1. Madhav Goyal, MD Internal Medicine
Case Review
Madhav Goyal, MD
Internal Medicine

2. Center for Primary Care
3/23/16: 1st visit
72 yo M w/ DM,  lipids, s/p bariatric surg 2013
Walks, goes to gym daily
9/28/16
notes 3 wks of pain behind both legs that gets worse when he gets up from a chair or extends his legs. Feels like pain in the muscles
12/9/16
Progressive pain lower back/ buttox, now pain worst w/ standing & getting up from sitting. Somewhat relieved when sits down. Advil daily.
Very slow to get up from chair, gait has slowed as well

3. Pain/ NS present Had MRI & referred to NS
4/11/17: Left L4-5 ESI (3 d relief then pain returned)
May 2017: wife dx’d w/ panc cancer
7/28/17: repeat Left L4-5 ESI
8/25/17: increased gabapentin 300 tid; doing well in terms of pain
Nov 2017: wife passed away

4. Center for Primary Care
1/5/18
hasn’t been lifting as much due to wife who passed away, back pain has gotten much better
Walking dog 2 miles daily
4/23/18
Takes gabapentin 300mg qhs
3/10 pain in morning which resolves after his walk