Document jyvybBwgYz4m3bxGMpRXNM1N5

COMfENift.^T!ON D -: ..,m f m m B MAY17 194 fS a w . Ky,, fI M W iffF*amat. gad.- fiiefie, -Ka, i*sa3iSiA Kay II, l M General Petroleum Corp* 1-iS last 2nd Street Los Angelos 12, Calif* Gentlemen* Att* !`r. K, P. Luoago, dedical Director Res 'A May, -1&7 dur File So. On year authorisation the above captioned patient- reported to the Titer for exasinotion on L~2y~a3. He is a married, white sale, and at the time of his alleged injury was employed & a tank clearer, He lives, at 10663 Hasssaa St*, Sunland, Calif. t The patient gave the following history* - In Kay of 19k7 he start ed to have pains in his left loser abdoaetu After their incep tion they seeded to work up along the side of his abdomen Ints his left ara. This condition lasted for approximately two minutes. Because of it he went to the Glendale Clinic where he states all sorts of tests were made. He particularly stated that they did not find anything wrong with his kidneys or his heart. The 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 th position of his legs frequently, and-t,he pains will wake him up at night. .He recently consulted a physician who gave him some tablet. Fast:Medical History; - The patient state^he .has 'always been .in excellent . health, M s never had any serious illness, acci d'ent or- ope.r;at%ion* ., - Inventory of System; . Head - The patient states he M s no headache, diasiness or tinnitus. Be has poor vision which M s been corrected by bifocal glasses# He has had no sinus trouble* He states his teeth have been false for a number of years*- - '- ' - . ' . Tonsils - Intact* ' - ; - . respiratory System - Patient M s 'a slight morning cough which is also slightly productive* This has been present for a number of years. K 0016052 N18632 A i. '17'.' % \, - : V;..-.' -i A\. Sardiac - The patient denies any dyspnea, palpitation, or cardiac pain. Ke does state, however, that he uses two pillows to sleep on at night, -sMeatiag the possibilityoSf sosie mild degree of orthopnea. V .Gastro-intestinal - Appetite good* Has no symptoms of indigestion. Is not constipated* He sever has noticed any abdominal cramps or colic. /. Oenito-urInary - No nocturia, frequency or dysuria. Sentes venereal diS' ease. Servons System - Negative.' Weight - Stationary. Occupational Historyt Mr. states he 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 oat of tank cars* These tank cars have con tained both regular gasoline and Ethyl gasoline. When questioned as to hm 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 t?rough the opening a hose which pours into the tank hot steam. After this has been done 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 so caking or any material adherent to the sides of the tank car he uses a material which he calls a gas-oil. Shan ques tioned as to whether or not this work within a tank every bothered him or annoyed him in any manner, he states not usually. Once in a while he will-feel sort of diz.zy or maybe his head will feel a little heavy, but otherwise he states he has never noticed anything obnoxious. PfSSISAL EXAMINATION: The patient is a pleasant, affable, and normally " - , intelligent, white male. His weight was 212 lbs. ' and: height 5 ft. 7| in. ;. Head;: The pupils were small, round, but reacted to light. Because of tm: smallness of the pupils the fundi were not well visualised. 12 ear canals and ear drums were normal. - . ', . The was no evidence of any inflammation of th nasal mucosa. The teeth were all false. ' "''/ 'XT.."'' .Bgaatr '"'Negative* V :'XX:. - . hast:" This was barrel shaped in type and there was slight restriction bilaterally of the cheat on deep inspiration* This is a usual finding in one 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 Ectopic 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. |stv 1 4 1 . : *&.:?- '-' . Ho* 3 a* Louis Gilbert Arndt $-11-48 .* '4lf Prostate? Bo enlargement of the prostats as noted* txt^^lllesi segative on general inspection, there was as evidence of ankle edem. ".here was some weakness of grip of. both hands bilaterally* - Beurological cxaain&tiosu Exas&nsttoa of the cranial nerves revealed no abnormalities-. the patient has 'normal reaction to the senses of smell and taste, tiere was wNtoesS the facial jsasnLe*. The rest of the iseurological system was examined and it was found that the Jbsfcerg was negative the Babinskl ire negative, and gait was normal, the left patellar reflex and left tendo-Achilies reflex was present but slightly diminished over that of the right. This diminution, however, was so slight as to not be thought significant* The reflexes of the upper extremities were normal. In testing the sensory system the patient had some alight diminution of sensation to pin prick in both the left arm and left leg. Motion of the extremities was normal but the patient complained of same slight discos fort on raising his left arm* fills discomfort as felt in the area of the shoulder joing* . ~ ,1 -~4:[ ' ` ` '" >;4? yyy% LABnRATGRT* Whole Blood Test for Lead Lead content - 0.0$ 3g./100 ml, blood = (dorsali 0.0 to 0*07 *g*) Blood ibunti Hemiglobia erythrocytes Leucocytes Polys. Lymphs. Monos. 5 4 ,300,000 14,300 70 28 2 `, v. ' - V4 ' Blood Sedimentation. fosti $ m in 1 hour (aormali 2 to S am.) U rin a lys is * Co lo r - T e l l c s r - ' . Appearance - Clear Keactioa - Acid Specific Gravity - 1.030 ..., ' Albumin 0 ' ,v. : * . -; ' 'Sugar 0 ' Microscopic* Occasional epithelial ' 8 white blood cells Blood Hissersann and Kahn* Negative KLECmoSARBIOGBAMi The auricular and ventricular rates are equal. There is no evidence of prolongation of tee time interval in the P-a or the Q-R-3 complexes. Use P-wave is normal in all three leads that is, la I, II and 1?, but Is domarsrd in lead III* This Is of no sig nificance. The T-srav is upright in leads I, II and If, and diaphasic in lead III* There is a slight tendency towards notching of tee S-lirab and the amplitude is somewhat lower than norsal. /.ASi^S Interpretations There is no evidence froa this eie atrocardiogram f any coronary disease, It does indicats .slid degree of cardiac in sufficiency in keeping ita the patient*s age. - . l-RAX EX&glgAflQSt rostero-antericr views of tbs chest reveal soae v:' slight snlargsaseat of the aortic balb and soaa def inite enlargement of the left ventricle* there is generalised increase of the perivascular markings in' feeing with his 'age* -' ' ` ; ' ''' DISCH3SIC The complete physical examination of this individual is essentially normal, and the laboratory investigatici fails to reveal any aboonaal findings other than a leucocytesla, the cause of which was not apparent fro the physical examination It s i n be partieularly noted that the whole blood for lead is well within the normal limits. In fact, it is on the lower side of the normal. The electrocardiograa revealed so significant findings, and the chest x-rays are i n keeping with those of an individual with a barrel-type chest. It would, therefore, appear from the writer1s examination of this indi vidual that he has no disturbance of any type which sight be attributed to nis occupation* likewise, he does not appear to have any specific pathological disturbance of non-occapational origin other than the possible cause for. the lag pain* It is the opinion of the writer that this pain which this patient baa la bia left leg is probably m to sosas arterial spasa sballar to inter- attieni claudication, the patient is definitely not that of a neuritis and no evidence was found of any disturbance to the left sciatic nervo* It will be noted that the patient notices this pais particularly in bis leg when it has been at rest, that is, after sitting for any length of time o r a t .night in .bod* ,, this, again, indicates the possibility of a poor blood supply to tbs part* `" - - r:"c'-. ' As previously stated, the writer does hot believe that this patient has ahy disturbane to his occupati^ hit, the writer cannot help but fasi that this m m is inMoiiu6th3^W%olu% into a tank which vieusly contained Ethyl gasoline, Projsomhly, under ordinary eir- \ cuasUnces, there exists no haaard, but one wonders if such luck css 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 Y@ry truly^yours, X im s, a. &*