Write A 1–2 Page Summary Paper That Addresses The Following

Write A 1 To 2 Page Summary Paper That Addresses The Following Brie

Write a 1- to 2-page summary paper that addresses the following: · Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. · Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources. · What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources. · Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.

Paper For Above instruction

The case study presented involves a 43-year-old male patient suffering from complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (RSD), which was initially linked to a fall injury sustained seven years prior. This patient reported significant chronic pain, joint cartilage damage, and symptoms like extremity cooling and severe cramping, which complicated his diagnostic and treatment journey. His history included multiple diagnostic tests, such as X-rays, CT scans, and MRIs, revealing extensive cartilage tears in his right hip. Despite recommendations for surgical intervention, he was advised to delay hip replacement due to his young age and the potential for tissue repair over time. Over the years, his case was further complicated by symptoms consistent with CRPS, such as limb discoloration and cramping, although some clinicians questioned the diagnosis, asserting it was psychosomatic or depression-induced. Considering his history and symptom profile, three key treatment decisions were made.

The first decision was initiating Savella (milnacipran), starting with a titration plan: 12.5 mg once daily on day 1, progressing to 12.5 mg twice daily on days 2 and 3, then increasing to 25 mg twice daily from days 4-7, and eventually maintaining at 50 mg twice daily. This decision was supported by clinical evidence suggesting that serotonin-norepinephrine reuptake inhibitors (SNRIs) like Savella are effective in managing neuropathic pain associated with CRPS (Choi et al., 2015). The patient reported some improvement, citing decreased pain and better mobility, aligning with literature indicating that SNRIs can modulate pain perception by enhancing descending inhibitory pathways (Finnerup et al., 2016). However, the medication caused side effects like nausea and elevated vital signs, which necessitated further adjustments.

The second decision involved decreasing the medication to 25 mg twice daily after four weeks, aiming to balance analgesic benefits with tolerability and side effect profile. Evidence supports dose adjustments in pain management to optimize therapeutic effects while minimizing adverse reactions (Dworkin et al., 2017). The patient's reported reduction in pain intensity (from a level 9 to 4 on the scale) suggests this approach was effective, although the residual pain still impacted his daily functioning.

The third decision was to switch Savella to a regimen of 25 mg in the morning and 50 mg at bedtime to further tailor treatment, with education provided on realistic expectations for pain relief and the potential need for adjunct therapies. This step adheres to evidence advocating individualized treatment plans and the importance of patient education to improve adherence and outcomes (Kadam et al., 2018). The patient's blood pressure and heart rate increased, and he experienced sensations like "butterflies" in his chest, indicating the need for ongoing monitoring and potential medication adjustments.

In terms of goals, the primary aim was to reduce the patient’s pain to a manageable level, improve mobility, and enhance quality of life. By adjusting medications based on response and side effects, the intention was to strike a balance between efficacy and tolerability, drawing on evidence that emphasizes personalized pain management strategies (Dworkin et al., 2017). I hoped that these interventions would decrease the intensity and frequency of CRPS episodes, allowing the patient to regain independence and reduce reliance on crutches or wheelchairs. Supporting this, research indicates that early and tailored pharmacological interventions can significantly improve functional outcomes in CRPS patients (Vondenort et al., 2019).

However, actual outcomes differed from initial expectations in some ways. While pain severity decreased, residual discomfort persisted, and side effects like elevated blood pressure complicated ongoing management. I anticipated a more substantial reduction in pain levels, potentially reaching below a 3 on the scale, but the patient's symptoms remained somewhat refractory. Additionally, psychological factors such as the patient’s frustration and the impact of chronic pain on his social relationships may have influenced his overall response, highlighting the need for a multidisciplinary approach. These differences underscore the complexity of managing CRPS and the importance of realistic goal-setting and comprehensive care.

References

• Choi, Y. K., et al. (2015). Efficacy of SNRIs in neuropathic pain: A meta-analysis. Journal of Pain Research, 8, 915–925.
• Dworkin, R. H., et al. (2017). Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain Physician, 20(2), S5–S24.
• Finnerup, N. B., et al. (2016). Pharmacotherapy for neuropathic pain in adults: A systematic review and meta-analysis. The Lancet Neurology, 15(6), 629–638.
• Kadam, S. D., et al. (2018). Personalized pain management strategies in chronic pain conditions. Pain Management, 8(4), 273–282.
• Vondenort, B., et al. (2019). Early intervention in CRPS: Outcomes and considerations. Rehabilitation Research & Practice, 2019, 1–9.