Browsing by Author "Taylor, Kristen"
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Item Integration of psychosocial and medical factors in the care of a 17-year-old with GSW at T5 – a case study(2024-03-21) Oliver, Madelyn; Taylor, Kristen; Wolfe-Christensen, CortneyBackground: Rehabilitation psychology involves the application of psychological knowledge in the care of individuals with disabilities and chronic health conditions. This specialty involves ongoing evaluation of a patient’s mental and psychological status and the formation of positive coping skills and behaviors to help the patient achieve a satisfactory and productive life, as defined by the individual patient. Individuals with spinal cord injuries (SCIs) have an increased risk for poor physical, psychological, and social health. This trend is even more pronounced in vulnerable populations, including the poor, racial and ethnic minorities, older adults, and pediatric patients. Case information: A 17-year-old male presented to Care Now with a gunshot wound (GSW) to the back. The patient was transferred to JPS. CXR showed that the bullet fractured T5 and remained lodged. The patient was diagnosed with incomplete SCI and paraplegia and treated for pulmonary and hepatic lacerations and diaphragm injury. The patient was transferred to Cook Children’s RCU for long-term management. Psychology was consulted to discuss patient’s dissatisfaction with catheterization and concerns on sexual functioning. Conclusions: The incorporation of rehabilitation psychology in the care of patients with SCIs, particularly in vulnerable populations, has been shown to improve long-term success and independence. It is essential to implement a multi-factorial approach that considers both medical and psychosocial variables in a patient’s treatment plan. Emphasis must be placed on individual priorities of the patient to help the patient achieve acceptance and long-term satisfaction.Item Multi-system Effects of Delayed Porphyria Diagnosis(2024-03-21) Heidenreich, Taylor; Taylor, Douglas; Taylor, KristenBackground: Acute Intermittent Porphyria is a life-threatening, debilitating, but treatable condition that often eludes diagnosis. Symptoms can manifest in a variety of ways, making it critical to consider in patients that present with multisystem dysfunction. While some symptoms can include psychiatric disruptions, an underlying organic cause should not be discounted. Case Information: A 17-year-old female with history of abdominal pain presented to the hospital due to severe abdominal pain, requiring continuous opioid medications. She underwent cholecystectomy but continued to suffer. She experienced a seizure like event, decompensated into respiratory arrest requiring CPR. She recovered and discharged home a week later. She continued to experience pain, rapidly progressive numbness, weakness, and inability to walk. She was hospitalized again, noted to have dysarthria, multiple electrolyte abnormalities, and evidence of end-organ damage. Initially, she was diagnosed with Functional Neurological Disorder. She was transferred to a higher level of care, where she underwent extensive lab work, MRI Brain (negative), and EEG (negative). She was transferred to a dedicated pediatric hospital, where she was immediately diagnosed with porphyria. She had notable respiratory insufficiency with acidosis, requiring tracheostomy and gastrostomy placement. She began treatment with Hemin, slowly recovered completely, and is now back to a normal life. Conclusions: Individuals with porphyria are at increased risk for significant long-term effects if the diagnosis is delayed or missed entirely. Porphyria needs to be considered when patients exhibit a combination of polyneuropathy, psychological disturbances, hematuria and abdominal pain.