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Betty Miller is a 77-year-old female who has had right shoulder pain for 4 weeks. Through the case study, you will follow Betty through a visit to her primary care provider and pharmacist; a home health services for nursing, social services and physical therapy; and a primary care provider follow-up visit.
Catherine is a 46-year-old woman with Chronic Low Back Pain (CLBP), obesity, poorly controlled diabetes with peripheral neuropathy, and ankle pain on high dose opioids for past 4 years.
Mrs. Rose is an 89-year-old, widowed white female who has resided in a nursing home for the past 3 months. Admission was precipitated by inability to function independently, related to Dementia Alzheimer’s –type (DAT) and to widespread arthritic pain. Her mobility is severely limited.
Edna is a 70-year-old woman with chronic low back pain. After completing the course, you should be able to differentiate the weak link and the treatment targets in older adults with chronic low back pain, articulate realistic treatment expectations for chronic non-cancer pain, and describe a rational stepped care treatment approach for older patients with chronic low back pain.
Harold is an adult male with pain from trauma experienced in a car accident. This case covers assessing the aspects of the pain experience in a trauma patient with substance use disorder by integrating the health history into the treatment decision-making process, examining multimodal approaches to treat acute trauma across transitions of care, recognizing the biopsychosocial impact of the treatment of acute pain in patients with substance use disorder, and designing an appropriate treatment plan using case-based learning to address acute trauma related pain in patient with substance use disorder.
CA is a 48-year-old female patient who is status post left total knee replacement arthroplasty under a general anesthetic. Patient controlled analgesia was initiated in the post-anesthesia care unit. After transfer to the regular ward, the patient complains of worsening acute post-surgical pain coupled with chronic pain from inflammatory degenerative joint disease.
Margaret Andersen is an 85-year-old woman with limited communication who demonstrates changes in behavior two weeks after entering a nursing care facility.
Melanie is a 15-year-old girl with jaw clicking with and without pain, and frequent headaches over the last three months. This course illustrates the foundational underpinnings of pain, pain assessment and pain management strategies using a longitudinal case of acute to persistent/chronic orofacial pain with mixed nociceptive and neuropathic phenotypes.
This is a case of a fourteen year old girl with worsening headaches. The case covers four months, beginning with entries into her video diary ("vlog" or "video blog"). She explores several approaches to headache management in a series of encounters with health professionals.
Mr. Clark is an 80 year old, moderately overweight Caucasian male who awoke two nights ago with severe pain in his left foot. He has tried elevating his foot and has taken ibuprofen, with minimal pain relief. His wife states that he has some problems with his memory. She states that he has not been able to sleep, and asks the urgent care staff to give him something for the pain as well as something to help him sleep.
Mr. Gateway is a 52-year-old male smoker with a history of substance abuse with recurrent laryngeal cancer who presents with increased throat and neck pain, dysphagia (pain with swallowing), and dehydration.
Follow 52-year-old Mr. Jones, 78-year-old Mrs. Hubbard, 38-year-old Mrs. Miller, and 45-year-old Mr. Nguyen as their care teams navigate opioid management for their acute pain once hospitalized.
This case presentation follows a 43-year-old farmer named Mr. Lane who injured his right arm after it got stuck in a combine. He was then air lifted to a tertiary care center. The case includes Mr. Lane's initial injury, acute pain, and the development of chronic pain and acute on chronic pain.
Mr. Smith is a 46 year-old male with a history of HIV, hepatitis C cirrhosis, and substance abuse, presenting with bilateral hip pain.
Ms. Jackson is a 38-year-old, African American nurse who completed treatment for triple negative breast cancer 5 months ago. She opted for bilateral mastectomy, radiation, and chemotherapy. The patient is frustrated that she still experiences pain, states “it’s ruining my life."
Ms. Rhodes is a 46-year-old woman with CPP: Stage IV endometriosis (cyclic component of pain treated with continuous oral contraceptives), abdominal and pelvic floor muscle pain, vestibulodynia, IBS with constipation, possible IC, anxiety and depression and sexual dysfunction.
Ms. Tatum is a 30 year-old woman with a history of opioid use disorder (heroin and fentanyl) who has been treated for 2 months with buprenorphine/naloxone (Suboxone) in a substance use disorder treatment program. 4 months after she transitioned her medications to her PCP, she was in a Motor Vehicle Accident and sustained multiple left-sided rib fractures as well as a jaw fracture. She has severe pain in the face, neck, and ribs and needs an acute pain management plan.
Owen Jones is a 46-year-old man who presents for followup of low back pain with intermittent radicular symptoms and numbness which started ~ 2 years ago following a lifting related injury. He describes the pain as, "Sharp, pinching, and sore."
Pam is a 41-year-old woman diagnosed with breast cancer approximately one year ago. Pam underwent treatment including a bilateral mastectomy and subsequent breast reconstruction. Now she is experiencing pain that she feels should be improving.
Peter James is a 49-year-old veteran with phantom limb pain. While in the reserves he was injured by an IED in Afghanistan. His lower left leg was amputated at Walter Reed. He wants to better control his phantom limb pain so he can take on a farm management opportunity.
Sharee is a teenage girl coping with pain crises related to sickle cell disease (SCD). The case provides a history of the disease onset and progression from infancy though high school as seen from her perspective explained by case principals. The case then provides details of a pain crisis episode as she prepares to transition from high school to college.