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Life Threatening? No
Write-up: Pt is in with left arm pain. She said she used to get some cramps or charley horse occasionally somewhere in her hand between the third and fourth digits kind of "like toe cramps". Subsequently she got more cramps the day of the shot and then started developing an allusive pain in the anterior shoulder across the pectoral region and anterior deltoid and then down the arm into the radial forearm and into the hand. The pain migrates a little bit worse with use. It dose not keep her from sleeping at night. She notes that her hand is somewhat weaker and it has been progressively getting worse for the last 2 weeks. She has not had any neck pain. Denies any loss of sensation. No color change. No temperature change or coldness or circulatory symptoms. She received the Gardasil on 04-06-07 left deltoid. 2 months ago she was Indian wrestling and somewhat wrenched her neck a little bit and had some minor discomfort and when she extends her head she has a little bit of pain or discomfort at the base of her neck. No history of neck pain. No history of cervical disk problems, any other injury, or trauma to the left upper extremity. No other neurologic symptoms. No fevers. No URI symptoms, respiratory complaints, no cough, wheezy, dyspnea, no cardiac complaints. No abdominal pain, diarrhea or vomiting. No urinary frequency, dysuria or change, No gross weight change or any constitutional symptoms. No swelling of the extremities. No skin rashes or unusual markings.
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