Mr. Kentucky Case Summary

Ken Harrison is an amazing and talented sculptor, whose life revolves around his art. His entire purpose in life is to create and sculpt. One day all of that changed, when Ken was involved in a horrific car accident. The results of this accident resulted in severe injuries, including a broken neck, which left him permanently paralyzed from the neck down. He is left to lie in a hospital bed all day, while nurses and hospital staff do everything for him. Ken soon realizes that his life will never return to normal, and he will forever be confined to a bed and wheelchair. He soon starts believing that his life isn’t worth living, because he is unable to sculpt again. Sculpting gave Ken’s life purpose, and without that, life is already over. Or so Ken believed. The hospital staff does everything in their power to change his mind, but to no avail. The staff believes they must do whatever it takes to keep Ken alive, even if he does not want to live. But Ken’s mind is made up, and will not be changed. He fights the hospital for the right to be discharged, and begins a case of life and death. Should a man be able to choose if he wants to die, or should the

Proceed with case close per Mr. McKnight’s verbal request from 4/10/17. The agency has decided to place Mr. McKnight on the No Do Not Open List program. In order to apply for future VR services, Mr. McKnight will have to provide documentation that he is receiving ongoing mental health services at least for six months from the date of application. Mr. McKnight will need to also provide proof that he has successfully completed anger management training prior to reapplying for future VR services. Mr. McKnight will have to be serviced out the local PPP office and not permitted to enter the local area office; therefore, Mr. McKnight will have to contact you directly in order to submit his documentation for review and to schedule his appointment

Diabetic Peripheral Neuropathy (DPN) is one of the most common microvascular complications in diabetes and can result in foot ulceration, ampuation and an impaired quality of life(Carrington AL, et al 2002,Boulton AJ,et al 2004). The reported prevalence of diabetic peripheral neuropathy ranges from 16% to as high as 66%2 and its prevelance is believed to increase with the duration of diabetes and poor glucose control.(Boulton AJ.et al 2000) It’s accounts for 50–75% of non-traumatic amputations in diabetic patients.(Holzer SE, et al 1998, Boulton AJM, 1998,Malay DS, et al 2006)

The elenctic table was a bad experience for the both of us. Kingsfield stated that, “at times you may feel that you have found the correct answer. I assure you that this is a total delusion on your part. You will never find the correct, absolute, and final answer.” After stating our responses during the Elenctic Table, we felt as if we had given the perfect answer. However, we later felt shot down when we received bad scores on our answers or when the person who spoke after us came up with an even better answer. “Some of us might have nervous breakdowns.” Because we had to attempt at a response at least twice, the pressure of finding the right timing and insightful answers drove

Management involves establishing that the neuropathy is caused by diabetes instead of other underlying causes and aiming for strict glycemic control. Many diabetics suffer amputations to limbs as a result of diabetic neuropathy. "The symptoms typically start in the toes, gradually ascending to the lower limbs. In advanced cases, it spreads to the upper limbs (glove-stocking sensation) and also the abdominal wall (Rajan , 2013)." Diabetics are prone to having diminished circulation in their limbs. Diabetes causes the blood vessels of the feet and legs to narrow and harden. Some of the causes of increasingly diminished blood flow can be controlled, such as smoking, high blood pressure and high cholesterol. " In addition to being a diabetic, the risk of developing and progression of diabetic neuropathy also depends on the duration of diabetes, glycemic control, presence of comorbidities like hypertension, hyperlipidemia, obesity, and smoking (Rajan, 2013). One of the consequences of poor circulation is a slowed or insufficient healing process. This problem requires diligent inspection of the feet especially. Poor circulation and thus poor healing often leads to wounds that are more prone to becoming infected. If a wound is not felt, it is often noticed only when it has already become seriously

Those with diabetes usually face foot problems due to the high levels of sugar (glucose) in the bloodstream. This can cause nerve damage and reduce the effectiveness of blood flow ,leading to foot problems. As podiatrists ,they understand that looking after a client 's feet is necessary. When patients experience foot pains or develop or

Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus [2]. Non-healing ulceration usually progress to amputation in spite of standard care. DFUs result from interaction of ;neuropathy, peripheral vascular disease and foot deformity. 80% of diabetic persons with foot ulcers present with peripheral neuropathy which is the greatest risk of foot ulceration [3]. Neuropathy in DM shows variable degrees of autonomic, sensory, and motor functions changes[4]. Motor neuropathy causes atrophy of the foot muscles resulting in clawing of the toes, sensory neuropathy results in repetitive trauma to the foot, and autonomic neuropathy changes skin consistency so accelerating ulcer formation [5] .40 to 50% of all patients show ischemic manifestations with the most having neuroischemic ulcers, and only few of them has purely ischemic

Peripheral neuropathy in diabetes frequently leads to amputation; for this reason, foot care is of paramount importance. Daily personal foot examination is mandatory to arrest problems early. In addition, expert appraisal is also recommended, several times a year.

Evaluate care for a person with an acute or chronic diabetic foot problem, detail clinical presentation and discuss assessment, diagnosis, classification and treatment choices. Assess the need for medical and/or pharmacological management, justify your decisions using current guidelines, recommendations and literature. Further consider the role of the multidisciplinary foot team and discuss referral at the most appropriate stage of each intervention.

access for a chief complaint of plantar foot pain. One week prior to the initial

In 1993, Rodney Peairs, a local meat market manager was acquitted from a criminal charge against him. Rodney Peairs was charged with shooting a 16-year-old Japanese exchange student, Yoshihiro Hattori in Louisiana (LA Times). It took a twelve- member jury three hours to acquit the 31-year old Rodney Peairs (NY Times). On October 17, 1992, was unlike a day before when Yoshihiro Hattori mistakenly rung Rodney Peairs’ doorbell to find out directions to the Halloween party he was attending. In contrast, the evidence presented to the jury necessitates Rodney Peairs’ acquittal. Some spectators commented that, "A man's home is his castle," one potential juror said early last week, expressing puzzlement about why the case had even come to trial. (LA

On the statement of medical necessity on the C-4 form dated 12/16/15, bilateral foot is not at MMI and more therapy is needed to restore function and range of motion. Six additional weeks of therapy is anticipated to improve function and activities of daily living. The medication is g helping for pain but therapy is needed to restore range of motion and strength. A home program is important but not appropriate alternative to treatment. The claimant agrees to the proposed medical

The pain Giovanni feels when ambulating and the tingling in his peripheries are an important sign of diabetic neuropathy (Carlson & Castro 2016). Over time, diabetes can cause damage to the nerves in the body. This is more common in patients who

Plantar fasciitis is a common condition that causes foot pain. It is inflammation of the band of tough fibrous tissue on the bottom of the foot that runs from the heel bone (calcaneus) to the ball of the foot.

Mr. Taylor is generally in good health. He is very disciplined with his exercise routine and diet and has his cholesterol and diabetes under good control. Consequently, he has been able to cut the dosage of one of his medications in half. He is due to return to his physician in three months at that time they will recheck his A1C to ensure he is getting the correct amount of medication that is needed to control his diabetes. Numbness are tingling in the feet of diabetics is a common problem (neuropathy). When Mr. Taylor sees his physician he will discuss his current condition with him.