INTRODUCTION. she has filled 32 prescriptions for eight

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Last updated: May 26, 2019

INTRODUCTION.Disability is considered an impairment that may be Lucinda, is a 37-year-old overweightMexican-American female referred for integrated case management by insurancereviewers specifically looking for patients who use many health services. Shecame to their attention because a request was being made for approval to removea gangrenous toe. Lucinda has had numerous procedures, hospitalizations, andemergency room visits in the past 2 years. During the past 12 months, she hasfilled 32 prescriptions for eight different medications from six independentphysicians, one of whom is a diabetic specialist, one a psychiatrist (fordiazepam), and one a surgeon (for a pain medication).

Three prescribers areprimary care physicians. Lucinda has four other physicians who have submittedmedical charges for her care in the past year. Her last ad-mission was 2 weeksearlier for 2 days and she has been to the emergency room three times in thelast month. During her hospitalization, at that time, she had blood sugarlevels of 400+, a gangrenous toe, and a fever of 104 degrees Fahrenheit. Herlast HbA1c was 9.2. THETREATMENT GOALS AND OBJECTIVES YOU WOULD PROPOSE  TO HELP WITH LUCINDA.Majority of the reports of limb loss worldwideusually occur on individuals who have diabetes.

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Gangrenous toe is a condition thatusually occurs when blood tissue dies. It is usually caused by by a loss ofblood supply due to an underlying illness, injury or infection. Blood plays animportant role in humans body system by transporting blood, it also transportsnutrients which is needed to feed the cells in the human body.I would recommend the treatment  of geangreuos through the removal of the deadtissues to prevent the the spread of infection this can be achieved throughsurgery or introduction of maggots in the body they are tasked with consumptionof eating the dead tissues without harming the living tissues. Once gangrene istreated perfectly and the patient has healed measures will be put to stop itfrom re occurring.

Lucinda should also work out and eat a healthy foodsso as to watch her weight. She should put it under control so as to be able toprevent having difficulties in breathing. I recommend her to exercise daily.ROBERTDepression is a state of mind producing a serious,long term lowering of enjoyment of life or inability to visualize a happyfuture. This disease cuts across all races, countries and continents andtherefore should be taken seriously. Depression has been the cause of mostpeople ending their life pre maturely. Depression is a risky health issue that needs to beaddressed as we are losing a lot of people through suicides which can bepreventable, also such attacks such as panic attacks and anxiety also lead tomore suicide deaths in the world. Awareness to depression and showering peoplewith love and affection can come in handy when dealing with depression.

He shouldalso be on put on medications to control his mild anxiety and depressions. Robert ought to reduce the amount of cigarettes hesmokes on a daily basis 2 packets are too much as it too much for his healthand might lead to lung problems.PAULPaul ought to start being tutored at home so as tobe able to catch up academically with his peers. Medical management consists ofwater pills and heart strengthening medications which he ought to be used on followingthe prescribed prescription. He should use the oxygen mask while sleeping andto be convinced so as he will be able to get over his anxiousness.  Cardiac cathernaziation is the insertion of aCather in the vessel of the heart. The parents ought to have confidence withthe process and believe it will be successful.

CONCLUSIONThe 3 study cases ought to follow the recommendedobjectives so as to prolong their life on earth.  

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