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,° <br />DURANGO DRTHDPEDIC ASSDCIATES, P.C. <br />ORTHOPEDIC SURGERM <br />IB DD EAST THINU AVENUE. SUITE 16 <br />DLIRANGD, C[]LORADD B13O1 <br />TCLEPHONC 3D]QAT696] <br />TA%LD. NU dA~06dB56T <br />WIL LIAMJ %NAU S[N. M.D. <br />OCAN L. FUNNY, M.D. <br />BANNY MILLM[N. M.D. <br />LOBATO, Fidel Ref: Leo W, Lloyd, M.D. <br />12-21-82: This gentleman states that he is not improved at all <br />since starting his home treatment last week. He is still having severe leg <br />pain on the left. His range of motion has not significantly improved, and <br />therefore he would like to go ahead with hospitalization and the more inten- <br />sive PT as recommended on the initial exam. Unfortunately he also wants to <br />be home for the holidays and so we will com?romise keeping him quiet at home <br />with medication for now. He does get sorle relief from tree I•totrirl so we evil i <br />_, refill that and he will probably tome into the hospital right after Christmas <br />for the proposed conservative treatment. <br />~. <br />cc: Dr. Lloyd* De~R~I-. Furry, M.D./t <br />Hospital Records* <br />01-21-83: This 61-year-old male has had a birthday since his <br />last visit but apparently his low back has not improved. Ile was seen just <br />before Christmas and decided at that point that he would go into the hospi- <br />tal for more strenuous therapy right after the holidays. He has finally <br />gotten around to that, noticing that he has not improved, and he wants <br />to enter the hospital now for a trial at conservative therapy. <br />PAST HISTORY: Relatively benign regarding his back. He has had <br />_. several kidney stones, most removed with the basket, one open surgery was <br />performed, I think by Dr. Kiracofe. General health aside from these kid- <br />ney tone problems is good. <br />REVIEW OF SYSTEMS; Denies any cardiovascular, GI or GU difficulty other <br />than mentioned above. <br />PHYSICAL EXAMINATION: Today reveals a healthy appearing elderly male who <br />moves about somewhat guardedly. <br />HEENT: Not remarkable. <br />CHEST: Clear to auscultation and pe.,cussion without roles. <br />HEART: Normal sinus rhythm without murmurs. <br />ABDOMEN: Scaphoid, soft, organs not palpated. There is a well-healed right <br />lower quadrant scar from previous kidney surgery. <br />NEUROLOGICAL: DTRs on the right are normal; left shows absent knee reflex <br />but normal ankle reflex and there is diminution to pinprick over the med- <br />ial aspect of the left foot. <br />BACK: SLR is still positive on the left at about 65 or 70 degrees. <br />IMPRESSION: Probable herniated intervertebral disk, most likely <br />L4-5, left, with lumbar spondylosis <br />PLAN: Admission to MMC for con , votive therapy. <br />cc: above Dean L: Furry, H.D./t <br />