Age: 75.0
Sex: M
Vaccine: COVID19
Symptoms: Exploratory operation, Hypotension, Phimosis, Spinal stabilisation, Urethral meatotomy
Clinical narrative: Discharge Examination & Summary  Patient Name:   DOB:   Admission Date and Time: 12/10/2023  9:57 AM Discharge Date: 12/22/2023 Attending Physicians: DO, MD, MD, MD, PA Discharge Physician:  DO Admission Diagnosis: Osteomyelitis of thoracic spine   Discharge Diagnosis: Osteomyelitis of thoracic spine    REHABILITATION COURSE  Patient is a pleasant 78 YO right handed male with hx thoracic osteomyelitis and discitis treated with 8 weeks IV ceftriaxone completed 12/4/23, hx CHF, HTN, BPH, history of E coli urosepsis, anxiety and depression, who presented 12/10/2023  9:57 AM to facility after primary admission to  Hospital - for planned thoracic spine stabilization surgery.  He underwent T7-10 instrumented stabilization of T8, T9 vertebral body/disc spas erosion due to hx of discitis on 12/6/23. Staples may remain in place until 12/20, ok for removal at rehab.  Hospital course was complicated by phimosis and urinary retention. Urology was consulted and performed Exploration of buried penis lysis of adhesions penile degloving meatotomy circumcision of scarred tissue, cystoscopy on 12/7/23. Patient had a foley through 12/9 and was able to void afterwards. He is on Keflex through 12/16.  When medically stable, the patient was discharged to facility for acute inpatient rehabilitation of functional and cognitive deficits.  Symptoms related to these abovementioned conditions and events were well-controlled, and the patient was discharged medically stable and improved. There were no significant acute episodes that affected length of stay or tolerance to therapies.  The patient was also provided orthotics / durable medical equipment to ensure improved function and safety in the rehabilitation and home setting.  Occupational, Physical and Speech Language Pathology therapists and a Neuropsychologist were consulted for evaluation and treatment so as to best determine the amount and extent of services required for cognitive and functional optimization. The patient received a minimum of 180 minutes of therapy per day for 5 out of 7 days, or more than 15 hours of intensive therapy over the course of a week.   While in the unit, the acute rehabilitation service also held interdisciplinary team conferences on a weekly basis to establish specific short- and long-term goals during rehabilitation, and for discharge. Barriers to discharge were also noted and updated as they were addressed. Plans to assure continuity and coordination of care after discharge from the acute rehabilitation unit were also established and explained to the patient and care provider(s).  While on the unit, the patient was monitored on a daily basis by a physician who evaluated and managed co-morbidities and medical conditions, as necessary.  Noteworthy events related to the patient's rehabilitative stay included the below mentioned - which were treated as indicated:  1. He had some intermittent hypotension, proscar and then flomax were held with improvement however he began to retain urine again.  Flomax is now restarted.  Patient instructed to change positions slowly.  He will f/u pcp and/or urology regarding proscar restart. 2.   He feels safe and ready to dc home today.