Dr Matthew Sebastian

Royal Melbourne Hospital

Melbourne 3054

19.02.2018

Dear Dr Sebastian,
Re: Alex David, aged 45

Thank you for accepting Mr David into your care for further assessment and management due to a
possible nerve root compression and disc prolapse. He is being sent via ambulance today.

Today, an urgent home visit was requested by Mr David as he could not get out of bed due to severe
pain in his back and left leg. On examination, a straight leg raise test showed to be positive around
30-40 degrees. Please note that Mr David is a diabetic and his current blood glucose is 14 mmol
because of recent inactivity associated with his pain.

Prior to today, Mr David had presented on three occasions complaining of sudden lower back pain
which radiated to his left thigh that was worse while working. Initially, he was advised to have lots of
rest and continue his anti-inflammatory medication. However, the pain become worse without any
improvement. Therefore, his dose of NSAIDS was increased, but these have been ineffective in
treating his pain. It is important to mention that he had an X-ray a year ago that showed narrowing
and osteoarthritis in his lower spine vertebras.

In view of the above, it would be greatly appreciated if you could diagnose and treat Mr David’s
condition. If you require any information, please do not hesitate to contact me.

Yours sincerely,

Registered Nurse