Question: Hey, I had a spinal fusion done from T8-T10 about 7 months ago. The doctor says that I am pretty much healed and can assume regular activities. Doctor advise me not to ever play basketball the rest of my life...I am going to wait a full year before I start any strenous activities. My question is since that area (t8-t10) is not that XXXXXXX would I be able to run, jump, play tennis, etc, in a years time? I ask my doctor about the vertebrae above and below the fusion taking on more force over time and my doctor said that more often happens in the lumbar area. The doctor said that I could not play basketball for the rest of my life. I know there is a risk of doing any strenous activity, but will it take a catastrophic accident to injured the fusion or just simply running, jumping, twisting, slight fall without any catastrophic injury? I am in great shape and feel like I can do anything. I want to get back to riding my dirtbike (ofcourse wearing a spine/back protector thats level C2 certified for impact) just not sure if my fusion/back is somewhat stronger, pre accident conditions or more fragile. Please look at Xrays,reports,etc and advise on severity and second opinion for activites post surgery?

Hey, I had a spinal fusion done from T8-T10 about 7 months ago. The doctor says that I am pretty much healed and can assume regular activities. Doctor advise me not to ever play basketball the rest of my life...I am going to wait a full year before I start any strenous activities. My question is since that area (t8-t10) is not that XXXXXXX would I be able to run, jump, play tennis, etc, in a years time? I ask my doctor about the vertebrae above and below the fusion taking on more force over time and my doctor said that more often happens in the lumbar area. The doctor said that I could not play basketball for the rest of my life. I know there is a risk of doing any strenous activity, but will it take a catastrophic accident to injured the fusion or just simply running, jumping, twisting, slight fall without any catastrophic injury? I am in great shape and feel like I can do anything. I want to get back to riding my dirtbike (ofcourse wearing a spine/back protector thats level C2 certified for impact) just not sure if my fusion/back is somewhat stronger, pre accident conditions or more fragile. Please look at Xrays,reports,etc and advise on severity and second opinion for activites post surgery?

Discharge Summary:
Encounter ID: G0000
03
April
Patient XXXXXXX XXXXXXX
Dictation Date
4/03/2020 4:17 PM
Facility
ORANGE PARK MEDICAL CENTER
2001 KINGSLEY AVE
ORANGE PARK FL 32073
Summary

ORANGE PARK MEDICAL CENTER (COCOP)
Discharge Summary
REPORT#:0403-0892 REPORT STATUS: Signed
DATE:04/03/20 TIME: 1617

PATIENT: XXXXXXX XXXXXXX UNIT #: G0000
ACCOUNT#: G0000 ROOM/BED: G.364-A
DOB: 08/22/74 AGE: 45 SEX: M ATTEND: CALLANDER XXXXXXX MD
ADM DT: 03/28/20 AUTHOR: Starck XXXXXXX APRN
REP SRV DT: 04/03/20 REP SRV TM: 1617
* ALL edits or amendments must be made on the electronic/computer document *


STARCK XXXXXXX M APRN 04/03/20 1617:
PCP

PCP
PCP:
PCP: NO PRIMARY OR FAMILY PHYSICIAN

Discharge to: home

General Information
Problem List/A P:
1. Motorcycle accident

2. T6 vertebral fracture (Acute, Onset: 03/29/20)

3. T11 vertebral fracture (Acute, Onset: 03/29/20)

4. Closed T10 fracture (Acute, Onset: 03/29/20)

5. Closed fracture of T9 vertebra (Acute, Onset: 03/29/20)

6. Multiple fractures of left hand bones

Discharge date: 04/03/20
Hospital course:
45 y/o male s/p MCC. Injuries included T11/10 end plates fx's, unstable T9 and
T6 vertebral body fxs, T8 SP fx, and Left hand distal 3rd phalanx and comminuted
4th phalange fx. He underwent T9 kyphoplasty, T8-10 posterior fusion on 3/29. He
also underwent ORIF L middle finger, CRPP L ring finger, I D L elbow laceration
on 3/30. Post-op course has been complicated by tachycardia. Today, he reports
pain is well controlled and he is ready to go home. He is tolerating a regular
diet and ambulating in the hallway frequently. Heartrate has improved and is now
running 80-low 100s, vital signs stable.

Plan is to discharge home today. Continue pain management, pulmonary toilet, IS/
acapella, and frequent ambulation. Encourage PO intake, continue stool softener
while taking narcotics. Wear TLSO brace when upright as well as out of bed,
avoid thoracic trauma. Keel left arm dressing in place, reinforce for
saturation. Will discharge home on Abx per hand surgery recommendations.

Follow up with PCP in 1 week. Follow up with NSG in 2-3 weeks. Follow up with
Ortho Hand in 2 weeks. Follow up with Trauma PRN.

Plan of care discussed and questions answered.

Consultants: neurosurgery, Hand surgery
Pt. condition on discharge: improved
Allergies:
Allergies:
No Known Allergies (Coded, 03/28/20)



Med Rec

Med Rec
Discharge meds:
Continue taking these medications:
CHOLECALCIFEROL (VITAMIN D3) 1,000 UNITS CAP
1,000 UNITS ORAL DAILY

amLODIPine (NORVASC) 10 MG TAB
10 MILLIGRAM ORAL DAILY

Start taking the following new medications:
CYCLOBENZAPRINE (FLEXERIL) 10 MG TAB
10 MILLIGRAM ORAL THREE TIMES DAILY as needed for MUSCLE SPASMS
Qty = 20
No Refills

oxyCODONE (ROXICODONE) 5 MG TAB
5 MILLIGRAM ORAL EVERY 4 HOURS AS NEEDED as needed for Pain Scale 4-6
Qty = 15
No Refills

DOCUSATE SODIUM (COLACE) 100 MG CAP
100 MILLIGRAM ORAL TWICE DAILY
Qty = 20
No Refills

CEPHALEXIN (KEFLEX) 500 MG CAP
500 MILLIGRAM ORAL EVERY 6 HOURS
Days = 7 Qty = 28
No Refills



Objective
VS/I O
Last Documented:
Result Date Time
Pulse 98 04/03 1658
Pulse Ox 99 04/03 1517
B/P 145/71 04/03 1517
B/P Mean 95.8 04/03 1517
Temp 99.0 04/03 1517
Resp 13 04/03 1517
O2 Delivery Room air 04/03 1109
FiO2 28 04/01 1941
O2 Flow Rate 2.000000 04/01 1941

24 hour I O ending at 0700:
04/03 0700 04/02 1900
Intake Total 500
Output Total 2275 250
Balance -1775 -250

Intake, Oral 500
Number Voids 3 1
Output, Urine 2275 250

Patient Weight

Weight (lb):
Weight (oz):
Weight (kg): 80.000

General appearance: alert, awake, oriented, no acute distress, pleasant,
conversational, mental status normal
Head/eyes: atraumatic, clear cornea, EOMI, PERRLA
ENT: moist mucosal membranes, normal dentition
Neck: full range of motion, non-tender, supple/no meningismus
Cardiovascular: BP/pulses equal bilat., normal capillary refill, pedal pulses
present, regular rate rhythm (rate 80-90s)
Respiratory: aerating well, no distress, no tenderness
GI: non-tender, normal bowel sounds, soft
Extremities: moves all, normal capillary refill, normal motor function, normal
range of motion, normal sensory
Musculoskeletal: full range of motion, normal inspection
Neuro/CNS: alert, normal gait, normal speech, no motor deficits
Skin: dry, normal color, normal temperature, LUE splint
Psychiatry: normal affect, normal judgment/insight, normal mood

Results
Results: no new labs, vital signs stable, current med profile rev'd

Discharge Instructions
Diet: regular
Activity: as tolerated, partial weight bearing,Lt (LUE)
Wound/dressing care: Leave dressing in place (Reinforce PRN for saturation)
Prescriptions: on chart
Discharge management: less than 30 mins
Time spent:
Time spent with patient (minutes): 20

Follow-up Appointments
PCP:
PCP:
.PRIMARY CARE PROVIDER
Follow up timeframe: In 1-2 weeks
Attending Physician:
Attending Physician:
SIM XXXXXXX MD
Phone: 904-276-2549
Follow up: PRN
Consulting provider 1:
Provider 1:
Rothschild,Cheslovas MD
Specialty: Neurological Surgery
Follow up timeframe: In 2-3 weeks
Consulting provider 2:
Provider 2:
Baez-Lorenzo XXXXXXX MD
Specialty: Hand Surgery
Follow up timeframe: 2 weeks


SIM XXXXXXX 04/03/20 1754:
Attestations

Physician Attestation
Agree w/findings plan:
Agree with the findings and plan as documented by [insert APP name];
* my personal evaluation is
[ ]
patient was seen multiple times throughout the day. Heart rate was in 80-90s.
This was also noticed by the nursing staff. He admits to some anxiety
everytime vitals and staff walk in the room. He is clear for discharge.

Electronically Signed by Starck XXXXXXX APRN on 04/03/20 at 1706
Electronically Signed by SIM XXXXXXX MD on 04/03/20 at 1755

RPT #: 0403-0892
***END OF REPORT***
You are now viewing the provider report detail page

Discharge Summary:
Encounter ID: G0000
03
April
Patient XXXXXXX XXXXXXX
Dictation Date
4/03/2020 4:17 PM
Facility
ORANGE PARK MEDICAL CENTER
2001 KINGSLEY AVE
ORANGE PARK FL 32073
Summary

ORANGE PARK MEDICAL CENTER (COCOP)
Discharge Summary
REPORT#:0403-0892 REPORT STATUS: Signed
DATE:04/03/20 TIME: 1617

PATIENT: XXXXXXX XXXXXXX UNIT #: G0000
ACCOUNT#: G0000 ROOM/BED: G.364-A
DOB: 08/22/74 AGE: 45 SEX: M ATTEND: CALLANDER XXXXXXX MD
ADM DT: 03/28/20 AUTHOR: Starck XXXXXXX APRN
REP SRV DT: 04/03/20 REP SRV TM: 1617
* ALL edits or amendments must be made on the electronic/computer document *


STARCK XXXXXXX M APRN 04/03/20 1617:
PCP

PCP
PCP:
PCP: NO PRIMARY OR FAMILY PHYSICIAN

Discharge to: home

General Information
Problem List/A P:
1. Motorcycle accident

2. T6 vertebral fracture (Acute, Onset: 03/29/20)

3. T11 vertebral fracture (Acute, Onset: 03/29/20)

4. Closed T10 fracture (Acute, Onset: 03/29/20)

5. Closed fracture of T9 vertebra (Acute, Onset: 03/29/20)

6. Multiple fractures of left hand bones

Discharge date: 04/03/20
Hospital course:
45 y/o male s/p MCC. Injuries included T11/10 end plates fx's, unstable T9 and
T6 vertebral body fxs, T8 SP fx, and Left hand distal 3rd phalanx and comminuted
4th phalange fx. He underwent T9 kyphoplasty, T8-10 posterior fusion on 3/29. He
also underwent ORIF L middle finger, CRPP L ring finger, I D L elbow laceration
on 3/30. Post-op course has been complicated by tachycardia. Today, he reports
pain is well controlled and he is ready to go home. He is tolerating a regular
diet and ambulating in the hallway frequently. Heartrate has improved and is now
running 80-low 100s, vital signs stable.

Plan is to discharge home today. Continue pain management, pulmonary toilet, IS/
acapella, and frequent ambulation. Encourage PO intake, continue stool softener
while taking narcotics. Wear TLSO brace when upright as well as out of bed,
avoid thoracic trauma. Keel left arm dressing in place, reinforce for
saturation. Will discharge home on Abx per hand surgery recommendations.

Follow up with PCP in 1 week. Follow up with NSG in 2-3 weeks. Follow up with
Ortho Hand in 2 weeks. Follow up with Trauma PRN.

Plan of care discussed and questions answered.

Consultants: neurosurgery, Hand surgery
Pt. condition on discharge: improved
Allergies:
Allergies:
No Known Allergies (Coded, 03/28/20)



Med Rec

Med Rec
Discharge meds:
Continue taking these medications:
CHOLECALCIFEROL (VITAMIN D3) 1,000 UNITS CAP
1,000 UNITS ORAL DAILY

amLODIPine (NORVASC) 10 MG TAB
10 MILLIGRAM ORAL DAILY

Start taking the following new medications:
CYCLOBENZAPRINE (FLEXERIL) 10 MG TAB
10 MILLIGRAM ORAL THREE TIMES DAILY as needed for MUSCLE SPASMS
Qty = 20
No Refills

oxyCODONE (ROXICODONE) 5 MG TAB
5 MILLIGRAM ORAL EVERY 4 HOURS AS NEEDED as needed for Pain Scale 4-6
Qty = 15
No Refills

DOCUSATE SODIUM (COLACE) 100 MG CAP
100 MILLIGRAM ORAL TWICE DAILY
Qty = 20
No Refills

CEPHALEXIN (KEFLEX) 500 MG CAP
500 MILLIGRAM ORAL EVERY 6 HOURS
Days = 7 Qty = 28
No Refills



Objective
VS/I O
Last Documented:
Result Date Time
Pulse 98 04/03 1658
Pulse Ox 99 04/03 1517
B/P 145/71 04/03 1517
B/P Mean 95.8 04/03 1517
Temp 99.0 04/03 1517
Resp 13 04/03 1517
O2 Delivery Room air 04/03 1109
FiO2 28 04/01 1941
O2 Flow Rate 2.000000 04/01 1941

24 hour I O ending at 0700:
04/03 0700 04/02 1900
Intake Total 500
Output Total 2275 250
Balance -1775 -250

Intake, Oral 500
Number Voids 3 1
Output, Urine 2275 250

Patient Weight

Weight (lb):
Weight (oz):
Weight (kg): 80.000

General appearance: alert, awake, oriented, no acute distress, pleasant,
conversational, mental status normal
Head/eyes: atraumatic, clear cornea, EOMI, PERRLA
ENT: moist mucosal membranes, normal dentition
Neck: full range of motion, non-tender, supple/no meningismus
Cardiovascular: BP/pulses equal bilat., normal capillary refill, pedal pulses
present, regular rate rhythm (rate 80-90s)
Respiratory: aerating well, no distress, no tenderness
GI: non-tender, normal bowel sounds, soft
Extremities: moves all, normal capillary refill, normal motor function, normal
range of motion, normal sensory
Musculoskeletal: full range of motion, normal inspection
Neuro/CNS: alert, normal gait, normal speech, no motor deficits
Skin: dry, normal color, normal temperature, LUE splint
Psychiatry: normal affect, normal judgment/insight, normal mood

Results
Results: no new labs, vital signs stable, current med profile rev'd

Discharge Instructions
Diet: regular
Activity: as tolerated, partial weight bearing,Lt (LUE)
Wound/dressing care: Leave dressing in place (Reinforce PRN for saturation)
Prescriptions: on chart
Discharge management: less than 30 mins
Time spent:
Time spent with patient (minutes): 20

Follow-up Appointments
PCP:
PCP:
.PRIMARY CARE PROVIDER
Follow up timeframe: In 1-2 weeks
Attending Physician:
Attending Physician:
SIM XXXXXXX MD
Phone: 904-276-2549
Follow up: PRN
Consulting provider 1:
Provider 1:
Rothschild,Cheslovas MD
Specialty: Neurological Surgery
Follow up timeframe: In 2-3 weeks
Consulting provider 2:
Provider 2:
Baez-Lorenzo XXXXXXX MD
Specialty: Hand Surgery
Follow up timeframe: 2 weeks


SIM XXXXXXX 04/03/20 1754:
Attestations

Physician Attestation
Agree w/findings plan:
Agree with the findings and plan as documented by [insert APP name];
* my personal evaluation is
[ ]
patient was seen multiple times throughout the day. Heart rate was in 80-90s.
This was also noticed by the nursing staff. He admits to some anxiety
everytime vitals and staff walk in the room. He is clear for discharge.

Electronically Signed by Starck XXXXXXX APRN on 04/03/20 at 1706
Electronically Signed by SIM XXXXXXX MD on 04/03/20 at 1755

RPT #: 0403-0892
***END OF REPORT***
You are now viewing the provider report detail page

Ok....I ask my surgeon about the adjacent levels taking more abuse and he said that its more damaging or prevalent in the lumbar area. When you say that there is correct consolidation compared with the previous imaging studies. Are you referring to the fusion becoming solid? So it will more likely take a hard fall or catastrophic accident to damage or break the fusion or just a simple/minor fall or accident would do it. (example: if i run, trip and fall in the grass ) ....if this makes sense.

Ok....I ask my surgeon about the adjacent levels taking more abuse and he said that its more damaging or prevalent in the lumbar area. When you say that there is correct consolidation compared with the previous imaging studies. Are you referring to the fusion becoming solid? So it will more likely take a hard fall or catastrophic accident to damage or break the fusion or just a simple/minor fall or accident would do it. (example: if i run, trip and fall in the grass ) ....if this makes sense.

thanks for the follow up....Do I have a 1,2 or 3 level fusion?

thanks for the follow up....Do I have a 1,2 or 3 level fusion?

So, is bending ok once the fusion solidifies, according to my x-rays? Since the fusion is T8,T9,T10 and not the lumbar, bending should not affect anything right? I am bending now with no problem, just want to make sure.

So, is bending ok once the fusion solidifies, according to my x-rays? Since the fusion is T8,T9,T10 and not the lumbar, bending should not affect anything right? I am bending now with no problem, just want to make sure.

According to my xray, has my fusion become solid?

According to my xray, has my fusion become solid?