Tramadol

DOI: 9/22/2006. The patient is a 46-year-old female sales representative who sustained cumulative trauma to her back. Based on the progress report dated 07/26/16, the patient complains of same aching pain of the low back, which radiates to the buttocks and posterior legs. She has numbness at the top of her right foot. She takes Norco and ibuprofen with good relief and tolerates it well. Pain levels are 8-9/10 without medication, coming down to 5-6/10 with medication. Her pain is worse with…

Many men suffer from premature ejaculation. Since this condition is fairly common, there are many premature ejaculation treatments available. Generally, before suggesting a treatment method, a doctor will want to do a physical exam and may want to talk to the man's partner as well. These are some of the common treatment methods that are being used today. Dapoxetine is a prescription medication that is short-acting. As an SSRI, it is marketed for the treatment of premature ejaculation and is…

You requested a hearing to address weaning the claimant off of opioid medications based on the 05/17/17 report from your IME consultant, Dr. Fiorini. Dr. Fiorini recommends that the claimant’s methadone usage be reduced to a reasonable level and tramadol be eliminated through a…

DOI: 4/8/2011. Patient is a 63-year-old male route sales representative who sustained injury when he was taking bread rack off the left gate and he ended up falling off the truck and the rack fell on him. Per OMNI entry, IW is status post left knee surgery on 09/20/11 and right knee surgery on 02/26/16. Based on the progress report dated 09/21/16 by Dr. Pelton, the patient complains of persistent pain in neck which he rates at 6/10, it is constant and radiates to the shoulders and pain in the…

DOI: 2/10/2015. Patient is a 48-year-old female transaction processor who sustained injuries to her left side and back when she slipped and fell in the lunchroom. Per OMNI, she was diagnosed with low back strain, left sided low back pain with left sided and lower back injury. Based on the progress report dated 04/15/16 by Dr. Quesada, the patient complains of worsening mid/low back pain, rated as 8-9/10. She states that she has radiation going down her left leg to her knee. She states her…

muscle spasms and lower extremity radicular symptoms. IW was advised to stop Neurontin and cyclobenzaprine. She was given a prescription for Lorzone and Horizant to decrease her radicular symptoms with less side effects. She will continue on her tramadol. She will continue her physical therapy. She will return to the office in one month’s time. Attached is the IME report dated 08/26/14 by Dr.…

Assessment: The patient has developed painful post traumatic arthritis to the left ankle. She has large osteophytes to the anterior ankle joint causing impingement and pain with active range of motion. The left ankle fracture is well healed by x-ray evaluation. The most likely diagnosis is post-traumatic osteoarthritis after an open fracture dislocation of the left ankle 20 years ago. In a fracture dislocation of the ankle, the exposed cartilage can be disrupted and lead to osteoarthritis. In…

psychological factors. He was given a prescription for gabapentin and Capsaicin cream. Diclofenac sodium, Norco and pantoprazole were discontinued. Patient will start on gabapentin to see if this will help with neuropathic pain. She has trialed tramadol in the past without benefit. If she fails on gabapentin, she may require a long-acting opioid medication. The 9/30/15 confirmatory urine screen report was reviewed which is negative for all entities. Patient has been previously denied with 1…

She visits the physician for a physical exam twice a year, with the most recent visit on April 22, 2015. The person takes Tramadol for knee pain, Prednisone for arthritis, and Triamterene for hypertension. She spends approximately 1.15 percent of her annual income on her medications. When asked about any dietary restrictions, the person stated that she tries to limit her sugar…

DOI: 11/30/2011. Patient is a 60-year-old male maintenance employee who sustained a work-related injury after tripping over a chain in between 2 pillars which keep cars from turning. Per the AME report dated 04/02/13 by Dr. Hall, the left shoulder was injured. Per the AME report dated 03/11/16 by Dr. Hall, IW was diagnosed with left shoulder pain with chronic left shoulder impingement. IW remains P & S. Based on the medical report dated 12/07/16, the patient continues to experience pain in…