6 for the next four weeks, providing ongoing support for Angela. A formal evaluation would take place at the end of four weeks. It was decided not to refer Angela to an occupational therapist regarding splinting at this stage but to evaluate the above plan of care and refer if there was no improvement in Angela’s spasm and pain.
Four weeks after your initial visit to Angela with her MS CNS both you and the MS CNS are visiting Angela to evaluate the plan of care that was implemented. Angela has continued to assess her pain as outlined in her action plan; she is now experiencing pain on four nights out of seven and on two days out of seven, with her pain intensity having reduced to between 3 and 4.
She also reports that while she is still experiencing pain on four nights
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Angela agrees to this suggestion and will discuss it with her physiotherapist at her next appointment. A further recheck meeting is planned for one week’s time.
Case Studies
7
Frazer: Type 1 diabetes
Chapter 1
Frazer is 42 years old. He has Type 1 diabetes, which was diagnosed when he was eight years old.
He lives with his long term partner Claire and their daughter, Fiona, aged six. Frazer currently works part time as an office administrator and Claire works full time as a primary school teacher. Frazer works part time partly due to complications of his diabetes, mainly diabetic polyneuropathy, and partly to help out with childcare for Isobel, their daughter. He is currently receiving treatment due to having an ulcer on his left foot that is slow to heal.
Chapter 2
Frazer is 42 and is living with Type 1 diabetes. In the past he has not always managed his diabetes as effectively as he should. Since the birth of his daughter six years ago he has taken a more proactive role in managing his diabetes, though he still smokes ten cigarettes a day. You are working with Frazer’s practice nurse today and Frazer is visiting her to have the ulcer on his
foot