Document wDRwRB1nnoORyeb3EM2Qx5E96

UPJOHN HEALTHCARE SERVICES TO: Gen Corp, Inc. ATTN: Ken Breyley NO: OD21223-22 RE: William Price DATES: 6/14/85 - 7/19/85 CASE UPDATE REPORT: HEALTH PROGRAMS Orangewood Place 3690 Orange Place, Suite 540 Beachwood, OH 44122 (216) 292-4333 As reviewed in our last report of contact Mr. William Price has continued his participation in the physical therapy conditioning program at Ashtabula General Hospital under the supervision of Brian Schreck, LPT. At the time of my last report we were recommending the use of a stationary bike as part cardiovascular aerobic reconditioning program that had been designed for him. On 6/17/85 I spoke with Mary Custer via telephone and it was suggested that we rent this equipment for Mr. Price's use. After several telephone calls to several rental agencies and an inability to arrange in a cost effective manner for this equipment to be delivered to Mr. Price's home I again spoke with Mary Custer who asked that we purchase the needed equipment. It was agreed by all parties that Mr. Price would be allowed to use this equipment as long as necessary but it would remain the personal property of Gen Corp. Mr. Price has verbally agreed to this arrangement but I am suggesting that we obtain a verification of this agreement in writing. I will discuss this recommendation with you personnally in the near future. On 6/26/85 I received an initial report from Brian Schreck, LPT of Ashtabula County Medical Center which has been previously forwarded to you. This report outlines Mr. Price's physical therapy conditioning program which has been discussed in my previous reports of contact. On 7/8/85 I telephoned Mr. Price but he was unavailable to speak with me. His wife informed me he was doing well and continued his participation in the physical therapy program. They were to leave Wednesday, July 10, 1985 \for a three week vacation in Europe and will return on August 6, 1985. On 7/16/85 I received the enclosed physical therapy report from Brian Schreck, LPT. As you can see by reviewing this report he is voicing some concerns regarding Mr. Price's motivation and compliance with this program. In my past reports I have discussed Mr. Price's hesitation to over exert himself physically due to a fear he will cause an exacerbation of his previous physical problems. As stated he has a follow-up appointment scheduled with his physician Dr. G. Thomas Budd, M.D. of the Cleveland Clinic in August upon his return from vacation. I feel at present Mr. Price is pre-occupied and anxious regarding this examination and the outcome of it. He is reporting an RECEIVED JUL 2 2 1985 WORKER'S COMPENSATION DEPT. 6ENC 002395 2 increase in left shoulder and upper back pain which is possibly due to the stretching exercises but his is apprehensive in this regard due to the fact that he experienced similar symptoms prior to the diagnosis of his cancer. I have kept Dr. Budd informed of Mr. Price's participation in all rehabi litation planning to date. I will be addressing a letter to him including the two physical therapy reports prior to his examination of Mr. Price. Based on the outcome of his medical follow-up evaluation I feel it will be necessary to contact Dr. Budd and Mr. Price in order to re-evaluate future rehabilitation planning. If it is determined that Mr. Price remains medically stable it is my recommendation that a more aggressive physical . therapy program be devised which could be submitted to the Industrial Commission Rehabilitation Division as part of a reimbursable rehabilitation plan. Based on Mr. Price's participation of a self directed aerobic cardio vascular reconditioning program I feel we would achieve better compliance in a more closely supervised setting. I can appreciate Mr. Price's hesitancy and anxiety regarding his physical well being, but I feel he will not improve his general condition and stamina unless he is involved in a more vigorous physical therapy exercise program. I will be in contact with you in the near future to discuss future rehabi litation efforts on this client's behalf. I will wait until following his appointment with Dr. Budd to do this. In the meantime, should you have any questions regarding this plan please do not hesitate to contact me. Sincerely, /-V Diane M. Hill, R.N., B.S.N. Rehabilitation Nurse DMHrmg cc: G. Thomas Budd, M.D., Cleveland Clinic Foundation Brian Schreck, LPT, Ashtabula General Hospital RECEIVED JUL 22 1985 WORKER'S COMPENSATION DEPT. GENC 002396 a lip Ashtabula County Floyd E. Farley President 2420 Lake Avenue Ashtabula, Ohio 44004 (216) 998-3111 July 15, 1985 Diane M. Hill, R.N., B.S.N. Upjohn Healthcare Services 3690 Orange Place, Suite 540 Beachwood, OH 44122 RE: William Price Dear Diane: Mr. Price was last seen in our department on July 8, prior to his July 10 departure far Europe. He informed me that he has an appointment to see his physician on August 21. At this last appointment, Mr. Price reported that he had been experiencing an increase in left shoulder, upper back, and right leg discomfort. He attributed this disccmfprt to his warm-up and stretch ing exercises and he therefore had discontinued them. He related that his apprehension in this regard as being due to experiencing similar symptoms prior to the diagnosis of his cancer. I have completed coverage of the majority of the material as it per tains to the reconditioning program for Mr. Price. An individuallydesigned aerobic exercise program has been outlined for him. Also, appropriate stretching and warm-up exercises have been demonstrated. Additional time will be spent on posture and body mechanics. My concern is Mr. Price's motivation and compliance with this pro gram. The program is designed to be a gradual one progressing from intensity levels far below one's target heart rate to a level of exercise that will assist with cardiovascular conditioning and fitness. This is done to encourage participation and avoid early discouragement. Mr. Price's adherence to guidelines that we have established for his program has been sporadic, in my opinion. My impression is that this is due primarily to his apprehension as to hew vigorously he can exercise as well as what the implications nay be on his-past diagnosis of cancer. He is very cautious of overdoing due to his fear of recurrence of the cancer. QENC 0023?'? Perhaps if his physician and you could reassure him regarding the inpact of this type of exercise program on his general health and its possible inpact on his previously diagnosed cancer. Please let me know if I can be of further assistance. Sincerely, Brian V. Schreck, LPT RECEIVED JUL 22 1985 WORKER'S COMPENSATION DEPT. 6EHC 00