Instructions: Response must be 510 words per case study written in current APA format with at least two academic references cited. References must be within the last five years. 1020 words in total. G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed. H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week. Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.

G.J., a 71-year-old overweight woman, presents to the Family Practice Clinic with a long history of bilateral knee discomfort. Her symptoms worsen with rainy weather and improve with warm and dry weather, but she noticed that her arthritis did not improve over the summer. The discomfort in her left knee is greater than in her right knee. She also experiences low back pain that has been increasingly severe, making it difficult for her to use the stairs in her home. G.J. had previously visited a rheumatologist who prescribed various NSAIDs, which provided only mild relief but caused significant stomach discomfort. Eventually, she found relief with oxycodone, but developed increasing tolerance and began requesting higher doses. The rheumatologist suggested surgery and refused to prescribe more oxycodone. G.J. is now seeking medical care at the Family Practice Clinic. Additionally, G.J. has gained 20 pounds in the past nine months, which has exacerbated her knee pain. Her joints are most stiff when she has been sitting or lying for an extended period, and they tend to “loosen up” with activity. Despite concerns about osteoporosis due to a family history of the disease, G.J. has not experienced any nonclinical manifestations of osteoporosis.

H.M., a 67-year-old female, recently retired from her position as a school teacher after 40 years. Her husband passed away two years ago due to complications of a cerebrovascular accident (CVA). Her medical history includes controlled hypertension with Olmesartan 20 mg once daily. Her family history does not contribute to her current symptoms, and her last annual visits with her primary care physician yielded normal results. H.M. lives alone, but her children visit her regularly. Her daughter noticed that she is having difficulty focusing during conversations, is not as organized at home, repeats and asks the same questions multiple times, and recently had trouble navigating her way back home from the grocery store.

In these two case studies, both patients present with cognitive decline and memory impairment. G.J. demonstrates symptoms consistent with osteoarthritis, while H.M. exhibits features indicative of cognitive decline, possibly related to a neurodegenerative disorder such as Alzheimer’s disease. This analysis will explore the potential underlying causes, implications for treatment, and the role of the Family Practice Clinic in managing these conditions.

For G.J., her longstanding knee discomfort and recent worsening, along with stiffness that improves with activity, are characteristic of osteoarthritis. The fact that her symptoms are worse with rainy weather suggests a potential link between weather changes and joint pain. This phenomenon, known as “weather sensitivity,” has been linked to changes in barometric pressure, temperature, and humidity. While the exact mechanisms are not fully understood, it is thought that these weather factors may affect joint fluid pressure and alter pain perception. Additionally, G.J.’s weight gain may contribute to increased load on her knees, exacerbating the pain. The Family Practice Clinic could consider a multimodal approach to managing G.J.’s osteoarthritis, focusing on weight management, physiotherapy, and appropriate analgesic medications.

In contrast, H.M.’s symptoms suggest cognitive decline and memory impairment. Her difficulty focusing, organization problems, repetitive questioning, and trouble with spatial orientation raise concerns for a neurodegenerative disorder. Alzheimer’s disease is the most common cause of dementia and typically presents with progressive memory loss and cognitive decline. Given her age and the presence of vascular risk factors, it is also essential to consider vascular dementia as a possibility. The Family Practice Clinic could play a crucial role in evaluating H.M. further, referring her for a comprehensive geriatric assessment and neuroimaging studies to aid in diagnosis and treatment planning.

In conclusion, G.J. and H.M. present with distinct clinical features and health concerns. G.J.’s case highlights the impact of osteoarthritis on her daily functioning and the potential role of weather sensitivity and weight management in managing her symptoms. On the other hand, H.M.’s symptoms are suggestive of cognitive decline, potentially due to a neurodegenerative disorder such as Alzheimer’s disease or vascular dementia. Both cases call for a multidisciplinary approach, involving the Family Practice Clinic, to address the patients’ concerns, optimize their care, and improve their quality of life.