Highlights
Case Study
Gillian is a 71 year old woman who presents to a new GP with chronic bilateral knee pain, and lumbar spine pain, that is really impacting her ability to move around. She has gained a significant amount of weight (10 kg) in the past six months, and the pain has been getting steadily worse. She has seen other doctors who prescribed Non-Steroidal Anti-inflammatory Drugs, but they upset her stomach, so she moved to Tramadol, but quickly developed a tolerance, and her other doctor is reticent to prescribe oxycodone. Gillian wants improved pain control so she can return to regular exercise to try to shift this newly gained weight. She admits that movement actually helps decrease the pain, but at the moment she can’t get over the initial pain barrier to start moving.
Gillian’s past medical history includes:
• Left knee injury at 23 yo due to a motor vehicle accident
• Fractured Right hip at 60 yo due to a fall when out walking to the local park
• High Blood Pressure since turning 40
• High cholesterol started at 65 yo
• Type 2 Diabetes started at 65 yo
• Menopause began at 49 yo
• No recollection of recent injury to her knees nor back
• Long history of chronic joint pain
Gillian’s current medications include:
• OTC Melatonin before bed
• OTC Calcium with Vitamin D at night
• OTC Multi-vitamin with breakfast
• Lipitor 20 mg at night
• Atenolol 25 mg with breakfast
• Lisinopril 40 mg with breakfast
• Metformin 250 mg at night
• Paracetamol (Osteomol) eight hourly (two tablets)
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