1st post ever to the site but frequent lurker.
As the title states, pcm is putting me up for a MEB. PCM's 1st time doing a NARSUM and was curious if the case is strong based on the notes:
Diagnosis: M79.7 Fibromyalgia
Date of Initial Onset: Month, Year
Narrative HPI:
Male with fibromyalgia and has daily debilitating aches and pains. Patient reports that his worst areas are
probably his back/shoulders and knees/ankles. He is currently under the care of rheumatology and is not currently well managed for his
pain. Pain currently averages 7/10. Currently on Effexor 75mg, Cymbalta 60mg every other day, and Gabapentin 300mg twice dally. He is
also seeing physical therapy 3-times weekly for his pain. Physical Therapy on base was ineffective. He now has a referral to off-base physical
therapy. Patient reports that he cannot perform any aspect of his PT test and he does not think he can deploy and run 100 yards or lift 40
pounds.
Diagnosis: F32.1 Major Depressive Disorder, Single Episode, Moderate
Date of Initial Onset: Month, Year
Narrative PI:
Male suffers from major depressive disorder, anxiety, and insomnia. He sees mental health once weekly for follow up of this. He also
sees the chaplain once weekly. He feels that his mental health is not managed well. He has a referral to seek off-base counseling. He does
not feel that Effexor has helped his mood (previously tried Zoloft which was also ineffective). **He denies suicidal or homicidal thoughts.
Never has thought of self-harm. ***PCM UPDATED THIS PORTION AS SUICIDAL IDEATION IS PRESENT*** A major stressor for him has been the military. He has been in 4 years now and feels that he is not getting the support that he needs from the military. He has given up on hobbies and has stopped socializing with others. Reports he has
"become a recluse" since his divorce. He reports that his depression has worsened and thinks that it is related to his military service.
Patient expresses desire to leave the military to improve his mental health.
END
Thoughts?
As the title states, pcm is putting me up for a MEB. PCM's 1st time doing a NARSUM and was curious if the case is strong based on the notes:
Diagnosis: M79.7 Fibromyalgia
Date of Initial Onset: Month, Year
Narrative HPI:
Male with fibromyalgia and has daily debilitating aches and pains. Patient reports that his worst areas are
probably his back/shoulders and knees/ankles. He is currently under the care of rheumatology and is not currently well managed for his
pain. Pain currently averages 7/10. Currently on Effexor 75mg, Cymbalta 60mg every other day, and Gabapentin 300mg twice dally. He is
also seeing physical therapy 3-times weekly for his pain. Physical Therapy on base was ineffective. He now has a referral to off-base physical
therapy. Patient reports that he cannot perform any aspect of his PT test and he does not think he can deploy and run 100 yards or lift 40
pounds.
Diagnosis: F32.1 Major Depressive Disorder, Single Episode, Moderate
Date of Initial Onset: Month, Year
Narrative PI:
Male suffers from major depressive disorder, anxiety, and insomnia. He sees mental health once weekly for follow up of this. He also
sees the chaplain once weekly. He feels that his mental health is not managed well. He has a referral to seek off-base counseling. He does
not feel that Effexor has helped his mood (previously tried Zoloft which was also ineffective). **He denies suicidal or homicidal thoughts.
Never has thought of self-harm. ***PCM UPDATED THIS PORTION AS SUICIDAL IDEATION IS PRESENT*** A major stressor for him has been the military. He has been in 4 years now and feels that he is not getting the support that he needs from the military. He has given up on hobbies and has stopped socializing with others. Reports he has
"become a recluse" since his divorce. He reports that his depression has worsened and thinks that it is related to his military service.
Patient expresses desire to leave the military to improve his mental health.
END
Thoughts?
