Avascular necrosis of the right hip

The patient comes in today for a follow-up visit. He continues to have chronic intractable right hip pain from avascular necrosis as well as some neck pain and abdominal pain with history of Crohn’s disease. Pain medication keeps the pain at tolerable. He denies any memory impairment, oversedation, constipation, nausea, itching or high on the medications. He is alert and functional with better quality of life since coming to the Pain Center. He is still working with nutritionist regarding his poor appetite. He is no longer taking the Periactin as it did not significantly affect his appetite. He denies any change in his past medical history, past surgical history, medication history, allergies, family history, social history, or review of systems.

DIAGNOSES:
Avascular necrosis of the right hip.
Osteoarthritis of the right hip.
Right hip joint pain.
Decreased appetite.
Cervicalgia.
Crohn’s disease.

RECOMMENDATIONS:
We will recommend the patient try the P-stim procedure for treatment of his chronic pain. We discussed risks, benefits, and alternative options with the patient and he agrees to proceed. We will continue the Roxicodone 15 mg one q.6h. as needed for pain. I have given him 120 tablets for one month supply. He will continue to followup with a nutritionist. We will see the patient in one-month period of time for reevaluation.

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