Orthopaedic (5)_transcript.json

{
  "text": "Mr. [PERSON_NAME]? Yes. How you doing, mate? My name's [PERSON_NAME], I'm a [OCCUPATION] [OCCUPATION] here. Yeah, hi [PERSON_NAME]. Yeah, please call me [PERSON_NAME]. [PERSON_NAME]. Well, [PERSON_NAME], how are you doing today? Yeah, not bad things, [PERSON_NAME]. A little bit sort of drowsy from the [DRUG] I think. But yeah, the knee seems to be alright, which is good. That's good, all things considered. Can't complain after a [MEDICAL_PROCESS]. So how is the knee? Oh yeah, look, it's all right. It'll be all right. Yeah. Okay. Any [OCCUPATION] [OCCUPATION] been looking after you? Yeah, look, they have been. They've been giving me regular medication for the pain, which is good. I think I had something about [DURATION] [DURATION] ago, which is good. Seems to have the pain under control. Okay, so you said the pain's under control. Does that mean you're not experiencing any pain now? No, experiencing some at the moment, [PERSON_NAME]. Yeah. Okay. Well [PERSON_NAME], if I could give you a scale from 0 to 10, 0 being no pain and 10 being the worst pain that you can imagine, what would you say the pain is at at the moment? Three. Three on that sort of scale. So just a three. Okay, that's good. Have you tried to move it around much? I did try to move it there a little while ago and that shot the pain up a bit. Okay. Then I had the [DRUG] [DRUG]. Since then I haven't tried to move it again. Okay, and what was the pain like when you moved it back to that scale, [PERSON_NAME]? It would have gone up to about seven and hurt quite a bit. Yeah. Okay. Now [PERSON_NAME], I know the pain's [MEDICAL_PROCESS] [MEDICAL_PROCESS] knee, it having been replaced and all, but can you just describe to me where the pain is? Yeah, right behind the knee sort of, and a bit below it heading down towards the calf area. So it does head down towards the calf. And is there any pain around the side or on the top of the knee? No. What about emanating up into the thigh? No, no, perfect. Thanks for that. Okay. Now have you had any nausea or light headedness or any sort of trouble like that? Any trouble breathing? No, not at all, [PERSON_NAME]. Not at all. Okay, that's good. As I say, just a little bit drowsy, but drowsy. I guess that's the after effects of the [DRUG]. So now it says here, [PERSON_NAME], that you only used to be able to walk 200 metres prior to coming in today. What do you think that was? Oh, look, that was because of the knee, right, [PERSON_NAME]? I mean 200 metres, that was about the extent that I could walk before the pain became so severe I just had to stop. Okay. I guess that's why I needed the [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Probably. Now, at the moment, can you feel [MEDICAL_PROCESS] [MEDICAL_PROCESS]? Is [MEDICAL_PROCESS] [MEDICAL_PROCESS] fine? Do you have any numbness or pins and knees? Not at the moment. There was some numbness last night. Okay. Yeah, but I haven't noticed it this morning. Seemed to be my whole leg. Okay, well, we'll have a look. Curiously, that probably was the. Just the nerve block from the [DRUG]. It can do that to the muscles and such. They can get a bit stiff afterwards. So it's not permanent, is it? No, no, no, no, no, it's not permanent. It's temporary. We'll make sure that it's not the case. Good, good. You'll be fine. Okay. Now, [PERSON_NAME], just want to confirm that you live on a farm. It says here a farm out in [LOCATION]. Yeah, we do, [PERSON_NAME]. That must be nice. It's a lovely location. Yeah. Good. It also says here you have six stairs in the back and the front. And you live with your [MARITAL_STATUS]. Yeah, that's good to know. And aside from everything, how much do you do around the farm? Look, it's really hands on for me. I mean, I've got a couple of guys that come in and help me during the week, but yeah, I mean, most of the work [PERSON_NAME] and I do ourselves. Okay, we'll keep that in mind and try and make sure we can get this knee sorted so you can get back there. Well, I hope so. I'm a little bit concerned about how the property's going to go with I'm [MEDICAL_CONDITION]. I understand that, but we're just a little concerned about sending you out too early. We just need to make sure your knee gets enough time to recover. The last thing we want is for it to start swelling and take you out of action for even longer. Don't want that. Now, I notice it says here that you have been talked to about strategies to deal with this, such as walking aids and such. Yes. What have you been thinking about walking aids? Oh, look, they did discuss that with me and we spoke about crutches and they seemed to think that that was quite feasible and measured mount for crutches. So I'm hoping that when I get out that I can get out on the crutches which will make life a bit easier, especially with those stairs. It'll make it a lighter. Exactly. So have you got any of that equipment yet? Have you been down and sorted that out? You have. They've organised all that. Excellent. Alright. Good job, [PERSON_NAME]. Now, what about your discharge guidelines? Have you had a look at those? Yeah, look, I've had a good read of those. I was reading them this morning actually, before I sort of drifted off. And [PERSON_NAME] had a good look at them as well, so he should keep me on the ball as far as they're concerned. Good, good. Well, what we'll do, we'll go through a bit of an assessment on your knee and just make sure that it's all right. And then we'll go over those discharge guidelines at the end just to make sure that everything's all right. It sounds good, [PERSON_NAME]. So you happy to continue with the assessment? Yeah, most certainly, yeah. Alright. Alright, [PERSON_NAME], how about we have a look at that knee? Yeah, sure, [PERSON_NAME], by all means. It's feeling quite good, actually. It's good, yeah. I'm pleased with it. Seeing a was only [MEDICAL_PROCESS] on yesterday, so it's feeling good. [PERSON_NAME], I'm just going to grab your gown now and just move this down. As I'm moving down, it sort of rides up with the catheter and all these things happen, mate. Get you that there. Perfect. Okay. So I'll just move that up there so we can have a look. Excellent. Okay. Well, there doesn't seem to be too much redness and swelling. How's it feeling? It feels quite good. Good. Okay. Now, [PERSON_NAME], what I'm doing is I'm just going to feel around the outside of it to see if I can feel for any warmth. Yeah, it does feel a little bit warm. I guess that's normal, is it? Yeah, it's to be expected. Have you been icing it regularly? Had some ice on it about [DURATION] [DURATION] ago. About [DURATION] [DURATION] ago? Not since then. Okay. What I'm going to do is I'm going to talk to the [OCCUPATION] and make sure that you have a steady supply of ice coming in. My recommendation would be for [DURATION] [DURATION] on and [DURATION] [DURATION] off and that'll help to reduce the swelling. Okay, sounds good. Now, you mentioned yesterday that you were having some pain. Yes. Is that still going on? Can you see that? It is, yes. It's in behind the knee there. Okay. Behind the joint and just a little bit above it. A little bit above it, yeah. Okay. So it sounds like your hamstring. Hamstring, yes. Well, before you came in, your knee was bent and [MEDICAL_PROCESS] [MEDICAL_PROCESS] was bent. Now what that's done is it's caused the hamstring muscle to tighten. Okay. Yeah. So what we need to do now is we need to allow that muscle to stretch out again so that we can get your legs straight. Can we put a pillow under it? Would that help? Well, we can and it will help with the pain temporarily, but it's going to impede the muscles stretching out. So if you need it, then yes, feel free to put the pillow under it for a short time frame. But ideally we need to keep that muscle stretching so that we can get your movement back. Okay? Yeah. Alright, so for now we're just going to do a couple of our exercises just to see how it's working. Yeah, yeah, sure, [PERSON_NAME]. Okay, so for now can you please just move [MEDICAL_PROCESS] [MEDICAL_PROCESS] in a circle? Good job, [PERSON_NAME]. Now wiggle your toes. Excellent. No discomfort with that. That's good. Okay, so I'm just going to come around to the other side. Okay. So [PERSON_NAME], just so I can give you an idea of what it feels like on this leg so you know what normal feel. What I'm going to do now is I'm just going to hold my hand above your knee. I just need you to push down on the bed. What that is going to do is it's going to activate the muscle above the knee. Right. So you'll have an idea of how that should feel. Just like that? Just like that. That's perfect. Okay, easy. Excellent. Okay, so I'm just going to go around back to the other side. The other knee. Okay, so same thing. Yeah, there's definitely some tightness there, but yeah, bit of time. I can do that. You can do that. Okay, well that's good. All right, one last exercise. Need you to squeeze your buttocks together. Squeeze my buttocks? Yes, I need you to squeeze your buttocks together. It's okay. It's just for the muscles. Perfect. You can stop that. Good. That was fun. Okay. Okay. Now, [PERSON_NAME], all these exercises that we've just gone through, if I could ask that, you could complete those probably 10 times per [DURATION] in your bed. That's just wiggling your toes and moving [MEDICAL_PROCESS] [MEDICAL_PROCESS] and pushing that knee down and squeezing your buttocks. It seems silly, but what that will help to do is to help facilitate the muscle recovery and increase your circulation, which will help with recovery in the long term. Okay. Yeah, I'll do that. Excellent. Good to hear. Okay, so [PERSON_NAME], just like to try some leg raises, okay? Yeah, sure, [PERSON_NAME]. Now what I'd like you to do is just to keep this knee straight and then just lifting from here. Try and keep that leg straight. Excellent. Yeah, yeah, you do that. Yeah. Easy, easy. Let's see about this side. Now just Be aware you may not be able to do this. A lot of patients can't do this day one after [MEDICAL_PROCESS]. But I'd just like to check if there is any discomfort. Just let me know and just stop straight away. We'll give it a shot. Keep the knee straight. Lifting from here. No, no. Okay. That's fine, [PERSON_NAME]. That's fine. What I'd like to do now, [PERSON_NAME], is just to move on to a [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Right, okay. Just to [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Yeah, sure. So first of all, I'm just gonna lift your arm up here. It's gonna give you a base reading. So this is what that feels like. Cool. And before we move on, I'm just gonna take your socks off because we are gonna need to [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] and [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. So lift up there side as well. These things are a bit of a pain. Yes, they're the worst they get off them. They are to get on. Better to have them than not, believe me. Okay, so with that base, is that normal? Just give you that one again. Yep. Just gonna start on your right leg. You want me to close my eyes? That's fine. Alright, I can feel that. Can you feel that? Mm. Okay, so now continuing with that, if that's normal. Yes. How is it on this side? Same, same. Mm. Okay. Normal. Yes. And yeah, feels the same, [PERSON_NAME]. Feels the same there. That's normal. How's that? Same. Nice work. And that one to that one. Yeah. Thanks, [PERSON_NAME]. We'll just do the top [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] here. There. Yeah, same on both feet. Let's do a quick one just between your toes there. Yeah, Sensations the same. Excellent. Alright, now we're just going to go under the feet. Hope it doesn't tickle. And that side? Yeah, same on both feet, [PERSON_NAME]. Excellent. Okay. So [PERSON_NAME], we've just done your [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Just wondering, have you done any knee bends yet? No, I haven't, [PERSON_NAME]. I've been a little bit reluctant to even try it, actually. Am I allowed to do that? You're. It's understandable you'd be a little kind of nervous about doing it. How about we go through it together? Yep. Okay. That'll be good, right? Yep. So what's made you so nervous about this? Well, just, you know, the fact of the [MEDICAL_PROCESS] and as I say, just a little bit anxious about. It's understandable. But it is one thing that we need to do to help facilitate your joint movement. So we'll just go slow to start. This might be a bit uncomfortable. All right. What do you want me to do? [PERSON_NAME], are you just trying to bend the knee? Just try and bend the knee. I'm help you do it. Okay, we're getting a bit of resistance there. Starting to tighten up a bit there. Okay, we're just going to go a little bit further. You just let me know as soon as you need to stop. Oh, yeah, yeah, yeah, yeah. Tolerable. It's tolerable. Okay. Do you want to go any further or leave it there for now? We'll leave it there just for a moment. Sure thing. Okay, Just hold it there. Excellent. Thank you, [PERSON_NAME]. Sitting at about 60 degrees at the moment. Okay, so we'll just drop the knee down. Okay. How are you feeling after that? Yeah, yeah. Okay. What I'd like to do now is to go through that another 10 times. Okay. We're just going to take it slow. We're not going to go any further than we need to, but that motion will help your recovery. All right. All right, Go through it again. You're good? Yeah, for sure. Okay, so moving forward. 1. Yeah, about that point, I start to feel the need tighten up. Yeah. Okay, that's all right. Strap it down. Okay, so we'll go up to number two. So how's the farm going? Yeah, it's going well. I think I've gone a bit further that time. Yeah, we have. Yeah. Yeah, it's a good farm. We're getting close to retirement now. Kids have all grown up and disappeared and got their own family. So not quite sure what we'll do in the future. Okay, again, number nine. There we go. Number nine. Oh, yeah, that's. Look at that, [PERSON_NAME]. Better? Yeah, I think I can go past that point, though. That's pretty tight. That's all right. We'll drop it down one more. Yep. Okay, last one. All right. There we go. That's progress, [PERSON_NAME]. Okay, can you hold that there? Yeah, I can. All right, let's see just how much progress, [PERSON_NAME]. Yeah, 30 degree increase. Excellent. Excellent. Very good. Gone from 60 to 90. That's pleasing. So if I could just ask that you do that. Only a little bit, but do it often. Don't try and push yourself up to the 90 unless you can just keep that knee bending and moving and that'll really, really help. Alright, [PERSON_NAME]. Okay, [PERSON_NAME], thanks for that. Now we're going to move on to some of those walking exercises. Walking? You sure it's not premature to be walking? I only had the [MEDICAL_PROCESS] yesterday. [PERSON_NAME]. It's not premature. In fact, it's openly incarcerated. Yeah, evidence suggests that Our early mobility will help with outcomes, so. I knew it was coming. I'm a little bit apprehensive about it, though, I must be honest. Yeah, no, that's understandable. Look, I'll tell you what. I'll leave. I'm gonna go grab my [OCCUPATION]. [PERSON_NAME], we'll come back, There'll be the two of us, we'll bring a walking frame, and you'll have both of us assisting you. Sounds good. We'll make it as comfortable for you as we can. Sounds good, [PERSON_NAME]. Okay. I'll see you soon. Okay. What have you got there, [PERSON_NAME]? The wonders of modern technology. Now, this is [PERSON_NAME]. He's my [OCCUPATION]. You may have met him. Hi. [PERSON_NAME] [PERSON_NAME]. How are you? Yeah, yeah, doing all right. Thanks, [PERSON_NAME]. I'm one of the [OCCUPATION] here. I'm just going to be helping [PERSON_NAME] out today. Oh, excellent, excellent. Now, to start with, we've already done our [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Excellent. Everything was fine there. Everything was fine there. What I'll get you to do is I'll get you to grab me the catheter there. And we're going to just going to ask you to stand behind Mr. [PERSON_NAME], [PERSON_NAME]. Yep. [PERSON_NAME]. [PERSON_NAME]. [PERSON_NAME]. Yep. Get you to stand behind [PERSON_NAME] and to support his weight while I support his leg and we bring him across. Okay. No problems. Cool. Okay, so guide me here, [PERSON_NAME]. What do you want me to do? Well, [PERSON_NAME] going to support your back. I'm going to support [MEDICAL_PROCESS] [MEDICAL_PROCESS]. We'll just get you to kind of shift over to the side of the bed. And then we're going to assist you to turn around and we'll lower [MEDICAL_PROCESS] [MEDICAL_PROCESS] to the ground. Alright, Here goes. There we go. Take it slow. Just swivel around a bit here. Yeah. How you doing? Yeah, you're doing all right. Excellent. Okay. Okay, so we're gonna start lowering the leg. All right. How's that? Yeah. Yeah, that's good. That's good, [PERSON_NAME]. Perfect. A little bit of tenderness there, but yeah. Are you comfortable there? Your feet are on the ground. Yeah, I am too smart. [PERSON_NAME], how about we go for a walk? Yeah. Alright, [PERSON_NAME]. Excellent. So far so good. So far so good. Yeah. [PERSON_NAME], is it okay if you come around over to this side? I can be on this side. Yeah, that's good. I might need a bit of support, I think, initially. Well, that's what we're here for, [PERSON_NAME]. Good. So [PERSON_NAME] and I are going to support your weight as we move you up onto the frame. What I'm going to get you to do is push down with your hands. Then I'm going to get you to move your arms up here and hold onto these handles. Yep. We'll support your weight. Going up. Here we go. Ready? And. Oh. Good job. Beautiful. So, [PERSON_NAME], just before we get going, how are you feeling? Any light headed nausea? Yeah, just a little bit woozy when I first got up, but it's clear now. Thanks, [PERSON_NAME]. Here, what I'd like you to do is if it starts to change, just immediately let me know. Will do. For now, we're just going to go for a short walk and then if you're feeling better, we'll come back to the chair. Yeah. Alright, sounds good. Okay, ready? So one step forward.",
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