A watercolor tribute to Ernestyna, for her selfless service helping prisoners learn life skills - available at http://course.volunteerministers.org
[Watercolor art of Ernestyna: a lady with short gray hair and circular glasses; wearing a black, pleated skirt and black socks; yellow shoes, and a yellow T-shirt with the words "Volunteer Minister" written on it in black. She is standing on an oversized paper airplane with illegible words written on it, flying through a partly cloudy sky, while looking forward through a gray spyglass.]

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9" x 12" watercolor draft/proposal - for 6' x 9' wall in Educ. Dept
[Watercolor art of a river running through a grassy field under a large oak tree. The art has rounded corners at the top, and words written in dark green in the river near the bottom that read "The oak tree, with its strength and roots, symbolize the vision. The creek with its motion is the action... and together they make the change."]

[written in red ink in the bottom right margin:]
symbolizes
period after vision (not comma)

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California Correctional Health Care Services

MCSP - Mule Creek State Prison
4001 Highway 104
Ione, CA 95640-

Patient: GOEHLER, WILLIAM ROBERT
DOB/Age/Sex: 2/15/1964 59 years Male
Encounter Date: 5/22/2008
Attending:

CDCR #: K77832
PID #: 1123924

Consultation Notes

Document Type: Physical Therapy Consultation
Document Subject: PT Eval for Chronic LBP w/ L LE radiculopathy, Eval only
Service Date/Time: 11/17/2022 13:12 PST
Result Status: Auth (Verified)
Perform Information: [whited out] LIC PT (11/17/2022 13:16 PST)
Sign Information: [whited out] Physician & Surgeon (11/18/2022 08:10 PST); [whited out] LIC PT (11/17/2022 13:20 PST); [whited out] LIC PT (11/17/2022 13:17 PST)

Encounter Info: Patient Name: WILLIAM GOEHLER, DOB: 02/15/1963, CDCR: K77832, FIN: 10000002711123924K77832, Facility: MCSP, Encounter Type: Institutional Encounter

S: "I got my MRI, says something about disc stuff and I'm just trying to figure how to be able to sleep better at night and maintain my composure throughout the day in this dangerous prison so that I don't look like someone to pick on. I don't want to exercise too much cause I don't want to mess with my chi and zen that I've created in my body. I'll do a little cardio tho cause I'm getting old and becoming at risk of dzs like diabetes and heart dz."

O: L/S mvmt screen: L/S Ext syndrome w/ L LE radicular sxs during L quadrant overpressure test. IP has good AROM for all directions.

A: Impression: L/S Ext syndrome w/ L LE radicular sxs during L quadrant overpressure test. IP had good AROM for all directions. Eval only per IP request.
NOTE: thorough education provided and all IP's questions answered during exam. IP verbalized understanding and asked very good questions. Additional tips provided on positions of sleep that may be comfortable w/ him and exercises that would help him maintain his composure that he feels he must maintain in his environment.

P: D/C w/ education & HEP. F/u w/ PCP PRN. Eval only.

Chart Review:
Service Date: 08/30/2022
CLINICAL INDICATION: age > 18, spinal stenosis seen on MRI severe L3-L4, pain in lower extremities, on Lyrica [Lyrica is underlined in pen; below that, written in pen: "Discontinued to regain mental clarity"] but continued symptoms, MRI requested by neurosurgery
COMPARISON: 2/14/2020
TECHNIQUE: Multiplanar, multisequence MRI of the lumbar spine. 137 images.

Report Requested ID: 62792931
Print Date/Time: 11/28/2022 13:46 PST

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MCSP - Mule Creek State Prison

Patient: GOEHLER, WILLIAM ROBERT
DOB/Age/Sex: 2/15/1963 / 59 years / Male
CDCR: K77832

Consultation Notes

FINDINGS:
Preservation of normal lumbar lordosis. Excluding endplate degenerative changes, vertebral body heights are preserved. Multilevel disc space height loss.
No marrow signal abnormality to suggest infiltrative process.
No cord signal abnormality distal thoracic cord. The conus terminates at approximately the L1-L2 level. Even distribution of the cauda equina nerve roots in the distal thecal sac.
No prevertebral or posterior paraspinous soft tissue abnormality.
No abnormality limited imaged intraabdominal contents.
Segmental Analysis:
T12-L1: No spinal canal or foraminal stenosis.
L1-L2: No spinal canal or foraminal stenosis.
L2-L3: Right central disc protrusion. No spinal canal stenosis. Mild left foraminal stenosis.
L3-L4: Disc bulge, ligamentum flavum hypertrophy, and facet arthropathy. Severe spinal canal stenosis. Severe right and mild left foraminal stenosis
L4-L5: Disc bulge with superimposed inferiorly oriented left central disc extrusion facet arthropathy. Mild spinal canal stenosis with superimposed effacement of the left lateral recess. Severe left and moderate right foraminal stenosis
L5-S1: Disc bulge with superimposed central disc protrusion. No spinal canal stenosis. Severe bilateral foraminal stenosis.
IMPRESSION:
Multilevel degenerative findings with spinal canal or foraminal stenosis as described.

Electronically Signed on 11/17/2022 01:20 PM PST
————————————————————————————————————————————————
[whited out], LIC PT

Electronically signed on 11/18/2022 08:10 AM PST
————————————————————————————————————————————————

Modified by [whited out] PT, LIC PT on 11/17/2022 01:17 PM PST
Modified by [whited out] PT, LIC PT on 11/17/2022 01:20 PM PST

[in pen: "getting old?"]

Report Request ID: 62792931
Print Date/Time: 11/28/2022 13:46 PST