Question: I have been given advise by Dr. XXXXXXX Chail regarding x-rays and MRI of my left shoulder. I returned to Dr. Stapleton on Thursday XXXXXXX 18, 2015 for a follow up. I had also received another prescription for Rehabilitation for my shoulder and I decided to return to the three occupational therapists named XXXX, XXXX, and XXXXXXX I learned that Dr. Stapleton is familiar with XXXXXXX and XXXX because they both formerly were therapists at Colleseum Hospital and Rehabilitation Department. This is one of the hospitals that Dr. Stapleton has surgical rights to perform orthopedic surgery.
I had discovered that the Rehabilitation Director named XXXX had discovered he did not know of my research and study of Physical Therapy and that he did not realize he and his staff had the wrong intuition of me through the patients his rehab department treated and the accident reports the had obtained from patients that became a part of the hospital inpatient to outpatient procedures and imbursements. I discovered that the therapists were not including my skills of Physical Therapy and I also discovered the Physical Therapy staff were doing too much overlapping and not allowing the Occupational Therapists to complete their evaluation skills. Each time I was in the sessions for rehabilitation, the department overlooked the obvious of my clavicular head sticking up from the acromium drastically and they did not want to document the extent of the dislocation. I also discovered that Ed and the whole department were not assessing the endurance, confidence, and strength levels of all the patients they had treated on each day of my appointment. My last treatment was a new evaluation by XXXXXXX on Wednesday July 9th.
I discovered then that the whole department was not allowing some of their patients to communicate to them when they had suffered strokes. It appeared to me that they had chosen to find it as a laughter to see the effects of facial paresis as funny and were very insensitive to these patients. That they had also chose to include me in their insults.
XXXX discovered I did not relate to this insensitivity at all and I had challenged the whole department to communicate to their patients and not to humiliate the patients which had caused a deafening block on each patients until they began to let the patients communicate. I had discovered that the last Occupational Therapy treatment of July 9th included that XXXXXXX finally asked what it was that was protruding so obvious for me to tell her it is the clavicle dislocated from the acromium.

I believe I have started the proper care and communication to patients by how I communicate. I hope to have access to the care takers through how they have discovered how I communicate to permit patients to communicate and give input into their goals of their rehab.

The goniometric measurements include that I still have real nerve impingements as well as defined limitations in range of motions that involve internal rotation and especially trying to raise the back of my left hand to slide it up my back to try to reach my shoulder blade. I am no where near this range of motion. My shoulder strength is not normal and at the same level as my normal right shoulder. I cannot hold my body weight evenly with my right shoulder.

The meetings I have had with Dr. Stapleton are what I have thought of while I wait for him to come into the examining room. Dr. Stapleton has performed shoulder reductions because I had my May 11tjh follow up after an MRI that included two shoulder patients in splints waiting for their discussion.
I had also seen shoulder reduction surgery performed successfully in a gentleman with a much more difficult manner that did not have any understanding of how to communicate his dislocation and the long time with pain that led to his shoulder surgical reduction. It also included home health care up dates including rehabilitation at home with a Physical Therapist Assistant. His surgery healed to pain free. The tissue involved with the incision healed and did not have residual neuromuscular scarring or pain. This man was an habitual heavy drinker and very overweight which is also a cardiovascular risk whether the heart was capable to survive the surgery as well as whether the anesthesia would cause disorientation . this did not occur. Last December I had a simple procedure unrelated that required anesthesia and I recovered with no side effects from the anesthesia.

Today July 14, 2015 Tuesday, I went to Occupational Therapy by XXXX. for each treatment it includes neuromuscular stimulation and hot packs on my shoulder. I discussed the strengthening exercises I do with weights and pulleys at the gym. She does not want me to make it painful when I am using training. I told her I do not have the internal rotation and also am very limited in sliding the back of my hand across my low back as well as sliding it upward. This isn't very far at all.

The hospital sent a photographer and a media person into the rehab setting and asked patients and therapists like myself if they could film the rehab treatment. The photographer would only take pictures and video away from my peripheral vision but still focus on me. I believe it also created a situation where the photographer was challenging everyone with his own concept of what he wants to produce.
I couldn't see when the photographer had his video on and also could not see when he was taking photographs but, I was under the impression he was looking for when XXXX was not stressing my shoulder and the pain I felt.

I believe the actions the photographer was taking was an action determined by what he and the hospital had taken steps in having an organized meeting on what they want to look into. The photographer may have chosen to take the video coverage to select the viewers that could include determining diagnosis unrelated to rehabilitation and the accident I had.

I contacted Dr. Stapleton's nurse to inform her about the filming and for the doctor to be informed of it.

I know it was not a marketing approach where the patients were given notice before our Tuesday afternoon appointment. I state this because about two years ago I went to a local Ear, Nose and Throat physician named Dr. Tolan because he performs procedures with Botox to treat crows feet. After the appointment, I went to return and I was told in person Dr. Toland told his staff he would not treat my crows feet. I personally assume that for a temporary filiming cosmetic make up can be used to prevent crows feet be seen in a filming or photograph sessions.

I will have a follow up appointment with Dr. Stapleton after these scheduled treatments.

But, I would like to address what may be a responsibility of Dr. Stapleton regarding the MRI I had on my left shoulder and what each orthopedic physician in the same practice that also have MRIs performed on their shoulder patients. I assume the progress and treatment regime of each patient because of the variations of MRI readings would also have to include:
1. Whether each treatment of each of the patients would include the accomplishments of a conclusion that their prognosis was reached or whether the prognosis changed through further examination.
2. MRI as a diagnostic tool is also a medical tool that patients, their families, associations effecting the patient from performing or being active with is also a variation that would determine whether the prognosis changes because of the activity level and whether the MRI may be a medical breakthrough to the patients associations simply because it had discovered a medical diagnosis other members of the association may have existing problems that leads members of associations to seek referals and have an examination to discover what the association was lacking in medical service.
3. Therapeutic Rehabilitation and Licensed career medical professionals may creat and awareness to people of associations while the patient is demonstrating safe progress in regaining what initially was lost to injury.
4. When patients like myself have a disability that demonstrates an identifiable inability to normal movement of a joint of the body may be considered a judgment a community may hold against the person. Law enforcement may consider it an identifiable trait that is regarded as a citizen that is subject to a possible offense to the law and may be considered a trait to limit a citezens's rights it not under medical supervision that contests a community's actions to make it a judgment.
5. The MRI I had can be considered the beginning of what I can achieve and the community may discover that my regiment to rehabilitation , special exercises, and progress may represent the community realizing I as a patient was not given consideration toward the symptons I was suffering from that I do have the right and option to have medical recovery by what is available to me in the specialty of orthopedic medicine.
6.The MRI may create a medical breakthrough to the community for the community to accept the condition of the patient that the symptoms he patient describes are valid versus continued affliction from induced re injury. Thereby the community relents to respect the patients symptoms as valid and the patient's rights for relief and increase to return to normal function under medical supervision.