The patient comes today for followup and reevaluation of his peripheral neuropathy. I discussed with him one more time the treatment that will include a NeuroMed treatment as well as nerve block. Today, we will block the nerves of the left foot, we do not want to take any chances blocking the nerves on both feet and him having any difficulty walking. He already has a compromise gait. We will do his left foot, this is the worse one. I have discussed with him the risk, benefit, alternative, and technical aspects of the nerve block. He does take an immunosuppressive medication and is aware of the increased risk of an infection after an interventional procedures. He understands and is agreeable to proceed. He is to continue his other medications as usual.
1. Peripheral neuropathy.
2. gait abnormality.
1. Recommend to continue physical therapy for his lower extremities, back and hip area, as well as gait training.
2. Neuromed treatment for the neuropathy pain.
3. Recommend performance of peripheral nerves block of the left foot including the sural, peroneal, superficial peroneal, tibial, and saphenous nerves. This will be done in a sterile manner to avoid any infection.