Suggest treatment for lumbar compression fracture
Patient: Hi, my name is Tonya. My 85 year old uncle lives with me. Last week he took a fall and was cleared in an ER. He has a lumbar compression fracture and has been taking 5mg oxycodone twice daily and limited 325mg acetaminophen once daily. He has several comorbidities which include diabetes, chronic kidney disease, and multiple cardiac issues. He is on 3mg warfarin daily, 0.125mg digoxin every other day. There are a few other meds along with vitamins that he takes. The long and short is he has not had a bowel movement in 6 days. He normally evacuates his bowel 2-3 times daily. What can I give him besides his 250mg daily dose of Colace? I am extremely cautious in what I give him because both bactrim and acyclovir have shut his kidneys down. We have had to do extended hospital stays with one time dialysis sessions to get him straightened out. Thank you for your assistance. Doctor: Hi,thank you for providing the brief history of your uncle.A thorough clinical neuromuscular assessment is advised with MRI of lumbar spine. Since your uncle is 85 years old, and had a fall, he needs a proper neuromuscular assessment, as this fall may disrupt his functional ability. Also, by understanding the proper neurological signs and symptoms one can come to conclusion of what to do.Usually, if there is absence of neurological signs and symptoms, then with simple physical therapy the patient responds well. As there is a compression fracture, taking proper bed rest is of due importance.RegardsJay Indravadan Patel