All Posts Tagged With: "arthralgias"

Full article: http://www.amc.edu/amr/archives/200606/case1.html

Excerpt:

A 52-year-old male marathon runner with a past medical history significant for glaucoma presented to the emergency department with a two-week history of increasing fatigue after an episode of syncope.

He initially presented to his primary care doctor’s office complaining of flu like symptoms one week after running a marathon and three weeks prior to admission. He described fever, chills, night sweats, increasing fatigue and body aches. He was noted to be an avid runner who had finished within the top five to ten athletes in prior marathons. He stated that despite training intensely, he only finished in 50th place. During this visit, a chest x-ray was obtained which showed no evidence of pneumonia or other abnormalities. He was diagnosed with a minor viral upper respiratory tract infection and over the following week began to notice improvement of his symptoms.

He returned to the office two weeks after the initial visit with worsening fatigue and decreased exercise tolerance. He had become increasingly short of breath after running more than 2 milles. A serologic test for Lyme disease was performed to rule out Lyme carditis after an EKG showed first-degree heart block.

Linda’s comment:  I suggest you copy and paste this and/or print out and take to your doctors or any healthcare practitioners and make sure they are recording things properly in your charts.  When you know your symptoms are attributed to Lyme disease, make sure this is noted.

In general, social security does not make decisions on a diagnosis, but on the restrictions and functional limitations a person has that results on their inability to work based on any training, education and experience the person had in the past.
 
Because Lyme disease is not listed in the “blue book”, it is even more important for those with Lyme disease to do the following.
Make sure all treating physicians understand the importance of documenting actual functional limitations in the actual patient notes.
 
Many physicians actually write “non-descriptive” patient notes which later are determined to be useless for SSDI purposes.
 
If a Lyme patient is suffering from neurological deficits that result in loss of balance and coordination, this should be clearly indicated in the patient record as attributable to Lyme disease.

Clinical practice guidelines are increasing in number. Unfortunately,
when scientific evidence is uncertain, limited, or evolving, as is often
the case, conflict often arises between guideline committees and
practicing physicians, who bear the direct responsibility for the care of
individual patients. The 2006 Infectious Diseases Society of America
guidelines for Lyme disease, which have limited scientific support,
could, if implemented, limit the clinical discretion of treating physicians
and the treatment options available to patients

Introduction

Clinical practice guidelines are now ubiquitous throughout the
United States. The National Guidelines Clearing House, under the
category “diseases,” currently lists 2,126 separate guidelines on its
web site. Clinical guidelines are intended to assist physicians in
patient care by clearly communicating the results of the guideline
committees’ evaluation of available therapeutic options. However,
the processes by which individual guidelines are constructed may be
less clear, leading to disagreements between the issuing committee
and the physicians who treat patients-physicians who may well be
as experienced and knowledgeable as the guideline committee. Continued