C09979917 / invoice 10000

Reason: Whole SpinePremed 0.5ml methadone 0.1 Rads taken- Reversed 0.1ml s/cRadiographs:- Slight c2/c3 narrowing and on vd subjectively increased disc space opacity- Thoracic vertebrae abnormalities: 4/5 and 9-12Options:- Strict rest and pain relief 10-14 days and slow return to exercise- Elevate food and water bowls, in/out to toilet only- Progress to ct/mriAt risk of future/recurring spinal issues    Vital Signs    

Hx: getting worse, right shoulder, crying when awake now, childrens panadol has helped, O lifting down the stairs 2-3 times a day,Pe:- fl fine- Painful to lower neck- muscle spasm when happensIn for rads in AM:- whole spine    Vital Signs    

Reason: Crying, Spasms In BackAppointment Notes: O convinced it's a reaction to quantum cdHx: was in on saturday was fine, Sunday AM crying when sleeping and all the time, since sunday unable to get around but not active, slowly improving, not able for stairs,Showed video - prayer posture crying and can happen when asleep- only seems to be when asleep he cries but less active when awake than usualPe:- BAR, MMPM, CRT<2', - Bright clean eyes/ears/nose- Heart and lungs ok: normal rate and rhythm, no murmur/crackles/wheezes- NAD abdo palp soft and comfy- thorough palp fine- NAD neck flex/ext/L and R- Fine on spinal palp- shockingly good given hx- zero rxn- Reflexes almost normal: withdrawal and knuckling fine, slightly slow in hemi walk- Rectyal tone fine temp 38.5Dx: back spasms while sleepin?- DDx dreaming/ partial sezuresPlan:- Paracetemol and gaba and reasses    Vital Signs