Presentation

A 54-year-old male presented to the emergency department with severe and debilitating pain originating in his left cheek and radiating from his left eye to his jaw.

A brain MRI revealed a suspicious lesion in the middle cerebellar peduncle and right periventricular white matter.

The client expressed concern about elevated PSA levels following testosterone pellet therapy, which correlated with PI-RADS 5 lesions found on the MRI. Additionally, he has a history of blastomycosis, histoplasmosis, and positive dengue serology following exposure to bat feces.

PHM Actions

Facilitated imaging, diagnostics, and consultations with leading experts to rule out potential multiple sclerosis or infectious disease involvement.

Coordinated a consultation with a medical cannabis expert to ensure safe and effective usage.

Ordered and reviewed genetic testing in the context of current and potential future medications to manage trigeminal neuralgia.

Identified speech-to-text technology to enable work when pain limited function.

Provided education on lifestyle modifications to reduce symptoms of trigeminal neuralgia and promote neurological health.

Educated the client on the mechanism of action of a specific medication and its theoretical interplay with testosterone.