Khaled s Radiology report

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1 Khaled s Radiology report Patient Name: Khaled Adli Moustafa Date 06/15/2014 The patient is not present. And the following report is based upon what was in the MRI of the cervical and lumbar spine report which reveals and states the following: 1- Toughness or roughness in the cervical spines 2- Cervical Disc herniation at the following levels C3-4, C4-5 and C Narrowing of the cervical spinal canal bilaterally 4- Narrowing of the lumbar spinal canal 5- Toughness or roughness of the lumbar spine 6- Lumbar disc herniation at the following levels L3-4, L4-5, L5-S1 (Sacral 1) Based upon these results, the patient needs a surgical operation to treat the herniated disc at the level L Dr. Nabil Mahmoud Al-embabi Consultant orthopedic surgeon Fellow of the Royal College of Surgeons, England

2 Bashar Alolabi, MD, MSc, FRCSC Orthopedic Surgery 2014/07/13 Re: Mr. Khaled Al-Qazzaz To whom it may concern, I was asked to provide my medical opinion and expertise, as an Orthopedic Surgeon, on the case of Mr. Khaled Al-Qazzaz. I had the opportunity to review Mr. Al-Qazzaz s MRI report and discuss details of his symptoms with family members. I was also able to read a recent letter written directly by Mr. Al-Qazzaz, describing his medical condition and symptoms. Mr. Al-Qazzaz s MRI demonstrates cervical disc herniation at the levels C3-4, C4-5 and C5-6. These disc herniations have resulted in narrowing of the spinal canal and compression of the spinal cord. The MRI also demonstrates lumbar disc herniations at the level of L3-4, L4-5 and L5-S1, again narrowing the spinal canal and resulting in compression on the cauda equina (the terminal nerve roots of the spinal cord in the lumbar region of the spine). These findings are quite extensive and very unusual in a young person of his age. The symptoms that Mr. Al-Qazzaz is experiencing, as relayed by his family and his letter, are consistent with the MRI findings. They include numbness in both the upper and lower extremities, especially on the left side, along with muscle weakness in the upper extremities. The symptoms have been progressing rapidly and are resulting in a rapid deterioration of his health status. Left untreated, these disc herniations have a high risk of resulting in significant loss of function of the arms and/or legs, permanent paralysis of Mr. Al-Qazzaz s upper and lower extremities as well as permanent loss of voluntary control of his bladder and bowels. Furthermore, there is a risk of loss of function of his phrenic nerve, which controls breathing, resulting in death. 1

3 Bashar Alolabi, MD, MSc, FRCSC Orthopedic Surgery 2014/07/13 Based on these findings, Mr. Al-Qazzaz is in need of urgent spinal surgery to his cervical and lumbar spine to prevent permanent disability. Sincerely, Bashar Alolabi, MD, MSc, FRCSC Sunnybrook Health Sciences Center Department of Orthopedic Surgery 2075 Bayview Ave, Toronto, ON, M4N 3M5 Canada 2

4 To Whom It May Concern: I have reviewed the Imaging report provided on behalf of Mr. Khalid Adli Moustafa dated 06/15/2014. The patients self reported clinical symptomology regarding, pain, sensory changes and motor function have also been provided to help determine a course of action. Mr. Khalid s reported symptoms include hyperestheic pain in a radicular pattern of the upper and lower extremity. Imaging is reported to have disc herniation and stenosis of the subaxial spine. Spinal stenosis and disc herniation are noted at several contiguous levels also at the lumbar spine with sensory and motor changes bilaterally in the lower extremity as noted by the patients symptomology transmitted in written accord. Standard of Care in this instance should include: 1.Transfer to a facility or to a physician with advanced imaging capabilities and surgical expertise 2.Immediate administration of analgesics if no allergy or medical contra-indication exists 3. Repeated physical exam with objective documentation of weakness and bowel and bladder function 4. Regular assessment of neuro- vital signs 5. Consideration for surgical decompression of the cord in the cervical spine or the Cauda in the lumbar spine as indicated I am happy to discuss this opinion with his physician. Sincerely, -- Dr. A. Lawendy HBSc MD PhD FRCSC Assistant Professor Department Of Surgery University of Western Ontario Division of Orthopedic Surgery Chair Masters of Surgery Program Scientist Center for Critical Illness Research X56093

5 To Whom it May Concern. I am writing to you regarding the case of Mr Khaled Al-Qazzaz. My understanding is that Mr. Al Qazzaz has been suffering from symptoms of motor weakness in his left arm and legs. This is also accompanied by symptoms of neuropathic pain and sensory changes. His recent MRI report was also reviewed and demonstrates evidence spinal stenosis and disc herniation at several levels of cervical and lumbar region of the spine. Most concerningly recent updates from Mr. Al-Qazzaz, report increasing weakness and sensory changes of his lower limbs. As a family physician this constitutes an urgent neurosurgical situation and any such patient in my office would be transferred immediately for neurosurgical/spinal orthopaedic evaluation for consideration of surgical decompression. The concern being that if this is left untreated, it could result in permanent disability including paralysis and permanent bowel and bladder dysfunction. Neuropathic pain from such cases can also be extremely severe and access to pain medication would be essential to treat symptoms. Thank you for your attention to this. Yours sincerely, Sumairah Syed MD CCFP Markham Stouffville Hospital Program Director, Family Medicine Residency Program Lecturer, University of Toronto

6 To Whom It May Concern: I have recently reviewed Mr. Khaled Al-Qazzaz s MRI report of his cervical and lumbar spine as well as his symptomatology. He has been suffering from constant pain in his neck radiating to his arms in addition to severe back pain. He is also developing motor weakness in his upper and lower limbs with parasthesias (numbness). His MRI report shows disc herniation throughout the cervical and lumbar spine with narrowing of spinal canal, correlating with his symptoms. These symptoms, in conjunction with Mr. Khaled Al-Qazzaz s MRI report, lead to the diagnosis of significant nerve impingement and spinal cord compression, likely severe in nature given the rapid progression and wide range (pain, weakness and parasthesias) of symptoms. Given the widespread nature of his stenosis throughout the spine, severity of symptoms, likely lack of access to medical care and his young age, this is gravely concerning. Untreated emergently, spinal cord compression can lead to permanent disability, immobility and paralysis, intractable severe pain, permanent bowel and bladder dysfunction as well as possible paralysis of respiratory muscles resulting in death. The clinical picture presented, shows that Mr. Khaled Al-Qazzaz has a significant, imminent risk for developing such debilitating neurologic complications and requires immediate medical attention. He needs to be urgently transferred to a medical centre with neurosurgical and/or orthopedic surgical treatment available. He requires thorough medical examination to assess the level of his neurologic complications, administration of analgesia and likely surgical spinal cord decompression. Without such urgent intervention, he will develop permanent disability. Dr. Sana Rahman, MD, CCFP Family Physician Milliken Medical Centre Scarborough, ON

7 Dr. Khurram J. Khan MD, BSc, MSc, FRCPC Assistant Professor of Medicine Department of Medicine Tel: Ext Rm H Charlton Ave East, Office Fax: Hamilton, Ontario, Canada L8N 3Z5 Clinic Fax: July 14, 2014 To whom it may concern, I was asked to review the MRI report and assessment for a patient Khaled A Moustafa dated June 15 th Based on the symptoms described by the patient, and finding of the MRI, I concur that this patient needs immediate expert surgical assessment and intervention to prevent long term loss of function of his critical limbs. The report clearly describes worrisome features of radiculopathy (injury from compressed nerves) along multiple vertebrae in the both his neck and lower back. The consequences of such advanced nerve injury, if not treated, are likely not reversible. This man needs emergent treatment at an advanced surgical center to deal with this significant medical problem. Yours sincerely, Khurram J. Khan, FRCPC

8 To whom it may concern, I have had the opportunity to discuss with family members of Mr. Khaled Al-Qazzaz who have received direct information about his symptoms and I have also seen direct letters written from him. He has numbness and weakness in his upper extremities, particularly, on the left side and is beginning to have symptoms in his lower extremities. Review of his MRI report reveals cervical and lumbar spine disc herniation at C3-4, C4-5, C5-6, L3-4, L4-5, and L5-S1. His symptoms appear to be progressing and urgent spinal orthopaedic or neurosurgical assessment and possible surgical intervention is clearly indicated. If left untreated this may lead to permanent disability including paralysis of all four limbs. He may also lose the ability to control his bowels and bladder and in the most extreme situation lose his ability to breathe on his own and die. I must say as well that it is unusual for a young person to have such severe symptoms and it begs the questions about what kind of condition he is in that would lead to such symptoms. He needs urgent spinal orthopaedic or neurosurgical assessment and may require urgent surgery to prevent long term irreversible neurological damage. Yours sincerely, Hany Soliman, MD, FRCPC Radiation Oncologist, Specialist in Brain and Spinal tumours

9 Based upon the MRI report that I read, the symptoms conveyed to me from family members, including numbness, tingling, and loss of the motor power of both upper extremities and extending to the lower extremities, and based on my medical expertise, it is my provisional diagnosis that Mr. Khaled Al-Qazzaz is suffering from severe compression of the spinal cord in the cervical and lumbar areas which is progressing rapidly. At this point, the spinal cord is suffering from the cervical disc herniation and also the lumbar disc herniation. His condition currently is deteriorating and he needs emergent neurosurgical attention. He requires surgical operations on the cervical and lumbar regions in order to relieve the compression on the spinal cord. If left without surgical attention, Mr. Al-Qazzaz may suffer from long term disabilities, including but not limited to, the following: 1) Quadriplegia (paralysis of the whole body starting from the neck area as a result of the cervical spinal stenosis and sever compression of the spinal cord at that area) 2) Paraplegia (paralysis of the both lower extremities as a result of the spinal cord stenosis at the lumbar area) 3) Loss of the nerve supply to the respiratory muscles as a result of paralysis of their nerve supply which leads to inability to breath and possible suffocation and death. 4) Severe pain in the arms, legs and may be the whole body, as a result of compression on the spinal cord (which leads to suffering from a neuropathic type of pain) 5) Loss of control of urination and defecation 6) He may become bed ridden for the rest of his life with the need to have a tracheostomy and the need to become ventilator dependent Accordingly, the condition presented is a life or death situation. Mr. Khaled Al-Qazzaz needs emergent surgical attention as soon as possible in order to save his life or avoid any permanent disability. Ahmed Rahman, MD, FRCPC, MBA Board Certified Anesthesiologist, USA Board Certified Intensive Care Medicine, USA Fellow of the Royal College of Physicians and Surgeons, Canada Fellowship Trained in Acute and Chronic Pain Management, USA

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