Document RamEQvpKBG3p0Kp7B0jk6axNE

COMPENSATION Div-t- i IfCfclVED MAY 1*7194 Eirr|~~r (V t5lMW i Am*lt4 >! fsjJKKS j ftaa`a ------ >.** S<*._ ^ May 11, im General Petroleum -3rp* l-S 2est 2nd Street Los Angelos 12, Calif* Oentleasat Attj t`r. E* P. Luongo, Medical Director Has 'A tey, l?it? Cur File So. l?it?-5 On year authorisation the above captioned patient- reported to the writer for examination on !*~2y~3. He is a married, white c&le, and at the tin of his alleged injury was employed & a tank cleaner, He lives. at 10663 Hasseaa St., Sualaad, Calif. HICDIgt The patient gave the following history: - In Kay of 19h7 he start ed to have pains in his left lower abdomen* After their incep tion they sesaad to work up along the side of his ahdoaer: into his left ara. This condition lasted for approximately two minutes* Because of It he went to the Glendale Clinic where ho states all sorts of tests were made. He particularly stated that they did not find anything wrong with, his kidneys c-r his heart, Ihe condition partially cleared up but he states never entirely. Then about one month ago th patient noticed this pain in his left leg and ankle. He has noticed none on the right side. Because of this-pain he has to change the position of his legs frequently, and the pains will wake him up at night. . Ha recently consulted & physician who gave hisi some tablets. Past--Medical History; - The patient sia.te?hehas always been in excellent health, has never bad any serious illness, acci dent or operation* Inventory of Systeast Head - The patient states he has no headache, difcSinsss or tinnitus, lie has poor vision which has been corrected by bifocal glasses.' He has ted no sinus trouble* He states his teeth have been false for a number of years. Tonsils -Intact* respiratory System - Patient has a slight morning cough which is also slightly productive. This has been present for a number of years* US 0016052 N18632 5-ll4j3 Cardiac - The patient denies any dyspnea, palpitation, or cardiac pain. Se does state, however, that he uses tiro pillows to sleep on at night, indicating the possibilityodf some mild degree of orthopnea. .Gastro-inteatInal - Appetite good* Has no symptoms of indigestion* Is net constipated* He never has noticed any abdominal cramps or colic* Qenito-urinary - Ho nocturia, frequency or dysuria. Benies venereal dis ease*/ , Nervous System - Negative/-' ' Weight - Stationary* Occupational History: Mr, states ho has worked for the General Petroleum Corporation for twenty-four years. By trade he is a pipe fitter but for approximately twenty years he work has: entailed the cleaning out of tank cars* These tank ears have con tained both regular gasoline and Ethyl gasoline. When questioned as to iw many tank cars he cleans, he states that he will average one. a day and thinks that in the past twenty years he has cleaned out 10,000 cars. He describes his work as follows: He first runs through the opening a hose which pours into the tank hot steam. After this has been don and the tank drained, and cooled down, the patient then enters the tank with an ordinary water hose, and cleans it out again. In addition and on occa sions if there is some caking or ary material adherent to the sides of fee tank car he uses a material which he calls a gas-oil. When ques tioned as to whether or not this work within a tank every bothered him or annoyed him in any manner, ha states not usually. Once in a while he wiXL-feel sort of di^zy or maybe his head will feel a little heavy, but otSwwise he states he has never noticed anything obnoxious. PigSISAL EXAMINATION: The patient is a pleasant, affable, and normally ' intelligent, white male. His weight was 212 lbs. and: height 5 ft. 71 in. Head* The pupils were small, round, but reacted to light. Because of the smallness of the pupils the fundi were not well visualised. Hi ear- canals and ear drum were normal. There was no evidence' of any :inflammation of the nasal mucosa. Thai; teeth were all false. ' ThrmtV "Negative. - SSSIt This was barrel shaped in type and there was slight restriction bilaterally of the chest on deep inspiration.- This is a usual finding in om of this age and with this type of chest* The percussion note was resonant throughout. Auscultation of the lungs revealed no friction rubs or rales. Heart: Hate of 70} there was an occasional ctopic beat present. No mur murs were heard. The blood pressure was 160/90* Abdomen: Obese} no organs or masses were palpated. It was particularly noted there was no enlargement of the liver. ,.*r- . US 001605:) ' ------'*.... jjfj.K& - - il :KA#y-' ?: :;> No. 3 " . R* Louis Gilbert Arndt -11-1*8 : V^'l L' ,, > SI:S:. Prostate? 80 enlargement of the prostate was acted.. Siareaitieet negative on general inspection. There was ns evidence of ankle edSaia. Here eras ssm weakness of grip of. bath .hands bilaterally. - Neurological Mx&sination* Sx&atn&tioa of the cranial nerves revealed no 15norSHtTee. The patient has .'normal reaction to the senses of smell and taste* There was no weakness of the facial muscle*. The rest of the heurological system was examined and it was found th&tthe &mberg was negative the Babinski was negative, and gait was normal, Th left patellar reflex and left teodo-Achilles reflex was present bat slightly diminished over that of the right. This diminution, however, was so slight as to not be thought significant. The reflexes of the upper extremities were normal* In testing the sensory system the patient had some alight diminution of sensation to pin prick in both the left arm and left leg. Motion of the extremities was normal but the patient complained of some slight discom fort on raising his left arm. This discomfort was felt in the area of the shoulder joing. 'J -* J. <v V'-'-s. ": - V?-'. LABORATORY; Whole Blood Test for Lead; Lead content - 0.0$ ag,/100 si. blood (Normal* 0.0 to 0.07 mg.) Blood "bunts Hoaiglobia erythrocytes Leucocytes Polys. Lymphs. Monos. as L,300,000 lh,30Q 70 28 2 ' , Blood Sedimentation Test* 5 m* la 1 hour (Sorsali B to 8 mm.) Urinalysis* Color -Yellow Appearance - Clear Reaction - Acid Specific Gravity - 1.030 ' Albumin - 0 _v . - ; : ' Sugar -- 0 Microseopie* Occasional epithelial 8 white blood cells Blood i&sserssann and Kahns Negative LLSdliQCARDIOGRAM; The auricular and ventricular rates are eqaal. There is no evidence of prolongation of the time interval in the F-S or the Q-ft-3 complexes. The P-sava is normal in all three leads that is, in I, II and I?, bat is downward in lead III. This is of no sig nificance. The T-srave is upright In leads I, II and If, and diaphaale in lead III. There is a alight tendency towards notching of the R-Iiiab and the amplitude is somewhat loser than normal. Kff 0016054 5--11--bS Interpretations There is no evidence froa this alect.rocardiogras of any coronary disease* It dots indicats a.slid degree of cardiac in sufficiency in keeping witr. the patiet*s age. - X-RAI EXAHSlAflOlit Poat^ro-antorior views of the chest reveal seat'-/'' slight solargejaeat of the aortic balb and aoac def inite enlargement of the loft ventricle, there is generalized increase of the. perivascular ssarklags in' keeping with his 'age* - -' ' ` ; DISCUSS1081 The cotaploie physical examination of this individual is essentially normal, and the laboratory investigation. fails to reveal any abooriaal findings other than a leucocytesla, the cause of which was not apparent fro the physical examination. It will be par ticularly noted that the whole blood for load is well within the normal limits. In fact, it is on the lower side of the normal. The electro cardiogram revealed so significant filings, and the chest x-rays are i n keeping with tuose of an individual with a barrel-type chest. It would, therefore, appear fro the writer1 s exasia&tioa of this indi vidual that he has no disturbance of any type which sight be attributed to his occupation* likewise, he does not appear to have any specific pathological disturbance of non-occapational origin other than the possible cause for. the leg pain* It is the opinion of the writer that this pain which this patient baa la bia left leg is probably 4m to sosas arterial spasm similar to inter mittent claudication. The patient is definitely not that of a neuritis and no evidence was found of any disturbance to the loft sciatic nerve* It will be noted that the patient notices this pais particularly in his leg when it has been at rest, that is, after sitting for any length of tine or at night in bed*, this, again, indicates the possibility of a poor blood supply to the part* ` - ' As previously stated, the writer does hot believe that this patient has any disturbance to his ocoupatl^. Mt, the writer cannot help but ' feel that this st& is inad^aathljrW^I^ into a tank which px*~rM vieusly contained Ethyl gasoline, frosombly, under ordinary cir- ~ cusast&nces, there exists no hazard, but one wonders if such luck can always hold out. In conclusion there exists in this case no disturbance due to his em ployment, and, therefore, no temporary disability of occupational origin. ETJ/lds Very truly^yours, LxO* I0M8, a. D. 'V. , - .--Tv W 0016055-