[HN]

Council: Dermatology referral if not improved with curent treatment plan.=1

Council: Evaluate for potential skin infection=1
[%%HN]
Council:Steriod cream BID (risk/benefits).=P
Council:Medrol dose pack (risk/benefits).=P
*D=P
Council -Keep feet dry/clean.=P
Council- Avoid harsh chemicals.=P
Council- Avoid temperature extremes.=P
Council -Manage stress.=P
Council- Avoid excessive skin washing.=P
Council- Try avoid scratching area.=P
***=P
Council: Evaluate for skin infection=P
Council: Shoes (Buying and fiting).=P
Council (Shoe) Multiple shoe evaluated.=P

[%%H]

DISCONTINUE:=P
Steriod cream use (not helping)
Steriod cream (Worsens condition)
------------------------=S
Council:Steriod cream BID (risk/benefits).=S
Council:Medrol dose pack (risk/benefits).=S
*D=S
CONTINUE AVOIDING:=P
temperature extremes,=P
excessive skin washing,=P
harsh chemicals,=P
avoid scratching area.=P
************************=P
at this time. CONTINUE:=P
CONTINUE:=P
*************************=P
Keeping feet (dry/clean)=P
stress management=P

***=P
Council: Evaluate for skin infection.=S
Council: Shoes (Buying and fiting).=S
Council (Shoe) Multiple shoe evaluated.=S
[H]
Council: Dermatology referral if not improved with curent treatment plan.=1
Council: Evaluate for potential skin infection.=1
##########################=1

[%%TX1]
Topicort cream (BID use).=P
2nd Steriod injection right foot (trigger).=P
3rd Steriod injection right foot (trigger).=P
4th Steriod injection right foot (trigger).=P
5th Steriod injection right foot (trigger).=P
6th steriod injection right foot (trigger).=P
..=1
IM Steriod injection RT arm.=P
IM Steriod injection LT arm.=P
-=P
BK Cast right foot (3 wks).=P
BK cast left foot (3wks).=P
BK cast removal right foot.=P
BK cast removal left foot.=P
X-ray-(reviewed-discussed).=S
X-ray again (reviewed-discussed)=S
X-ray from outside source (reviewed, discussed.=S
_=S
Defers (x-ray) today. If not improved by next visit will x-ray.=S
___=S
Rx: Mobic.=S
Rx: Voltren gel (BID) Application.=S
Rx: Naprosyn 500mg 1PO BID.=S
_____=S
RX-Crutches.=S
Rx- Role-about.=S
Rx- Walker.=S
Rx- Non-pneumatic Upright boot.=S
Rx- Pneumatic Upright boot.=S
[TX1]
LEFT FOOT=1
1st Steriod injection left foot (trigger).=1
2nd Steriod injection left foot (trigger).=1
3rd Steriod injection left foot (trigger).=1
4th Steriod injection left foot (trigger).=1
5th Steriod injection left foot (trigger).=1
6th steriod injection left foot (trigger).=1
RIGHT FOOT=1
1st- Steriod injection right foot (trigger).=1
2nd- Steriod injection right foot (trigger).=1
3rd- Steriod injection right foot (trigger).=1
4th- Steriod injection right foot (trigger).=1
5th- Steriod injection right foot (trigger).=1
6th- Steriod injection right foot (trigger).=1
***=1
Defers (x-ray, treatment). Patient request just councilling on condition.=1
Applied today without complications.=1
Removed today without dermatological (ill effects).=1
Will watch the capsulitis symptoms for now.=1

###################################################################################
###

[AN]
Council: Shoes (Buying and fiting- Needs more supportive shoe)=1
Continue: stable well designed shoes=1
stable well designed shoes=1
moving forward=1
##########################=1
at this time.=1

[%%AN]
Council:Steriod Inj (risk/benefits).=P
*=P
Council: Inserts (use/benefits).=P
Council: Shoes (Buying and fiting).=P
Council (Shoe) Multiple shoe evaluated.=P
***=P
Council- Heel lifts (use/purpose).=P
Council-Gel inserts (use/benefits).=P
****=P
Council -NSAID (use / purpose).=P
Council- Voltaren gel (use/purpose).=P
__=P
Council -Upright boot (use/purpose).=P
Council- Physical medicine modalites (use /Purpose).=P
##_# (INJ-HEEL LIFTS-SHOES-NSAIDS)=P
Council: Steriod Inj (risk/benefits), Heel lifts (use/purpose), Shoes (Buying and
fiting), NSAID (use / purpose).=P

CONTINUE USE:=S
*******=S
Continue: NSAID-Mobic (until finished), then discontinue.=S
Continue: NSAID- Mobic (refilled).=S
-------------------------------------------=S
Continue: NSAID- (until finished), then discontinue.=S
Continue: NSAID- (refilled).=S

[%%AF]
Council:Steriod Inj (risk/benefits).=S
**=S
Council: Home stretching regiment (daily).=1
Council- Physical medicine modalites (use /Purpose).=S
*=S
Council: Shoes (Buying and fiting).=S
Council (Shoe) Multiple shoe evaluated.=S
Council: Recommending better stable shoe.=S
***=S
Council: Inserts (use/purpose).=S
Council: Inserts (patient purchused).=S
Council-Gel inserts (use/benefits).=S
****=S
Council -NSAID (use / purpose).=S
Council- Voltaren gel (use/purpose).=S
Council - upright boot (use/purpose).=S

NSAID-Mobic,=P
NSAID-Mobic (GI upset),=P
Voltren gel,=P
Inserts (painful),=P
upright boot,=P
(not helping)=P
************************=P
at this time. CONTINUE:=P
CONTINUE:=P
stable well designed shoes,=P
_=P
Voltaren gel- (as needed),=P
Voltren gel- (refilled),=P

[AF]
Council: Shoes (Buying and fiting- Needs more supportive shoe)=1
Continue: stable well designed shoes=1
stable well designed shoes=1
moving forward=1
##########################=1
NSAID-Mobic (until finished), then discontinue.=1
NSAID- Mobic (refilled).=1
NSAID- (until finished), then discontinue.=1
NSAID- (refilled).=1
NSAID- Ibuprofen 600mg BID.=1
-------------------------------------=1
at this time.=1
at that time.=1
moving forward.=1
until symptoms full subside.=1

[%%TX2]
RIGHT=P
1st Steriod injection right foot (trigger).=P
2nd Steriod injection right foot (trigger).=P
3rd Steriod injection right foot (trigger).=P
4th Steriod injection right foot (trigger).=P
5th Steriod injection right foot (trigger).=P
6th steriod injection right foot (trigger).=P
..=1
IM Steriod injection RT arm.=P
IM Steriod injection LT arm.=P
-=P
BK Cast right foot (3 wks).=P
BK cast left foot (3wks).=P
BK cast removal right foot.=P
BK cast removal left foot.=P
X-ray reviewed today with patient. All questions answered.=S
X-ray again reviewed today with patient.=S
X-ray from outside source (reviewed, discussed.=S
_=S
Defers (x-ray) today. If not improved by next visit will x-ray.=S
___=S
Rx: Mobic.=S
Rx: Voltren gel (BID) Application.=S
Rx: Naprosyn 500mg 1PO BID.=S
_____=S
RX-Crutches.=S
Rx- Role-about.=S
Rx- Walker.=S
Rx- Non-pneumatic Upright boot.=S
Rx- Upright boot.=S
[TX2]
LEFT FOOT=1
1st Steriod injection left foot (trigger).=1
2nd Steriod injection left foot (trigger).=1
3rd Steriod injection left foot (trigger).=1
4th Steriod injection left foot (trigger).=1
5th Steriod injection left foot (trigger).=1
6th steriod injection left foot (trigger).=1
RIGHT FOOT=1
1st- Steriod injection right foot (trigger).=1
2nd- Steriod injection right foot (trigger).=1
3rd- Steriod injection right foot (trigger).=1
4th- Steriod injection right foot (trigger).=1
5th- Steriod injection right foot (trigger).=1
6th- Steriod injection right foot (trigger).=1
***=1
Defers (x-ray, treatment). Patient request just councilling on condition.=1
Applied today without complications.=1

###################################################################################
##

[DF]
DEFERS
at this time=1
---------------------------------=1
at this time. Council: (Use/benefits/risks) discussed. DEFERS (may consider in
future)=1
Council: (Use/benefits/risks) discussed. DEFERS (may consider in future)=1
-----------------------------.=1
steriod injection,=1
physical therapy,=1
.....=1
inserts,=1
custom insert,=1
.......=1
upright boot,=1
.........=P
NSAIDs,=1

[%%DF]
Council: (Use/benefits/risks) discussed. DEFERS:=P
.=P
steriod injection,=P
physical therapy,=P
..=P
inserts,=P
custom insert,=P
...=P
pneumatic upright boot,=P
....=P
##########################=P
NSAIDs,=P
NSAIDs (hx of reflux),=P
Nsaids (Hx GI upset),=P
NSAIDs (Allergic),=P
Nsaids (taking blood thinner),=P
###########################=P
________FUTURE=P
Council: (Use/benefits/risks) reviewed. DEFERS (may consider in future)=P

[%%D]
DISPENSED: (ABN sheet signed, (Fitted, use instruction)--=P
DISPENSED: (Fitted, instructional use)--=P
____=P
Inserts,=P
Inserts with metataral pad,=P
Gel inserts,=P
_____=P
Night splint,=P
Non-pnuematic upright boot,=P
Pneumatic upright boot,=P
Darco shoe,=P
Role-about,=P

[D]

this date.=1

[%%A] ACTIVITY
Continue (Weightbearing)=P
Continue (Weightbearing) with crutch assistance=P
Continue (Weightbearing) with walker assistance=P
*=P
Continue (Nonweightbearing) with crutch assistance=P
Continue (Nonweightbearing) with roleabout=P
Continue (Nonweightbearing) with walker=P
**=P
Begin (Nonweightbearing with crutch assistance)=P
Begin (NWB-with roleabout)=P
Begin (Nonweightbearing with walker assistance)=P
***=P
Begin (PWB) in=P
****=P
Begin (Weightbearing) to tolerance in=P

then progress to shoe as tolerated.=S

then progress to shoe as tolerated,return to shoe if needed.=S
then progress to (PWB) partial weight bearing if tolerated.=S
then progress to weightbearing in boot.=S
---------=S
Continue weightbearing (minimal amount) to tolerance.=S
Activity level should remain at a minimal.=S
Activity (Minimal) to tolerance.=S
(Minimal) activity until pain substantially improves, then progress to normal
activity to tolerance.=S
.---=S
Continue activity level at current pace but do not exceed.=S
Slowly increase activity level at a mild pace.=S
Resume normal activity level to tolerance.=S
[A]
non-pneumatic upright boot for 3 wks=1
non-pneumatic upright boot for 2 wks=1
non-pneumatic upright boot for (additional) 2 wks=1
non-pneumatic upright boot for (additional) 3 wks=1
non-pneumatic upright boot for (additional) 1 wk=1
-----=1
pneumatic upright boot for 2 wks=1
pneumatic upright boot for 3 wks=1
pneumatic upright boot for (additional) 2 wks=1
pneumatic upright boot for (additional) 3 wks=1
pneumatic upright boot for (additional) 1 wk=1
--=1
Begin (Weightbearing) in stable designs shoe.=1
Continue weightbearing (minimal amount) to tolerance=1
Activity level should remain at a minimal=1
Activity (Minimal) to tolerance=1
(Minimal) till pain substantially improves, then progress to normal activity to
tolerance=1
---=1
Continue activity level at current pace but do not exceed=1
Slowly increase activity level to tolerance=1
Resume normal activity level to tolerance=1
Continue normal activity to tolerance=1

[PT]
BEGIN=1
Begin-physical medicine (2 X wk X 3 wks)=1
Begin-physical therapy (therapy south) 3 times wk for 3 wks=1
Begin-physical therapy (pro-therapy) 3 times wk for 3 wks=1
Begin-physical therpay (Rx sent to Kiser) 3 times wk for 3 wks=1
CONTINUE=1
Continue-physical medicne=1
Continue- Physical therapy=1
Continue-physical medicine (2 time wk for 3 wks)=1
Continue-physical therapy (therapy south) 3 times wk for 3 wks=1
Continue-physical therapy (pro-therapy) 3 times wk for 3 wks=1
Continue-physical therpay (Rx sent to Kiser) 3 times wk for 3 wks=1
[%%PT]
for additional wk=S
for additional 2-3 visits=S
--=S
or until condition plateau's=S
or until condition resolved=S
as needed=S

[S]
Taking anti-coagulant drug- Will need to hold for 5 day before surgery. Need
clearance from PC.=1
----=1
They live alone,without family members and no nearby help. We had discussed
previously they are (not a surgical candidate).=1
(Medical history significant)- previously informed that they are (not surgical
candidate).=1
***********=1
Nsaids (reflux history) unable to take.=1
Nsaids (reflux history) GI upset history.=1
Nsaids (allergic history) unable to take.=1
Nsaids (on anti-coagulent therapy) unable to take.=1
[%%S]

Nsaids (reflux history) unable to take.=S

Nsaids (reflux history) GI upset history.=S
Nsaids (allergic history) unable to take.=S
Nsaids (on anti-coagulent therapy) unable to take.=S
[%QUESTION]
Capsulitis (new) council=HN|HA
Capsulitis council=H|HA
TX1=TX1|HA
Capsulitis Sx (Detail)=HS1|HA
Capsultis Sx (Review=HS2|HA
***********************=Z|HA
Metatarsalgia (new) council=AN|HA
Metatarsalgia council=AF|HA
TX2=TX2|HA
Metatarsalgia Sx (Detail)=AS1|HA
Metatarsalgia Sx (Review=AS2|HA
##################=Z1|HA
Defers=DF|HA
Dispensed=D|HA
Activity level=A|HA
PT=PT|HA
STAYS=S|HA