA: Had a Cup of coffee at 9:30am
[9/17, 10:56 AM]PA: Breakfast
