Lack of commas or just misunderstanding

I'm wondering if this is correctly spelled or is there something wrong with the phrase itself.

Patient will be placed on IV steroids with compression stockings for lymphedema should physical therapy be cleared by cardiology for manipulation of that region. Documentation of spinal fluid will be obtained under fluoroscopy. Her glucose and blood pressures must be carefully monitored.

The question they ask me is :

How will lymphedema be controlled should physical therapy be undertaken?

Are they missing some commas or it's just me not being able to read this correctly. Asking this because, from what I understand, the lymphedema will be controlled with "IV steroids with compression stockings". But, how about the "compression stockings for lymphedema should physical therapy be cleared by cardiology for manipulation of that region". I'm really confused.

Solution 1:

From the point of view of English, the first part of this is ambiguous. It could mean that the patient will be on IV steroids in any case, and only if cleared by cardiology will she also have compression stockings for lymphedema. Alternatively, it could be that both the IV steroids and the compression stockings are intended for lymphedema and are contingent on being cleared by cardiology.

From the point of view of medicine, I think the first reading is more likely, because IV steroids are more likely to cause lymphedema than to alleviate it.

Actually, now that I think about it some more, there's a third reading, in which only the compression stockings (not the IV steroids) are "for lymphedema", but both are contingent on cardiology clearance.

Maybe we need a new stackexchange site for "medical language and usage".

Solution 2:

The OP contains a lot of medical jargon which, obviously, is directed to health care professionals. Let's try to make it clearer, so you can understand it.

• Patient will receive intra-venous steroids.
• If a cardiologist sees the patient and she is cleared for manipulation of her lower limbs, compression stockings must be worn to alleviate lymphedema.
• Spinal fluid will be obtained for analysis under X-ray guidance.
• Blood glucose levels and blood pressure must be carefully monitored.

Or, if you want to keep the same structure, I've added some commas and substituted a few words.

Patient will be placed on intra-venous steroids. Compression stockings to alleviate lymphedema, if physical therapy is cleared by cardiology for manipulation of that region (lower limbs). Documentation of spinal fluid will be obtained under fluoroscopy. Her glucose and blood pressure must be carefully monitored.

Solution 3:

I'm not a medical professional and I don't know what that sentence actually means, but just based on the grammar I think that it's probably correct the way it's written. In which case it would be you "not being able to read this correctly", but it's definitely a confusing phrasing.

You might rewrite that first sentence like this:

Should physical therapy be cleared by cardiology for manipulation of that region, the patient will be placed on IV steroids with compression stockings for lymphedema.

Or, more radically:

If cardiology clears physical therapy for the manipulation of that region, the patient will be placed on IV steroids with compression stockings for lymphdema.

After reading over the accepted answer I see a second possible meaning, but if this second meaning is the intended one then I would say that they are missing commas, rather than you reading it incorrectly. Here's a rewriting consistent with that second meaning:

Patient will be placed on IV steroids, and also given compression stockings for lymphedema if cardiology clears physical therapy for manipulation of that region.