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marion Cervial ADR
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| Surgical Outcomes and Blogs Discuss marion Cervial ADR in the Main forums forums; ISPINE.ORG Forum > Main forums > Surgical Outcomes Blank surgical outcomes form Welcome, marion. You last visited: Yesterday at ... |
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01-04-2009, 10:55 AM
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marion Cervial ADR
ISPINE.ORG Forum > Main forums > Surgical Outcomes
Blank surgical outcomes form Welcome, marion. You last visited: Yesterday at 07:09 PM Private Messages: Unread 0, Total 0. User CP FAQ Members List Calendar New Posts Search Quick Links Log Out Surgical Outcomes Discuss Blank surgical outcomes form in the Main forums forums; SURGERY DATE: AGE AT SURGERY DATE: SURGEON: SURGERY LOCATION/CLINIC: DEVICE(s), LEVEL(s): COST = AMOUNT BILLED: INSURANCE ALLOWED: OUT ... Search Forums Show Threads Show Posts Tag Search Advanced Search Quick Links Today's Posts Mark Forums Read Open Contacts Popup Networking Contacts & Friends Social Groups Pictures & Albums User Control Panel Edit Signature Edit Your Details Edit Options Miscellaneous Private Messages Subscribed Threads Your Profile Who's Online Go to Page... LinkBack Thread Tools Search this Thread Rate Thread Display Modes #1 (permalink) 05-16-2008, 04:12 AM mmglobal Administrator Join Date: Sep 2006 Posts: 1,070 Blank surgical outcomes form -------------------------------------------------------------------------------- SURGERY DATE: 16th Sept 08 AGE AT SURGERY DATE: 48 SURGEON: Mr Ian Shackleford SURGERY LOCATION/CLINIC: Warrington, UK DEVICE(s), LEVEL(s): Cervical C5/6 C6/7 COST = N/A - UK AMOUNT BILLED: zero INSURANCE ALLOWED: N/a OUT OF POCKET: N/a TRAVEL: 500 miles round trip EXPLANATIONS? n/A ONSET OF LUMBAR PROBLEMS, DATE OF INJURY, CAUSE, ETC...: fall June 06, neck pain Jan 07 DDD diagnosed caused by trauma PRIOR SPINE SURGERIES AND PROCEDURES (IDET, ESI, etc...):None PRE-OP MEDICATIONS: Tramadol, Paracetamol , Diazepam, PRE-OP DIAGNOSTICS (discogram, nerve root blocks, etc...): MRI and physical exam PRE-OP NEUROPATHIES (what, where, & degree of pain, numbness, tingling, sexual/bladder/bowel symptoms, etc.): pain 4-8/10 wax wane worse after day wears PRE-OP CONDITION (Please include %leg pain/% back pain, pain levels, type of pain, ability to work and function, disability status, etc.... be direct, but be as verbose as you need to): Unable to work pain constant and like toothache TIME POST-OP AT ORIGINAL POST HERE: 3.5 months DESCRIBE YOUR SURGICAL EXPERIENCE: Out in 2 days, in alot of post op pain for 5 days RATE FUNCTIONALITY / SATISFACTION AT INTERVALS BELOW: FUNCTIONALITY: 1. Very poor: much worse... disabled after surgery. 2. Poor: worse after surgery. 3. Neutral: No improvement, or improvements offset by new problems. 4. Fair, some improvement, limitations are still serious. 5. Good, substantial improvement, some limitations. yes 6. Excellent: no limitations. SATISFACTION: 1. Very sorry I had the surgery. 2. Somewhat sorry I had the surgery. 3. Too soon to tell, or I'm ambivalent about the surgery. 4. I'm somewhat glad I did my surgery. yes 5. I'm very glad I did my surgery. Don't forget the detail update section below! DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [6 WEEKS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [3 MONTHS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [6 MONTHS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [1 YEAR POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [2 YEARS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [3 YEARS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [4 YEARS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [5 YEARS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [6 YEARS POST-OP] DATE UPDATED: _________ FUNCTIONALITY: ___ SATISFACTION: ___ [7 YEARS POST-OP] 6 WEEKS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ECT... (discuss surgery induced symptoms [leg pain?]): 3 MONTHS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 6 MONTHS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 1 YEAR POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 2 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 3 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 4 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 5 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 6 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): 7 YEARS POST-OP - DESCRIBE LIFESTYLE / PAIN / MEDICATIONS / NEUROPATHIES / ETC... (discuss surgery induced symptoms [leg pain?]): -------------------------------------------------------------------------------- Last edited by mmglobal; 05-17-2008 at 09:15 PM. mmglobal View Public Profile Send a private message to mmglobal Send email to mmglobal Find all posts by mmglobal Add mmglobal to Your Contacts Bookmarks Digg del.icio.us StumbleUpon Google Edit Tags Tags None vBulletin Message Cancel Changes Quick Reply The following errors occurred with your submission Okay Message: Please click one of the Quick Reply icons in the posts above to activate Quick Reply. Options Quote message in reply? Posting Quick Reply - Please Wait « Previous Thread | Next Thread » Thread Tools Show Printable Version Email this Page Subscribe to this Thread Display Modes Linear Mode Switch to Hybrid Mode Switch to Threaded Mode Search this Thread Advanced Search Rate This Thread Excellent Good Average Bad Terrible Posting Rules You may post new threads You may post replies You may post attachments You may edit your posts -------------------------------------------------------------------------------- BB code is On Smilies are On [IMG] code is On HTML code is Off Trackbacks are On Pingbacks are On Refbacks are On Forum Jump User Control Panel Private Messages Subscriptions Who's Online Search Forums Forums Home Main forums iSpine Surgical Outcomes Abstracts and Articles Community Support - NSR Surgery Blogs Travel forums German Travel (for international patients) Straubing and Bogen Munich - Alpha Klinik Transparent (private, not spine related) All times are GMT. 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