
Hello Bob Patient
PT Number: 153991 Expiry date: 2026-09-16
Date of birth: 11/22/1973
Address: 1 Bobs Street, Suburb,VIC,3000
Phone: 1234 1234
Referred By:
Pain Summary:
Key
- Electric
- Scratchy
- Pins/needles
- Dull/ache
- Burning
- Add
Document the pain in order of concern (ie. 1 is your most troublesome area)

- In the morning
- During the day
- In the evening
- During sleep
Managing the pain
Always | Sometimes | Never | N/A | |
---|---|---|---|---|
Physically, I feel: | ||||
breathless | ||||
I have nothing to look forward to | ||||
tense and unable to relax | ||||
downhearted and blue | ||||
Due to the issue: | ||||
I’m more irritable | ||||
I sit or lie down most of the day | ||||
I need help with seating | ||||
The painful facts are: | ||||
use the handrail with stairs | ||||
climb stairs more slowly | ||||
lie down for a rest more often | ||||
avoid heavy jobs at home | ||||
The issue stops me from: | ||||
making a hot drink | ||||
doing the jobs around the house | ||||
going to the shops | ||||
Speaking | ||||
Emotionally, I feel: | ||||
My situation will never change | ||||
moving will make things worse | ||||
my life is ruined | ||||
of terrible conversations to myself | ||||
the situation is hopeless | ||||
Support I have: | ||||
supportive friends | ||||
family who are understanding | ||||
work assistants | ||||
a great community | ||||
wellness care providers | ||||
What exacerbates the issue: | ||||
Stress | ||||
Any movement | ||||
Not moving | ||||
Loud noise | ||||
What eases the issue: | ||||
Rest | ||||
Sleep | ||||
Walking |
Professional and personal life in brief
Professional Life
Full-time Graphic Designer 20 years I ran my own design company
Personal life then
- Married /
- no children /
- 1 dog
Medical history
Childhood Asthma / no other medical conditions
Pre existing medical conditions
No other current medical conditions
The pain and other issues
Managing the pain
How did the pain begin?
I was sitting on a fitball (exercise ball) it was my seat in the studio but it exploded and I fell to a concrete floor
Describe the health issue
Neuropathic pain (pelvis)
Has there been a diagnosis?
Pudendal Neuralgia
Note any health cover / insurance
Health 1 private insurance but Workcover no longer help at all.
The health issue
Note any medication
None but previously stopped very low doses of Amitryptaline
Note treatment
Peripheral stim implant that I use daily
Other details worth noting
I am able to do a little walking but I cannot lift more than a few kilos, I cannot drive and being a passenger or commuting is very difficult. I cannot sit without a seating aid. I can no longer work more than 15 hours per week. I require much help to be able to work and this is distressing.
Current management journey
Psychology - 4 sessions
Physiotherapy - 4 sessions
Physiotherapy
Related reports, files & imaging
Clinical Letter from Dr Mary Navy Test-x-ray.jpeg uploaded on 2011-09-02 12:00
X-ray - pelvis Spinal-Stim-Trial-02.png uploaded on 2015-10-20 12:00
Trial placement x-ray Boston-Scientific.jpg uploaded on 2015-11-27 12:00
New sacral stimulation implant
Personal notes
Patient journey
Jun'14 |
Dr Red, Psychology |
Sep'14 |
Dr Red, Acupuncture |
Oct'14 |
Prof Theo, Nerve block/treatment |
Feb'15 |
Violet, Physiotherapy |
May'15 |
Hydrotherapy |
Nov'15 |
Remedial massage |
Feb'16 |
Remedial massage |
Jun'16 |
Remedial massage |
Mar'17 |
Mindfulness - meditation |
Oct'17 |
Pain Management |
---|
Map of mood, medication & exercise

Pain Summary:
Key
- Electric
- Scratchy
- Pins/needles
- Dull/ache
- Burning
- Add
Document the pain in order of concern (ie. 1 is your most troublesome area)

- In the morning
- During the day
- In the evening
- During sleep
Managing the pain
Always | Sometimes | Never | N/A | |
---|---|---|---|---|
Support I have: | ||||
shoulder to cry on | ||||
supportive friends | ||||
wellness care providers | ||||
Emotionally, I feel: | ||||
My situation will never change | ||||
of terrible conversations to myself | ||||
the situation is hopeless | ||||
Physically, I feel: | ||||
tense and unable to relax | ||||
less confident in public | ||||
Due to the issue: | ||||
I’m more irritable | ||||
I stay home more than I used to | ||||
I change position all the time | ||||
I only walk short distances | ||||
The painful facts are: | ||||
use the handrail with stairs | ||||
climb stairs more slowly | ||||
walk more slowly | ||||
avoid standing | ||||
The issue stops me from: | ||||
running | ||||
walking with the dog | ||||
Time/s in life that you believe the pain triggers: | ||||
Wear and tear |
Professional and personal life in brief
Professional Life
Professional life is the same but I try move less
Personal life then
I ran 30kms per week
Medical history
I have great medical history and no major issues.
Pre existing medical conditions
Asthma during child years.
The pain and other issues
Managing the pain
How did the pain begin?
I was in a car accident and my legs were squashed by the inside of the car. No bones were broken but they were terribly hurt nevertheless
Describe the health issue
The pain hasn't gone away. It's persisted, perhaps even getting worse. I have to buy different shoes and I use supportive slip in for the shower even.
Has there been a diagnosis?
Chronic pain
Note any health cover / insurance
Private health cover. Transport insurance
The health issue
Note any medication
I'm trying not to take too much medication. Gabapentin as I need it. Panamax or Panadol.
Note treatment
I see a physiotherapist fortnightly.
Other details worth noting
I'm feeling like not many people understand me.
Current management journey
Physiotherapy
Physiotherapy
Physiotherapy
Pretty happy this issue is getting much better
Related reports, files & imaging
Borderline patella alta. 7D966FB3-1646-4C06-9CB7-D2A2C2D37E97.jpeg uploaded on 2018-04-06 12:00
Knee illustration for reference
Personal notes
Patient journey
Aug'16 |
Emergency check up |
Aug'16 |
Sent home |
Sep'17 |
Checkup |
Sep'17 |
Maintenance |
---|
Map of mood, medication & exercise

Pain Summary:
Key
- Electric
- Scratchy
- Pins/needles
- Dull/ache
- Burning
- Add
Document the pain in order of concern (ie. 1 is your most troublesome area)

- In the morning
- During the day
- In the evening
- During sleep
Managing the pain

Professional and personal life in brief

The pain and other issues

The health issue
Note any medication
I only occasionally take Panamax. The pain has settled greatly
Note treatment
I have physiotherapy and I am strict with my exercises and walking
Other details worth noting
I'm very happy after the operation
Current management journey
Ongoing exercises and lots of walking!
Related reports, files & imaging

Personal notes

Patient journey
Jan'18 |
Follow up apt |
Feb'18 |
Surgery follow up |
Mar'18 |
Physiotherapy |
May'18 |
Physiotherapy |
Jul'19 |
Pain Management |
Sep'19 |
Final check up |
---|
Map of mood, medication & exercise

Pain Summary:
Key
- Electric
- Scratchy
- Pins/needles
- Dull/ache
- Burning
- Add
Document the pain in order of concern (ie. 1 is your most troublesome area)

- In the morning
- During the day
- In the evening
- During sleep
Managing the pain
Always | Sometimes | Never | N/A | |
---|---|---|---|---|
The issue stops me from: | ||||
reading a book | ||||
running | ||||
Speaking | ||||
The painful facts are: | ||||
It's really beginning to stress me out | ||||
The sharp stabbing pains are frightening | ||||
Due to the issue: | ||||
I’m more irritable | ||||
I stay home | ||||
I change position | ||||
I don’t feel like eating | ||||
My sleep is disrupted | ||||
Physically, I feel: | ||||
tense and unable to relax | ||||
less confident in public | ||||
Emotionally, I feel: | ||||
My situation will never change | ||||
moving will make things worse | ||||
Support I have: | ||||
shoulder to cry on | ||||
supportive friends | ||||
family who are understanding | ||||
What exacerbates the issue: | ||||
Stress | ||||
A hot day | ||||
Being in a busy place | ||||
What eases the issue: | ||||
Sleep |
Professional and personal life in brief
Professional Life
Full-time Graphic Designer 20 years I ran my own design company
Personal life then
- Married /
- no children /
Medical history
Childhood Asthma / no other medical conditions
Pre existing medical conditions
No other current medical conditions
The pain and other issues
Managing the pain
How did the pain begin?
One morning when I woke up
Describe the health issue
It's severe stabbing pains occasionally and then other times I have really dull aching.
Has there been a diagnosis?
No diagnosis
Note any health cover / insurance
I have private health insurance
The health issue
Note any medication
I only occasionally take Panamax.
Note treatment
Other details worth noting
I have always had sinus issues and allergies.
Current management journey
Related reports, files & imaging

Personal notes
Patient journey
Sep'19 |
Nasal checkup |
Mar'20 |
Check in |
---|
Map of mood, medication & exercise

Pain Summary:
Key
- Electric
- Scratchy
- Pins/needles
- Dull/ache
- Burning
- Add
Document the pain in order of concern (ie. 1 is your most troublesome area)

Managing the pain
Always | Sometimes | Never | N/A | |
---|---|---|---|---|
The issue stops me from: | ||||
doing the jobs around the house | ||||
walking with the dog |
Professional and personal life in brief
The pain and other issues
The health issue
Current management journey
Related reports, files & imaging

Personal notes

Patient journey
Map of mood, medication & exercise
