Patient comes in complaining of hoarseness. The patient apparently lives with his wife and does a fair amount of talking. The left side of his cranium is missing. He does have well-known hemorrhoids. Reflexes in the upper extremities are normal and symmetrical.
Lower extremities show an absent right ankle compared to the left.
I also gave her a back book to start doing exercises in. He does have a fairly high stress job and appears in the clinic with his lap-top computer today. The patient wishes to establish with a neurologist with the diagnosis of Parkinson's disease. She has not been taking the medications that were prescribed. She notes that smoking marijuana currently helps most of her symptoms.