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{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7500 }
Medical Text: Admission Date: [**2134-11-18**] Discharge Date: [**2134-12-10**] Date of Birth: [**2081-9-26**] Sex: M Service: NEUROSURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1835**] Chief Complaint: Spehenoid [**Doctor First Name 362**] mass Major Surgical or Invasive Procedure: [**2134-11-19**]: Right pterional craniotomy for tumor resection History of Present Illness: Patient is a 53M s/p fall at home(reportedly tripped on trash), down for approximately 12hrs. EMS arrived, and he was found to be disoriented. He was apparently able to walk to the ambulance of his own volition, but became obtunded, tachycardic and hypoxic en route to the hospital. He was intubated at that time. Head CT was done, which revealed a significantly sized right fronto-parietal mass, and he was then transferred to [**Hospital1 18**] for definitive neurosurgical care. Past Medical History: HTN, DM, GOUT, OSA, Class III Obestiy Social History: Unmarried, resides at home alone. Per brother(who resides in OH), he was laid off approximately two years ago(previously workes as a security operations manager for [**Company **]). He reports since that time, he has had subtle personality changes. Within the last six months, had become progressively socially recluse, to the point of neglecting self care. His parents are alive(residing in FL-mother with dementia, father w/ [**Name2 (NI) **] IV Renal CA), a sister(who also resides in FL), and brother([**Name (NI) **])-whom resides in OH. Family History: Non-contributory. Physical Exam: On Admission: 98.9 BP: 116/66 HR: 99 R: 14 O2Sats: 97% on AC/100%/600/14/10 Gen: Intubated, sedated, NAD, grossly obese HEENT: Pupils: ERRLA, [**2-28**] b/l. +Corneal Neck: Supple. Lungs: bibasilar coarse crackles Cardiac: RRR no M/G/R Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: Intubated/sedated Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, to mm bilaterally. Motor: withdraws to noxious stimuli x4, L symmetric to R Sensation: Unable to assess Reflexes: B T Br Pa Ac Right 2+ Left 2+ Toes downgoing bilaterally Exam on Discharge: Alert, oriented to person, place, month and year. Face is symmetric, tongue is midline. Full strength and power throughout upper and lower extremities. Cognition is somewhat impaired, and intermittant expressive confusion. Wound is clean dry and intact; sutures/staples have been removed Pertinent Results: Labs on Admission: [**2134-11-18**] 07:00PM BLOOD WBC-13.6* RBC-4.80 Hgb-14.8 Hct-44.1 MCV-92 MCH-30.9 MCHC-33.6 RDW-14.7 Plt Ct-251 [**2134-11-18**] 07:00PM BLOOD Neuts-89.0* Lymphs-2.9* Monos-5.9 Eos-2.0 Baso-0.4 [**2134-11-18**] 07:00PM BLOOD PT-12.7 PTT-28.8 INR(PT)-1.1 [**2134-11-18**] 07:00PM BLOOD Glucose-122* UreaN-34* Creat-1.5* Na-149* K-4.5 Cl-105 HCO3-33* AnGap-16 [**2134-11-19**] 03:05AM BLOOD ALT-18 AST-18 AlkPhos-82 TotBili-0.7 [**2134-11-18**] 07:00PM BLOOD CK(CPK)-95 [**2134-11-18**] 07:00PM BLOOD CK-MB-5 cTropnT-0.05* [**2134-11-18**] 07:00PM BLOOD Calcium-9.3 Mg-2.4 Labs on Discharge: [**2134-12-10**] 01:40AM BLOOD WBC-5.7 RBC-3.78* Hgb-11.4* Hct-34.2* MCV-91 MCH-30.2 MCHC-33.3 RDW-15.7* Plt Ct-235 [**2134-12-9**] 02:02AM BLOOD PT-12.5 PTT-32.1 INR(PT)-1.1 [**2134-12-9**] 10:24PM BLOOD Glucose-129* UreaN-11 Creat-0.7 Na-146* K-3.8 Cl-99 HCO3-42* AnGap-9 Imaging: CTA of Head: significantly sized sphenoid [**Doctor First Name 362**] mass extending up to the right fronto parietal region. Measure approx 8cm in diameter. approx 1.5cm of subfalcineherniation. CT Head(post-op): showing appropriate resection and decompression. Head CT [**11-28**]: area of hypodenisity within the right MCA distribution. Again noted are expected post-surgical changes. Head CTA/P [**12-2**]: 1. There is no evidence of acute hemorrhagic transformation. 2. Status post craniotomy. Persistent hypodensity in the right frontal and temporal lobes, unchanged. Mass effect upon the ipsilateral cerebral peduncle with midline shift, is slightly decreased in size when compared to prior study. 3. Perfusion study demonstrates decreased cerebral blood volume in the right MCA territory with increased MTT, consistent with prior right MCA infarct. Brief Hospital Course: The patient was admitted to the ICU for Q1 hour neuro checks. He remained intubated and was on dilantin and decadron. He was able to withdraw all 4 extremities to noxious stimuli. The patient was morbidly obese and was unable to undergo an MRI because he was over the weight limit. His CT scan revealed a 7.5 x 5.3 cm mass in the right middle and anterior cranial fossa with midline shift and uncal and subfalcine herniation. The patient was taken to the operating room on [**2134-11-19**] and underwent a right craniotomy for tumor resection. The procedure was technically difficult due to the large size of the mass and the proximity of the MCA. However, the tumor was able to be decompressed well with no complications. The patient remained intubated and was brought directly to CT for a post-op scan. It revealed expected post-operative fluid within the resection cavity, decompression, and decreased midline shift. The patient then returned to the ICU. His exam improved and he was able to follow commands when the sedation was turned off. He was started on a decadron taper. His dilantin levels were monitored and adjustments made as indicated. The patient was extubated on [**11-23**] in the afternoon without incident. It was further noted that his serum sodium levels were becoming more elevated(153), so he was started on 100cc of free water q6h. This was successfully treating his hypernatremia. On [**11-24**], he was transferred to the stepdown unit. The sodium continued to improve. PT and OT worked with the patient to get him OOB to chair. The patient's brother brought in a list of home medications and these were added on [**11-26**]. Additionally a psych consult was obtained to determine if the patient was competent to make his own decisions and to give his brother permission to assist him with his affairs. On [**11-27**] the patient was noted to be more obtunded and then began to have respiratory distress he was immediately transferred to ICU. He was found to have a hypercarbic acidosis. Further imaging showed a RLL consolidation and a right mca hypodensity. He continued to move all extremities with more spontaneously movement on the right. Attempts to wean the vent were successful, and he transferred to the neurosurgical stepdown unit after extubation. LENIS and CTA ruled out DVT/PE. Perfusion studies were performed for hypodensity on CT. This showed decreased cerebral blood volume in the right MCA territory with increased MTT, consistent with prior right MCA infarct. He was without neurologic deline but he continued to have cognitive impairment. He was seen by psychiatry who felt that he would benefit from inpatient cognitive rehab. On [**12-8**], he was found to be significantly lethargic, and minimally following commmands in comparision to previous days. A blood gas was obtained and he was found to be hypercarbic acidosis. An urgent Pulmonary and medicine consult was obtained. He was transferred to the ICU for further pulmonary managment. After further titration of his non-invasive support, his acidosis was corrected, and mental status improved. Pulmonary made significant recommendations as to the subsequent treatment of his pulmonary management. He was screened and accepted for disposition to [**Hospital1 **], and this was carried out on [**2134-12-10**] Medications on Admission: Atenolol Discharge Medications: 1. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical TID (3 times a day) as needed for rash. 2. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain/fever. 3. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 4. Docusate Sodium 50 mg/5 mL Liquid Sig: Two (2) PO BID (2 times a day). 5. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. White Petrolatum-Mineral Oil 42.5-56.8 % Ointment Sig: One (1) Appl Ophthalmic PRN (as needed) as needed for dry eyes. 7. Albuterol Sulfate 90 mcg/Actuation HFA Aerosol Inhaler Sig: Six (6) Puff Inhalation Q4H (every 4 hours) as needed for wheeze/ desaturation. 8. Fluticasone 50 mcg/Actuation Spray, Suspension Sig: One (1) Spray Nasal DAILY (Daily). 9. Lidocaine HCl 2 % Gel Sig: One (1) Appl Mucous membrane PRN (as needed) as needed for foley insertion. 10. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 11. Enalapril Maleate 10 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 12. Levetiracetam 500 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 13. Atenolol 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 14. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 15. Famotidine 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 16. Ondansetron HCl (PF) 4 mg/2 mL Solution Sig: One (1) Injection Q8H (every 8 hours) as needed for nausea. 17. Hydralazine 20 mg/mL Solution Sig: One (1) Injection Q6H (every 6 hours) as needed for sbp>190. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: Sphenoid [**Doctor First Name 362**] mass - Atypical meningioma (Who Grade II) Sleep Apnea Hypercarbic respiratory failure Urinary tract infection Discharge Condition: Neurologically Stable Discharge Instructions: GENERAL INSTRUCTIONS WOUND CARE: ?????? You or a family member should inspect your wound every day and report any of the following problems to your physician. ?????? Keep your incision clean and dry. ?????? You may wash your hair with a mild shampoo ?????? Do NOT apply any lotions, ointments or other products to your incision. ?????? DO NOT DRIVE until you are seen at the first follow up appointment. ?????? Do not lift objects over 10 pounds until approved by your physician. DIET Usually no special diet is prescribed after a craniotomy. A normal well balanced diet is recommended for recovery, and you should resume any specially prescribed diet you were eating before your surgery. Be sure however, to remain well hydrated, and increase your consumption of fiber, as pain medications may cause constipation. MEDICATIONS: ?????? Take all of your medications as ordered. You do not have to take pain medication unless it is needed. It is important that you are able to cough, breathe deeply, and is comfortable enough to walk. ?????? Do not use alcohol while taking pain medication. ?????? Medications that may be prescribed include: -Narcotic pain medication such as Dilaudid (hydromorphone). -An over the counter stool softener for constipation (Colace or Docusate). If you become constipated, try products such as Dulcolax, Milk of Magnesia, first, and then Magnesium Citrate or Fleets enema if needed). Often times, pain medication and anesthesia can cause constipation. ?????? You have been prescribed Keppra for anti-seizure medicine, take it as prescribed until you are seen in neurosurgery follow up. ?????? Unless directed by your doctor, do not take any anti-inflammatory medicines such as Motrin, Aspirin, Advil, and Ibuprofen etc, as this can increase your chances of bleeding. ?????? You are being sent home on steroid medication, make sure you are taking a medication to protect your stomach (Prilosec, Protonix, or Pepcid), as these medications can cause stomach irritation. Make sure to take your steroid medication with meals, or a glass of milk. ACTIVITY: The first few weeks after you are discharged you may feel tired or fatigued. This is normal. You should become a little stronger every day. Activity is the most important measure you can take to prevent complications and to begin to feel like yourself again. In general: ?????? Follow the activity instructions given to you by your doctor and therapist. ?????? Increase your activity slowly; do not do too much because you are feeling good. ?????? You may resume sexual activity as your tolerance allows. ?????? If you feel light headed or fatigued after increasing activity, rest, decrease the amount of activity that you do, and begin building your tolerance to activity more slowly. ?????? DO NOT DRIVE until you speak with your physician. ?????? Do not lift objects over 10 pounds until approved by your physician. ?????? Avoid any activity that causes you to hold your breath and push, for example weight lifting, lifting or moving heavy objects, or straining at stool. ?????? Do your breathing exercises every two hours. ?????? Use your incentive spirometer 10 times every hour, that you are awake. WHEN TO CALL YOUR SURGEON: With any surgery there are risks of complications. Although your surgery is over, there is the possibility of some of these complications developing. These complications include: infection, blood clots, or neurological changes. Call your Physician Immediately if you Experience: ?????? Confusion, fainting, blacking out, extreme fatigue, memory loss, or difficulty speaking. ?????? Double, or blurred vision. Loss of vision, either partial or total. ?????? Hallucinations ?????? Numbness, tingling, or weakness in your extremities or face. ?????? Stiff neck, and/or a fever of 101.5F or more. ?????? Severe sensitivity to light. (Photophobia) ?????? Severe headache or change in headache. ?????? Seizure ?????? Problems controlling your bowels or bladder. ?????? Productive cough with yellow or green sputum. ?????? Swelling, redness, or tenderness in your calf or thigh. Call 911 or go to the Nearest Emergency Room if you Experience: ?????? Sudden difficulty in breathing. ?????? New onset of seizure or change in seizure, or seizure from which you wake up confused. ?????? A seizure that lasts more than 5 minutes. Important Instructions Regarding Emergencies and After-Hour Calls ?????? If you have what you feel is a true emergency at any time, please present immediately to your local emergency room, where a doctor there will evaluate you and contact us if needed. Due to the complexity of neurosurgical procedures and treatment of neurosurgical problems, effective advice regarding emergency situations cannot be given over the telephone. ?????? Should you have a situation which is not life-threatening, but you feel needs addressing before normal office hours or on the weekend, please present to the local emergency room, where the physician there will evaluate you and contact us if needed. Followup Instructions: FOLLOW UP APPOINTMENT INSTRUCTIONS ??????You have an appointment in the Brain [**Hospital 341**] Clinic on [**2134-12-27**] at 4pm. The Brain [**Hospital 341**] Clinic is located on the [**Hospital Ward Name 516**] of [**Hospital1 18**], in the [**Hospital Ward Name 23**] Building, [**Location (un) **]. Their phone number is [**Telephone/Fax (1) 1844**]. Please call if you need to change your appointment, or require additional directions. ??????You will need a CT with contrast of the brain prior to this appointment, as you are unable to have an MRI. You Also have an appointment with your PCP(Dr. [**Last Name (STitle) **] on [**2-8**], [**2135**] at 1:45pm. He is located at [**Hospital3 **] at [**Location (un) 84395**] call [**Telephone/Fax (1) 250**] if you require additional directions, or need to change the date and time of this approintment. Completed by:[**2134-12-10**] ICD9 Codes: 486, 2760, 2762, 5990, 4019, 2749
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7501 }
Medical Text: Admission Date: [**2103-7-3**] Discharge Date: [**2103-7-12**] Service: MEDICINE Allergies: Allopurinol Attending:[**First Name3 (LF) 2279**] Chief Complaint: hypotension, LLE pain Major Surgical or Invasive Procedure: Right groin line placement Right radial artery line placement History of Present Illness: Pt is a legally blind [**Age over 90 **] y/o F with PMH significant for CHF, infra-renal AAA s/p endovascular repair with chronic leak, and peripheral vascular disease with chronic bilateral LE skin tears, presented to the [**Hospital1 18**] on [**7-3**] with hypotension and a 3-day hx of worsening LLE pain. She was seen by her VNA (helps manage her chronic skin tears) who found patient hypotensive. Patient also reports LE pain was throbbing and sharp diffuse throughout her entire leg. On presentation, she denies any chest pain/SOB/palpitations, fevers/chills (although frequently cold), nausea/vomiting. She reported chronic diarrhea, decreased appetite and chronic skin tears worse in the lower extremities bilaterally. . Per patient's nephew (very involved in her care): Pt. has been hypotensive over the last week accompanied with weakness and confusion. Also, pt's PCP discontinued her [**Name9 (PRE) **] 80 mg on [**2103-6-27**] for these episodes of hypotension and weakness, but increased her furosemide to 40 mg [**Hospital1 **]. Her nephew voiced concern about pt's very poor PO intable, ability to take medications on her own and perform ADLs. . In the ED, initial vs were: T 97.4 P 61 BP 91/48 R 20 O2 sat. SBPs were in the 90-100s range. On exam she is a frail, elderly woman and LLE warm, erythematous w/ appearance of cellulitis. Cannot palpate pulses, but easy to doppler. Patient was given vanc/zosyn/clinda. Access 20G in R antecub. Got 1500cc of fluid total. Reported guiac positive stool in the ED. Vitals prior to transfer 96.7 56 101/83 13 96% on 4L NC. . On arrival in the MICU, her VS were T:94.8 (rectal) BP: 95/42 P:64 R: 18 O2: 94% on 3L NC and she complained of pain in her LE extremities worse in her left, chills, oriented to self, place and date but had somewhat of tangential speech. She was bolused 500cc twice with unresponsive MAPs and with difficult central access via SC or IJ, an A-line was placed and phenylepherine (stopped at 6AM on [**7-5**]) given for 24 hours and was gradually weaned off. She was found to grow 4000 GNR on urine cultures resistant to b-lactams on speciation. There were no other impressive sources of infection although a CT abd and gallbladder U/S had evidence of chronic cholecystitis. LE films was neg for gas or fluid collections. She was worked up with a CT abd, hand was gradually weaned of pressors with 250cc boluses. Her labs were neg for bands. Past Medical History: 1. CHF (EF 45%, though likely an overestimate given severe MR) 2. CAD (last cath in [**2096**] with complete occlusion of ramus intermedius, moderate disease elsewhere) 3. Decreased vision R eye, now legally blind 4. PVD - s/p arthrectomy and B/L superficial femoral artery PTCA 5. Severe mitral regurgitation 6. Depression 7. Hysterectomy 8. Endoscopic aortic aneurysm repair [**11-28**] 9. Chronic kidney disease (baseline Cr 1.4) Social History: Born in [**Location (un) 669**] MA but currently lives in [**Location **] Corner alone. She has a home VNA and someone to help clean her house. Her nephew who lives in [**State 2748**] visits weekly to check on her and brings her groceries. Has no family in [**Location (un) 86**] (twin sister and two older siblings passed away). Retired from advertising and currently spends her days listening to the television. Ambulates with a scooter but nephew has expressed concern about patient's inability to ambulate well around her home in addition to inconsistently taking her medication. - Tobacco: remote history, discontinued over 35 years ago - Alcohol: 6oz of Vermouth every evening (per patient's nephew). Patient states drinks occassionally). . Family History: Twin sister-died from liver cancer at age 43 Physical Exam: ADMISSION PHYSICAL EXAM: Vitals: T:94.8 (rectal) BP: 95/42 P:64 R: 18 O2: 94% on 3L NC General: Alert, oriented, no acute distress HEENT: Sclara are cloudy, reactive pupils 3-->2 mm. Dry mucuos membranes. Oropharynx clear without lesions or ulcers. Neck: supple, JVP to level of mandible at 30 degrees Lungs: Poor inspiratory effort without rales. CV: Regular rate with occassional PVC's, 2/6 systolic murmur. No rubs, gallops Abdomen: protuberant abdomen with linear midline scar. Soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly. Tympanic to percussion GU: foley with clear urine Ext: B/L lower extremity erythema with erosions and ulcerations. TTP. Dopplerable pulses. Neuro: AOX3 but tangeintal speech. Sluggish but MAE. Can move toes and hands . DISCHARGE PHYSICAL EXAM: Vitals: Tc:97.2, BP:138/69(90-130/50-60) HR:74(60-80), R:20 O2:95% on 2L. I/O: 8h (100/200, 24h (2380/1300) General: Elderly female lying comfortable in bed, oriented to self and place not date, no acute distress HEENT: Sclera translucent, mucous membranes dry, poor dentition with many missing dention, oropharynx clear Neck: supple, JVP not assessed, no LAD Lungs: Clear to auscultation bilaterally, decreased breath sounds on the right base and mild crackles in the left base CV: Regular rate with extra heart sounds, 2/6 systolic murmur Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, midline abd scar, dependent edema and skin breaks in the lower abdomen/inguinal area (better than yesterday). Ext: Warm, well perfused, 2+ edema with several ulcerations of different depths. pulses not palpated Pertinent Results: Admision Labs ================= [**2103-7-3**] 06:31PM LACTATE-2.3* [**2103-7-3**] 02:09PM URINE HOURS-RANDOM [**2103-7-3**] 02:09PM URINE GR HOLD-HOLD [**2103-7-3**] 02:09PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.014 [**2103-7-3**] 02:09PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-2* PH-5.5 LEUK-LG [**2103-7-3**] 02:09PM URINE RBC-<1 WBC-20* BACTERIA-MOD YEAST-NONE EPI-<1 TRANS EPI-<1 [**2103-7-3**] 02:09PM URINE MUCOUS-RARE [**2103-7-3**] 01:32PM LACTATE-2.6* [**2103-7-3**] 01:20PM UREA N-45* CREAT-1.5* SODIUM-126* POTASSIUM-4.3 CHLORIDE-91* TOTAL CO2-22 ANION GAP-17 [**2103-7-3**] 01:20PM ALT(SGPT)-16 AST(SGOT)-29 LD(LDH)-203 CK(CPK)-63 ALK PHOS-151* TOT BILI-1.9* DIR BILI-1.5* INDIR BIL-0.4 [**2103-7-3**] 01:20PM LIPASE-15 [**2103-7-3**] 01:20PM CK-MB-11* MB INDX-17.5* cTropnT-0.02* [**2103-7-3**] 01:20PM ALBUMIN-3.5 [**2103-7-3**] 01:20PM WBC-8.3 RBC-3.51* HGB-11.9* HCT-35.4* MCV-101* MCH-33.9* MCHC-33.6 RDW-18.2* [**2103-7-3**] 01:20PM NEUTS-75* BANDS-8* LYMPHS-9* MONOS-4 EOS-0 BASOS-0 ATYPS-1* METAS-3* MYELOS-0 [**2103-7-3**] 01:20PM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-1+ MACROCYT-OCCASIONAL MICROCYT-NORMAL POLYCHROM-NORMAL TEARDROP-1+ [**2103-7-3**] 01:20PM PLT SMR-NORMAL PLT COUNT-151 [**2103-7-3**] 01:20PM PT-19.2* PTT-36.7* INR(PT)-1.7* [**2103-7-6**] 06:15AM BLOOD WBC-6.2 RBC-3.49* Hgb-11.3* Hct-36.3 MCV-104* MCH-32.4* MCHC-31.1 RDW-19.0* Plt Ct-118* [**2103-7-7**] 07:00AM BLOOD WBC-6.3 RBC-3.96* Hgb-12.6 Hct-41.3 MCV-104* MCH-31.8 MCHC-30.5* RDW-18.9* Plt Ct-134* [**2103-7-8**] 06:30AM BLOOD WBC-6.8 RBC-3.45* Hgb-11.6* Hct-37.3 MCV-108* MCH-33.8* MCHC-31.2 RDW-18.6* Plt Ct-125* [**2103-7-9**] 06:35AM BLOOD WBC-6.8 RBC-3.63* Hgb-11.8* Hct-37.7 MCV-104* MCH-32.4* MCHC-31.3 RDW-18.5* Plt Ct-126* [**2103-7-10**] 07:17AM BLOOD WBC-6.8 RBC-3.61* Hgb-11.7* Hct-37.3 MCV-103* MCH-32.3* MCHC-31.3 RDW-18.4* Plt Ct-123* [**2103-7-11**] 05:21AM BLOOD WBC-7.4 RBC-3.33* Hgb-11.2* Hct-34.8* MCV-105* MCH-33.8* MCHC-32.3 RDW-18.2* Plt Ct-168 [**2103-7-12**] 05:30AM BLOOD WBC-7.6 RBC-3.24* Hgb-10.9* Hct-34.0* MCV-105* MCH-33.5* MCHC-32.0 RDW-18.3* Plt Ct-201 [**2103-7-6**] 06:15AM BLOOD Neuts-79.8* Lymphs-15.6* Monos-2.4 Eos-1.9 Baso-0.3 [**2103-7-7**] 07:00AM BLOOD Neuts-76.0* Lymphs-17.5* Monos-4.1 Eos-2.1 Baso-0.3 [**2103-7-8**] 06:30AM BLOOD Neuts-72.1* Lymphs-20.8 Monos-4.1 Eos-2.5 Baso-0.4 [**2103-7-10**] 07:17AM BLOOD Neuts-74.5* Lymphs-21.9 Monos-2.6 Eos-0.8 Baso-0.2 [**2103-7-6**] 06:15AM BLOOD Plt Ct-118* [**2103-7-7**] 07:00AM BLOOD Plt Ct-134* [**2103-7-8**] 06:30AM BLOOD Plt Ct-125* [**2103-7-9**] 06:35AM BLOOD Plt Ct-126* [**2103-7-10**] 07:17AM BLOOD Plt Ct-123* [**2103-7-11**] 05:21AM BLOOD Plt Ct-168 [**2103-7-12**] 05:30AM BLOOD Plt Ct-201 [**2103-7-8**] 03:33PM BLOOD Glucose-114* UreaN-22* Creat-1.1 Na-142 K-4.4 Cl-113* HCO3-18* AnGap-15 [**2103-7-9**] 06:35AM BLOOD Glucose-105* UreaN-20 Creat-1.0 Na-144 K-4.0 Cl-112* HCO3-19* AnGap-17 [**2103-7-10**] 03:45PM BLOOD Na-140 K-4.3 Cl-109* [**2103-7-11**] 05:27PM BLOOD Na-140 K-4.2 Cl-108 [**2103-7-12**] 05:30AM BLOOD Glucose-96 UreaN-22* Creat-0.9 Na-140 K-4.1 Cl-108 HCO3-23 AnGap-13 [**2103-7-7**] 07:00AM BLOOD ALT-15 AST-22 AlkPhos-154* TotBili-1.1 [**2103-7-8**] 06:30AM BLOOD ALT-13 AST-25 AlkPhos-137* TotBili-1.1 [**2103-7-10**] 07:17AM BLOOD ALT-14 AST-23 LD(LDH)-258* AlkPhos-134* TotBili-1.4 [**2103-7-9**] 06:35AM BLOOD Albumin-2.8* Calcium-8.5 Phos-2.8 Mg-2.0 [**2103-7-10**] 03:45PM BLOOD Mg-1.9 [**2103-7-11**] 05:21AM BLOOD Calcium-8.1* Phos-3.1 Mg-2.6 [**2103-7-12**] 05:30AM BLOOD Calcium-8.1* Phos-2.9 Mg-2.1 [**2103-7-4**] 12:55AM BLOOD Lactate-3.2* [**2103-7-4**] 10:37AM BLOOD Lactate-1.9 [**2103-7-7**] 08:18PM BLOOD Lactate-1.8 Brief Hospital Course: . #Septic Shock: Patient presented with hypotension, as well as bandemia and hypothermia to 35C. She was admitted to the ICU. Her blood pressure was refractory to IV fluids and she was started on vasopressors to maintain a MAP> 60 through a left femoral line. Her blood pressure medications (isosorbide mononitrate, metoprolol, lasix ) were held due to hypotension. She was started on broad spectrum antibiotics that included Vanc/Cefepime/Flagyl. Her blood culture from admission grew Acinetobacter Baumannii. Her antibiotics were changed to meropenem on [**2103-7-5**]. She was weaned of vasopressors by ICU day three and was transferred out to the medicine floor where she remained hemodynamically stable with systolic blood pressures ranging from 90s to 120s. #Acinetobacter bacteremia: Her blood culture from admission grew Acinetobacter Baumannii. The infectious disease service was consulted. The source was likely urinary as urine culture on admission was dirty (although culture not obtained until after antibiotics initiated). A skin source was also considered given multiple skin tears in her lower extremities. She was started on meropenem on [**2103-7-5**] with plan to complete a fourteen day course (finishing [**2103-7-18**]). She will need blood cultures drawn after completion of antibiotics to verify eradication of infection. . #Acute on chronic systolic heart failue: An echocardiogram showed an ejection fraction of 30-35% with a 2+ mitral regurgitation, new as compared to a study in [**11/2102**] which showed an ejection fraction of 45%. She developed a new oxygen requirement. Exam and chest imaging were consistent with volume overload (2-3L nasal cannula). This likely occurred due to aggressive IVF resuscitation in the ICU. She was started on lasix 10-20IV boluses for goal diuresis of 500cc daily. She has achieved that goal with a regimen of 20IV lasix twice daily. This at times has been limited by borderline blood pressures with systolics in the 90s. At discharge she is satting 95% on 2L nasal cannula breathing comfortably at 16 resps per minute. She still appears volume overloaded with crackles at bases and significant lower extremity edema at her upper thighs. Would recommend further diuresis with lasix 20IV [**Hospital1 **] with goal negative of 500cc daily. She was given a dose of 20IV this morning at 11AM. Would check electrolytes twice daily and replete as has had brief runs (up to 8 beats) of SVT with LBBB conduction noted on telemetry. Her home metoprolol succinate (100mg daily) was changed to 6.25mg TID during the hospitalization, which her blood pressure tolerates well. Isosorbide has been held during diuresis. She has a foley catheter for urine monitoring and also has lower extremity breakdown that could potentially be a nidus for infection. . #Lower extremity Skin tears: This is a chronic problem although per her nephew her legs looked significantly worse of late. Ultra-sound of the legs were negative for deep venous thrombosis. Wound care was consulted and recommended: 1. Pressure Redistribution - Atmos Air 2. Cleanse bilateral groins and perineum with Aloe Vesta foam cleanser daily. Pat dry 3. Apply Critic aid clear to bilateral groins daily. Place Kerlix in between skin fold to separate skin and wick moisture. [**Month (only) 116**] re-apply skin barrier ointment after each 3rd cleansing. 4. Apply Crit aid clear antifungal to perineum daily. 5. Reposition q2 hours. 6. OOB to chair on chair cushion for 2 hr at a time. 7. Waffle to bilateral feet. Float heels. 8. Apply Aloe Vesta ointment to intact dry skin daily. 9. Continue with wound care to BLE's traumatic skin tears for planning. 10. Patient is not safe at home alone, MSW and Case Management for planning. Her wounds were improved at discharge. . #Coagulopathy: Her PTT/PT were elevated on admission (INR of 1.9) thought to be due to malnutrition or possibly chronic liver disease. She was given vitamin K 10mg PO for three days and her INR trended down to 1.4 at discharge. . #Gallstones: She was found to have gallstones but no evidence of acute cholecystitis on abdominal imaging (CT and ultrasound). . #Chronic Kidney Disease: Her creatinine on admission ranged from 1.5-1.1 and on discharge it was 0.9. All nephrotoxins were avoided and her medications were renally dosed. . #Diarrhea: She reports loose stools at home and etiology is unclear especially since CT of the abdomen showed well formed stools but there was no evidence of inflammation or enteritis. C diff toxin was negative. There was some concern for overflow encoparesis and stool impaction. She was put on a bowel regimen and this stabilized over the hospital stay. . #Aneursym: CTA showed her aneursym was stable w/ type 3 endoleak with unchanged aneurysmal sac diameter and no evidence of any free fluid suggestive of blood. . #CAD: No symptoms of active ischemia. Her isosorbide was held in the setting of hypotension from sepsis and then active diuresis. was stable and she was continued on her pravastatin and aspirin. . #Code status: per patient and her nephew she would want to be DNR but ok to intubate. Medications on Admission: Furosemide 40mg [**Hospital1 **] Metoprolol Succinate 100mg daily ASA 81mg daily Pravastatin 10mg daily Sertraline 50mg daily Omeprazole 20mg daily Ferrous sulfate 325mg daily Vit D3 1000 daily Multivitamin daily Imiquimod 5% cream Isorbide mononitrate 30mg daily Discharge Medications: 1. meropenem 500 mg Recon Soln Sig: One (1) Intravenous every twelve (12) hours for 6 days: last day to complete 14 day course will be [**2103-7-18**]. Disp:*12 * Refills:*0* 2. pravastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 4. sertraline 50 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 6. cholecalciferol (vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 7. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. silver sulfadiazine 1 % Cream Sig: One (1) Appl Topical DAILY (Daily) as needed for apply to leg ulcers. 9. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 10. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for Pain/Fever. 11. metoprolol tartrate 25 mg Tablet Sig: 0.25 Tablet PO TID (3 times a day). Disp:*10 Tablet(s)* Refills:*2* 12. Meropenem 500 mg IV Q12H Day 1 = [**2103-7-5**] 13. Outpatient Lab Work check Chem-7 twice daily while diuresing with IV lasix 14. lasix 20IV twice daily; hold for SBP<90 15. telemetry Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: 1. Primary Diagnosis: -Septic Shock -Pulmonary Edema . 2. Secondary Diagnosis: -CHF (EF 45%, though likely an overestimate given severe MR) -CAD (last cath in [**2096**] with complete occlusion of ramus intermedius, moderate disease elsewhere) -Decreased vision R eye, now legally blind -PVD - s/p arthrectomy and B/L superficial femoral artery PTCA -Severe mitral regurgitation -Depression -Hysterectomy -Endoscopic aortic aneurysm repair [**11-28**] -Chronic kidney disease (baseline Cr 1.4) Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Dear Ms. [**Known lastname **], It was a pleasure taking care of you at the [**Hospital1 18**] when you were recently admitted for low blood pressures and found to have bacteria growing in your blood. You were first stabilized in the intensive care unit and then you were transferred to the medicine floor where your blood pressures continued to be stable. You were treated with antibiotics for you infection. You will need to contine to take antibiotics while at rehab until [**7-18**]. . Over your hospital stay, you required oxygen to maintain your oxygen saturation at normal levels. The decline in your pulmonary function was thought to be from a combination of fluid in your lungs and decreased lung volumes. You were give some lasix to reduce the fluid in your lungs and that is something you will have to continue at rehab. . We changed the dressings on your leg ulcers daily and they were improved your hospital stay. . Followup Instructions: You should follow-up with the scheduled appointments below: Department: VASCULAR SURGERY When: THURSDAY [**2103-9-6**] at 2:45 PM With: [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern4) 2604**], MD [**Telephone/Fax (1) 1237**] Building: LM [**Hospital Unit Name **] [**Location (un) **] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: CARDIAC SERVICES When: THURSDAY [**2103-9-20**] at 12:00 PM With: [**Name6 (MD) **] [**Last Name (NamePattern4) **], MD [**Telephone/Fax (1) 62**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 2285**] ICD9 Codes: 0389, 2761, 5990, 4280, 4240, 4439, 311, 496
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Medical Text: Admission Date: [**2185-6-15**] Discharge Date: [**2185-7-2**] Date of Birth: [**2116-6-24**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2181**] Chief Complaint: Neck pain Major Surgical or Invasive Procedure: ACDF C5-7 Posterior laminectomy and fusion C5-T1 History of Present Illness: Mr. [**Known lastname 431**] is a 68 year-old man with hx of alcohol abuse, pancreatic insufficiency, DM, and HTN who was admitted on [**2185-6-15**] to Ortho-Spine after falling from a 12-foot ladder while intoxicated. MRI spine at [**Hospital **] Hospital revealed unstable right C7 facet fracture and C6/7 disc herniation. He was transferred to [**Hospital1 18**] for further management. Past Medical History: DM HTN Prostate cancer s/p prostatectomy Alcohol abuse Pancreatic insufficiency Social History: Lives with wife. [**Name (NI) **] history of tobacco or drug abuse. According to wife, pt began drinking heavily at age 60 when diagnosed with prostate cancer. He has been intermittently sober since then. He has recently been drinking 0.5-1 pint vodka. He often goes through withdrawal at home which manifests as tremors and anxiety. He once had hallucinations, but there is no history of seizures. Family History: N/C Physical Exam: Vitals: T 98.3 BP 140/80 HR 67 RR 18 O2 sat 96%RA General: alert and oriented to person but not place or time, agitated and delirious CV: RRR, no murmurs/rubs/gallops Resp: CTAB, no wheezes/crackles/rhonchi GI: Abd soft NT/ND, bowel sounds present Extremities: BUE- 4/5 strength at deltoid and biceps, [**5-4**] triceps, wrist flexion/extension, finger flexion/extension and intrinics; sensation intact C5-T1 dermatomes; - [**Doctor Last Name 937**], reflexes symmetric at biceps, triceps and brachioradialis BLE- good strength at hip flexion/extension, knee flexion/extension, ankle dorsiflexion and plantar flexion, [**Last Name (un) 938**]/FHL; sensation intact L1-S1 dermatomes; - clonus, reflexes symmetric at quads and Achilles Pertinent Results: On admission: [**2185-6-15**] 06:58PM BLOOD WBC-5.8 RBC-3.47* Hgb-10.5* Hct-32.0* MCV-92 MCH-30.4 MCHC-33.0 RDW-16.7* Plt Ct-128* [**2185-6-15**] 06:58PM BLOOD Neuts-89.9* Lymphs-6.1* Monos-3.2 Eos-0.7 Baso-0.1 [**2185-6-15**] 06:58PM BLOOD Plt Ct-128* [**2185-6-15**] 07:41PM BLOOD PT-11.7 PTT-23.0 INR(PT)-1.0 [**2185-6-18**] 01:45PM BLOOD Fibrino-505* [**2185-6-15**] 06:58PM BLOOD Glucose-129* UreaN-22* Creat-1.2 Na-139 K-5.2* Cl-103 HCO3-20* AnGap-21* [**2185-6-16**] 06:50AM BLOOD Calcium-7.6* Phos-3.2 Mg-1.2* [**2185-6-16**] 06:39PM BLOOD Type-ART Temp-37.1 Rates-/40 Tidal V-600 FiO2-40 pO2-155* pCO2-41 pH-7.34* calTCO2-23 Base XS--3 Intubat-INTUBATED Vent-CONTROLLED [**2185-6-18**] 02:04PM BLOOD Glucose-166* Lactate-0.9 Na-132* K-3.9 Cl-97* [**2185-6-16**] 06:39PM BLOOD Hgb-9.8* calcHCT-29 [**2185-6-16**] 11:34PM BLOOD freeCa-1.04* . On discharge: [**2185-7-1**] 04:09PM URINE bnzodzp-POS barbitr-NEG opiates-NEG cocaine-NEG amphetm-NEG mthdone-NEG [**2185-7-1**] 12:55PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-19 Bnzodzp-NEG . [**2185-6-29**] and [**2185-6-26**] BLOOD CULTURE-pending [**2185-6-29**] Ucx neg [**2185-6-24**] & [**2185-6-26**] ucx neg [**2185-7-1**] 06:10AM BLOOD WBC-5.7 RBC-3.01* Hgb-8.7* Hct-26.7* MCV-89 MCH-28.8 MCHC-32.5 RDW-16.1* Plt Ct-484* [**2185-7-1**] 06:10AM BLOOD Plt Ct-484* [**2185-7-1**] 06:10AM BLOOD Glucose-261* UreaN-8 Creat-0.9 Na-140 K-3.9 Cl-105 HCO3-25 AnGap-14 [**2185-7-1**] 06:10AM BLOOD Calcium-8.3* Phos-3.4 Mg-1.8 [**2185-7-1**] 12:55PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-19 Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2185-7-2**] 07:35AM BLOOD WBC-5.4 RBC-2.94* Hgb-8.2* Hct-25.7* MCV-88 MCH-28.0 MCHC-32.0 RDW-16.3* Plt Ct-522* [**2185-7-2**] 07:35AM BLOOD Glucose-206* UreaN-14 Creat-0.8 Na-137 K-4.1 Cl-101 HCO3-27 AnGap-13 [**2185-7-2**] 07:35AM BLOOD Calcium-8.4 Phos-2.8 Mg-1.8 . CT C-Spine w/o contrast [**2185-6-15**]: IMPRESSION: Fracture of right superior articulating facet of C7 with anterior subluxation of C6 inferior facet. C6-C7 disc space widening, concerning for ligamentous injury; posterior osteophyte disc complex at C5-C6 that narrows the canal; Recommend MRI to further assess. . MR [**First Name (Titles) 11598**] [**Last Name (Titles) 1093**] w/o contrast [**2185-6-16**]: IMPRESSION: 1. Disruption of the anterior and posterior longitudinal ligaments and the ligamentum flavum at the level of C6/7, with adjacent soft tissue abnormalities, compatible with highly unstable extension-type fracture injury. 2. Right C7 facet fracture with impaction of the C6 inferior facet into the fracture site. This has not significantly changed since the CT examination from the prior day. 3. Acute C6/7 posterior disc herniation resulting in moderate stenosis of the spinal canal at this level. Signal abnormalities within the cord are suggestive of contusion. No hematoma is seen. . C-SPINE (PORTABLE); SPINAL FLUORO [**2185-6-16**]: IMPRESSION: There is an anterior plate at the C5 through C7 levels with normal alignment at this time. . Portable CXR [**2185-6-16**]: IMPRESSION: AP chest reviewed in the absence of prior chest radiographs: Tip of the endotracheal tube is substantially above the upper margin of the clavicles, at least 9 cm above the carina, 6 cm above optimal placement. Subsequent chest radiograph, 6:05 a.m. on [**6-17**] available at the time of this review showed no change in this malposition. Lungs are low in volume but aside from mild left basal atelectasis, clear. Heart size normal. No pleural abnormality. . ECG [**2185-6-21**]: Sinus rhythm. Consider left atrial abnormality. Left anterior fascicular block. Delayed R wave progression is non-specific but clinical correlation is suggested. No previous tracing available for comparison. . CT Head w/o contrast [**2185-6-23**]: IMPRESSION: 1. No acute hemorrhage or fracture is detected. 2. Fluid in the paranasal sinuses, may be secondary to recent intubation/surgery. . Right Elbow Xray [**2185-6-23**]: IMPRESSION: 1. Slight irregularity at the radial head suspicious for an occult fracture. Small joint effusion. 2. Enthesopathy at medial and lateral epicondyles of distal humerus and triceps insertion on the olecranon. . Portable CXR [**2185-6-18**]: FINDINGS: Endotracheal tube is in a proximal location, 9.5 cm above the carina. New nasogastric tube terminates within the stomach with side port near the GE junction. Dr. [**Last Name (STitle) 85028**] has been paged with these results. Exam is otherwise remarkable for worsening atelectasis at the left lung base, with no other relevant short interval changes. . Portable CXR [**2185-6-26**]: FINDINGS: The feeding tube has been removed. The lungs are grossly clear without focal consolidation. Hardware within the lower cervical spine is seen. . OROPHARYNGEAL VIDEOFLUOROSCOPIC SWALLOWING EVALUATION [**2185-6-28**]: EVALUATION: An oral and pharyngeal swallowing videofluoroscopy was performed today in collaboration with Radiology. Nectar-thick liquid (tspn, cup) and pureed consistency barium (1 tspn only) were administered. Results follow: . ORAL PHASE: Oral phase was most remarkable for moderately reduced bolus control resulting in premature spillover of nectar thick liquid to the valleculae and airway before the swallow. Mild-moderate tongue weakness (specifically base of tongue) contributed to pharyngeal residue. Oral transit time for individual swallows was WNL. . PHARYNGEAL PHASE: Swallow was initiated in a timely manner, however pt presented with severely reduced hyolaryngeal excursion, moderately reduced laryngeal valve closure, and near absent epiglottic deflection. Pt had at least moderately reduced bolus propulsion and apparent edema near the level of the UES (in line with new cervical spinal hardware). Deficits in combination with oral phase deficits resulted in moderate to severe vallecular and pyriform sinus residue after [**5-5**] swallows per bolus. . ASPIRATION/PENETRATION: Pt demonstrated penetration before and during the swallow which resulted in aspiration after the swallow with both nectar thick liquids and purees. Pt had spontaneous throat clear which temporarily would improve the amount of aspiration or penetration, however it did not fully clear and thus the material would be re-aspirated. Cued cough was also ineffective at fully eliminating aspirated material. . TREATMENT TECHNIQUES: Pt benefits partially but not fully from spontaneous repeat swallows (5-6 per bite/sip) and cued swallow-cough-swallow maneuver. There is no strategy, however, which eliminates aspiration or pharyngeal residue. . SUMMARY: Pt, currently POD #[**8-9**] from anterior and posterior cervical spinal surgeries with hardware, demonstrates severe oropharyngeal dysphagia as described above most notable for reduced movement of the pharyngeal swallow mechanism and swelling at the level of the cervical hardware. Deficits result in significant pharyngeal residue and aspiration across all consistencies assessed. Based on the results of today's evaluation, he does not appear safe for PO intake and should remain fully NPO at this time including no Dobbhoff today. Given the length of time pt will require to recover from his current deficits and his propensity to self-d/c NGTs despite our efforts otherwise, MD team may wish to consider longer term means of nutritional support such as PEG. If we can be of further assistance with discussion regarding plan of care, please contact us. Otherwise, we will f/u in approximately 1 week's time for reassessment, if he remains at this facility. Alternatively, pt could have swallow f/u in a rehab setting. . RECOMMENDATIONS: 1. NPO, no ice chips, no oral meds 2. Q4 oral care while NPO. 3. Support non-oral means of nutrition, hydration, and medication 4. Consider longer term means of non-oral nutrition. 5. Repeat swallowing evaluation in 1 week's time. Page/reconsult if we can be of further assistance prior to that f/u. 6. Pt will benefit from intensive swallow therapy and cognitive-linguistic dx/tx in a rehab setting upon d/c. . NG tube placement [**2185-6-30**]: IMPRESSION: Successful placement of a nasointestinal tube into the post-pyloric position. The tube is ready to use. . Ct head [**2185-6-29**] non contrast: There is no acute hemorrhage, edema, mass effect or acute major vascular territorial infarction. Global, predominantly central parenchymal atrophy is likely age-related. Periventricular white matter hypodensities are most likely the sequelae of chronic small vessel ischemic disease. There is minimal fluid in ethmoid air cells and frontal sinuses, bilaterally. The remainder of the paranasal sinuses and mastoid air cells appear clear. Surgical clips and post-surgical changes are noted in the scalp overlying the left occipital bone. IMPRESSION: No acute intracranial abnormality. . CXR [**2185-6-29**]: FINDINGS: Small retrocardiac opacity, could be atelectasis. There is no pneumonia. There is no pleural effusion, or pneumothorax. Hilar, mediastinal, and cardiac silhouette are within normal limits. There is mild rightward scoliosis in the thoracic spine. Anterior posterior cervical fusion at the lower C-spine. IMPRESSION: 1. No pneumonia. 2. Small retrocardiac opacity, could be atelectasis. Brief Hospital Course: Mr. [**Known lastname 431**] was admitted to the [**Hospital1 18**] Spine Surgery Service on [**2185-6-15**] and taken to the Operating Room for a cervical fusion through an anterior approach C5-7. Please refer to the dictated operative note for further details. The surgery was without complication and the patient was transferred to the PACU in stable condition. TEDs/pnemoboots were used for postoperative DVT prophylaxis. Intravenous antibiotics were given per standard protocol. Initial postop pain was controlled with a PCA. Post-operatively he was noticed to be confused and withdrawing from alcohol. He was transfered to the T/SICU for further management. On HD#3 he returned to the operating room for a scheduled posterior cervical fusion as part of a staged 2-part procedure. Please refer to the dictated operative note for further details. The second surgery was also without complication and the patient returned to the T/SICU intubated. . He was subsequently extubated without difficulty but failed a speech and swallow likely secondary to soft tissue swelling from his surgeries. A Dobhoff was placed and he was given tubefeeds. His further withdrawal symptoms were managed with ativan and valium. He pulled out his Dobhoff tube on [**6-21**]. He was transfered to the medical service for further management. . On the medical service, he failed a second speech and swallow evaluation on [**6-22**] and another Dobhoff tube was placed on [**6-23**]. We started him on thiamine and a multivitamin and continued his folate. It was felt that his altered mental status was largely due to delirium and not alcohol or benzodiazepine withdrawal, and we thus sought to minimize use of narcotics and benzodiazepines. . On [**6-23**], Mr. [**Known lastname 431**] [**Last Name (Titles) 18095**] an unfortunate fall to the floor as he was getting out of his chair. He had a CT scan of his head and complete spine, which showed no acute intracranial process and no fractures. An x-ray of his right elbow showed a tiny non-displaced fracture of his radial head. His right arm was put in a sling, and on discahrge was recommended for full [**Last Name (un) **] of motion, non weight bearing, and sling for comfort. Subsequently, he was kept with a 1:1 sitter until his transfer to an outside hospital. . The patient had several aspiration events associated with a brief desaturation and occasional fever. The differential for these fevers included aspiration pneumonitis vs. neuroleptic malignant syndrome. His CXRs did not demonstrate a consolidation and making pneumonia less likely although he certainally is at risk for developing a true aspiration PNA. All psych meds were stopped due to concern of NMS and he remained afebrile without leukocytosis throughout rest of hospital stay. While at [**Hospital 26260**] hospital these psych meds should be restarted soon after arrival. He was re-evaluated by Speech and Swallow on [**6-27**] and again failed a bedside speech and swallow exam. On [**6-28**] he underwent a video swallow study that showed mild-moderate tongue weakness, near absent epiglottic deflection, and edema near the level of the UES in line with new cervical spinal hardware. These defects resulted in aspiration with both nectar thick liquids and purees. Based on these results, it was recommended that patient be kept NPO without oral meds. A dobhoff was placed for nutrition but he pulled it out the same day before it could be utilized for tube feeds. The next day, another dobhoff was attempted and patient was kept on restraints so as not to pull it out. Tube feeds were started on [**6-30**]. . Given that he does not tolerate [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **]-gastric tube well, a more long-term means of non-oral nutrition should be pursued, possibly with a PEG tube. We discussed the issue of the PEG tube with the patient and his wife on [**6-28**]. However, his wife expressed her desire for the patient to be transferred to [**Hospital 85029**] Center to be under the care of his primary care physician. [**Name10 (NameIs) **] patient should continue this discussion on a means for long-term nutrition at his outside hospital. If he is discharged to a rehab facility without a PEG tube in place, he should continue to be kept NPO until re-evaluation one week later with a repeat swallow study. He should receive intensive swallow therapy and cognitive-linguistic treatment in a rehab setting. He should also receive q4h oral care while NPO. He also had episodes of oxygen desaturations to the high 80s that improved to the high 90s with both oxygen via nasal cannula and with suctioning of oral secretions. By discharge, his oxygen saturation was stable in the mid to high 90s on room air. Please note: blood cultures were still pending on discharge. . Of note, patient continued to show signs of sun-downing until the 2 days before transfer. Delirium persisted despite the fact that he was ostensibly taken off all possible sedatives, including benzos and his psychiatric medications. Patient periodically agitated, often requiring restraints. He was combative off restraints and received one dose of 5mg zyprexa IM which did not alleviate symptoms. Psych consult was obtained to evaluate and recommended starting 1mg haldol standing and 1mg qhs prn on [**6-30**]. QTC was mildly prolonged to 455 and thus he was changed to liquid haldol. His psych meds were so far in the hospitalization but citalopram was started at low dose and should be titrated up. Patient's mental status improved after the haldol; he was alert and oriented x 3 the next morning [**7-1**]. CXR, UA, and blood cx were unremarkable. TSH, B12, folate, and RPR were checked as part of delirium work up and were pending on discharge. . However, throughout the day, he became more somnolent and lethargic, out of proportion to the amount of haloperidol he was receiving. A urine toxicology returned on [**7-1**] positive for benzos in the urine which had been discontinued since [**6-23**]. It is unclear why he had benzos in the urine at that time. Blood toxicology was negative. Of note Mrs. [**Known lastname 431**] was updated daily by several members of the medical team including Dr. [**Last Name (STitle) **] (attending), Dr. [**Last Name (STitle) 3315**] (pgy3), and Dr. [**Last Name (STitle) **] (pgy1). She repeatedly expressed concern that we were not caring for her husband well. [**Name2 (NI) **] was transferred to [**Hospital 26260**] Hospital on [**2185-7-2**] per the wishes of his wife. Medications on Admission: Lantus 12 units Metformin 500 mg [**Hospital1 **] Lisinopril 30 mg qam Nifedipine 30 mg qam Simvastatin 10 mg pm Pancrease 10 mg TID Clonazepam 0.5 mg qid Citalopram 40 mg qam Albuterol NEB Prilosec 20 mg pm Chromium 500 mcg Fenugreek 600 mg [**Hospital1 **]/meals Discharge Medications: 1. Lipase-Protease-Amylase 12,000-38,000 -60,000 unit Capsule, Delayed Release(E.C.) Sig: One (1) Cap PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 2. Metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. Lisinopril 20 mg Tablet Sig: 1.5 Tablets PO QAM (once a day (in the morning)). 4. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 5. Thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO QHS (once a day (at bedtime)). 9. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 10. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection three times a day. 11. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Insulin per attached sliding sclae 13. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 14. Acetaminophen 650 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours). 15. Haloperidol Lactate 2 mg/mL Concentrate Sig: o.5 PO BID (2 times a day). 16. Citalopram 20 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 17. Ondansetron 4 mg IV Q6H:PRN nausea Discharge Disposition: Extended Care Discharge Diagnosis: Primary diagnosis: C7 superior facet fracture and C6 perched right inferior facet with C6-7 disc injury, delirium, ?NMS, failed speech and swallow Secondary diagnoses: Diabetes mellitus type 2, hypertension, alcohol abuse, pancreatic insufficiency, history of prostate cancer s/p prostatectomy Discharge Condition: Discharge Instructions: You were admitted after falling off a ladder and fracturing a cervical vertebra (a part of your spine). Our surgeons performed anterior and posterior fusion of your cervical spine. You [**Hospital1 18095**] a fall while you were in the hospital. CT scans of your head and spine showed no acute bleeding in your head and no disruption of your spine. An elbow x-ray showed a tiny nondisplaced fracture of your right radius (one of the bones in your forearm), and you were given a sling. It was not possible to tell the age of that fracture. . You were very confused at the hospital and psychiatry was consulted. You are now on haldol. Your confusion is getting better. . You also showed symptoms of alcohol withdrawal which was treated with medications. You should abstain from alcohol in the future. You also had some confusion due to sedating medications which slowly improved. You had some fevers that were thought to be due to neuroleptic malignant syndrome (in which patients develop high temperatures due to psychiatric medications) or aspiration pneumonia. However, your chest x ray was clear, making pneumonia less likely. Your fevers resolved when your psychiatric medications were stopped, your psych medications will be restarted after transfer to your new hospital but they may be restarted slowly. We started your citalopram at a low dose on [**2185-7-1**]. . You had persistent difficulty with swallowing, as shown by several swallowing tests in the hospital. As a result of your swallowing difficulties, you like aspirated while in the hospital. We tried to give you nutrition through a tube that goes through your nose into your stomach but you pulled it out several times. You will likely need a more long-term source of nutrition such as a PEG tube, which is a tube that goes into your stomach and attaches to the outside. You will be transferred to an outside hospital as you and your family requested. There, this issue of the feeding tube should be addressed further. For now you have a tube through your nose. . Post op instructions from our surgeons: -Activity: You should not lift anything greater than 10 lbs for 2 weeks. You will be more comfortable if you do not sit or stand more than ~45 minutes without getting up and walking around. -Rehabilitation/ Physical Therapy: 2-3 times a day you should go for a walk for 15-30 minutes as part of your recovery. You can walk as much as you can tolerate. Limit any kind of lifting. -Brace: You have been given a collar. This is to be worn for when you are walking. You may take it off when sitting in a chair or while lying in bed. -Wound Care: Remove the dressing in 2 days. If the incision is draining cover it with a new sterile dressing. If it is dry then you can leave the incision open to the air. Once the incision is completely dry (usually 2-3 days after the operation) you may take a shower. Do not soak the incision in a bath or pool. If the incision starts draining at anytime after surgery, do not get the incision wet. Cover it with a sterile dressing. Call the office. -You should resume taking your normal home medications once you are taking things by mouth. No NSAIDs (ibuprofen, aleve). -Please call the office if you have a fever>101.5 degrees Fahrenheit and/or drainage from your wound. . We will send the doctors at your [**Name5 (PTitle) **] hospital a list of your medications on transfer. Followup Instructions: Please schedule a follow-up appointment with Dr. [**Last Name (STitle) 363**] in 10 days at ([**Telephone/Fax (1) 11061**]. Completed by:[**2185-8-11**] ICD9 Codes: 5849, 4019, 2859, 311
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Medical Text: Admission Date: [**2165-8-20**] Discharge Date: [**2165-8-22**] Service: MEDICINE Allergies: Digoxin Attending:[**First Name3 (LF) 134**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: None History of Present Illness: hpi:86 yo female with non-ischemic CM, EF 10-20%, severe MR, asthma who was admitted [**8-20**] with right facial droop. CT and MRI negative for CVA. On hospital day#2 developed acute onset soba dn increased rr and hr. Lasix had been held in the am due to low bp. Denied CP, though was not mentating well and unable to answer questions reliably. Stat cxr showed worsening chf. ABG showed 7.25/46/235 on nrb. Pt received 80 and then 40 mg IV lasix with no response. 1 mg IV morphine given. EKG showed ST with baseline LBBB. Pt transferred to CCU for presumed CHF exacerbation. Social History: lives at facility, no EtOH or tob, retired real estate broker Family History: No DM, CAD, HTN, cancer 86 yo F with EF 10-20%, 4+ MR [**Name13 (STitle) **] to the CCU with acute tachy/hypoxia. 1) Respiratory distress--Ddx: CHF +/- aspiration PNA. By CXR, history, CHF likely a component. However, pt showed no response to another lasix 120 mg IV as well as lasix drip. Also, per nursing staff, pt had not been mentating well and had had difficulty taking PO and may have aspirated. O/N pt developed a fever over empiric levo/flagyl. Though the pt satted well and had improved abg's on NRB and then high flow mask, the underlying pathophysiology--her CHF and likely pna--did not appear improved. 2) Poor cardiac output--The has had a hx of declining mentation over the past few weeks that has fallen precipitously leading to this admit. Also, during this admit, the pt's Cr has elevated significantly and her urine output has fallen. This is likely due to worsening cardiac out-put. It is unclear what the precipitating event was that led to the acute decompensation of her cardiac output. O/N her CO was unresponsive to dobutamine and her BP was worsening by its effects. 3) Low [**Name (NI) 49810**] pt's BP worsening with the dobutamine. During the administration of the dopamine, she was found to have a temp to 103. The pt's BP did not recover despite the dobutamine being stopped and levophed being administered and escalated to the maximum dose. The pt was felt to be septic. 4) Code status: [**Name (NI) 49811**] pt's cardiogenic shock exacerbated by an apparent underlying septic shock was discussed with the family. The pt's family had been updated as to Ms. [**Known lastname 49812**] condition throughout the night. With no improvement in pt's MAPs despite escalating doses of levophed, the felt including son (hcp) felt goals of care should be to make pt [**Name (NI) 3225**]. 5) Communication Son [**Name (NI) 382**]: Dr. [**First Name4 (NamePattern1) **] [**Known lastname **] [**Telephone/Fax (1) 49813**] (c), [**Telephone/Fax (1) 49814**] (h) Past Medical History: 1. PE 2. hypertension 3. hypothyroidism 4. asthma 4. nonischemic CHF with EF <20% 5. dementia 6. depression 6. CRF baseline 1.3-1.5 Social History: Social History: lives at facility, no EtOH or tob, retired real estate broker Family History: Family History: No DM, CAD, HTN, cancer Physical Exam: PE: 101 rr20 bp 103/60 hr88 Gen: opens eyes to name, o/wnon-responsive skin: no lesions heent: pupils sluggishly reactive to light, mmd heart: rrr no mrg lungs: diffuse rales on post and ant exam abd: soft/nt/nd +BS ext: non edema , PT pulss intact neuro: unable to assess Pertinent Results: [**2165-8-20**] 11:40PM GLUCOSE-133* UREA N-42* CREAT-1.6* SODIUM-136 POTASSIUM-4.3 CHLORIDE-100 TOTAL CO2-27 ANION GAP-13 [**2165-8-20**] 11:30PM URINE HOURS-RANDOM [**2165-8-20**] 11:30PM URINE GR HOLD-HOLD [**2165-8-20**] 11:30PM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.010 [**2165-8-20**] 11:30PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2165-8-20**] 06:52PM GLUCOSE-163* LACTATE-2.0 NA+-133* K+-4.6 CL--96* TCO2-27 [**2165-8-20**] 06:45PM UREA N-43* CREAT-1.9* [**2165-8-20**] 06:45PM CK(CPK)-31 [**2165-8-20**] 06:45PM TSH-11* [**2165-8-20**] 06:45PM T4-7.2 [**2165-8-19**] 04:40AM PLT COUNT-179 [**2165-8-19**] 12:35PM PT-16.1* PTT-35.2* INR(PT)-1.8 [**2165-8-20**] 06:45PM PT-14.7* PTT-32.9 INR(PT)-1.5 Brief Hospital Course: A/P: The pt is an 86 yo F with EF 10-20%, 4+ MR transferred to the CCU with acute tachycardia/hypoxia. 1) Respiratory distress??????On admission the pt??????s differential diagnosis was: CHF +/- aspiration PNA. By CXR, and the patient??????s history, CHF was a likely a component to her presentation. However, the pt showed no response to a bolus of lasix IV as well as lasix drip. Also, per nursing staff, the pt had not been mentating well and had had difficulty taking PO and may have aspirated. O/N pt developed a fever over empiric levo/flagyl. Though the pt satted well and had improved abg's on NRB, then high flow mask, the underlying pathophysiology--her CHF and low cardiac output as well as her likely pna--did not appear improved. By [**2165-8-21**] the pt had made little urine out-put and , thus, appeared to remain volume overloaded pulmonary-wise. Per Dr. [**Last Name (STitle) **] and the cardiology fellow, low dose peripheral dobutamine was atarted in hopes of improving cardiac output. However, the urine output remained low and the pt??????s BP dropped to around 60/30. The pt??????s temp spiked as well to around 103 F. Thus, the picture was complicated by sepsis. 2) Poor cardiac output??????Before admission the pt had a hx of declining mentation over the past few weeks that has fallen precipitously leading to this admit. Also, during this admit, the pt's Cr has elevated significantly and her urine output has fallen. This was likely due to worsening cardiac out-put. It is unclear what the precipitating event was that led to the acute decompensation of her cardiac output. On [**8-21**] her CO was unresponsive to dobutamine and her BP was worsening by its effects. This likely led to the pulmonary effects described above. 3) Low [**Name (NI) 49810**] pt's BP worsened with the dobutamine. During the administration of the dopamine, she was found to have a temp to 103. The pt's BP did not recover despite the dobutamine being stopped and levophed being administered and escalated to the maximum dose. Eventually levophed was added with minimal effect. The pt was deemed to be septic. 4) Code status: [**Name (NI) 49811**] pt's cardiogenic shock exacerbated by an apparent underlying septic shock was discussed with the family. The pt's family was updated as to her condition throughout her admission. With no improvement in the pt's MAPs despite escalating doses of levophed, the pt??????s son, Dr. [**Name (NI) **] [**Name (NI) **] (hcp) felt the goals of care should be to make the pt [**Name (NI) 3225**]. Eventually, the patient died on [**2165-8-22**] and was declared dead by Dr. [**First Name8 (NamePattern2) 2808**] [**Last Name (NamePattern1) 1726**]. 5) Communication throughout admission: the pt??????s son [**Name (NI) 382**]: Dr. [**First Name4 (NamePattern1) **] [**Known lastname **] [**Telephone/Fax (1) 49813**] (c), [**Telephone/Fax (1) 49814**] (h) Discharge Medications: n/a Discharge Disposition: Expired Facility: Pt expired on [**2165-8-22**] Discharge Diagnosis: n/a Discharge Condition: n/a Discharge Instructions: n/a Followup Instructions: n/a ICD9 Codes: 0389, 486, 5849, 5990, 4280, 4240, 4019, 2449
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Medical Text: Admission Date: [**2204-4-8**] Discharge Date: [**2204-4-13**] Date of Birth: [**2137-7-10**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2387**] Chief Complaint: feeling unwell Major Surgical or Invasive Procedure: Right Internal Jugular Line placement History of Present Illness: 66 yo m with DM, h/o CAD s/p CABG with PCI in '[**99**], severe PVD, CKD, and s/p Vfib arrest who presents with 1 day of vague symptoms. He reports that he started feeling unwell yesterday afternoon with nausea, lightheadedness, and some shortness of breath. He denies chest pain or pressure, palpitations, vomiting, sweating. He was noted to be altered by his wife with concern re: difficulty speaking, perhaps a left sided facial droop and possible left hemianopsia, but limited evidence for this. The patient denies having any difficultly speaking or visual changes, but says that he was confused and seeing things that weren't there. His wife reported to the neurologist that he never had a facial droop. . He reports chronic DOE, no CP at rest or with exercise, + claudication (calf pain) with ambulating 2 blocks, denies orthopnea, sleeps on 4 pillows at night. + PND. He reports LE edema at baseline. He lost 10 lbs over past 3 months, which he attributes to diet and exercise. He initially went to an OSH, where CT head was negative. He was found to have new [**Last Name (un) **] and elevated cardiac enzymes. He was hypotensive at OSH to SBP 80s, started on peripheral dopamine and sent to the ED. In the ED, initial vs were: 98.9 86 94/45 on dopamine 20 95%. He was also reporting worsening of chronic low back pain. His exam was notable for [**3-11**] murmur, benign abdomen, rectal was guaiac neg. A bedside U/S in the ED was neg for pericardial effusion. Cardiology consult was requested for stat ECHO in ED, to look for new WMA, but was not performed. EKG was not felt to be markedly changed from baseline. There was some concern for aortic aneurysm given back pain so he had a CT torso w/o contrast, which was negative for aneurysm. Vascular was consulted and felt aortic dissection was unlikely. Neurology was consulted for concern re: TIA and they did not feel he had a primary neurologic process. Due to persistent hypotension, a RIJ was placed and he was started on levofed. He was not given any antibiotics as he was afebrile without e/o infection. VS prior to transfer were 79 93/36 on levofed 0.12mcg, 18 99% on 3L. Past Medical History: Diabetes Dyslipidemia Hypertension Severe CAD s/p CABG in [**2196**] and PCI in [**2199**] CKD (Baseline Cr = 2.6) S/p VF arrest on a treadmill test in [**2196**] Bilateral SFA stenting with re-stenosis and arthectomy (+) ABI and claudication (worse on L) [**4-11**] - left common femoral to below-knee popliteal artery bypass with non reversed right saphenous vein Social History: Lives with wife, immigrated from Caribbean approximately 40 years ago. Retired construction worker. -Tobacco history: Denies -ETOH: Denies -Illicit drugs: Denies Family History: Mother died of stroke at age 45. Father with diabetes and hypertension and died at age 70. Two brothers with coronary artery disease, one died [**2200**] at age 59 from MI. Physical Exam: Admission Exam: Vitals: 79 93/36 on levofed 0.12mcg, 18 99% on 3L General: Alert, oriented x3, no acute distress HEENT: Sclera anicteric, EOMI, MMM, oropharynx clear Neck: CVL in right IJ (CVP 21), supple, difficult to assess JVP on left, no LAD Lungs: bilat rales at bases. CV: Regular rate and rhythm, distant heart sounds, normal S1 + S2, 2/6 SEM at RUSB, no rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: foley in place Ext: cool extremities, unable to palpate DP or PT pulses, trace non-pitting edema. NEURO: CN 2-12 intact, MAE, sensation grossly intact. Disharge Exam: General: Alert, oriented x3, answering questions appropriately, no acute distress HEENT: Sclera anicteric, EOMI, MMM, oropharynx clear Neck: CVL in right IJ (CVP 21), supple, difficult to assess JVP on left, no LAD Lungs: bilat rales at bases. CV: Regular rate and rhythm, distant heart sounds, normal S1 + S2, 2/6 SEM at RUSB, no rubs, gallops Abdomen: soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly GU: foley in place Ext: cool extremities, unable to palpate DP or PT pulses, trace non-pitting edema. NEURO: CN 2-12 intact, MAE, sensation grossly intact. Pertinent Results: Admission Labs: [**2204-4-8**] 04:00AM BLOOD WBC-8.3 RBC-4.82 Hgb-12.6* Hct-38.4* MCV-80* MCH-26.1* MCHC-32.7 RDW-14.9 Plt Ct-271# [**2204-4-8**] 04:00AM BLOOD PT-22.5* PTT-27.2 INR(PT)-2.1* [**2204-4-8**] 04:00AM BLOOD Glucose-135* UreaN-66* Creat-5.0*# Na-137 K-4.0 Cl-107 HCO3-20* AnGap-14 [**2204-4-8**] 04:00AM BLOOD ALT-150* AST-59* LD(LDH)-250 AlkPhos-109 TotBili-0.2 Cardiac Markers: [**2204-4-8**] 04:00AM BLOOD cTropnT-0.39* [**2204-4-8**] 07:15AM BLOOD CK-MB-16* MB Indx-6.6* [**2204-4-8**] 07:15AM BLOOD cTropnT-0.44* [**2204-4-8**] 04:34PM BLOOD CK-MB-19* MB Indx-6.7* cTropnT-0.56* [**2204-4-9**] 01:34AM BLOOD CK-MB-14* MB Indx-5.5 cTropnT-0.50* [**2204-4-9**] 06:19AM BLOOD CK-MB-12* MB Indx-5.0 cTropnT-0.53* [**2204-4-9**] 05:30PM BLOOD CK-MB-9 cTropnT-0.71* [**2204-4-8**] 04:59AM BLOOD Lactate-1.3 K-4.0 [**2204-4-8**] 07:32AM BLOOD Lactate-1.0 Imaging: carotid series: [**2204-4-9**] 1. Less than 40% stenosis of the right internal carotid artery. 2. 40-59% stenosis of the left internal carotid artery. 3. Reversal of flow in the right vertebral artery, suggestive of subclavian steal. Echo: [**2204-4-9**] Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. Overall left ventricular systolic function is severely depressed (LVEF= 25-30 %) with global hypokinesis and apical akinesis. A left ventricular mass/thrombus cannot be excluded. There is no ventricular septal defect. with severe global free wall hypokinesis. There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. No mitral regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion CT abdomen/ pelvis: [**2204-4-8**] 1. normal caliber thoracic and abdominal aorta. no hematoma detected. Dissection cannot be detected due to lack of IV contrast. 2. Unusually large appendix (12 mm diameter) but no secondary signs of appendicitis. This may represent a mucocele, and elective resection should be considered. 3. Hyperdense right renal mass may represent a hemorrhagic cyst, but this is incompletely evaluated with this technique. This can be further assesed with ultrasound. 4. No acute intrathoracic, intraabdominal, or intrapelvic process seen. 5. Enlarged pretracheal lymph node. Discharge Labs: CBC: WBC-7.8 RBC-5.01 Hgb-12.7* Hct-38.0* MCV-76* MCH-25.4* MCHC-33.4 RDW-14.4 Plt Ct-221 PT-19.4* PTT-72.0* INR(PT)-1.8* Glucose-140* UreaN-102* Creat-3.8*# Na-140 K-3.7 Cl-103 HCO3-24 AnGap-17 ALT-50* AST-21 AlkPhos-94 TotBili-0.2 Calcium-8.8 Phos-3.7 Mg-2.2 Brief Hospital Course: 66 yo m with DM, h/o CAD s/p CABG with PCI in '[**99**], severe PVD, CKD, and s/p Vfib arrest who presents with 1 day of vague symptoms found to have hypotension, [**Last Name (un) **] and elevated CE. # Shock/Hypotension: On arrival to the ED, patient's exam was most consistent with cardiogenic shock, with a prior known EF 25-30%. He had no evidence of sepsis or hypovolemia on exam. His hypotension was likely triggered by new administration of minoxidil causing hypotension and stress leading to stress and demand ischemia. Home BP medications were held, and he was started on levophed with a goal MAP of 55-60. On admission to the MICU, an a-line was placed for monitoring of his blood pressures. Overnight in the MICU he required increasing doses of levophed to maintain blood pressure. His CE were trended, showing elevation of troponin and mild elevation in CK in setting of acute kidney injury and demand ischemia. Repeat Echo showed stable EF of 25-30%, RV free wall hypokinesis and apical akinesis. The patient was transferred to the CCU for further management of cardiogenic shock. Levophed was transitioned to dopamine and patient was started on lasix gtt for diuresis with good result. Dopamine was weaned off on [**2204-4-11**]. Throughout hospitalization, patient was maintained on therapeutic INR with coumadin or with therapeutic PTT with heparin gtt given history of recently diagnosed LV thrombus. In setting of renal failure, patient was started on carvedilol on [**2204-4-11**] and was not restarted on atenolol. As an outpatient, the patient should be restarted on [**Last Name (un) **] and spironolactone as tolerated by BP and recovery of kidney function. Of note, noninvasive blood pressures were difficult to monitor on patient secondary to severe PVD. Carotid dopplers showed possible subclavian steal on right, so BP should be monitored on left. # Coronaries: Upon admission serial EKG showed nonspecific ST changes in the lateral leads, that were initially concerning for ACS. Cardiac enzymes were trended, showing elevation of troponin to 0.95 with only mild CK elevation in the setting of worsened renal failure (see below) and cardiogenic shock. Patient continued on ASA, plavix and atorvostatin through duration of hospitalization. Atenolol was held secondary to renal failure and hypotension, and was later transitioned to carvedilol once cardiogenic shock had resolved. Carvedilol dose uptitrated to 25mg [**Hospital1 **] by time of discharge but other anti-hypertensives were held since BP had been so low at presentation and had not yet rebounded to previously elevated levels. # Acute Kidney Injury on chronic kidney disease: Patient admitted with oliguric renal failure with Cr elevated to 5.0 from baseline of 2.6. Likely etiology secondary to ATN in the setting of his ongoing hypotension and poor forward flow. Renal was consulted for help with management given his possible need for catheterization and severe renal dysfunction. Kidney function improved with initiation of dopamine and lasix gtt. Home [**Last Name (un) **] and atenolol were held given worsened renal function. Renal function was trended daily with creatinine peaking at 6.5. On discharge had improved to 3.8 and was trending in the right direction but will be rechecked on Monday at Dr.[**Name (NI) 5452**] office. # Altered mental status/reported neurologic changes: Presented with vague neurologic complaints of confusion, dysarthria, and facial droop which had resolved by presentation to the ED. Initially the patient was noted to have some waxing - [**Doctor Last Name 688**] mental status thought to be secondary to toxic metabolic encephalopathy from azotemia and cerbral hypoperfusion from hypotension. Neurologic exam was nonfocal and mental status improved through hospital course. Neurology was consulted and felt that initial presentation was consistent with a TIA. For secondary prevention, risk factor management was optimized and patient constinued on strict control of hypercholesterolemia, hypertension, and on antiplatelet agents. HA1C was found to be 10.6. Patient contined on coumadin to prevent embolic stroke from known LV thrombus although this was held for a couple days during hospitalization while there was concern that proceedure might be needed as below. # Known LV thrombus: Pt with history of LV thrombus documented on prior TTE. Had been on warfarin as an outpatient but this was held for a couple days as inpatient as concern that patient would need additional invasive proceedures. Placed on heparin gtt to cover while INR subtherapeutic. Warfarin was restarted 2 days prior to D/c and INR climbing but only up to 1.8 on day of D/c so pt administered one sub-cutaneous dose of 80mg enoxaparin on day of discharge and given script for one additional dose of 80mg enoxaparin the next day. Pharmacy was contact[**Name (NI) **] to confirm that dosing should be 80mg daily for therapeutic anti-coagulation in setting of improving renal failure. # Transaminitis: New this admission, likely secondary to poor forward flow given his presentation of hypotension. Trended through hospital course and noted to be downtrending. # Diabetes: Type II on insulin, on 75/25 [**Hospital1 **] [**First Name8 (NamePattern2) **] [**Last Name (un) 387**] recommendations. Home regimen was held upon admission given poor PO intake and patient transitioned to glargine + ISS. Insulin regimen was adjusted to maintain blood sugars in 100-200. Ultimately put on NPH (70/30) regimen of 15 units in AM and 15 units in PM with ISS to cover. Discharged on this regimen. # Incidental CT findings - noted incidentally on CT A/p. Large appendix (12 mm diameter) but no secondary signs of appendicitis, enlarged pretracheal lymph node and hyperdense right renal mass that may represent a hemorrhagic cyst requires outpatient surgical follow-up. Medications on Admission: -hydralazine?? Minoxidil Coumadin -Lipitor 80 mg Tab 1 Tablet(s) by mouth DAILY (Daily) -Plavix 75 mg Tab 1 Tablet(s) by mouth DAILY (Daily) # Humalog Mix 75-25 100 unit/mL (75-25) Susp, Sub-Q Inj 1 Insulin(s) once a day As [**First Name8 (NamePattern2) **] [**Last Name (un) 387**] DM -Benicar 20 mg Tab 2 Tablet(s) by mouth qd () -Aspirin 325 mg Tab 1 Tablet(s) by mouth DAILY (Daily) -Atenolol 100 mg Tab 1 Tablet(s) by mouth once a day -Isosorbide Mononitrate SR 30 mg 24 hr Tab 2 Tablet(s) by mouth DAILY (Daily) -Spironolactone 25 mg Tab 2 Tablet(s) by mouth three times a day -Folic Acid 1 mg Tab 1 Tablet(s) by mouth DAILY (Daily) -hydralazine 50 mg Tab Oral 1 Tablet(s) Three times daily -Coumadin 5 mg Tab Oral 1 Tablet(s) Once Daily -gabapentin 100 mg Tab Oral 1 Tablet(s) Three times daily -minoxidil 10 mg Tab Oral 1 Tablet(s) Once Daily -started few days ago by Dr. [**Last Name (STitle) **] [**Name (STitle) 46090**] 20 mg Tab Oral 1 Tablet(s) Once Daily -Pletal 100 mg Tab Oral 1 Tablet(s) Twice Daily cilostazol -aldactone 50mg TID Discharge Medications: 1. atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. 5. insulin NPH & regular human 100 unit/mL (70-30) Suspension Sig: Fifteen (15) Units Subcutaneous twice a day. Disp:*900 Units* Refills:*2* 6. furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 7. carvedilol 12.5 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*0* 8. enoxaparin 80 mg/0.8 mL Syringe Sig: One (1) syringe Subcutaneous DAILY (Daily) for 1 doses: Please take dose at 3pm on Sat, [**4-14**]. Disp:*1 syringe* Refills:*0* 9. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. insulin aspart 100 unit/mL Solution Sig: One (1) syringe Subcutaneous four times a day: Take your blood sugars before each meal and administer additional insulin according to attached sliding scale:. Disp:*900 units* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary Diagnosis: 1) Hypotension 2) Acute renal failure Secondary Diagnosis: 1) Diabetes 2) Systolic Heart Failure 3) Hypertension Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Mr. [**Known lastname **], you were admitted to the hospital with low blood pressure and worsened kidney function. You initially were sent to the cardiac ICU where medications were used to support your blood pressure. You had a cat-scan of your abdomen to see if there was something obstructing your kidenys. You received contrast with this CT and medications after the CT to protect your kineys from the contrast. Your warfarin was stopped for a couple days because we thought you might need additional proceedures with high risk of bleeding. We also stopped many of your blood pressure medications because you had such a low blood pressure initially. Your kidney function has improved and should continue to improve and your blood pressure has come back up so we have restarted some blood pressure medications. Your INR is currently slightly less than 2 even though we have restarted your warfarin so you will get a shot of lovenox today and give yourself 1 shot of lovenox tomorrow to make sure your blood is thin enough until you are seen in clinic on Monday. While you were in the hospital there was also initially some concern that you had a stroke. The neurologic service came to see you and said you did not have a stroke but may have experienced what we call a TIA with no residual symptoms. You will follow up with Dr. [**Last Name (STitle) **] in clinic on Monday where you will have your INR and electrolytes checked. The following changes were made to your medications: - Start carvedilol 25mg by mouth twice each day for blood pressure - Increase home furosemide to 80mg by mouth once each day for fluid - Start enoxaparin 80mg sub-cutaneously for 1 day (only take this medication on Saturday, then stop) - Your insulin coverage was changed to NPH 70/30 taking 15 units in the morning and 15 units in the evening with a sliding scale to cover your meal time insulin (see attached sheet) - Continue your home Atorvastatin, warfarin, plavix, aspirin, folic acid - Stop all your other home medications for now until further instructed by Dr. [**Last Name (STitle) **]: stop minoxidil, hydralazine, isosorbide mononitrate, spironolactone, cilostazol, atenolol, benicar, your former sliding scale. Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight goes up more than 3 lbs. Please give yourself your enoxaparin shot on Saturday as mentioned above. Please make sure to check your blood sugars before each meal and give yourself the additional insulin as instructed by the attached insulin slidding scale. Followup Instructions: You have a follow-up appointment scheduled on Monday [**2204-4-16**] with Dr. [**Last Name (STitle) **]. You will have your INR and electrolytes checked at this visit. You also have a follow-up appointment scheduled with your PCP [**Last Name (NamePattern4) **]. [**Last Name (STitle) 11139**] on Thursday [**4-26**] at 12:30pm. At this appointment you should discuss the findings of your CT scan described below. ** While you were hospitalized, you received a CT scan of your abdomen and pelvis to make sure there was no damage to your kidneys. While your kidneys looked fine there were the following findings which should be discussed with your PCP at next visit. 1. Unusually large appendix (12 mm diameter) but no secondary signs of appendicitis. This may represent a mucocele, and elective resection should be considered. 2. Hyperdense right renal mass may represent a hemorrhagic cyst, but this is incompletely evaluated with this technique. This can be further assesed with ultrasound. 3. Enlarged pretracheal lymph node. ICD9 Codes: 5845, 4280, 4439, 5859
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Medical Text: Admission Date: [**2183-10-14**] Discharge Date: [**2183-10-18**] Date of Birth: [**2128-10-2**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2901**] Chief Complaint: VT arrest Major Surgical or Invasive Procedure: cardiac catheterization History of Present Illness: Patient is a 55 yo M with PMHx of CABG [**2175**], PCI [**2180**] who presented to [**Hospital1 **] on [**10-13**] with increasing back pain and chest pressure. Back pain was described as sharp x 30 min, improved with nitroglycerin. Patient was otherwise asymptomatic. He was admitted with chest pain for ROMI and possible stress test [**10-14**] (CTA was negative). However at approx 10 PM he was found face down in his room after his roommate called out. He was initially breathing with shallow breaths, but then became apneic and pulseless. Code blue was called and CPR initiated. Patient was found to have Ventricular tachycardia and patient was shocked per ACLS protocol. As well, patient was loaded with amiodarone 300 mg and intubated for airway protection (though no report of respiratory distress). Patient was briefly transferred to the ICU at [**Location (un) 620**], but quickly transported to [**Hospital1 18**]. Per report after intubating food particles were suctioned from the ET tube. Patient was then directly sent to the cath lab. There he was found to have a total occlusion of his SVG-OM2 graft, this was dilated and stented x2. Right heart catherization was done that showed elevated pulmonary pressures and an elevated PCWP to approx 40. IV lasix was administered. A 40 cm balloon pump was placed and patient was transported to the CCU. . Review of systems not possible as patient is intubated and sedated. As OSH, review of systems was positive only for chest pain, back pain and lower extremity edema Past Medical History: Hypertension Hyperlipidemia CAD Social History: Social history is significant for current tobacco use. There is no history of alcohol abuse. Family History: There is significant family history of premature coronary artery disease with several male relatives having [**Name2 (NI) **] in their 40s, 50s with the youngest occurring at age 25-26. Physical Exam: VS: T 99, BP 82/50, HR 89, RR 20, O2 100% on AC volume controlled 600 x 20 FiO2 60% PEEP 5 Gen: WDWN middle aged male intubated and sedated. HEENT: NCAT. Sclera anicteric. PERRL, EOMI. Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. Neck: Supple with JVD CV: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No S4, no S3. Difficult to assess secondary to balloon pump Chest: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. No crackles, wheeze, rhonchi. Abd: Obese, soft, NTND, Ext: No c/c/e. No femoral bruits (difficult to assess with balloon pump). Skin: No stasis dermatitis, ulcers, purpuric chest/neck Pulses: Right: Carotid 2+ without bruit; Femoral 2+ without bruit; 0 DP, PT 1+ Left: Carotid 2+ without bruit; Femoral 2+ without bruit; 2+ DP Pertinent Results: [**2183-10-14**] 10:54PM WBC-8.0 RBC-2.75* HGB-9.3* HCT-26.7* MCV-97 MCH-33.9* MCHC-35.0 RDW-13.2 [**2183-10-14**] 08:27PM CK-MB-83* MB INDX-0.9 cTropnT-3.12* [**2183-10-14**] 05:34AM CK-MB-242* MB INDX-5.7 . cardiac Cath [**2183-10-14**] COMMENTS: 1. Coronary angiography of this right dominant system revealed three vessel coronary artery disease. The LMCA had a 50% ostial stenosis. The LAD had a 50% proximal stenosis. The LCx system had a 100% occluded OM2. The RCA was diffusely diseased with an 80% ostial stenosis and a 60% proximal stenosis. 2. Arterial conduit bypass angiography revealed a widely patent LIMA-->LAD with retrograde filling. The radial graft to the R-PDA had a 40% proximal stenosis. The SVG-->OM2 was totally occluded. 3. Resting hemodynamics revealed markedly elevated right and left heart filling pressures, with RVEDP of 31 mm Hg and mean PCWP of 40 mm Hg. Pulmonary arterial pressures were elevated with PASP of 58 mmHg. There was systemic arterial hypotension with aortic SBP of 78 mm Hg. Cardiac index was depressed at 1.34 L/min/m2. 4. Successful stenting of proximal and distal SVG-OM graft with 3.5x28mm Vision BMS and 2.5x28mm Minivision BMS respectively in setting of ACS. 5. Insertion of IABP for cardiogenic shock FINAL DIAGNOSIS: 1. Three vessel coronary artery disease. 2 Occluded SVG-->OM2. 3. Cardiogenic shock. 4. Succesful Stenting of SVG-OM2 5. Intraaortic ballon pump placement. . ECHO [**2183-10-14**] The left atrium is elongated. There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. There is moderate regional left ventricular systolic dysfunction with inferolateral akinesis, inferior hypokinesis, apical hypokinesis/akinesis. No apical thrombus identified. Overall left ventricular systolic function is moderately depressed (LVEF= 35 %). Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Physiologic mitral regurgitation is seen (within normal limits). The tricuspid valve leaflets are mildly thickened. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. Brief Hospital Course: 55 yo M with CAD s/p CABG, PCI who presents after VFib/tach arrest with total occlusion of his SVG s/p PCI. . V fib/tach arrest: Likely caused by ischemia and thus possibly reversible. Was revascularized in cath lab and now without further episodes. Was loaded on amiodarone IV on gtt overnight, and then turned off. . Cardiogenic shock: Secondary to STEMI and CAD as patient had totally occluded SVG. Cardiac index low at 1.34. IABP placed to support blood pressure and coronary artery filling. Briefly on phenylephrine for hypotension. Patient on heparin, plavix, aspirin, add beta blocker. Patient was eventually weaned off IABP as his blood pressure tolerated. BBlocker was added. He was transitioned to coumadin from heparin, and will be maintained on this for apical akinesis. . Fluid overload: patient with increased PCWP and right sided pressures. Possible that patient received excessive fluids prior to transfer. As well patient with poor forward flow. diuresed as blood pressure tolerated. Euvolemic on dc. . Aspiration event: Patient with suctioned food particles. Patient with mild fever and leukocytosis. possible stress response, but given hypotension, treated empirically with antibiotics for aspiration pneumonia. CXR without signs of infiltrate. treated intially with Vanc/zosyn, no signs of infection, so this was discontinued. . Respiratory status: patient intubated on OSH before transferred. STable from respiratory status, and was weaned off vent on HD 2. . Anemia: likely in the setting of blood loss due to catherizations and acute stress, stable on discharge. . Acidosis: improved after improvement in vent settings. [**Month (only) 116**] have metabolic acidosis after hypoxic insult. Discharge Medications: 1. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 2. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 3. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 6 days: You should take this medication until until [**10-24**]. 4. Nicotine 21 mg/24 hr Patch 24 hr Sig: One (1) Patch 24 hr Transdermal DAILY (Daily). Disp:*30 Patch 24 hr(s)* Refills:*0* 5. Nitroglycerin 0.3 mg Tablet, Sublingual Sig: One (1) Tablet, Sublingual Sublingual PRN (as needed): Use only when with chest pain. 1 tablet every 5 minutes, for a maximum of 3 doses in 15 minutes. . Disp:*30 Tablet, Sublingual(s)* Refills:*0* 6. Toprol XL 100 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day: take along with the 50 mg tablet. Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*2* 7. Toprol XL 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*2* 8. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Primary: ST elevation MI . Secondary: Aspiration Pneumonia Hypertension Tobacco dependence Discharge Condition: Stable Discharge Instructions: You were initially admitted to the hospital with chest pain. While you were in the hospital you had a cardiac arrest requiring defibrillation. The most likely reason this occurred was because you had an acute heart attack. You were taken to the catheterizartion lab where we found that one of your bypasses had clotted off. This was likely the reason why you had a cardiac arrest. . The following medications were changed during your hospitalization: Your Crestor was discontinued due to elevated levels of enzyme involved in muscle breakdown from your cardiac arrest. You should follow up with your cardiologist and restart a lipid lowering [**Doctor Last Name 360**] at his discretion. You were also started on plavix for the maintenance of your stent. You were also started toprol xl and lisinopril. Note that your aspirin dose has also been increased for cardioprotective effect. You have also been started on a nicotine patch. You are being treated for a pneumonitis following an aspiration event secondary to yoru cardiac arrest with levoflox. Please take all of your medications as directed. Lastly you were started on a blood thinner called coumadin for your decreased heart function. For which you will need frequent blood checks. . If you have any of the following symptoms, you should return to the ED or see your PCP: [**Name10 (NameIs) **] pain, difficulty breathing, lightheadedness, loss of consciousness or any other serious concerns. Followup Instructions: We have scheduled an appointment for you with your cardiologist Dr. [**Last Name (STitle) 3321**] on [**10-30**] at 3pm. You should follow up with your primary care doctor, Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 17753**] to have your INR (coumadin level) monitored. Dr. [**Name (NI) 42449**] office will call you with an appointment within the next 1 week. If you do not hear from his office, it is important that you schedule an appointment with him to have your INR checked within the next week. . You were also noted to have blood tinged sputum. It is important that you follow up with your primary care doctor for a full work up. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**] Completed by:[**2183-10-26**] ICD9 Codes: 4275, 5070, 2851, 2762, 5849, 4280, 4019, 3051
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Medical Text: Admission Date: [**2137-5-12**] Discharge Date: [**2137-6-3**] Date of Birth: [**2104-3-27**] Sex: M Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5880**] Chief Complaint: s/p rollover MVC Major Surgical or Invasive Procedure: ORIF zygoma, orbital floor, maxilla Right radial fracture ORIF Tracheostomy and G tube placement Chest tube placement Bolt placement History of Present Illness: 25 yo male s/p MVC rollover, unresponsive at scene, +ETOH. Failed attempts to intubate on the scene. Temporary airway placed and pt brought to ED. Past Medical History: none Social History: + ETOH Family History: NC Physical Exam: 97.8 58 100/50 100% Fast neg DPL neg GCS 3 multiple facial lacs, with full thickness lac on lower lip; fork shaped chin lac; unstable mid-face; epistaxis, facial swelling, CTAB, deformity left clavicle RRR Abd soft, bruising around abdomen pelvis stable Ext cool, mottled, superficial lacs +LLE Pertinent Results: CT abd/pel: 1) Grade 4 AAST liver laceration involving segments 5, 6, 7, and 8 of the liver, with evidence of active bleeding. 2) Laceration of upper pole of right kidney. 3) Large right-sided pneumothorax. 4) Left apical pneumothorax. 5) Right first posterior rib fractures. 6) Bilateral medial clavicular fractures. 7) Fracture through posterior acetabulum. CT head: multiple facial fractures in maxilla and orbit; complex numerous mandibular fractures Right forearm fracture CT head: No cervical spine fracture or malalignment is evident. There is extensive soft tissue swelling in the neck, especially on the left. Findings were discussed with Dr. [**Last Name (STitle) **]. At this time (8 a.m.), he reports that the patient has a right hemiparesis. No evidence of acute intracranial hemorrhage or edema; There are no skull fractures, but there are numerous facial fractures. [**2137-5-12**] 06:03PM LACTATE-3.1* [**2137-5-12**] 01:48PM UREA N-11 CREAT-1.1 SODIUM-145 POTASSIUM-4.0 CHLORIDE-109* TOTAL CO2-28 ANION GAP-12 [**2137-5-12**] 01:48PM HCT-40.6 [**2137-5-12**] 01:48PM PT-13.6 PTT-25.7 INR(PT)-1.2 [**2137-5-12**] 08:10AM GLUCOSE-114* UREA N-10 CREAT-1.1 SODIUM-147* POTASSIUM-3.7 CHLORIDE-107 TOTAL CO2-26 ANION GAP-18 [**2137-5-12**] 08:10AM CALCIUM-7.1* PHOSPHATE-4.3 MAGNESIUM-1.5* [**2137-5-12**] 08:10AM OSMOLAL-322* [**2137-5-12**] 08:10AM URINE bnzodzpn-POS barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2137-5-12**] 08:10AM URINE BLOOD-LG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2137-5-12**] 05:20AM ALT(SGPT)-396* AST(SGOT)-355* CK(CPK)-625* ALK PHOS-57 AMYLASE-231* TOT BILI-0.7 [**2137-5-12**] 05:20AM LIPASE-155* [**2137-5-12**] 05:20AM CK-MB-21* MB INDX-3.4 cTropnT-0.30* [**2137-5-12**] 05:20AM ETHANOL-134* [**2137-5-12**] 04:00AM WBC-21.7* RBC-3.93* HGB-12.1* HCT-34.4* MCV-87 MCH-30.8 MCHC-35.2* RDW-13.6 [**2137-5-12**] 02:29AM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2137-5-12**] 02:29AM URINE BLOOD-LG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2137-5-12**] 02:20AM ASA-NEG ETHANOL-229* ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**5-19**]: Sputum: 1+ GNR [**5-17**]: Sputum 1+ GNR [**5-20**]: Blood Cx: GPC [**3-6**] coag neg [**5-18**]: CSP 1+ PMNs/coag neg staph [**5-17**]: JP: 3+ PMNs [**5-19**]: cdiff neg [**5-23**]: urine cx: neg [**5-26**]: sputum: GNR 2+, GPC in prs 1+; resp cx GNR Brief Hospital Course: Pt arrived in trauma bay with GCS of 3. Multiple attempts to intubate pt failed. LMA placed until pt brought to OR for trach. No scans were initially performed on patient due to hemodynamic instability. Pt brought immediately to OR for exploratory laparotomy, BOLT, and trach. See results section for list of traumatic injuries. CT chest showed large PTX for which a chest tube was placed in the right apex. Pt underwent multiple surgeries spanning 2 days. Exploratory lap negative for significant findings. Pt tolerated the surgeries well. However, the post operative course was complicated by O2 desaturation in the PACU down to the low 80's. Xray did not show changes in pneumothorax. Pt placed on NRB with adequate improvement of O2 sat. ICU stay complicated by + sputum cultures for GNR and high fevers. Started on 3 antibiotic regimen therapy x 7 days and improved. Pt improved on the floor, satting well on trach mask. Floor stay complicated by delirium/altered mental status from ?etiology. White count was elevated. Patient remained afebrile, urine negative. Sputum cultures positive for GPC and GNR on [**5-26**] and started on Zosyn and Vanc. White count improved. Mental status seemed to improve with decrease of ativan use and antibiotics for presumed PNA (aspiration vs CAP). Pt was able to sit without sitter, and plans made to discharge to rehab for further care. Medications on Admission: none Discharge Medications: 1. Bacitracin-Polymyxin B 500-10,000 unit/g Ointment Sig: One (1) application to wounds Topical every six (6) hours. Disp:*2 months* Refills:*0* 2. Artificial Tear Ointment 0.1-0.1 % Ointment Sig: One (1) Ophthalmic five times a day. Disp:*2 months* Refills:*0* 3. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation every 4-6 hours as needed. 4. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO every [**5-8**] hours as needed. 5. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 6. Enoxaparin Sodium 30 mg/0.3 mL Syringe Sig: One (1) Subcutaneous Q12H (every 12 hours). 7. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 1-2 MLs PO Q4H (every 4 hours) as needed. 8. Heparin Lock Flush (Porcine) 100 unit/mL Syringe Sig: One (1) ML Intravenous DAILY (Daily) as needed. 9. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical TID (3 times a day) as needed. 10. Morphine Sulfate 8 mg/mL Syringe Sig: One (1) Injection Q4H (every 4 hours) as needed for breakthrough pain. 11. H2O2 Sig: One (1) twice a day: Please give H2O2 rinses for oral hygiene. 12. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Chlorhexidine Gluconate 0.12 % Liquid Sig: One (1) ML Mucous membrane [**Hospital1 **] (2 times a day). 14. Haloperidol 5 mg Tablet Sig: One (1) Tablet PO twice a day. Tablet(s) 15. Fentanyl 100 mcg/hr Patch 72HR Sig: One (1) Patch 72HR Transdermal Q72H (every 72 hours). 16. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed. 17. medications Regular Insulin SC Sliding Scale Breakfast Lunch Dinner Bedtime Glucose Insulin Dose Insulin Dose Insulin Dose Insulin Dose 0-50 [**2-3**] amp D50 [**2-3**] amp D50 [**2-3**] amp D50 [**2-3**] amp D50 51-120 0 0 0 0 121-140 2 2 2 2 141-160 4 4 4 4 161-180 6 6 6 6 181-200 8 8 8 8 201-220 10 10 10 10 221-240 12 12 12 12 241-260 14 14 14 14 261-280 16 16 16 16 [**Telephone/Fax (2) 61306**] 18 18 > 301 Notify M.D. 18. Sodium Chloride 0.9% Flush 3 ml IV DAILY:PRN Peripheral IV - Inspect site every shift Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: 1) Grade 4 AAST liver laceration involving segments 5, 6, 7, and 8 of the liver, with evidence of active bleeding. 2) Laceration of upper pole of right kidney. 3) Large right-sided pneumothorax. 4) Left apical pneumothorax. 5) Right first posterior rib fractures. 6) Bilateral medial clavicular fractures. 7) Fracture through posterior acetabulum. 8) multiple facial fractures in maxilla and orbit; complex numerous mandibular fractures 9) Right forearm fracture 10) There is extensive soft tissue swelling in the neck, especially on the left. Discharge Condition: stable Discharge Instructions: 1. Take all the medications as directed 2. Continue oral care with peridex and Peroxide rinses 3. Please take out the staples of head on [**Last Name (LF) 766**], [**2137-6-3**]. 4. You need your antibiotics through your picc line daily. 5. Continue with physical therapy at the rehab 6. Continue using your eye drops Followup Instructions: 1. Please follow up with oralmaxilofacial surgery clinic in 2.5-3 weeks by calling [**Telephone/Fax (1) 14288**] for an appointment. Ask for the surgery resident on-call 2. Please call the plastic surgery clinic by calling [**Telephone/Fax (1) 17687**] to schedule an appointment for any Friday in the next 2-3 months if you have any cosmetic issues from your surgery 3. You also should follow up with your primary care doctor in the next few weeks. If you don't have one, you can call [**Telephone/Fax (1) 250**] to schedule an appointment with physicians at the [**Company 191**] here at [**Hospital1 18**]. 4. You should also call the trauma clinic to schedule an appointment by calling [**Telephone/Fax (1) 61307**] to schedule an appointment in the next 10-14 days. ICD9 Codes: 5185, 2851, 486
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Medical Text: Admission Date: [**2200-10-20**] Discharge Date: [**2200-10-24**] Date of Birth: [**2146-4-28**] Sex: M Service: MEDICINE Allergies: spironolactone Attending:[**Last Name (un) 11974**] Chief Complaint: s/p VT ablation Major Surgical or Invasive Procedure: Ablation of ventricluar ectopic automaticity focus History of Present Illness: 54 year old man with HTN, HLD, CAD with h/o anterior MI s/p DES to LAD ([**7-/2198**]), systolic CHF NYHA Class III(EF 30-35% from TTE [**5-/2200**]), h/o sustained VT s/p BIV ICD (BIV pacing turned off [**5-/2200**]), and COPD requiring 2L at day and night. Recent device interrogation revealed 23 episodes of NSVT lasting between 1 and 5 seconds. There were 11 logs of SVT by the device with episodes lasting between 9 seconds and 2 minutes and 42 seconds. He had one episode of pace terminated monomorphic VT that fell in the VF zone but has never had an ICD shock. Due to his underlying heart failure and COPD, Dr. [**Last Name (STitle) 23246**] does not feel that he is a candidate for antiarrhythmic medication given COPD and has referred him for VT ablation. . In the last several months the patient reports frequent episodes of pre-syncope and palpitations with the sensation that "my heart's going to come right out of my chest." These episodes occur multiple times per day and last for 10-15 minutes at a time. He reports having associated chest tightness and a feeling that he is starved for air. He also describes multiple episodes of feeling like he is going to pass out but denies any frank syncope. These episodes are unrelated to activity. Occasional diaphoresis, no PND, no Orthopnea. . In EP Lab tandem heart inserted prior to VT ablation for prophylactic support. Were able to recreate NSVT not sustained VT -> successful ablation -> extubated, tandem heart removed; - 21F venous sheath on R, 8F arterial sheath on R, 15F arterial sheath on L, 7F and 9F venous sheaths on L; - Bed rest till 10pm - 4L positive; goal 2L negative by midnight; got 40 IV lasix in lab - full dose aspirin . On arrival to the CCU, HR 90, 120/75, SpO2 98 on 100% facemask. . REVIEW OF SYSTEMS: Pt difficult historian. On review of systems denies recent illness, does confirm pre-syncopal episodes for about 6 months, worse recently and palpitations. . Cardiac review of systems is notable for some mild chest pain with episodes, sometimes diaphoresis, both symptoms resolve on own. No orthopnea or PND. Past Medical History: - Hypertension - Hyperlipidemia - CAD s/p anterior wall MI [**7-/2198**] treated with a DES to the LAD - Systolic CHF (LVEF 30-35% or 10-15%? unclear) - Sustained ventricular tachycardia- [**2199-11-2**]; [**2200-3-5**] - S/p BIV -ICD implant [**11/2199**] at [**Hospital6 **]; BIV pacing turned off [**5-15**]? - Underlying bifasicular block - Severe COPD on 2L home day and nightO2; referred to [**Hospital1 2025**] for consideration of heart lung transplant, turned down on basis of lacking social supports (heavy smoker, poor social support) - Was evaluated by [**Hospital1 2025**] for heart/lung tx and declined due to poor social support Social History: Single, lives alone. No children. Disabled. Quit smoking [**3-7**] years ago, previously smoked 1.5 ppd for 39 years. - Former heavy drinker Family History: Adopted Physical Exam: Wt 90 kg Ht 72 inches . VS: 97.8, 80/54, 75, 99% on facemask GENERAL: Caucasian man, looks stated age, with facemask laying flat and complaining of back pain. HEENT: EOMI, Sclera anicteric. MMM. NECK: JVP difficult to appreciate given large habitus, seems to be to angle of jaw? CARDIAC: +S1+S2 but distant heart sounds, difficult to hear. LUNGS: No chest wall deformities, scoliosis or kyphosis. Resp were unlabored, no accessory muscle use. CTAB, no crackles, wheezes or rhonchi. ABDOMEN: Soft, NTND. Hypoacive BS. EXTREMITIES: Warm, Right radial aline, left PIV, groin bandages clean/dry. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Dopplerable b/l LE Pertinent Results: [**2200-10-20**] 07:10AM PT-10.9 INR(PT)-1.0 [**2200-10-20**] 07:10AM PLT COUNT-340 [**2200-10-20**] 07:10AM WBC-10.6 RBC-5.17 HGB-13.8* HCT-44.7 MCV-86 MCH-26.7* MCHC-30.9* RDW-16.8* [**2200-10-20**] 07:10AM estGFR-Using this [**2200-10-20**] 07:10AM GLUCOSE-95 UREA N-15 CREAT-0.9 SODIUM-142 POTASSIUM-4.2 CHLORIDE-97 TOTAL CO2-38* ANION GAP-11 [**2200-10-20**] 07:44AM freeCa-1.13 [**2200-10-20**] 07:44AM HGB-13.0* calcHCT-39 [**2200-10-20**] 07:44AM GLUCOSE-95 LACTATE-0.6 NA+-140 K+-3.8 CL--92* [**2200-10-20**] 07:44AM TYPE-ART PO2-203* PCO2-73* PH-7.35 TOTAL CO2-42* BASE XS-11 [**2200-10-20**] 10:03AM TYPE-ART PO2-339* PCO2-56* PH-7.40 TOTAL CO2-36* BASE XS-8 INTUBATED-INTUBATED VENT-CONTROLLED [**2200-10-20**] 01:44PM freeCa-1.00* [**2200-10-20**] 01:44PM HGB-9.7* calcHCT-29 O2 SAT-99 [**2200-10-20**] 01:44PM GLUCOSE-99 LACTATE-0.8 NA+-138 K+-3.4 CL--102 [**2200-10-20**] 01:44PM TYPE-ART PO2-350* PCO2-54* PH-7.40 TOTAL CO2-35* BASE XS-7 [**2200-10-20**] 07:56PM PLT COUNT-244 [**2200-10-20**] 07:56PM WBC-13.3* RBC-3.69*# HGB-9.9*# HCT-31.8*# MCV-86 MCH-26.7* MCHC-31.0 RDW-17.0* [**2200-10-20**] 07:56PM ALBUMIN-3.4* CALCIUM-7.8* PHOSPHATE-3.4 MAGNESIUM-1.7 [**2200-10-20**] 07:56PM GLUCOSE-123* UREA N-15 CREAT-0.7 SODIUM-144 POTASSIUM-4.8 CHLORIDE-105 TOTAL CO2-34* ANION GAP-10 [**2200-10-20**] 09:30PM HCT-30.8* . EKG: 80-90bpm, sinus, LAD, PR < .2, QRS > .12, RBBB, LAFB, Q in V3,V4, II, III, aVF (old inferior septal MI) . STRESS MIBI ([**2200-5-7**]): Large fixed severe defect, almost total anterior septum and apex. RV enlarged. EF 23%. . TTE ([**2200-5-27**]): EF 30-35% with apex, septum, and distal anterior wall akinetic; remainder of LV hypokinetic. Mildly dilated right ventricle with normal function. . TTE at [**Hospital1 112**] ([**2199-11-29**]): LV function severely reduced with regional variability. LVEF 25-30%. Mild generalized RV systolic dysfunction. No evidence of pericardial effusion or tamponade. Brief Hospital Course: 54 year old man h/o anterior MI in [**2199-7-3**] and with BIV-ICD since [**2199-12-3**], found to have multiple episodes of VT and NSVT on device interrogation and also symptomatic of presyncope/palpitation, referred to [**Hospital1 18**] for ablation of Ventricluar ectopic automaticity focus. Now s/p Ventricular ablation. . # Ventricular Tachycardia - Ablation performed on [**10-20**]. Post ablation patient was in sinus rhythm with occasional PVCs. VT was Found on device interrogation which prompted his admission. On ROS pt endorsed palpitation and pre-syncope. Of note, patient is a poor Amiodarone candidate given severe COPD. On discharge pt denied palpitations, pre-syncope. . # Acute blood loss - Post procedure pt developed severe abdominal pain and low back pain, with a Hct that was 29, down from 44 on admission. A Non-Con CT Abd/Pelvis showed small perinephric hematoma with no extravasation, but some tracking into the pelvis. His HCT was monitored serially and had a HCT nadir of 24.3. On [**10-23**], his abdominal pain acutely woresened after transfusion of 1U PRBCs, repeat CT at that time did not show enlargement of the hematoma. His abdominal pain resolved after he had a BM. He recieved a second unit of PRBCs and his HCT increased to 27.3 and he was discharged home in stable condition. His back and and abdominal pain resolved prior to discharge. # Ischemic Cadiomyopathy with sCHF EF 30-35%: volume status was overloaded on admission, on 40mg PO Lasix daily at home. Received 3L IVF during ablation, followed by 40mg IV Lasix. Dry Weight 97kg, currently 90kg. He was gently diuresed during admission until his O2 requirement decreased to his baseline of 2L, and he was not objectively overloaded on exam. Metop succinate 25 mg was started which is half of his home dose and was increased back to 50mg prior to discharge. In addition, the following medications were continued: Aspirin 81mg (lower dose than when he came in [**3-6**] acute blood loss), furosemide, and rosuvastatin. . # Chronic COPD with 2L requirement at home day and night - currently on facemask SaO2 99%, no wheezing, and moving air well. He was diuresed as mentioned above and weaned to his home O2 requirement of 2L. In addition, his combivent was continued q6h during this hospital admission. . # CAD - asymptomatic currently. AMI in [**2198-7-3**] DES to LAD in [**2198**]. Rosuvastatin 10, Metop succinate 50 mg, Plavix 75, ASA 81. His cardiologist notes intolerant to Lisinopril, can consider [**Last Name (un) **] as an outpatient. . TRANSITIONAL - Pt was placed on medications based on list from his primary cardiologist prior to discharge. - CHECK HCT in 1 Week - consider starting [**Last Name (un) **] [**3-6**] ACE intolerance (per Cardiologist) as an outpatient - consider f/u scan to make sure RP bleed resolved on own, and consider this etiology if patient continues to complain of abdominal/back pain - DNR/Ok to intubate Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from PCP. 1. Clopidogrel 75 mg PO DAILY 2. Furosemide 40 mg PO DAILY 3. Metoprolol Succinate XL 50 mg PO DAILY hold for sbp < 100, hr < 55 4. Pantoprazole 40 mg PO Q24H 5. Rosuvastatin Calcium 10 mg PO DAILY 6. Zolpidem Tartrate 10 mg PO HS:PRN insomnia 7. Aspirin 162 mg PO DAILY 8. ALPRAZolam 1 mg PO QID:PRN anxiety hold for rr< 12 9. Albuterol-Ipratropium 2 PUFF IH Q6H wheezing/sob 10. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN wheezing 11. Nitroglycerin SL 0.4 mg SL PRN chest pain, inform HO Discharge Medications: 1. Albuterol 0.083% Neb Soln 1 NEB IH Q6H:PRN wheezing 2. Albuterol-Ipratropium 2 PUFF IH Q6H wheezing/sob 3. Aspirin 81 mg PO DAILY 4. ALPRAZolam 1 mg PO QID:PRN anxiety hold for rr< 12 5. Clopidogrel 75 mg PO DAILY 6. Furosemide 40 mg PO DAILY 7. Metoprolol Succinate XL 50 mg PO DAILY hold for sbp < 100, hr < 55 8. Nitroglycerin SL 0.4 mg SL PRN chest pain, inform HO 9. Pantoprazole 40 mg PO Q24H 10. Rosuvastatin Calcium 10 mg PO DAILY 11. Zolpidem Tartrate 10 mg PO HS:PRN insomnia Discharge Disposition: Home Discharge Diagnosis: Ventricular tachycardia Acute blood loss anemia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Mr. [**Known lastname 112187**], You were admitted to [**Hospital1 18**] to fix the irregular beating in your heart. The procedure was done without complications on [**10-20**]. After the procedure you had several episodes of abdominal pain. We performed a CT scan which showed a small amount of blood in your abdomen, but not a concerning amount. We monitored your lab results, which were not concerning and stable. Your vital signs were stable and normal during the duration of your stay. We have made an appointment for you with Dr. [**Last Name (STitle) **], who performed the procedure. Followup Instructions: PCP Primary care Appointment: [**Last Name (LF) 766**], [**10-27**] at 1:30pm With:[**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 112188**],MD Location: HILLTOP FAMILY PRACTICE Address: [**Location (un) **], SOMERSWORTH,[**Numeric Identifier 112189**] Phone: [**Telephone/Fax (1) 87160**] . CARDS: Department: CARDIAC SERVICES When: FRIDAY [**2200-11-7**] at 11:00 AM With: [**Name6 (MD) **] [**Name8 (MD) **], MD [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 11975**] Completed by:[**2200-10-26**] ICD9 Codes: 4271, 412, 496, 2851, 4019, 2724, 4280
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Medical Text: Admission Date: [**2148-3-24**] Discharge Date: [**2148-4-4**] Date of Birth: [**2074-7-7**] Sex: F Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1990**] Chief Complaint: Respiratory distress Major Surgical or Invasive Procedure: None History of Present Illness: 73 y/o F with hx of asthma, HTN, DM, HL and obesity presents today with acute onset shortness of breath. For the last week or so, she had been having some worsening dyspnea, cough, productive sputum and wheezing. She thought she was having an asthma attack. Her last one was a few years ago, and she has had a hx of intubations with attacks in the past. She has had low grade fevers at home. No chest pain, hemoptysis. No dizziness, fainting. She did have some nausea yesterday, but no vomiting. No abdominal pain. No diarrhea or constipation. She lives at home with her granddaughter and her two great grandbabies, but they are not sick that she knows of. No other sick contacts. She did receive her flu shot this year and her pneumonia shot a few years ago. . In the ED, intial vitals were T 99.4, P 111, BP 160/60, and 89% on NRB. She received ipratroprium and albuterol nebs. She received levofloxacin, ceftriaxone and methlyprednisone. On transfer, is 93% on NRB. Has not been febrile in the ED. . On arrival to the floor, she is febrile, satting in the 90s on 6L NC. She is comfortable and talking in full sentences, but tired. She still feels wheezy. Past Medical History: PMH: HTN DM Asthma Seasonal allergies Hypercholesterolemia B Cataracts Obesity . PSH: [**2147-12-14**] Right shoulder reverse total arthroplasty (recent) - was in rehab until early [**Month (only) 1096**] from this surgery Vitrectomy TAHBSO Social History: Non smoker now. Quit > 20 years back. No etoh use or illicit drug use. Lives with granddaughter. Daughter died 7 years ago from cancer. Family History: non contributory Physical Exam: EXAM AT ADMISSION: GEN: pleasant, mild respiratory distress, tachypneic HEENT: PERRL, EOMI, anicteric, MMM, op without lesions, no supraclavicular or cervical lymphadenopathy, no jvd, no carotid bruits, no thyromegaly or thyroid nodules RESP: severe bilateral wheezes, poor air movement CV: RR, S1 and S2 wnl, no m/r/g ABD: nd, +b/s, soft, nt, no masses or hepatosplenomegaly EXT: no c/c/e SKIN: no rashes/no jaundice/no splinters NEURO: AAOx3. Cn II-XII intact. 5/5 strength throughout. No sensory deficits to light touch appreciated. No pass-pointing on finger to nose. 2+DTR's-patellar and biceps EXAM AT DISCHARGE: Vitals (1145am): 98.9 128/70 80 20 95% on 2L Gen: NAD. Alert and oriented x3. Mood and affect appropriate. Pleasant and cooperative. Sitting in bed, speaking in complete sentences. HEENT: EOMI. MMM, oropharynx non-erythematous, no lesions. Neck: Supple. No carotid bruits noted, no increased JVP noted. CV: RRR. Normal S1, S2. No murmurs, rubs, or gallops. Pulm: Respiration unlabored, no accessory muscle use. clear inspiratory breaths with mild expiratory wheezes in posterior lung fields Abd: Obese. BS present. Soft, NT, ND. Ext: WWP, no cyanosis or clubbing. Distal pulses radial 2+. mild lower extremity edema Skin: No rashes, ecchymoses, or other lesions noted. Neuro/Psych: CNs II-XII intact. Coordination grossly intact. Pertinent Results: Hematology: [**2148-3-24**] 01:55AM BLOOD WBC-4.8# RBC-4.22 Hgb-11.9* Hct-37.4 MCV-89 MCH-28.1 MCHC-31.8 RDW-13.3 Plt Ct-278 [**2148-3-26**] 03:39AM BLOOD WBC-14.6* RBC-4.05* Hgb-11.4* Hct-36.1 MCV-89 MCH-28.1 MCHC-31.5 RDW-13.3 Plt Ct-281 [**2148-3-29**] 01:49AM BLOOD WBC-16.5* RBC-3.90* Hgb-10.9* Hct-34.3* MCV-88 MCH-27.9 MCHC-31.8 RDW-13.1 Plt Ct-301 [**2148-4-3**] 05:28AM BLOOD WBC-19.4* RBC-3.86* Hgb-10.6* Hct-33.9* MCV-88 MCH-27.4 MCHC-31.3 RDW-14.4 Plt Ct-343 [**2148-4-2**] 03:23AM BLOOD WBC-20.7* RBC-3.94* Hgb-10.9* Hct-34.5* MCV-88 MCH-27.6 MCHC-31.5 RDW-13.9 Plt Ct-362 Differential: [**2148-3-24**] 01:55AM BLOOD Neuts-86* Bands-6* Lymphs-6* Monos-1* Eos-1 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2148-3-30**] 06:00AM BLOOD Neuts-49* Bands-1 Lymphs-24 Monos-14* Eos-0 Baso-0 Atyps-0 Metas-2* Myelos-10* NRBC-2* [**2148-4-2**] 03:23AM BLOOD Neuts-58 Bands-3 Lymphs-28 Monos-9 Eos-0 Baso-0 Atyps-0 Metas-2* Myelos-0 NRBC-2* Coags: [**2148-3-28**] 04:12AM BLOOD PT-11.8 PTT-27.4 INR(PT)-1.0 Chemistry: [**2148-3-24**] 01:55AM BLOOD Glucose-189* UreaN-27* Creat-0.9 Na-139 K-5.3* Cl-104 HCO3-27 AnGap-13 [**2148-4-3**] 05:28AM BLOOD Glucose-105* UreaN-19 Creat-0.7 Na-139 K-3.2* Cl-99 HCO3-34* AnGap-9 [**2148-3-24**] 01:55AM BLOOD cTropnT-<0.01 [**2148-3-24**] 07:18PM BLOOD CK-MB-4 cTropnT-<0.01 [**2148-4-3**] 05:28AM BLOOD Calcium-8.4 Phos-3.8 Mg-2.1 Culture Data: [**2148-3-24**] 1:55 am BLOOD CULTURE **FINAL REPORT [**2148-3-26**]** Blood Culture, Routine (Final [**2148-3-26**]): STREPTOCOCCUS PNEUMONIAE. FINAL SENSITIVITIES. Note: For treatment of meningitis, penicillin G MIC breakpoints are <=0.06 ug/ml (S) and >=0.12 ug/ml (R). Note: For treatment of meningitis, ceftriaxone MIC breakpoints are <=0.5 ug/ml (S), 1.0 ug/ml (I), and >=2.0 ug/ml (R). For treatment with oral penicillin, the MIC break points are <=0.06 ug/ml (S), 0.12-1.0 (I) and >=2 ug/ml (R). SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STREPTOCOCCUS PNEUMONIAE | CEFTRIAXONE-----------<=0.06 S ERYTHROMYCIN----------<=0.25 S LEVOFLOXACIN---------- 1 S PENICILLIN G---------- 0.12 I TETRACYCLINE---------- <=1 S TRIMETHOPRIM/SULFA---- <=0.5 S VANCOMYCIN------------ <=1 S Aerobic Bottle Gram Stain (Final [**2148-3-24**]): GRAM POSITIVE COCCI IN PAIRS AND CHAINS. Anaerobic Bottle Gram Stain (Final [**2148-3-24**]): GRAM POSITIVE COCCI IN PAIRS AND CHAINS. [**2148-3-30**] 12:25 am BLOOD CULTURE Blood Culture, Routine (Preliminary): STAPHYLOCOCCUS, COAGULASE NEGATIVE. Isolated from only one set in the previous five days. SENSITIVITIES PERFORMED ON REQUEST.. . . IMAGING: [**3-24**] Chest X-ray: IMPRESSION: Moderate interstitial/alveolar pulmonary edema. Recommend conventional chest radiographs after treatment to look for possible right lung nodule. . [**3-25**] CT Chest: IMPRESSION: 1. Multifocal parenchymal consolidation most compatible with multifocal pneumonia most severe within the left lower lobe and right upper lobe. 2. Cardiomegaly with extensive atherosclerotic calcification involving the coronary arteries. . Echo: The left atrium is dilated. There is mild symmetric left ventricular hypertrophy with normal cavity size and global systolic function (LVEF>55%). Regional left ventricular wall motion is normal. The aortic valve leaflets (3) are mildly thickened. There is a minimally increased gradient consistent with minimal aortic valve stenosis. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] The tricuspid valve leaflets are mildly thickened. There is mild pulmonary artery systolic hypertension. There is a very small pericardial effusion. There are no echocardiographic signs of tamponade. IMPRESSION: Mild symmetric left ventricular hypertrophy with preserved global and regional biventricular systolic function. At least mild mitral regurgitation. Mild pulmonary artery systolic hypertension. Brief Hospital Course: 73 year old female with a history of HTN, DM and asthma who presented to hospital with acute onset shortness of breath in background of one week of worsening dyspnea, cough, productive sputum and wheezing, initially admitted to the MICU found to have multifocal pnuemonia and CHF exacerbation. . # Shortness of breath/Pneumonia: The patient was found to have a multifocal pneumonia on CT chest which is likely causing the asthma exacerbation. She was initilly admitted to the ICU due to high oxygen requirement. An ECHO failed to reveal vegetations, making septic emboli a less likely cause of any pulmonary signs or symptoms. She was initially on vanco, cefepime and azithro, but narrowed to ceftriaxone when culture data returned. Strep pneumoniae found in blood cultures was sensitive to ceftriaxone, and she will need 2 weeks of total antibiotics (last day [**2148-4-8**]). Unfortunately, the patient's sputum culture was contaminated, and thus unrevealing. She was treated wtih steroids on admission, which were stopped when she was found to be bacteremic, but because of continued wheezing and poor respiratory improvement, steroids were restarted with a plan for 7 days of high dose steroids followed by a slow taper to treat possible concomittant asthma exacerbation. The patient also had acute pulmonary edema in the setting of hypertension and tachycardia. As for her dCHF, she was initially on a nitro gtt in the ED for hypertension and presumed dCHF exaccerbation. Her breathing improved with BP improvement and treatment for S. Pneumo pneumonia. Due to continued hypoxia after adequate antibiotic coverage, repeat Chest CT was ordered - this was negative for PE and showed interval improvement in her pneumonia. Based on these results and clinical improvement, patient was transferred to the floor for further management. Once transferred to the floor, her oxygen was weaned to 1-2L, requiring intermittant diuresis while on antibiotics. She remained afebrile. Ceftriaxone is to be continued for 2 weeks total course (last day [**2148-4-8**]). . # Steptococcus pneumoniae bacteremia: Presumed secondary to her S. pneumoniae pneumonia. She was given IV ceftriaxone with a plan for two weeks of treatment, as above. PICC placed prior to discharge. Of note, ortho evaluated her recent shoulder prosthesis (from [**2147**]) and did not think the joint was seeded in the setting of her bacteremia. Serial cultures were negative. LAST DAY OF Antibiotics: [**2148-4-8**] (2 week course). Of note: She had one set of positive cultures from [**3-30**] that grew coagulase negative staphylococcus (started vancomycin pending final result). This was felt to be contaminant and vancomycin was discontinued. At time of discharge she had blood cultures from [**4-2**] and [**4-3**] that were pending with no growth to date. These should be followed-up after discharge. . # Leukocytosis: Was initially presumed to be due to PNA and becteremia. Was downtrending and then began to trend up again. Could be secondary to steroid administration however, c. diff was considered, but unlikely given lack of diarrhea. Pt was afebrile and having normal bowel movements so was discharged to Rehab with repeat CBC in 1 week to ensure that WBC trending down. . # Diastolic CHF: Mildly fluid overloaded on clinical admission exam, likely contributing to respiratory distress, as her dyspnea improved following furosemide PRN. She was intermittently treated with IV lasix as needed to keep her I/O balance negative. She was restarted on her home lasix dose and discharged to rehab for further follow up. . # DM: Initially continued home insulin regimen, however, due to steroids, insulin dosing was increased. Additionally, an insulin sliding scale was used to help control her hyperglycemia secondary to steroids. As steroids are tapered, insulin regimen can likely be tapered down to home regimen. . # Hypertension: Amlodipine 10mg PO daily and lisinopril 20mg PO daily were used to control hypertension while in the hospital. Home atenolol was changed to metoprolol for better heart rate control. . # Tachycardia: Sinus tachycardia on EKGs, started metoprolol as above. . # Code: full Medications on Admission: Albuterol PRN Flovent 2 puffs QID Atrovent 2 puffs daily Amlodipine 5 mg daily Atenolol 50 mg daily Moexipril 15 mg [**Hospital1 **] Lasix 40 mg daily Atorva 10 mg daily Insulin NPH 23 in AM, 12 in PM; regular 12 in AM, 8 in PM ASA 325 mg daily Omega 3 fatty acid tab daily Discharge Medications: 1. amlodipine 10 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 2. metoprolol tartrate 25 mg Tablet Sig: Three (3) Tablet PO TID (3 times a day). Disp:*270 Tablet(s)* Refills:*0* 3. atorvastatin 20 mg Tablet Sig: 0.5 Tablet PO once a day. 4. fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Inhalation twice a day. 5. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day. 6. ipratropium bromide 17 mcg/Actuation HFA Aerosol Inhaler Sig: Two (2) Inhalation every six (6) hours. 7. aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day: take with meals. 8. Humulin N 100 unit/mL Suspension Sig: Thirty Eight (38) units Subcutaneous in the am. 9. Humulin N 100 unit/mL Suspension Sig: Twelve (12) units Subcutaneous in the pm. 10. Fish Oil 1,000 mg Capsule Sig: One (1) Capsule PO once a day. 11. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization Sig: One (1) nebulizer Inhalation every six (6) hours as needed for shortness of breath or wheezing. 12. ceftriaxone 2 gram Piggyback Sig: One (1) Intravenous every twenty-four(24) hours for 5 days: Last Dose [**2148-4-8**]. 13. lisinopril 20 mg Tablet Sig: One (1) Tablet PO once a day. 14. Humalog 100 unit/mL Solution Sig: 0-12 units Subcutaneous four times a day: per sliding scale. 15. prednisone 10 mg Tablet Sig: Three (3) Tablet PO once a day: PREDNISONE TAPER: 30 mg x 3 days, 20 mg x 5 days, 10 mg x 5 days then stop. 16. trazodone 50 mg Tablet Sig: 0.5 Tablet PO at bedtime as needed for insomnia. 17. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. 18. senna 8.6 mg Tablet Sig: One (1) Tablet PO twice a day as needed for constipation. 19. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain, fever. Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: Primary Diagnosis: -Pneumonia -Asthma exacerbation . -Secondary Diagnoses: -Diastolic CHF -Pneumococcal bacteremia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Ms. [**Known lastname 98446**], You were admitted to the hospital because of trouble breathing. It was due to a combination of pneumonia, worsening asthma, and some mild diastolic heart failure resulting in extra fluid in your lungs. We treated you with antibiotics, steroids and lasix (the "water pill"). You were also found to have bacteria in your blood stream, likely related to the pneumonia. The antibiotics helped this as well, and you had no other bacteria in your blood stream after the first day. You are doing much better and will be discharged to Rehab to facilitate your improvement. . The following medication were started: Ceftriaxone 2gm intravenously for 24HRS for 5 days (total treatment 2 weeks). Prednisone 10-30 mg per taper listed in medication list . The following medications were changed: -Amlodipine 5 mg daily --> increased to 10 mg Daily -Atenolol 50 mg daily --> metoprolol 75mg by mouth Three times a day -Moexipril 15 mg [**Hospital1 **] --> lisinopril 20 mg daily -Insulin dosing increased while on steroids . Please take your other medications as prescribed Followup Instructions: Please follow up with your primary care doctor: Department: [**Hospital3 249**] When: FRIDAY [**2148-4-12**] at 9:00 AM With: [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**Telephone/Fax (1) 250**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 895**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: ORTHOPEDICS When: WEDNESDAY [**2148-4-10**] at 10:45 AM With: [**First Name11 (Name Pattern1) 177**] [**Last Name (NamePattern4) 5500**], M.D. [**Telephone/Fax (1) 1228**] Building: [**Hospital6 29**] [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: [**Hospital3 1935**] CENTER When: WEDNESDAY [**2148-4-10**] at 9:30 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4853**], M.D. [**Telephone/Fax (1) 253**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 7907, 2760, 4280, 4019, 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7509 }
Medical Text: Admission Date: [**2175-8-8**] Discharge Date: [**2175-8-17**] Date of Birth: [**2132-3-23**] Sex: M Service: MEDICINE Allergies: Zosyn Attending:[**Known firstname 30**] Chief Complaint: Fever of 103 on HD, abd pain, N/V Major Surgical or Invasive Procedure: ERCP on [**2175-8-8**] with stent placement ET Intubation on [**2175-8-8**] ERCP on [**2175-8-14**] with stent placement Extubation on [**2175-8-14**] Hemodialysis Central venous catheter - RIJ Arterial line Echocardiogram History of Present Illness: This is a 43 yo man transferred from MICU [**Location (un) 2452**] for ERCP in the setting of presumed biliary sepsis. Patient was transferred on [**2175-8-7**] from [**Hospital3 **] ED with fever found at HD [**2175-8-7**] to 103. He reports symptoms started the evening of [**8-6**] with sharp abdominal pain, nausea, vomitting, and diarrhea. At HD he was febrile with rigors to temp of 103. He had blood cultures and was given vanco/ceftazidime and sent to [**Hospital3 **]. At [**Hospital3 3583**] he was given benedryl 25mg iv, reglan 10mg iv, morphine 6mg iv, zosyn 2.25gm iv. He had an abdomen/pelvis CT that preliminarily showed gall bladder hypodensity without signs of acute cholecysitis. He was transferred here for ERCP given elevated amylase, lipase and transaminases. AT [**Hospital1 18**] ED he was given 3L IVF for SBP 77-111 with HR 100's with Tm 101.5. He was given tylenol 1gm. He was admitted to MICU [**Location (un) 2452**] overnight where a right IJ central line was placed and he received 2L NS, IV vancomycin and zosyn. Patient was transferred to the [**Hospital Unit Name 153**] for planned ERCP intervention on the [**Hospital Ward Name **]. Past Medical History: CAD s/p stent [**1-6**] at [**Hospital1 2177**] in the setting of pna HTN gout: no active symptoms for several years, does not take ppx ESRD on HD x9 years, ? [**12-31**] post-strep infection as a child?, on M/W/F schedule, last HD [**8-7**], at Forsinius in [**Location (un) 3320**] where he reportedly normally gets 5kg removed OSA on CPAP, pressure 17mmHg?, but is unable to tolerate at home Social History: Lives with children (age 19, 22), denies past or current tobacco, drinks etoh only on special occaisions (less than once/month) but drank more heavily prior to HD, occaisional MJ but no IVDU or cocaine. Family History: Father with hypertension, mother with DM, sibs healthy, children healthy. Physical Exam: VS: T 99.5 HR 101 BP 117/75 RR 28 Sat 93% on 4L NC Gen: NAD, obese man, speaking in full sentances, mild labored breathing, drowsy but arousable, witnessed apnic episodes while sleeping HEENT: PERRL, OP clear, MM dry, mild scleral icterus Neck: Supple, Right IJ in place, no LAD CV: Reg, Tachy, III/VI SEM best at RUSB, heard throughout, no r/g Resp: Decreased BS at both bases with scattered rales R base Abdomen: Obese, distended but soft, NT, no obvious masses but very protuberant, white striae, no fluid wave, tympanic to percussion throughout, unable to palpate liver or spleen; no periumbilical ecchymosis Ext: 1+ PE to thigh bilaterally; 2+ DP's B, left UE fistula +palpable thrill Neuro: A&Ox3, CN II-XII intact, strength 5/5 B UE/LE, sensation intact to light touch Skin: no rashes, lesions or ecchymoses . Pertinent Results: [**2175-8-8**] 10:22PM TYPE-ART TEMP-38.2 RATES-20/1 TIDAL VOL-700 PEEP-5 O2-60 PO2-79* PCO2-41 PH-7.42 TOTAL CO2-28 BASE XS-1 INTUBATED-INTUBATED VENT-CONTROLLED [**2175-8-8**] 10:22PM LACTATE-1.2 [**2175-8-8**] 10:22PM O2 SAT-95 [**2175-8-8**] 08:56PM TYPE-ART TEMP-38.2 RATES-[**10-30**] TIDAL VOL-700 PEEP-5 O2-60 PO2-86 PCO2-63* PH-7.28* TOTAL CO2-31* BASE XS-0 INTUBATED-INTUBATED VENT-CONTROLLED [**2175-8-8**] 08:56PM LACTATE-0.9 [**2175-8-8**] 08:56PM freeCa-1.03* [**2175-8-8**] 08:49PM GLUCOSE-101 UREA N-45* CREAT-10.1* SODIUM-140 POTASSIUM-4.6 CHLORIDE-98 TOTAL CO2-27 ANION GAP-20 [**2175-8-8**] 08:49PM CK(CPK)-534* [**2175-8-8**] 08:49PM CK-MB-5 cTropnT-0.29* [**2175-8-8**] 08:49PM CALCIUM-7.6* PHOSPHATE-5.9* MAGNESIUM-2.1 [**2175-8-8**] 02:22PM TYPE-MIX PO2-44* PCO2-54* PH-7.39 TOTAL CO2-34* BASE XS-5 [**2175-8-8**] 02:22PM LACTATE-1.4 [**2175-8-8**] 01:55PM GLUCOSE-125* UREA N-38* CREAT-9.1* SODIUM-139 POTASSIUM-4.4 CHLORIDE-96 TOTAL CO2-30 ANION GAP-17 [**2175-8-8**] 01:55PM ALT(SGPT)-70* AST(SGOT)-50* LD(LDH)-198 ALK PHOS-200* AMYLASE-241* TOT BILI-4.5* [**2175-8-8**] 01:55PM LIPASE-236* [**2175-8-8**] 01:55PM ALBUMIN-3.5 CALCIUM-7.8* PHOSPHATE-5.1* MAGNESIUM-2.1 [**2175-8-8**] 01:55PM WBC-6.9 RBC-3.60* HGB-11.2* HCT-33.2* MCV-92 MCH-31.2 MCHC-33.8 RDW-14.2 [**2175-8-8**] 01:55PM NEUTS-92.5* LYMPHS-3.1* MONOS-4.0 EOS-0.2 BASOS-0.2 [**2175-8-8**] 01:55PM PLT COUNT-179 [**2175-8-8**] 01:21PM LACTATE-1.7 [**2175-8-8**] 04:10AM GLUCOSE-127* UREA N-32* CREAT-8.8* SODIUM-140 POTASSIUM-4.8 CHLORIDE-92* TOTAL CO2-32 ANION GAP-21* [**2175-8-8**] 04:10AM ALT(SGPT)-87* AST(SGOT)-66* CK(CPK)-80 ALK PHOS-213* AMYLASE-376* TOT BILI-3.7* DIR BILI-2.3* INDIR BIL-1.4 [**2175-8-8**] 04:10AM LIPASE-459* [**2175-8-8**] 04:10AM CK-MB-NotDone cTropnT-0.21* [**2175-8-8**] 04:10AM ALBUMIN-3.9 CALCIUM-7.6* PHOSPHATE-4.4 MAGNESIUM-1.2* [**2175-8-8**] 04:10AM TRIGLYCER-236* [**2175-8-8**] 04:10AM CORTISOL-34.3* [**2175-8-8**] 04:10AM VANCO-10.4 [**2175-8-8**] 04:10AM ASA-NEG ACETMNPHN-7.0 bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2175-8-8**] 04:10AM WBC-10.3 RBC-3.63* HGB-11.2* HCT-32.5* MCV-90 MCH-30.9 MCHC-34.4 RDW-14.7 [**2175-8-8**] 04:10AM NEUTS-94* BANDS-4 LYMPHS-1* MONOS-1* EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2175-8-8**] 04:10AM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-NORMAL [**2175-8-8**] 04:10AM PLT COUNT-240 [**2175-8-8**] 04:10AM PT-15.5* PTT-28.7 INR(PT)-1.4* [**2175-8-8**] ERCP FINDINGS: The common bile duct was adequately opacified with contrast medium after the cannulation of the biliary duct. No apparent extrahepatic or intrahepatic biliary duct dilatation or irregularity is seen. No filling defects consistent with stones were noted. As per report, in subsequent images, biliary stent was successfully placed. IMPRESSION: Successful placement of biliary stent. [**2175-8-9**] Transthoracic Echo: The left atrium is moderately dilated. There is moderate symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Overall left ventricular systolic function is normal (LVEF 70%). Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). Transmitral Doppler and tissue velocity imaging are consistent with Grade II (moderate) LV diastolic dysfunction. There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic root is mildly dilated at the sinus level. The ascending aorta is moderately dilated. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] There is mild pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. There are no echocardiographic signs of tamponade. [**2175-8-14**] ERCP FINDINGS: Comparison is made with CT from [**8-12**], [**2174**] and prior ERCP from [**2175-8-8**]. There is removal of a plastic stent. A retrograde cholangiogram shows multiple filling defects, some of which likely represent stones, within otherwise normal- appearing biliary tree. A biliary stent was then placed. Brief Hospital Course: #Hypotension/Sepsis: On admission, patient met SIRS criteria with fever, tachypnea, tachycardia and lactate of 2.5 consistent with sepsis. Infectious source was likely biliary tract vs. HD line infection, however also considered was pulmonary source w/ new O2 requirements although more likely from capillary leak/CHF. Patient has remained fluid responsive intially without need for pressors. The underlying infection was treated with IV vancomycin/unasyn/gentamycin for synergy until cultures at OSH grew enterobacter at which point only zosyn was continued with appropriate coverage. The patients lactate level, fevers and WBC were trended and returned to [**Location 213**]. Zosyn was switched to Ciprofloxacin after the patient developed a drug rash. . #Mechanical ventilation: Patient came to the ICU intubated s/p ERCP, on a propofol drip. Initially he was hypotensive which was treated with IV fluids and discontinued propofol, switching to fentanyl/versed for sedation. Shortly thereafter the patient became restless, agitated and continued to be hypotensive. He was given 10mg vecuronium and paralyzed for arterial line placement and foley placement. His labile blood pressures also exacerbated his already fluid-overloaded state, making it difficult to wean off the vent. The initiation of hemodialysis effectively controlled his BP and fluid status, and on day 7, after his second ERCP, he was extubated and started on CPAP overnight. . # Gallstone Pancreatitis: On admission the patient had elevated LFTs, pancreatic enzymes, bilirubin and alk phos. His levels slowly trended down post-ERCP except bilirubin and AP, which continued to rise. The patient experienced intermittent epigastric discomfort which prompted a RUQ US, which showed a fatty liver but the common bile duct non-well visualised. CT scan of abdomen showed no intrahepatic biliary dilatation, cholelithiasis, and a subtle hypodensity in pancreatic head. Hepatology and ERCP were consulted prompting a second-look ERCP, which showed sludge drainage in the major papilla, stent migrated to major papilla and several stones in the cystic duct. The stent was replaced, antibiotics were continued, and the patient's enzymes and bilirubin were trended. . # ESRD: Initially the nephrology service felt HD was not appropriate early during admission, in setting of patient becoming hypertensive to 200s with volume resusitation for pancreatitis. Beta-blockers were started however the patient did not respond and O2 sats started trending down with worsening acidemia and low PaO2. The following day HD was initiated with good response in blood pressure. The patient received HD throughout his course, with the day before D/c the final time. . # Hypoxia: Suspected capillary leak in the setting of sepsis vs. CHF as pt with known CAD. The patient was weaned off his O2 requirement prior to discharge. . # Drug Rash: Patient developed a diffuse petticheal/macular rash on his chest and legs which was pruritic. Dermatology was consulted who felt consistent with a drug rash. Offending [**Doctor Last Name 360**] was felt to be Zosyn. [**Doctor Last Name **] was discontinued and rash improved. He will continue hydoxyzine, sarna and fluocinonide. . # CAD: An echo was performed to rule out endocarditis as a cause of fever. This showed extensive calcification of cardiac skeleton, mild calcific aortic stenosis, and no definite vegetations . His ECG had some ischemic changes of unclear duration, and the patient had no active symptoms. Cardiac enzymes were stably elevated on admission and, in the setting of ESRD, this was unlikely to be acute event. His aspirin and plavix were continued and the patient remained on telemetry for the duration of his stay. . # OSA: Witnessed apneic episodes while asleep. Known history of OSA on CPAP as outpatient but has not been tolerating of recent. Once patient was extubated he was started on CPAP overnight. . # Anemia: Normocytic with normal RDW. Unclear baseline. [**Month (only) 116**] be low related to ESRD (not on epo as outpatient that we know of). D. bili not consistent with hemolysis. Hematocrit was trended and continued to improve with HD and management. Renal recs: use epo during HD. . Medications on Admission: fish oil daily sensipar 120mg daily ativan 0.5mg prn (rare) percocet prn (rare) nifedipineER 90 daily (last [**8-7**]) minoxidil-dose unable to verify but pt states rx for 2 tabs and only takes 1 renagel 2400mg tid ac phoslo 1334mg (?) tid ac simvastatin 20mg daily plavix 75mg daily aspirin 325mg daily toprolXL 50mg daily Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 4. Metoprolol Succinate 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO DAILY (Daily). 5. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed. Disp:*1 tube* Refills:*0* 6. Ciprofloxacin 750 mg Tablet Sig: One (1) Tablet PO once a day for 5 days: Take this at least one hour before you take Renagel. Disp:*5 Tablet(s)* Refills:*0* 7. Hydroxyzine HCl 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) as needed for itching: Only take this as long as your rash is itching. Disp:*21 Tablet(s)* Refills:*0* 8. Fluocinonide 0.05 % Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day) as needed for rash for 12 days: Only use while you have the rash. Disp:*1 tube* Refills:*0* 9. Cinacalcet 30 mg Tablet Sig: Four (4) Tablet PO DAILY (Daily). 10. Nifedipine 90 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO DAILY (Daily). 11. Minoxidil 2.5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 12. Sevelamer HCl 800 mg Tablet Sig: Three (3) Tablet PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 13. Calcium Acetate 667 mg Capsule Sig: Two (2) Capsule PO TID W/MEALS (3 TIMES A DAY WITH MEALS). Discharge Disposition: Home Discharge Diagnosis: Primary Diagnoses: Biliary Sepsis Gallstone Pancreatitis Secondary Diagnoses: ESRD with hemodialysis CAD Drug rash OSA HTN Anemia Discharge Condition: Good, tolerating regular diet, ambulating with walker for deconditioning, able to climb a flight of stairs, no oxygen requirement, VSS Discharge Instructions: You were seen and treated at the hopital for a blockage in the area of your gallbladder, which caused you to become infected. You were treated with intravenous fluids, antibiotics and ERCP (Endoscopic Retrograde Cholangiopancreatography) twice. A small tube called a stent was placed near your gallbladder so that it will drain bile into your intestine. Please take the antibiotics (Ciprofloxacin) until it is finished. You may also use the skin cream for your rash as long as you need it. You may take all of your home medications, and none of the dosages were changed. Call your doctor or come to the Emergency Department right away if any of the following problems develop: * If you are vomitting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomitting, diarrhea or other reasons. Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your skin, or the whites of your eyes become yellow again. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * You have shaking chills, or a fever greater than 100.4 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. Followup Instructions: Please make an appointment to follow up with your PCP: [**Name10 (NameIs) **],[**First Name3 (LF) **] [**Telephone/Fax (1) 80088**] in the next week or two to further evaluate your response to treatment. You will also need to follow-up with the Gastroenterology team to have a repeat ERCP 6 weeks with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. Please call his office at ([**Telephone/Fax (1) 2306**] M-F 8:30am-4:30pm. The Dermatologists would also like you to make an appointment for some areas of skin that require follow-up. You may call their office at ([**Telephone/Fax (1) 8132**] to schedule the appointment. Completed by:[**2175-8-17**] ICD9 Codes: 5856, 2749, 4280
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Medical Text: Admission Date: [**2135-10-31**] Discharge Date: [**2135-11-7**] Date of Birth: [**2078-5-13**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2195**] Chief Complaint: chills, hypoxic episode, fever Major Surgical or Invasive Procedure: none History of Present Illness: 57 yo M with h/o metastatic prostate cancer presents after episode of chills and acute SOB. Patient was dx with prostate cancer 5 yrs ago on routine screening. He had recurrence about 1 year ago, now with known liver and bone met's. Of note, he started an estrogen based chemotherapy (Estramustine) on Wed. of last week with concurrent coumadin for possible hypercoagulable state. . Patient had been at baseline prior to 1 day PTA when he describes first feeling very cold and then developing severe SOB after walking to bathroom. He attempted to get into bed, but legs gave out and he fell onto floor. No LOC. Denies chest pain, fever, leg pain, N/V/D. + leg swelling few weeks ago, but none recently. Denies any cough or hemoptysis. He has had nosebleeds with clots when he blows his nose. Also had hemorrhoidal bleeding 1 month ago and was admitted for endoscopy. . Called EMS and was noted to be hypoxic to 80s on RA, tachy to 150s initially. EMS gave him 40mg IV lasix en route for ? flash pulmonary edema as he was on lasix at home. . In the ED, initial VS:97, 153, 112/68, 100% NRB. Shortly thereafter spiked to 104 . Noted to have a lactate to 4.2. Initial CXR was unimpressive, CTA was a suboptimal study but no large central PE. Recieved levofloxacin/zosyn, 1.5L NS, Zofran x1 and one unit of platelets. Noted to have guaiac positive red stool in ED and one episode of hemoptysis. Groin central line was placed. Given obstructive pattern on LFTs, got non-con CT abd with no obvious obstruction, only a multinodular liver. . Transferred to ICU, transfused 2 units PRBC given low hct, HCT went up 2 points only and has remained stable. On interview in the MICU, patient endorses sharp R subcostal pain this AM, but states that it occurs when he misses his neurontin and it has not recurred since. He currently denies any SOB or CP, is comfortable on room air. Past Medical History: Hypertension gout right shoulder fracture, history of chlamydia and gonorrhea prostate CA with mets to bone, liver and spine, status post prostatectomy with Lupron injection umbilical hernia status post arthroscopy of the knee. hemorrhoidectomy, with hx of anal fissures Recent lower GIB with negative [**Last Name (un) **] and EGD Depression/Anxiety Social History: lives with wife, has children and step-children. Had twice weekly VNA. No tobacco or EtOH. Family History: sister with [**Name2 (NI) 499**] CA Physical Exam: GEN: obese, NAD HEENT: MMM, JVP not visible due to body habitus CV: tachy, no m/r/g PULM: CTAB AB: positive BS, NT/ND, no HSM EXT: 1+ non-pitting pedal edema to shins NEURO: CN II-XII intact (q/o L facial droop but resolves with smiling), strength 5/5 throughout, sensation intact, reflexes 1+ throughout. Pertinent Results: CBC: 8.5 7.6 >---< 31 25.9 NEUTS-71* BANDS-9* LYMPHS-7* MONOS-4 EOS-0 BASOS-0 ATYPS-2* METAS-3* MYELOS-3* PROMYELO-1* NUC RBCS-23* HYPOCHROM-2+ ANISOCYT-2+ POIKILOCY-1+ MACROCYT-NORMAL MICROCYT-1+ POLYCHROM-OCCASIONAL SPHEROCYT-OCCASIONAL OVALOCYT-OCCASIONAL SCHISTOCY-OCCASIONAL TEARDROP-OCCASIONAL . CHEM: 138 | 106 | 21 / 141 4.6 | 16 | 0.8 \ ALBUMIN-2.8* CALCIUM-9.1 PHOSPHATE-2.7 MAGNESIUM-2.0 . COAGS: PT-21.4* PTT-30.3 INR(PT)-2.0* . LFTS: ALT(SGPT)-74* AST(SGOT)-261* LD(LDH)-4440* CK(CPK)-447* ALK PHOS-1129* TOT BILI-5.1* LIPASE-64* . TOX SCREEN: SERUM: ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG URINE: bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG . CE: [**2135-10-31**] 09:20PM cTropnT-0.03*, CK-MB-3 . fibrinogen 873 retic count 2.0 ferritin >[**2125**] haptoglobin 169 TRF 148 TIBC 192 . PSA 223.8 . ABG: TYPE-ART TEMP-37.6 RATES-/21 O2-15 PO2-234* PCO2-25* PH-7.46* TOTAL CO2-18* BASE XS--3 INTUBATED-NOT INTUBA COMMENTS-GREEN TOP . UA URINE BLOOD-NEG NITRITE-POS PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-TR RBC-0-2 WBC-0-2 BACTERIA-MOD YEAST-NONE EPI-0-2 . MICRO: URINE CX- NEG . BLOOD CX: [**10-31**]: 1 bottle growing MSSA repeat daily blood cx neg . urine Legionella neg influenza swab neg . ECG: Probable sinus tachycardia. ST-T wave changes are non-specific. . IMAGING: Portable CXR: 1. Low lung volumes which accentuate the bronchovascular markings. 2. Widened mediastinum, which could in part be due to low lung volumes and AP technique. However, if clinical concern for acute aortic syndrome, recommend chest CTA for further evaluation. 3. Hilar prominence may be due to vascular engorgement. 4. Subtle opacities in both lung fields may be due to edema, infection and/or metastases. 5. Bilateral, right greater than left pleural thickening versus less likely effusions. Chest CTA [**2135-10-31**]: 1. Suboptimal evaluation for pulmonary embolus, as above, although no large, central embolus identified. 2. Extensive osseous metastatic disease due to prostate cancer. 3. Central interstitial thickening in upper lobes may be due to pulmonary edema, but given fever, also consider infectious source. Due to history of malignancy, malignant component is also possible. Recommend follow-up to resolution. . CTA chest [**2135-11-2**] 1. No evidence of central pulmonary embolism or aortic dissection, but limited study due to timing of contrast and motion. 2. New peripancreatic fat stranding. Clinical correlation for acute pancreatitis is recommended. 3. Pulmonary edema vs atypical pneumonia, slightly improved. Multiple pulmonary nodular opacities are incompletely evaluated on the background of ground-glass opacity and a followup chest CT after the acute pulmonary process resolves is recommended on an outpatient. 4. 1.6-cm mediastinal lymph node, which may also be reassessed at the time of follow up CT. 5. Stable extensive osseous metastasis. . ECHO The left atrium is normal in size. Left ventricular wall thickness, cavity size, and global systolic function are normal (LVEF 60-70%). Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Right ventricular chamber size and free wall motion are normal. The aortic root is moderately dilated at the sinus level. The ascending aorta is moderately dilated. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. . CT AB/PELV 1. No evidence of colitis or acute abdominal process. 2. Cirrhosis. 3. Left base small effusion/atelectasis. Upper lobe interstitial changes; see chest CT. 4. Extensive osseous prostate metastases; e.g. vertebral body destruction. . RUQ U/S: Innumerable echogenic masses throughout the liver without biliary ductal dilatation. This is an unusual pattern for metastatic prostate cancer, and if appropriate, biopsy can be considered. . LENIS No deep venous thrombosis identified in the lower extremities bilaterally. Of note, the right common femoral vein was not interrogated due to overlying dressing. . HEAD CT 1. No evidence of hemorrhage, edema or mass effect. 2. No acute fractures are identified. 3. Soft tissue swelling is noted over the left parieto-occipital region. . . . DISCHARGE LABS: LFTS: . COAGS: . vancomycin trough [**11-6**]: 18.5 Brief Hospital Course: 57 yo M with metastatic prostate cancer (bone, liver mets) presents with episode of hypoxia and tachycardia, fever after starting estrogen-based therapy. . #. HYPOXIA/TACHYCARDIA/FEVER: Patient's initial presentation with acute dyspnea, hypoxia and tachycardia concerning for PE, especially in setting of pro-coagulable state on estrogen-chemotherapy. Patient had been started on coumadin [**2-20**] days prior, and also INR was 2/0 on presentation, it may have been subtherapeutic when his decompensation began. Patient underwent CTA which was non-diagnostic due to respiration artifact and poor contrast timing. There was no e/o RV strain on EKG or TTE. LENIS were negative for DVT. Patient was admitted to MICU, where he was treated empirically for PE with heparin gtt. Infection was also on the differential given high fever to 104 after presentation to the ED and CT chest showed upper lobe infiltrates. Patient was started on broad spectrum antibiotics (vancomycin, cefepime, levaquin) to cover for healthcare associated PNA, since his last hospital admission was less than 1 month prior. He was ruled out for flu. Legionella antigen was negative. In the MICU, patient improved on this treatment regimen, and he had stable 02 sat on room air. . Patient will need repeat chest CT once infection resolves ([**2-21**] weeks) to rule out underlying malignancy. . Patient was transferred to medical floor after stabilization. Heme-onc was consulted and recommended repeat CTA to rule out PE, since this diagnosis would be a contraindication for estramustine therapy. Patient's primary oncologist, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 23509**], was also contact[**Name (NI) **] and remained involved in our treatment plan. Repeat CTA showed no PE. Heparin gtt was stopped and patient was restarted on home dose coumadin. However, INR became supratherapeutic, likely because of interaction with levaquin, and coumadin was held, vitamin K given. Dr.[**Name (NI) 24775**] plan is to start patient on therapeutic dose Lovenox when he reinitiates estramustine (likely after 10 days antibiotics). Patient was placed on prophylactic dose Lovenox once INR normalized. . Patient had one positive blood cx, with MSSA, and all repeat blood cx were negative. He will therefore be treated with a HAP course (10 days of vancomycin and cefepime, 5 days of Levaquin) with 4 additional days of vancomycin for bacteremia (14 days total). PICC was placed. Patient remained afebrile after receiving initial abx on HD# 1. . #. ANEMIA: Admission Hct 25.9 from prior 28. Had h/o LGIB 1 month ago with neg [**Last Name (un) **]. Guiaic positive in ED and started on IV PPI. Had intermittent hemorrhoidal bleeding and epistaxis/hemoptysis [**12-20**] anticoagulation and thrombocytopenia. No evidence of significant GI bleeding. Received 3 total units PRBC and Hct remained stable. No e/o hemolysis. Likely [**12-20**] baseline anemia due to bone marrow replacement by cancer, with minimal acute bleeding. . #. HYPOTENSION: Patient was hypotensive in ED, but stabilized with antibiotics and fluids. He remained normotensive and stable, lactate trended down. Patient received stress dose steroids for since he was on a chronic dexamethasone regimen at home. After HD#2, his home dose of dexamethason 1 mg TID was resumed. . #. Thrombocytopenia: Most likely etiology is bone marrow replacement by malignancy in addition to past XRT/chemo. Patient was transfused platelets for count <50 and minor bleeding. . #. PROSTATE CA: Patient has prostate cancer with met's to liver, bone. Dr. [**Last Name (STitle) 23509**] was contact[**Name (NI) **] and agreed with holding estramutine during acute illness and infection. Our heme/onc was also consulted. PSA was 223. Home dexamethasone was continued. Patient had signs of worsening widespread disease, including worsening LFTs elevation, tachycardia, and decreased alertness. . #. TRANSAMINITIS: LFTs increased likely [**12-20**] met's, although there were no hepatitis serologies in our system so these were repeated. Results pending at transfer. . #. LOWER EXTREMITY EDEMA: Patient developed LE edema on HD# 2, likely due to high dose steroids and fluid resusitation. Patient was continued on home dose Lasix and tapered to home dose dexamethasone. Patient had no evidence of CHF on TTE, and patient appeared otherwise euvolemic. . #. TACHYCARDIA: Patient remained tachycardic 100-120s despite adequate hydration and no other signs of uncontrolled infection. Tachycardia was attributed to underlying malignancy, since heart rate seemed to increase with increase in LFT's, indicative of worsening disease. Telemetry and EKGs showed sinus tachycardia. He also had one episode atrial tachycardia vs. AVNRT on [**11-6**], which lasted <3 seconds and was asymptomatic and did not recur so was not treated. . #. Depression/anxiety: Patient became extremely fatigued and remained largely inactive. His alertness level seemed to decrease in days prior to discharge. Unclear if this was due to worsening underlying illness vs. depression. Con't Wellbutrin and clonazepam . *Patient was transferred to [**Hospital6 **] per request of family, with his primary oncologist Dr. [**Last Name (STitle) 27542**] as the accepting physician. Medications on Admission: Celebrex 200mg [**Hospital1 **] Colace 100mg [**Hospital1 **] Coumadin 3mg PO daily Clonazepam 0.5mg PO BID Dexamethasone 1mg TID Estramustine 140mg TID Fentanyl patch 75mcg/hr q72, last changed [**10-31**] Hydromorphone 4mg PO BID PRN Lasix 20mg PO as needed daily Neurontin 400mg PO TID Omeprazole 20mg PO BID Senna 2 Tabs [**Hospital1 **] Wellbutrin 100mg TID Lupron 22.5 q3mon, last [**2135-7-13**] Taxotere 20mg, last infustion [**2135-10-19**] Zometa 4mg, last shot [**2135-9-27**] Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for Constipation. 2. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for Constipation. 3. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 4. Fentanyl 75 mcg/hr Patch 72 hr Sig: One (1) Patch 72 hr Transdermal Q72H (every 72 hours). 5. Hydromorphone 4 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed for pain. 6. Gabapentin 400 mg Capsule Sig: One (1) Capsule PO TID (3 times a day). 7. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Bupropion HCl 100 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 9. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for fever. 10. Polyethylene Glycol 3350 17 gram/dose Powder Sig: One (1) PO DAILY (Daily). 11. Dexamethasone 2 mg Tablet Sig: 0.5 Tablet PO Q8H (every 8 hours). 12. Celecoxib 200 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 13. Enoxaparin 40 mg/0.4 mL Syringe Sig: One (1) Subcutaneous DAILY (Daily). 14. Cefepime 2 gram Recon Soln Sig: Two (2) g Injection Q12H (every 12 hours) for 2 days: end date [**11-9**]. 15. Vancomycin 500 mg Recon Soln Sig: 1250 (1250) g Intravenous Q 12H (Every 12 Hours) for 6 days: end date [**11-13**]. 16. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Discharge Diagnosis: primary: healthcare associated pneumonia prostate cancer . secondary: thrombocytopenia (low platelets) Discharge Condition: Mental Status:Clear and coherent Level of Consciousness:Alert and interactive Activity Status:Ambulatory - requires assistance or aid (walker or cane) Discharge Instructions: It was a pleasure taking care of you. You were admitted for difficulty breathing and fevers. You were found to have pneumonia. You underwent tests for blood clots, and you did not have a blood clot. You were treated with intravenous antibiotics and a PICC line was placed so you can continue these antibiotics at rehab. Your coumadin was stopped at the recommendation of Dr. [**Last Name (STitle) 23509**], and you will start a different bloodthinner (Lovenox) when you restart your estramustine chemotherapy. You received blood and platelet transfusions since you had small amounts of bleeding. . There following changes were made to your medications: - You should have infusions of vancomycin and cefepime through the PICC line. - You should take Lasix every other day until you are evaluated by a doctor. Followup Instructions: Dr. [**Last Name (STitle) 23509**] will see you at [**Hospital1 **]. ICD9 Codes: 486, 2762, 7907, 2851, 5119, 5180, 5715, 4019, 2749, 2875, 4589
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Medical Text: Admission Date: [**2139-9-16**] Discharge Date: [**2139-9-23**] Date of Birth: Sex: M Service: CCU/MEDICINE CHIEF COMPLAINT: Chest pain. HISTORY OF PRESENT ILLNESS: This is an 83 year old male with cardiac risk factors, his age, hyperlipidemia, with no known coronary artery disease, who experienced progressive substernal chest pain on [**2139-9-15**], around 11:30 p.m. The chest pain was six out of ten. It did not radiate. It was not associated with shortness of breath or palpitations. He did have diaphoresis and nausea. He took Aspirin without relief. The patient went to the [**Hospital6 1129**] Emergency Department where he was transferred to [**Hospital1 346**] as the [**Hospital1 2025**] Catheterization Laboratory was very busy. At [**Hospital1 2025**], he was found to have an acute ST segment elevation myocardial infarction with 3.0 to 5.[**Street Address(2) 2811**] elevation in leads V1 through V5. He was placed on Heparin, Nitroglycerin. and Integrilin drips prior to transfer and given Aspirin and a beta blocker. He was not given thrombolytic therapy. The patient remained with three to five out of ten chest pain despite the above drips upon arrival to [**Hospital1 69**] Catheterization Laboratory. His systolic blood pressure at the time was in the low 90s. In the Catheterization Laboratory, he presented alert, hypotensive, and briefly placed on Dopamine which was stopped secondary to tachycardia. His pulmonary capillary wedge pressure was 27, left ventricular end diastolic pressure was 24. His cardiac output was 2.64 and his cardiac index was 1.6. Left ventriculogram was not obtained. He was placed on an intra-aortic balloon pump Intracath. The left main coronary artery was normal as were the left circumflex and the right coronary artery. The left anterior descending had a 99% proximal occlusion with TIMI 1 flow, that was stented (3.0 by 23 millimeter) to a poststent 0% residual with TIMI 3 flow to the left anterior descending and major diagonal. His catheterization course was complicated by intermittent atrial fibrillation and hypotension requiring an intra-aortic balloon pump. He was transferred to the CCU following his catheterization for further monitoring. PAST MEDICAL HISTORY: 1. Hyperlipidemia. 2. Kidney stones. 3. Status post cataract surgery. 4. Glaucoma. 5. Left hernia repair 44 years ago. ALLERGIES: No known drug allergies. MEDICATIONS AT HOME: None. PHYSICAL EXAMINATION: On presentation, vital signs were stable. Heart rate was 110 to 120, blood pressure 93/53, sinus rate. In general, he was in no apparent distress, pleasant and talkative. His oropharynx was clear without lesions or exudates. His sclera were anicteric. His jugular venous pressure measured 8.0 centimeters. He had no carotid bruits. His lungs were clear to auscultation without crackles, without wheezes. His heart rate was regular rate and rhythm with S1 and S2 appreciated and S3. His abdomen was soft, nontender, nondistended with no organomegaly and normoactive bowel sounds. Extremities were without edema with 1+ dorsalis pedis pulses bilaterally. SOCIAL HISTORY: No tobacco use and no alcohol use, no drug use. He is a former vice president of commercial loan division of a bank. LABORATORY DATA: White blood cell count was 9.7, hematocrit 33.7, platelet count 190,000. Sodium 140, potassium 4.1, blood urea nitrogen 16, creatinine 0.8, glucose 148. Arterial blood gases on four liters nasal cannula was pH 7.48/27/127. His electrocardiogram at [**Hospital6 1129**] was normal sinus at 65 beats per minute with left axis deviation and 2.0 to 5.[**Street Address(2) 2811**] elevations in V1 through V6, I and aVL. His QRS was 125 ms. His electrocardiogram post catheterization showed atrial fibrillation at a rate of 110, left axis deviation, QRS complex 120 ms, and resolution of ST elevations and T wave inversions in aVL. HOSPITAL COURSE: This is an 83 year old male status post acute anterior myocardial infarction with proximal left anterior descending stent to 0% residual flow. His catheterization course was complicated by hypotension requiring an intra-aortic balloon pump and atrial fibrillation. 1. Cardiac - ischemia - His peak CK was 6655, peak cardiac index was 10.1. The patient was maintained on Aspirin, Plavix and Lipitor following his catheterization as well as completed a course of Heparin and Integrilin. He remained chest pain free for the duration of his admission. He had no further dynamic electrocardiographic changes and his lipid panel was measured with a total cholesterol of 165, triglycerides of 78, HDL 33, LDL 116. Pump - On hospital day number two, his intra-aortic balloon pump was affectively weaned. An echocardiogram was obtained on [**2139-9-16**], which demonstrated an ejection fraction of 20 to 30%, 1+ mitral regurgitation, 2+ tricuspid regurgitation, akinesis of all but the basal segments of the anterior septum and anterior free wall, also extensive apical akinesis but no mass or thrombus seen. He had moderate hypokinesis of the lateral wall and severe hypokinesis of the inferior septum. The patient was not anticoagulated for his apical akinesis secondary to bleeding. Please see sections below in genitourinary and gastrointestinal. Rhythm - His post catheterization course was complicated by atrial fibrillation which was self limited. He had several runs of nonsustained ventricular tachycardia, the longest of which was approximately 28 beats in the first 72 hours following his catheterization. He was given Amiodarone for those first 72 hours. Subsequent to the discontinuation of Amiodarone, the patient was in sinus rhythm without further ectopy. The patient also underwent a signal averaged electrocardiogram which was positive. The patient was informed about the possibility of potentially needing an AICD given his reduced ejection fraction. Further discussion in this regard will be deferred to his primary cardiologist at the [**Hospital6 1129**]. 2. Genitourinary - The patient had hematuria in the setting of Integrilin and Heparin anticoagulation. The urology service was consulted and a three way Foley catheter was placed with continuous irrigation to resolution of hematuria. A CT scan was obtained to further workup etiologies of said hematuria. The scan demonstrated a suspicious bladder mass along the right wall of the bladder which is questionably consistent with inflammation versus a clot versus a tumor. The patient also was noted to have bilateral renal stones and bladder stones as well that appear to be asymptomatic at the time of this admission. The urology service recommended outpatient follow-up with potential cystoscopy. 3. Gastrointestinal - On [**2139-9-18**], the patient had one episode of melena. He was maintained on intravenous Protonix and his stools were followed until resolution of melena and stable hematocrit. The episode was in the setting of anticoagulation but will require further outpatient workup. The patient was also seen by physical therapy during this admission and noted to be at his baseline function upon discharge. 4. Code Status - Full code. MEDICATIONS ON DISCHARGE: 1. Atenolol 12.5 mg p.o. once daily. 2. Protonix 40 mg p.o. once daily. 3. Zestril 2.5 mg p.o. once daily. 4. Lipitor 10 mg p.o. once daily. 5. Aspirin 325 mg p.o. once daily. 6. Plavix 75 mg p.o. once daily, [**2139-9-23**], is day seven of a thirty day course. 7. Sublingual Nitroglycerin p.r.n. chest pain. The patient will have visiting nurse this week for medication teaching. FOLLOW-UP: The patient will be followed up by his primary care physician, [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], at his Deacon [**Doctor Last Name **] office on [**2139-9-29**], at 4:00 p.m.. Follow-up issues will include following up his heme positive stool and potential gastrointestinal workup as an outpatient. The patient will also need cardiology follow-up as per Dr. [**Last Name (STitle) 44551**] office. The patient expressed wishes to be seen at [**Hospital6 1129**] as it is near his home. In terms of cardiology follow-up, the issue of considering an AICD in a patient with a reduced ejection fraction should be addressed. Also, anticoagulation was held this admission in the setting of hematuria and melena, but will need to be addressed in view of the patient's apical hypokinesis. Urology follow-up as the patient has resolved hematuria but a suspicious bladder mass that will need further evaluation with a potential cystoscopy. He also has bilateral renal stones and bladder stones that are currently asymptomatic but possibly may be amenable to lithotripsy in the future. Dr. [**First Name4 (NamePattern1) 717**] [**Last Name (NamePattern1) 44552**] office, [**Telephone/Fax (1) 44553**], will contact the patient on [**2139-9-23**], for follow-up. The patient can choose to use her services at [**Hospital1 346**] or follow-up urology as per his primary care physician's choice. Also of note, the patient had urine cytology sent prior to discharge and those results will be followed up by Dr. [**Last Name (STitle) **] and faxed to the Dr. [**Last Name (STitle) 44551**] office. DISCHARGE DIAGNOSIS: Acute anterior ST elevation myocardial infarction, status post percutaneous transluminal coronary angioplasty. CONDITION ON DISCHARGE: Stable. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1013**], M.D. [**MD Number(1) 1014**] Dictated By:[**Name8 (MD) 17844**] MEDQUIST36 D: [**2139-9-23**] 18:46 T: [**2139-9-23**] 19:00 JOB#: [**Job Number 44554**] ICD9 Codes: 4240, 4271
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Medical Text: Admission Date: [**2145-11-16**] Discharge Date: [**2145-12-2**] Service: MEDICINE, [**Location (un) 259**] FIRM HISTORY OF PRESENT ILLNESS: The patient is a 77-year-old female with a history of diverticular bleeding, coronary artery disease, atrial valve replacement on Coumadin, who presented with passing clots per rectum for three days. The patient had been having bright red blood per rectum two weeks prior to admission, but this had worsened over several days prior to admission. She denied fever, chills, nausea, vomiting. No chest pain. No shortness of breath. No recent antibiotic use. Her baseline hematocrit is 38-41. She denied taking Coumadin the night before admission. In the Emergency Room, she was noted to have continued bright red blood per rectum measuring approximately 300-400 cc. Her hematocrit on arrival was 37.9; four hours after arrival was 37.0. In the Emergency Room, she was given 1 L of intravenous fluids but no FFP or Vitamin K. She was hemodynamically stable and transferred to the floor. Incidentally she had an appointment scheduled for the day after admission with Dr. [**Last Name (STitle) 15505**] for her hemorrhoids. PAST MEDICAL HISTORY: 1. Sigmoid diverticulosis seen on colonoscopy in [**2144-7-2**]. 2. Atrial fibrillation. 3. Status post atrial valve replacement, St. Jude's valve. 4. Coronary artery disease. 5. Hypertension. 6. Diabetes mellitus type 2. 7. Chronic obstructive pulmonary disease. 8. Congestive heart failure. 9. Status post appendectomy. 10. Status post partial thyroidectomy. 11. Status post oophorectomy. 12. Hypercholesterolemia. MEDICATIONS ON ADMISSION: Coumadin 2.5 mg p.o. q.d., Glyburide 10 mg p.o. b.i.d., Lopressor 37.5 mg p.o. t.i.d., Lasix 40 mg p.o. b.i.d., Captopril 25 mg p.o. t.i.d., Glucophage 500 mg p.o. b.i.d., Serevent 2 puffs b.i.d., Zantac 100 mg p.o. b.i.d., Digoxin 0.125 mg p.o. q.d., Combivent MDI 2 puffs b.i.d., Lipitor 10 mg p.o. q.d. ALLERGIES: PENICILLIN CAUSES A RASH. SOCIAL HISTORY: She lives alone. Her daughter is supportive and lives in the area. She has a 20 pack-year tobacco history and quit many years ago. No alcohol history. PHYSICAL EXAMINATION: Vital signs: On admission temperature was 98.7??????, blood pressure 140/80, heart rate in the 100-110s and irregular, respirations 16, oxygen saturation 95% on room air. General: The patient was pleasant and in no acute distress. HEENT: Mucous membranes slightly dry. Oropharynx clear. Pulmonary: Bibasilar rales. No wheeze. Otherwise clear. Cardiovascular: Irregular rate. Loud S2. There was a 1 out of 6 systolic murmur heard at the apex and the left upper sternal border. Abdomen: Soft, nontender, nondistended. Positive bowel sounds. Extremities: There was 1+ edema. Neurological: The patient was alert and oriented times three. Grossly intact. LABORATORY DATA: On admission white blood cells 6.9, hematocrit 37.9, platelet count 172; CHEM7 with a sodium of 131, potassium 4.2, chloride 90, bicarb 29, BUN 15, creatinine 0.7, glucose 390; INR 5.6; digoxin level 0.6. Electrocardiogram showed atrial fibrillation with a rate of 100, right bundle branch block, poor R-wave progression. There were no significant changes compared to electrocardiogram performed on [**2145-2-28**]. IMPRESSION: This is a 77-year-old female with a history of diverticulosis, coronary artery disease, St. [**Male First Name (un) 1525**] AVR, who presented with bright red blood per rectum in the setting of an increased INR. HOSPITAL COURSE: The patient was originally admitted to the General Medicine Floor but continued to pass clots and bright red blood per rectum. A repeat hematocrit was checked, and this was 30. Her heart rate increased to the 160s, and while she with good mental status, it was felt that she was at hight risk for becoming hemodynamically unstable; therefore, she was transferred to the Medical Intensive Care Unit. 1. Gastrointestinal: Given the patient's history of diverticulosis, as well as hemorrhoids, it was felt that these were the two most likely sources of her gastrointestinal bleed. Tagged red cell scans were performed, and neither of these were diagnostic. The Gastrointestinal Service was consulted. A colonoscopy was recommended to visualize the possible source of the GI bleed, and because the patient became anxious and went into respiratory distress during the bowel prep for this procedure, it was not reattempted. In the end it was felt that since the patient had colonoscopy only one year ago that had documented the diverticular disease, it was felt that a repeat colonoscopy would be poor yield unless she were to actively rebleed. In fact, she did not rebleed following her transfer to the Medical Intensive Care Unit, and the only further treatment instituted was Anusol HC topically to her perianal area for her hemorrhoids. The patient was treated with protime pump inhibitor while on the Medical Intensive Care Unit, and we returned her to Zantac following discharge. Cardiovascular: It was very difficult to control the patient's rapid ventricular response to her atrial fibrillation during her hospitalization. In the Medical Intensive Care Unit, increasing doses of Lopressor were administered up to 75 mg p.o. q.i.d. plus supplemental Lopressor given intravenously. Unfortunately this seemed to incite a mild flare of her chronic obstructive pulmonary disease as described below under pulmonary. Therefore, she was weaned off of Lopressor and started on a Diltiazem drip. The Diltiazem drip was weaned, and p.o. Cardizem was instituted for total p.o. dose of Cardizem 90 mg p.o. q.i.d., and following discharge, this was changed to Cardizem CD 360 mg p.o. q.d. Her rate was well controlled with this dose and ranged from 75 to 90. We continued the patient's Digoxin and Lipitor. She was admitted on Captopril 25 mg p.o. t.i.d., but this was decreased to 12.5 mg p.o. t.i.d. given that her blood pressure was also well controlled with her Cardizem. 3. Infectious disease: The patient was found to have mild pneumonia. This was treated with Levofloxacin 500 mg p.o. q.d. for a 14-day course. The last day of her Levofloxacin dose should be [**2145-12-5**]. The patient also had a urinary tract infection which was found to be Enterococcus susceptible to Levofloxacin; therefore, Levofloxacin treated both her pneumonia, as well as her urinary tract infection. 4. Hematology: The patient's goal INR is 2.5-3.5 given her atrial valve replacement with a St. Jude's valve, as well as her atrial fibrillation. She was admitted supratherapeutic with an INR of 5.8. The patient was given FFP, as well as Vitamin K to reverse the INR. Several units of blood were transfused given the patient's low hematocrit and documented coronary artery disease, as well as congestive heart failure. When the patient was transferred from the Medical Intensive Care Unit to the General Medicine Floor, she was subtherapeutic on her Coumadin, so we treated her with Lovenox 80 mg subcue b.i.d. This should be continued until her INR reaches 2.5. On the patient's home dose of Coumadin, which was 2.5 mg p.o. q.d., the patient's INR stalled at 2.3; therefore, we increased her Coumadin dose to 3.0 mg q.Monday, Wednesday, and Friday, and 2.5 mg q.Tuesday, Thursday, Saturday, and Sunday. This should be continued until her INR is therapeutic between 2.5 and 3.5, and when this is achieved, her Lovenox can be discontinued. 5. Pulmonary: As mentioned during the patient's preparation for colonoscopy, she experience acute respiratory distress. It was actually unclear exactly why this occurred, but it could have been secondary to anxiety and underlying pneumonia, as well as possible contribution from her underlying chronic obstructive pulmonary disease. She required intubation for several days, following which she was extubated successfully without complications. She was then treated with nebulized Albuterol and Atrovent and later weaned off of these and treated with her regular metered dose inhalers. As mentioned, the patient had a pneumonia that was treated with Levofloxacin successfully. 6. Fluids, electrolytes, and nutrition: The patient received TPN while she was intubated on the Medical Intensive Care Unit. When she was extubated, she had a little bit of difficulty swallowing, so we consulted the Speech and Swallow Service which helped us in performing a video swallow study. This was normal, and the patient did well with liquids and solids. Her diet should be advanced as tolerated. 7. Endocrine: The patient had good glucose control with Glyburide, Glucophage, and regular Insulin sliding scale. CONDITION ON DISCHARGE: Good. DISCHARGE STATUS: Discharged to rehabilitation facility at [**Hospital **] Rehabilitation. DISCHARGE MEDICATIONS: Cardizem CD 360 mg p.o. q.d., Lipitor 10 mg p.o. q.d., Serevent MDI 2 puffs b.i.d., Combivent MDI 2 puffs b.i.d., Zantac 150 mg p.o. b.i.d., Digoxin 0.125 mg p.o. q.d., Glucophage 500 mg p.o. b.i.d., Glyburide 10 mg p.o. b.i.d., Captopril 12.5 mg p.o. b.i.d., Coumadin 3.0 mg q.Monday, Wednesday, Friday, 2.5 mg q.Tuesday, Thursday, Saturday, Sunday, once the patient's INR reaches 2.5, this should probably be decreased to 2.5 mg p.o. q.d., her goal INR is 2.5-3.5, this should be followed closely while she is an outpatient, Lovenox 80 mg subcue b.i.d. until her INR is therapeutic, Levofloxacin 500 mg p.o. q.d. until [**12-5**], Anusol HC topically to perianal area t.i.d. to q.i.d. p.r.n. DISCHARGE INSTRUCTIONS: Her diet should include thick liquids and solids, and she should advance to full solids as tolerated. The reason she is having some difficulties swallowing is that she is status post intubation. FOLLOW-UP: She should follow-up with her primary care physician [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. DISCHARGE DIAGNOSIS: 1. Lower gastrointestinal bleed, probably diverticular plus hemorrhoidal. 2. Pneumonia. 3. Chronic obstructive pulmonary disease flare. 4. Urinary tract infection. 5. Atrial fibrillation with rapid ventricular response. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 1019**] Dictated By:[**Name8 (MD) 2734**] MEDQUIST36 D: [**2145-12-1**] 16:02 T: [**2145-12-1**] 19:00 JOB#: [**Job Number 24986**] ICD9 Codes: 486, 5990, 2859
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Medical Text: Admission Date: [**2129-3-18**] Discharge Date: [**2129-3-26**] Date of Birth: [**2076-12-31**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 2712**] Chief Complaint: Hemoptysis Major Surgical or Invasive Procedure: [**3-19**]: Right superficial bronchial artery embolized with embospheres and 4 coils. Rt inferior bronchial artery embolized with PVAs. Angioseal deployed. [**3-20**]: Had another episode of bleeding which required DL ETT placement. Bronch showed active bleeding from same site of emoblization. Patient hemodynamically stable but did not respond to 1U PRBC. No further intervention. Intubation History of Present Illness: This is a 52 year old male with PMH of morbid obesity with resultant lymphedema, depression, Afib on Coumadin, OSA on CPAP, and h/o LLL pulmonary hemorrhage secondary to an AVM requiring rigid bronchoscopy and APC to cauterize area of bleeding presenting for further evaluation of repeat hemoptysis. He reportedly coughed up some bright red blood at home this evening and was initially stable upon arrival to the ED until he was witnessed coughing up a pint and a half of blood. Of note, he developed a UTI about a week ago and received ceftriaxone followed by a po cephalosporin, which likely interfered with his Coumadin levels. In the ED, initial VS were: 98, 130, 128/75, 16, 97% Non-Rebreather. He arrived with normal mental status and a patent airway, but began coughing in the ED which was productive of bright red blood. Over the next couple minutes, the significant bleeding continued and he was intubated for airway protection him. Before intubation, he was noted to have about 200-300 mL of bright red bloody hemoptysis. Peripheral IV access was obtained and 4 units of FFP were given in addition to 10mg of IV vitamin K since his INR was supratherapeutic at 6.1 on Coumadin. Interventional radiology, interventional pulmonology, and cardiothoracic surgery were consulted in the ED. After intubation, the ventilator kept alarming due to elevated pressures likely secondary to blood clot obstruction. He therefore required manual bagging to maintain his sats and his resistance improved once placed in the left lateral decub position to a point where he could be placed back on the vent. Of note his HR was consistently in the 130s probably from Afib RVR. . On arrival to the MICU, he could not be placed on the ventilator due to the high resistance in his airways from the blood and clots in his lungs. He required manual bagging at times to maintain his sats as well as paralysis with cisatracurium. A central line was placed in his right IJ to continue infusion of blood products. A bedside flexible bronchoscopy revealed massive hemoptysis and clotting of his bilateral bronchi. IP was contact[**Name (NI) **] and the patient was immediately taken to the OR for rigid bronchoscopy in an attempt to clean out the clots and find the site of bleeding in order to cauterize it. . Review of systems: unable to obtain Past Medical History: - hemoptysis ([**2123**]) - IP LLL - major depression - obstructive sleep apnea: on CPAP at home - morbid obesity - lymphedema - psoriasis - atrial fibrillation s/p cardioversion in [**4-/2128**] - dilated cardiomyopathy (EF 35-40%) Social History: Has not left his house in >1 year due to depression and now worsening obesity; lives with his sister. Formerly smoked 1 ppd up until 5 yrs ago. Was a binge drinker in his 20s, but no longer drinks. Distant marijuana and intranasal cocaine use. Denies IVDU. Family History: Father with 2 [**Name2 (NI) **] in his 50s but still living in his 70s currently. Mother with schizophrenia. Physical Exam: Admission physical exam: Vitals: T: afebrile, BP: 100s-110s/60s-70s, P: 110s, R: 22, O2: 99% RA General: intubated/sedated, bloody secretions in ET tube requiring HEENT: Sclera anicteric, MMM, ET tube in place, PERRL Neck: supple CV: Irregularly irregular, tachycardic Lungs: Diminished breath sounds bilaterally Abdomen: soft, large pannus, non-tender, bowel sounds present GU: Foley in place Ext: warm, well perfused, bilateral lower extremity lymphedema and venous stasis changes Neuro: intubated/sedated Pertinent Results: [**2129-3-18**] 09:33PM BLOOD WBC-7.2 RBC-4.24* Hgb-13.4* Hct-38.8* MCV-92 MCH-31.6 MCHC-34.5 RDW-13.0 Plt Ct-269# [**2129-3-19**] 10:50AM BLOOD WBC-17.5* RBC-3.53* Hgb-11.5* Hct-32.4* MCV-92 MCH-32.5* MCHC-35.4* RDW-13.4 Plt Ct-257 [**2129-3-20**] 02:20PM BLOOD Hct-28.9* [**2129-3-18**] 09:33PM BLOOD PT-61.1* PTT-51.4* INR(PT)-6.1* [**2129-3-19**] 06:27AM BLOOD PT-16.0* PTT-31.6 INR(PT)-1.5* [**2129-3-20**] 03:56AM BLOOD PT-14.3* PTT-29.5 INR(PT)-1.3* [**2129-3-18**] 09:33PM BLOOD Glucose-140* UreaN-12 Creat-0.9 Na-139 K-4.1 Cl-103 HCO3-26 AnGap-14 [**2129-3-20**] 03:56AM BLOOD Glucose-104* UreaN-12 Creat-0.7 Na-142 K-3.9 Cl-106 HCO3-29 AnGap-11 Brochial angiogram ([**2129-3-19**]): Two arteries of possible bleed in the right lung from the right superior and Preliminary Reportinferior bronchial arteries which were successfully embolized with Preliminary ReportEmbospheres, PVAs and four coils. CT head [**3-23**]: IMPRESSION: Compared to study of [**2129-3-14**], there are new regions of subtle hypodensity involving both the [**Doctor Last Name 352**] and white matter in the right temporal, right occipital, and left parieto-occipital regions. These are suspicious for cytotoxic edema related to acute embolic infarction. Recommend MR [**First Name (Titles) 151**] [**Last Name (Titles) **] of the brain for better evaluation. . Echo [**3-23**]: IMPRESSION: poor technical quality due to patient's body habitus. Left ventricular function is probably normal, a focal wall motion abnormality cannot be fully excluded. There is mild right ventricular dilatation and global free wall hypokinesis. No pathologic valvular abnormality seen. Pulmonary artery systolic pressure could not be determined. . Bilateral LENIs [**3-22**]: IMPRESSION: No evidence of deep venous thrombosis in visualized portions of bilateral lower extremities. Suboptimal exam due to patient's body habitus. . CTA chest [**2128-3-20**]: IMPRESSION: 1. Multiple bilateral segmental and subsegmental lower lung pulmonary emboli. 2. Bilateral peribronchovascular opacifications consistent with provided history of pulmonary hemorrhage or edema. 3. Dual channel endotracheal, distal chamber ends in left main bronchus, proximal channel ends in distal trachea. No apparent means of right bronchial obturation. 4. Possible right retrohilar hematoma. Brief Hospital Course: This is a 52 year old male with PMH of morbid obesity with resultant lymphedema, depression, dilated cardiomyopathy with an EF=35-40%, Afib on Coumadin, OSA on CPAP, and h/o LLL pulmonary hemorrhage secondary to an AVM requiring rigid bronchoscopy and APC to cauterize area of bleeding presenting for further evaluation of repeat hemoptysis. #. Hemoptysis/respiratory failure. He presented to the ED with massive hemoptysis requiring intubation for airway protection and ventilatory support to maintain his sats. Flexible bronchoscopy on admission in MICU showed fresh hemorrhage in right lung. He was taken to OR for rigid bronchoscopy whose course was complicated by persistent hypoxia and hypotension. He was taken to IR suite where they embolized superior bronchial artery embospheres and 4 coils while right inferior bronchial artery was embolized with PVAs. Coagulopathy was reversed with 8 units of FFP and vitamin K while coumadin was stopped and given 3 units of PRBC. On [**2129-3-20**] he was noted to have opacification of the right lung. IP's bronchoscopy showed fresh bleeding. He was given 1 unit of PrBC. Double lumen ET tube was placed and plan is to take him for rigid bronchoscopy tomorrow. After some brief progress was made at lowering the patient's oxygenation requirements, the patient had increasing oxygen requirements that resulted in a CTA chest, which ended up showing bilateral pulmonary embolism. In addition, the patient's chest X-ray suggested some left infiltrate and he was started on treatment for ventilator-associated pneumonia. It was also noted at this time that his pupils were not as responsive, though he was sedated so a neurological exam was not fully possible. A head CT was obtained that showed three areas concerning for embolic stroke. The patient's respiratory status showed no improvement and by [**3-24**], he was back to requiring pressors. The family was brought in for a series of discussions, during which the patient's poor progress and prognosis were discussed, along with the damage to three organ systems (lungs, heart, brain). The patient's father and health care proxy decided to make the patient [**Name (NI) 9036**] Measures Only. Fifteen minutes after the pressor was stopped, the patient died. #. Atrial fibrillation with RVR. Patient has h/o of Afib at home on warfarin and metoprolol as well as sotalol for rate/rhythm control. Coumadin held while INR reversed as above. Sotalol and metoprolol held. The patient was restarted on his sotalol following his embolization and spent more than two days in sinus rhythm following spontaneous conversion, which also allowed his blood pressure to recover. His then went back to atrial fibrillation and required pressors to support his blood pressure. A Cardiology consult was called and recommendations made, but these recommendations were superceded by the patient's deteriorating clinical status and decision to be made [**Name (NI) 9036**] Measures Only. #. Dilated cardiomyopathy. Most recent ECHO in [**2-/2129**] shows biatrial enlargement, mild symmetric left ventricular hypertrophy, and normal left and right ventricular function with normal valvular function. ASA, lisinopril and Lasix are held in setting of massive hemoptysis. # Likely embolic stroke: CT head showed three areas of hypodensity, most likely to be secondary to embolic stroke per radiology. Given that patient has AVM, it is possible the AVM was the source of paradoxical emboli. LENIs negative. Patient was made [**Year (4 digits) **] measures only. Medications on Admission: -ammonium lactate 12 % Lotion Apply to affected area twice a day -clobetasol 0.05 % Cream Apply to affected area twice a day -furosemide 40 mg by mouth once a day -lisinopril 2.5 mg by mouth once a day -lorazepam 0.5-1 mg by mouth twice a day as needed for anxiety -metoprolol tartrate 12.5 mg by mouth three times a day -polyethylene glycol 3350 17 gram by mouth daily as needed for constipation -sotalol 120 mg by mouth twice a day -trazodone 25 mg by mouth at bedtime -venlafaxine 225 mg Tablet Extended Rel 24 hr by mouth once a day -warfarin 2.5 mg Tablet 1.5 Tablet(s) by mouth once a day as directed Fridays 5mg -aspirin 81 mg by mouth once a day -cholecalciferol 2,000 unit by mouth once a day -cod liver oil by mouth once a day -docusate sodium 100 mg by mouth twice a day -fish oil-dha-epa 1,200 mg-144 mg Capsule by mouth once a day -multivitamin with minerals by mouth daily -sennosides 8.6 mg; 2 tablets by mouth daily Discharge Medications: None. Patient expired. Discharge Disposition: Expired Discharge Diagnosis: Expired. Discharge Condition: Expired. Discharge Instructions: Expired. Followup Instructions: Expired. ICD9 Codes: 5990, 2762, 4280, 4275
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Medical Text: Admission Date: [**2180-7-23**] Discharge Date: [**2180-8-14**] Date of Birth: [**2113-2-2**] Sex: F Service: CARDIOTHORACIC Allergies: Heparin Agents Attending:[**Last Name (NamePattern1) 1561**] Chief Complaint: shortness of breath Major Surgical or Invasive Procedure: [**7-21**] emergent tracheal intubation [**7-27**] rigid bronch/stenosis dilation/ETT advancement [**8-1**] balloon dilation of trachea [**8-3**] extubated [**8-7**] tracheal resection bronchoscopy History of Present Illness: 67-year-old woman who presented to an outside hospital on [**2180-7-14**] with shortness of breath, stridor and wheezing, and after extensive workup, was found to have subglottic stenosis. Her history dates back to [**5-/2180**] when she was found down in [**Male First Name (un) 1056**] and diagnosed with a large myocardial infarction. She was intubated for four days, subsequently extubated and reintubated several hours later due to respiratory distress. She was eventually extubated, discharged to home where she then flew on to [**Last Name (LF) 6185**], [**First Name3 (LF) 108**], where she underwent a coronary artery bypass grafting. Her surgery was uneventful and she was extubated without difficulty but subsequently developed progressive dyspnea and wheezing and was admitted on [**2180-7-14**] and found to have moderate-to-severe post-intubation tracheal stenosis commencing approximately 3 cm below the vocal cords. While waiting transfer to a tertiary care medical center, she developed an episode of bradycardia and required intubation, however, the endotracheal tube was unable be advanced beyond the stenosis. Her endotracheal tube was changed to 6.5, but again it could not be advanced beyond the area of stenosis. She was subsequently transferred to the [**Hospital1 346**] for further management by the airway service. Past Medical History: Significant for coronary artery disease status post myocardial infarction in [**5-/2180**], status post coronary artery bypass grafting x3 in [**Location (un) 6185**], hypertension, hypercholesterolemia, and type 2 diabetes. Social History: She is married, has children, no history of tobacco use or alcohol use. Physical Exam: On Admission: Vitals: 100.7F, HR 79, BP 142/72, RR 16 100% Gen - intubated, sedated HEENT - PERRL, EOMI B/L Neck - supple, no adenopathy CV - RRR, nl s1, s2 Pul - rhonchi b/l Abd - soft, NT, ND, +BS Ext - no c/c/e Pertinent Results: On admission: [**2180-7-23**] 08:30PM WBC-6.2 RBC-2.98* HGB-8.2* HCT-24.4* MCV-82 MCH-27.4 MCHC-33.5 RDW-16.3* [**2180-7-23**] 08:30PM PLT COUNT-76* [**2180-7-23**] 08:30PM PT-11.8 PTT-25.7 INR(PT)-1.0 [**2180-7-23**] 08:30PM GLUCOSE-128* UREA N-24* CREAT-0.4 SODIUM-145 POTASSIUM-3.2* CHLORIDE-109* TOTAL CO2-32 ANION GAP-7* [**2180-7-23**] 08:30PM ALT(SGPT)-23 AST(SGOT)-21 LD(LDH)-253* CK(CPK)-29 ALK PHOS-44 TOT BILI-0.4 [**2180-7-23**] 08:30PM CK-MB-NotDone cTropnT-0.01 [**2180-7-23**] 08:30PM ALBUMIN-2.5* CALCIUM-7.7* PHOSPHATE-1.6* MAGNESIUM-2.1 [**2180-7-23**] 10:16PM TYPE-ART TEMP-38.2 RATES-/16 TIDAL VOL-466 O2-40 PO2-209* PCO2-49* PH-7.46* TOTAL CO2-36* BASE XS-10 INTUBATED-INTUBATED VENT-SPONTANEOU At Discharge: [**2180-8-13**] 05:37AM BLOOD WBC-5.5 RBC-3.06* Hgb-9.1* Hct-26.0* MCV-85 MCH-29.8 MCHC-35.0 RDW-15.8* Plt Ct-357 [**2180-8-14**] 05:40AM BLOOD PT-31.8* PTT-45.1* INR(PT)-3.4* CXR [**8-8**]: IMPRESSION: The post-surgical drain is again demonstrated with its tip overlying the upper mediastinum. The heart size and mediastinal contours are unremarkable. The left lower lobe discoid atelectasis is unchanged. The right lung and upper portion of the left lung are unremarkable. CT HEAD W/O CONTRAST [**2180-8-10**] 8:25 AM Reason: ? acute bleed IMPRESSION: 1) No acute intracranial hemorrhage or major vascular territorial infarct identified. 2) Absence of the septum pellucidum, likely congenital in origin. CT TRACHEA [**2180-7-28**] IMPRESSION: 1. Focal segment of tracheal stenosis involving the subglottic and upper intrathoracic trachea. 2. Nonspecific mild ground-glass opacity in the medial aspect of the superior segment of the right lower lobe, which could be secondary to aspiration. 3. Small bilateral pleural effusions, unchanged Brief Hospital Course: Pt was transferred to [**Hospital1 18**] on [**7-23**] from an OSH for management of her tracheal stenosis likely secondary to intubation. She was admitted to the MICU service, intubated and sedated. On admission she was started on levofloxacin and flagyl for empiric coverage against a possible pneumonia, for which she was being treated with zosyn and ceftriaxone at her OSH. For her tracheal stenosis she was started on solumedrol and given nebs. Bronchoscopy on [**7-24**] showed severe tracheal stenosis 5mm in diamter and 2.5cm in length. On [**7-25**] Ms [**Known lastname **] was found to be HIT positive and was therefore started on an argatroban drip. At that time she was seen by cardiology for pre-operative clearance. Although she had had recent CABG, the cardiologists felt that she had no current high risk prognostic features and therefore cleared her for surgery. She was also seen by Dr. [**Last Name (STitle) 952**] at that time who planned to do a tracheal resection 8 days later. Tube feeds through her OG tube were started at that time to optimize pre-op nutrition. Pt. also began having runs of SVT at this time requiring IV lopressor 15-20mg. On [**7-27**] she was underwent rigid bronch and tracheal dilation without incident. Pt had TTE done as well which showed: 1. The left atrium is mildly dilated. 2. There is mild symmetric left ventricular hypertrophy with normal cavity size and systolic function (LVEF>55%). Regional left ventricular wall motion is normal. 3. The aortic valve leaflets (3) are mildly thickened. 4. The mitral valve leaflets are mildly thickened. Trivial mitral regurgitation is seen. She was planned for surgery on [**7-31**] for a tracheal resection, although her runs of SVT continued. Bronchial washings at this time were negative for malignancy. Pt contiued to have SVT with non-specific ST changes on [**7-31**], and therefore the surgery was postponed. Cardiac enzymes were negative. On [**8-1**] she went to the OR for rigid bronch and balloon dilation of trachea to 14mm without complications. No stent was placed at that time. For details please see OP note. On [**8-2**] pt was extubated without difficulty and was seen by speech and swallow who felt she was aspirating with thin liquids and recommended nectar thick liquids and ground solids. On [**8-3**] her abx were stopped after a total of 11 days (14 days of all abx's including OSH). She continued to have episodes of narrow complex SVT. On [**8-4**] she was transfered out of the MICU onto the regular floor in stable condition onto the thoracic surgery service. She was cleared by swallow for a regular diet and thin liquids and her tube feeds were stopped. Tracheal resection was planned for [**8-7**]. CT of trachea on [**8-4**] confirmed subglottic stenosis. on [**8-7**] she was made NPO after midnight and her argatroban drip was held 4 hours prior to the procedure. The procedure went without incident and she was transfered to the CSRU extubated in stable condition. Post-operatively her argatroban drip was restarted at her stable pre-op dose of 5.75. She was transfered out of the unit on POD 1 and was given 5mg coumadin in order to stop the argatroban. She was cleared by speech and swallow for a regular diet. On POD 2 pt became supratherapeutic on her coumadin. Her coags on [**8-9**] were as follows: PT - 49, PTT - 90, INR - 5.3. The argatroban was decreased to 5.0 at that time and she was given only 2.5 of coumadin. In addition, her metoprolol was decreased to 12.5 [**Hospital1 **] from 25 [**Hospital1 **] for hypotension into the low 90's/50s. On the morning of POD3 pt was noted to be hypoglycemic and was given 1amp of D50. However she continued to be lethargic and began having a short run of narrow complex SVT. This resolved with 15mg IV lopressor and her PO dose was placed back to 25 [**Hospital1 **]. When pt got up to ambulate, physical therapy noted right-sided weakness. Pt was sent for a head CT which was negative for an intracranial bleed and was seen by neurology. The right-sided weakness resolved later that day. Her coags were noted to be PT 98, PTT 100, and INR of 18.3 However these were drawn from the same PICC line as the argatroban was being given. Regardless, the argatroban was stopped and she recieved on coumadin that night. On POD4 pt had another run of SVT and her metoprolol was changed to toprol xl 50mg qday per cardiology. Her strength improved after daily and on POD7 she was cleared by physical therapy to go home without services. Her coags on [**8-14**] (the day of discharge) were PT 32, PTT 45, and INR 3.4. She was sent home on 1 day of coumadin at 1mg followed by 2 days of 0.5mg. Her INR will be followed by Dr. [**Last Name (STitle) **] until she returns to [**State 108**] and she will follow up with Dr. [**Last Name (STitle) **] on [**8-17**] at which point her coumadin dose will be readdressed. Medications on Admission: [**Last Name (un) 24116**], enalapril 5', imdur 30', lipitor 10', coreg 6.25", plavix 75', toprol 50', zofran prn Discharge Medications: 1. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 2. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 3. Trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed. Disp:*30 Tablet(s)* Refills:*0* 4. Alprazolam 0.25 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 5. Lansoprazole 30 mg Susp,Delayed Release for Recon Sig: One (1) PO DAILY (Daily). Disp:*500 ml* Refills:*2* 6. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 7. Ibuprofen 600 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed. 8. Metoprolol Succinate 50 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 9. Carvedilol 3.125 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 10. Warfarin 1 mg Tablet Sig: One (1) Tablet PO HS (at bedtime): Disp:*30 Tablet(s)* Refills:*0* 11. Glipizide 5 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*2* 12. Outpatient Lab Work INR [**2180-8-15**] [**Hospital Ward Name 23**] Clinical Center Lab 13. Outpatient Lab Work INR [**8-17**] [**Hospital Ward Name 23**] Clinical Center Lab 14. One Touch Ultra Test Strip Sig: One (1) strip Miscell. four times a day: check glucose 3-4 times daily. Disp:*1 box* Refills:*2* 15. Ipratropium Bromide 17 mcg/Actuation Aerosol Sig: 8-12 Puffs Inhalation Q4-6H (every 4 to 6 hours) as needed. Disp:*1 1* Refills:*1* 16. Albuterol 90 mcg/Actuation Aerosol Sig: 8-12 Puffs Inhalation Q4-6H (every 4 to 6 hours) as needed. Disp:*1 1* Refills:*1* 17. Coumadin 2 mg Tablet Sig: One (1) Tablet PO AS directed: as directed. Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: tracheal stenosis, Coronary artery disease s/p MI and Coronary artery bypass graftx 3 in [**5-/2180**], hypertension, hypercholesterolemia, Diabetes Mellitus type 2, HEparin induced thrombocytopenia +. Discharge Condition: good Discharge Instructions: CAll Dr.[**Name (NI) 14680**] office Interventional Pulmonary/Dr. [**Last Name (STitle) 17224**] Thoracic Surgery office for: fever, shortness of breath, chest pain. TAke medications as stated on discharte instructions. 2 sets of prescriptions provided- one month for now, 2 nd set for [**State 108**] use. NO lifting more than 5-7lbs. YOu may shower. Wipe incision dry after showering. Let white strips on incision fall off. REgular walking as in hospital. Go to [**Hospital Ward Name 23**] Clinical Center Lab for Blood draw Tuesday-[**2180-8-15**], and Thursday-[**2180-8-17**]. Appointment [**8-17**] 9:30am w/ Thoracic surgery Clinic- [**Hospital Ward Name 23**] clinical center, [**Location (un) **]. Take Coumadin 1mg tonight- [**2180-8-14**] ONLY. Dr.[**Name (NI) 14680**] office will call to let you know what dose of coumadin to take after blood draw.- on Tuesday and Wednesday, then again on Thursday. through the weekend until seen by following MD [**First Name8 (NamePattern2) **] [**Last Name (Titles) 6185**]. Be sure to eat well, add supplements as needed as taken in hospital. Followup Instructions: Appointment [**2180-8-17**]-Thursday @9:30am with Dr [**Last Name (STitle) **], [**First Name3 (LF) 1092**] Surgery Clinic, [**Hospital Ward Name 23**] Clinical Center-[**Location (un) **], [**Hospital Ward Name 516**], [**Hospital1 18**]- [**Location (un) **], [**Location (un) 86**], MA. CAll [**Telephone/Fax (1) 170**] for any questions regarding this appointment Completed by:[**2180-8-16**] ICD9 Codes: 412, 4019, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7515 }
Medical Text: Admission Date: [**2115-7-20**] Discharge Date: [**2115-8-1**] Date of Birth: [**2048-7-14**] Sex: M Service: MED Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 6114**] Chief Complaint: Hematemesis Major Surgical or Invasive Procedure: Esophagogastroduodenoscopy and esophageal biopsy Blood transfusions Esophageal Ultrasound History of Present Illness: Pt is a 66 yo M with a h/o CAD (s/p CABG x 3 [**10-30**] and ICD placement [**2-28**]), MVR, A.fib, HTN who presented to the ED w/ hematemesis. After the CABG in [**10-30**]' the patient noted a lump in his throat. The sensation was persistent and he felt as if his throat was closing. Over the next several months the pt also began noting increase in belching and small amounts of regurgitation. While eating he would bring up white frothy contents. Recently, he noted an increase need to chew his foods. He denies any difficulty swallowing liquids. On [**7-15**] his [**Month/Year (2) 263**] was found to be subtherapeutic 1.4, so his coumadin was increased from 1mg to 2mg and started on Lovenox 40mg QD. On [**7-19**] his [**Month/Year (2) 263**] was 4.7, both coumadin and lovenox were stopped. Later that day he had some coffee ground emesis and worsening dysphagia. The following day he had grossly bloody emesis and had noted dark stools for 2 days. He denies any recent weight loss, abd pain, CP, F/C. No NSAID use. In the ED he was given Vit. K and started on heparin drip. He was hemodynamically stable. Given 1LNS and 1 unit PRBC's. A gastric lavage was positive for blood. GI and Cardiology were consulted. An EGD was performed which showed a 8 mm stricture at the GE junction, with salmon colored mucosa, and a frond-like/vilous non bleeding mass of malignant appearance. The scope could not be passed the GE junction. He is transferred to the floor to await biopsy results and further plans. He is currently hemodynamically stable and on heparin drip for anti-coagulation. Past Medical History: CABG x 3 ([**10-30**]) MVR s/p ICD placement ([**2-28**]) A.fib HTN Hypothyroidism Social History: Denies ant T/A/D use. Lives with wife, has three children. retired from [**Company 20830**] Family History: Denies any h/o cancer, CAD. Parents died when he was young, unsure of causes. Physical Exam: PE T 98.9 BP 112/60 HR 68 RR 18 O2sats 100% RA Gen: Pt sitting in chair, A&O times 3, NAD HEENT: mmm, anicteric, clear OP, PERRL, EOMI Neck: + EJ IV, no supraclavicular nodes, no JVD Cardiac: RRR, + mechanical valve click, +S1/S2 Resp: crackles at the bases bilaterally, good air movement Abd: Soft, NT, ND, +BS Ext: no edema, 2+ DP, PT pulses bilaterally Neuro: motor/sensory function grossly intact Pertinent Results: [**2115-7-20**] 01:30PM WBC-9.2# RBC-3.11*# HGB-9.7*# HCT-28.2*# MCV-91 MCH-31.1 MCHC-34.3 RDW-15.5 NEUTS-81.4* LYMPHS-13.7* MONOS-3.9 EOS-0.6 BASOS-0.4 PLT COUNT-219 [**2115-7-20**] 01:30PM PT-19.1* PTT-34.0 [**Month/Day/Year 263**](PT)-2.4 [**2115-7-20**] 01:30PM GLUCOSE-104 UREA N-50* CREAT-1.4* SODIUM-144 POTASSIUM-4.4 CHLORIDE-108 TOTAL CO2-24 ANION GAP-16 EGD Findings: Esophagus: Lumen: An 8mm stricture was seen in the gastro-esophageal junction. The scope did not traverse the lesion. Mucosa: A salmon colored mucosa distributed in a localized pattern, suggestive of Barrett's Esophagus was seen. Protruding Lesions A frond-like/villous non-bleeding mass of malignant appearance was found at the gastro-esophageal junction. The scope could not traverse the lesion and the examination was interrupted. Stomach:Other Unable to visualize extent of mass or the stomach fundus/body due to GE junction stricture. Duodenum: Not examined Impressions: Stricture of the gastro-esophageal junction Barrett's esophagus Mass in the gastro-esophageal junction ECHO [**2115-2-6**] Conclusions 1. The left atrium is mildly dilated. 2. Overall left ventricular systolic function is moderately depressed. Anterior, septal and apical hypokinesis is present. EF 35-45% 3. The aortic valve leaflets (3) are mildly thickened. 4. A bileaflet mitral valve prosthesis is present. The mitral prosthesis appears well seated, with normal leaflet motion and transvalvular gradients. Cardiac Cath [**2114-11-21**] FINAL DIAGNOSIS: 1. Three vessel and left main coronary artery disease. 2. Mild-moderate mitral regurgitation. 3. Severe global systolic and mild diastolic left ventricular dysfunction. COMMENTS: 1. Selective angiography of this right-dominant system revealed three-vessel and LMCA disease. LMCA distal 40-50%. The LAD had severe ostial and proximal diffuse diseased and was totally occluded after D1. The distal LAD filled via left-to- left and right-to-left collaterals. D1 70% stenosis at its ostium. LCX had a 40% stenosis at the origin of a large OM1. The OM1 branch had serial 70% lesions proximally. The RCA mid-vessel tubular 60% stenosis and a 70% stenosis just before the RPDA. 2. The LVEDP was 16 mmHg. 3. Left ventriculography revealed an ejection fraction of 29%. There was anterobasal hypokinesis, anterolateral akinesis, apical dyskinesis/akinesis, inferior and posterobasal hypokinesis. There was mild to moderate ([**12-28**]+) mitral regurgitation. Labs on Discharge: [**2115-7-31**] 06:05AM BLOOD WBC-6.3 RBC-4.02* Hgb-12.6* Hct-37.2* MCV-92 MCH-31.3 MCHC-33.9 RDW-14.2 Plt Ct-235 [**2115-7-20**] 01:30PM BLOOD Neuts-81.4* Lymphs-13.7* Monos-3.9 Eos-0.6 Baso-0.4 [**2115-8-1**] 06:10AM BLOOD PT-24.9* PTT-99.8* [**Month/Day/Year 263**](PT)-4.1 [**2115-8-1**] 06:10AM BLOOD Creat-1.4* [**2115-7-31**] 06:05AM BLOOD Calcium-9.3 Phos-3.1 Mg-2.1 Brief Hospital Course: 1.[**Name (NI) 54040**] Pt was initially admitted to the MICU. His blood pressure was stable but on the low side for him, around 100/70's. His aspirin, coumadin, BB, ACEI, diuretic were all held and he was given fluids. In the MICU [**Name (NI) 263**] was elevated so it was reversed with Vit. K. He was given 2 units packed RBC's (crit was 28.2) and his Hct remained stable without further bleeding. Also started on PPI IV. He went for on EGD which showed a 8mm stricture at the GE junction w/ non bleeding mass of malignant appearance. Biopsy came back positive for adenocarcinoma. For the remainder of the hospital he had no bleeding and his HCT was stable. 2.Esophageal adenocarcinoma- Pt was diagnosed with adenocarcinoma after EGD with biopsy. An esophageal ultrasound showed that his stage was T2 with possible involvement of lymph nodes. A CT scan did not show any evidence of metastases. Several services including surgery, oncology, radiation oncology were consulted. Follow up appointments as an outpatient include Radiation oncology, thoracic oncology, and PET scan. 3. [**Name (NI) 54041**] Pt with MVR in [**10-30**]. He needed to be on anticoagulation but because of the bleeding his [**Date Range 263**] was reversed. After the EGD he was started on heparin and the PTT was maintained between 60-80 as per cardiology recommendations. After the EUS he was able to be transitioned to coumadin in anticipation of discharge. Goal [**Date Range 263**] was 2.5-3.5 given the MVR. It took several days to get Mr. [**Known lastname **] [**Last Name (Titles) 263**] therapeutic. Patient was drinking boost in hospital which has vitmain k. On discharge [**Last Name (Titles) 263**] 4.1 and patient is to see anticoagulation nurse in the am after discharge. 4.HTN- Mr. [**Known lastname 48753**] blood pressure meds were initially held because of bleeding and low BP. After he was stabilized and not bleeding his blood pressure was monitored. The beta blocker was added once his BP returned to the 120's/80's and slowly increased to his normal dose of metoprolol 25 mg [**Hospital1 **]. 5. CAD- Aspirin was held secondary to the bleeding. Continued the statin. Beta blocker as above. 6. Pulmonary- On CT the patient was found to have evidence of interstitial pneumonitis. He did have occasional crackles at the bases but had O2 sats in the high 90's. PFT's were done which exhibited a restrictive picture. Pulmonary was consulted they felt he had IPF, however treatment was not warranted at this time secondary to his need for cancer treatment. It was advised that he follow up with pulmonology during his cancer therapy and have regular PFT's. 7. Hypothyroidism- Continued his levothyroxine dose from home. 8. Rise in creatinine- Pt with creatinine to 1.4 at times during hospitalization. Could be secondary to poor po and fluid intake. Could be worked up as outpatient if though indicated. 9.PPx: Patient was on PPI and heparin until his coumadin was therapeutic (morning of discharge) Medications on Admission: Levothyroxine 100mcg QD, Atenolol 25 mg QD, Lisinopril 20mg QD, HCTZ 25mg QD, Zocor5mg QD, Coumadin 1mg QD Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*15 Tablet(s)* Refills:*0* 2. Levothyroxine Sodium 100 mcg Tablet Sig: One (1) Tablet PO QD (once a day). Disp:*15 Tablet(s)* Refills:*0* 3. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 4. Warfarin Sodium 1 mg Tablet Sig: as directed Tablet PO HS (at bedtime): No coumadin tonight, repeat [**Hospital1 263**] [**2115-8-2**], further medication adjustments [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) 2270**] [**Last Name (NamePattern1) 32624**] ([**Telephone/Fax (1) 54042**]. Disp:*30 Tablet(s)* Refills:*0* 5. Atenolol 25 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*15 Tablet(s)* Refills:*0* 6. Outpatient Lab Work Check Basic metabolic profile and communicate results to Dr. [**Last Name (STitle) 54043**]. Discharge Disposition: Home Discharge Diagnosis: Esophageal adenocarcinoma Upper gastrointestinal bleeding Anemia,acute blood loss Elevated creatinine Anticoagulation for mitral valve replacement Barrett's esophagus Coronary Artery Disease Discharge Condition: Stable, hematocrit stabilized, [**Last Name (STitle) 263**] 4.1 with followup [**Hospital 191**] [**Hospital3 **]. Discharge Instructions: 1)Have your [**Hospital3 263**] checked on [**2115-8-2**] and results to be communicated to [**Company 191**] Anticoagulation service, your coumadin will be adjusted based on these results by [**First Name8 (NamePattern2) 2270**] [**Last Name (NamePattern1) 32624**] ([**Telephone/Fax (1) 54042**]. 2) You will need a repeat chemistry next week to check for resolution of your creatinine, results to be followed by your primary care physician. [**Last Name (NamePattern4) **]. [**Last Name (STitle) 54043**]. 3) Your PET scan is schedule for [**2115-8-2**] at 1pm located in the [**Hospital Ward Name 23**] center, [**Location (un) **]. Instructions for the procedure-- -No strenous exercise before the procedure -You may take in only water for 6 hours before the scan, no food or other liquids. - 4) [**Known firstname **] [**Last Name (NamePattern1) 54044**] ([**2115**] will contact you regarding your appointment in the Thoracic Oncology Group, if you do not receive a call by [**2115-8-5**] please call the number above to confirm this appointment time. 5) Radiation Oncology appointment today, [**2115-8-1**], at 3pm at the [**Hospital Ward Name 23**] building, [**Location (un) 442**] Followup Instructions: Radiation oncology, Thoracic Oncology, and PET scan appointments listed above. Prior appointments include: Provider: [**Name10 (NameIs) 676**] CLINIC Where: [**Hospital6 29**] CARDIAC SERVICES Phone:[**Telephone/Fax (1) 59**] Date/Time:[**2115-12-16**] 2:00 Provider: [**First Name11 (Name Pattern1) 610**] [**Initial (NamePattern1) **] [**Last Name (NamePattern1) **], MD Where: [**Hospital6 29**] CARDIAC SERVICES Phone:[**Telephone/Fax (1) 285**] Date/Time:[**2115-12-16**] 2:30 ICD9 Codes: 5789, 2851, 2449, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7516 }
Medical Text: Admission Date: [**2199-9-2**] Discharge Date: [**2199-10-2**] Date of Birth: [**2132-7-30**] Sex: F Service: SURGERY Allergies: Penicillins / Erythromycin Base / Demerol Attending:[**First Name3 (LF) 1481**] Chief Complaint: Abdominal pain, nausea/vomiting Major Surgical or Invasive Procedure: [**2199-9-20**]: Removal of tunneled catheter and placement of Hickman catheter History of Present Illness: 67F with multiple medical problems, including fibromyalgia, MRSA osteomyelitis of L2-3, and a history of recurrent SBOs. She reports increasing abdominal pain since the day prior to admission, with waves of cramping. She has had PO intolerance and emesis and dry heaves on day of admission as well. She reports no flatus, but diarrhea for the past few days. All these symptoms are typical of her prior episodes of SBO -- her husband reports that this will be her 89th episode, typically averaging [**1-29**] hospitalizations per year. This attack to them, seem less severe than her prior episodes. She denies chest pain, fevers/chills, or sick contacts. Past Medical History: L2-L3 osteomyelitis and discitis Psoas abscess Left Upper Extremity Thrombosis Spinal Stenosis Multiple admissions for partial small bowel obstruction h/o ovarian CA diagnosed 23 years ago, s/p abdominal XRT Chronic abdominal pain Low back pain Fibromyalgia Hypothyroidism GERD Hypercholesterolemia Depression Radiation enteritis Elevated creatinine Cardiomyopathy EF 50%, [**12-28**]+ MR ([**5-31**]) Fe deficiency anemia Past Surgical History: TAH/BSO Exploratory laparotomy with lysis of adhesions Appendectomy Laminectomy and Spinal Fusion L4-L5 Social History: Married. Denies tobacco or alcohol use. Previously worked as a registered nurse in an outpatient medical practice. Family History: Cancer, heart disease in several family members Physical Exam: Tc 98.5, HR 84, BP 188/97, RR 20, O2sat 100% Genl: NAD CV: RRR Resp: CTA-B Abd: soft, tender to LLQ, RLQ, no tap tenderness, no reboud, no guarding, non-distended Extr: no c/c/e Pertinent Results: [**2199-9-2**] 05:45PM GLUCOSE-87 UREA N-13 CREAT-1.1 SODIUM-139 POTASSIUM-3.5 CHLORIDE-104 TOTAL CO2-23 ANION GAP-16 [**2199-9-2**] 05:45PM estGFR-Using this [**2199-9-2**] 05:45PM ALT(SGPT)-7 ALK PHOS-68 TOT BILI-0.2 [**2199-9-2**] 05:45PM LIPASE-30 [**2199-9-2**] 05:45PM ALBUMIN-3.6 CALCIUM-8.9 [**2199-9-2**] 05:45PM WBC-10.7 RBC-3.25* HGB-8.8* HCT-28.0* MCV-86 MCH-27.1 MCHC-31.5 RDW-16.5* [**2199-9-2**] 05:45PM NEUTS-65.6 LYMPHS-27.5 MONOS-5.7 EOS-0.8 BASOS-0.5 [**2199-9-2**] 05:45PM PLT COUNT-579* [**2199-9-14**] 05:23AM BLOOD WBC-6.2# RBC-2.60* Hgb-7.2* Hct-22.1* MCV-85 MCH-27.8 MCHC-32.7 RDW-16.1* Plt Ct-477* [**2199-9-15**] 07:00AM BLOOD WBC-7.6 RBC-2.73* Hgb-7.5* Hct-23.2* MCV-85 MCH-27.5 MCHC-32.3 RDW-16.3* Plt Ct-485* [**2199-9-16**] 04:39AM BLOOD WBC-8.9 RBC-2.77* Hgb-7.7* Hct-23.6* MCV-85 MCH-27.6 MCHC-32.4 RDW-16.2* Plt Ct-536* [**2199-9-21**] 04:17AM BLOOD WBC-12.3* RBC-2.44* Hgb-7.0* Hct-21.1* MCV-86 MCH-28.8 MCHC-33.3 RDW-16.1* Plt Ct-446* [**2199-9-21**] 09:24PM BLOOD WBC-12.1* RBC-3.63*# Hgb-10.4*# Hct-31.2*# MCV-86 MCH-28.6 MCHC-33.2 RDW-16.3* Plt Ct-398 [**2199-9-22**] 05:06AM BLOOD WBC-15.8* RBC-3.62* Hgb-10.6* Hct-30.9* MCV-85 MCH-29.4 MCHC-34.4 RDW-16.5* Plt Ct-418 [**2199-9-28**] 05:57PM BLOOD WBC-11.8* RBC-3.12* Hgb-9.0* Hct-27.2* MCV-87 MCH-28.7 MCHC-32.9 RDW-16.3* Plt Ct-492* [**2199-9-29**] 05:04AM BLOOD WBC-10.8 RBC-3.18* Hgb-8.9* Hct-26.9* MCV-85 MCH-28.1 MCHC-33.2 RDW-16.1* Plt Ct-509* [**2199-10-2**] 04:05AM BLOOD WBC-8.4 RBC-3.03* Hgb-8.6* Hct-26.2* MCV-87 MCH-28.3 MCHC-32.6 RDW-16.2* Plt Ct-520* [**2199-9-18**] 04:48AM BLOOD PT-13.7* PTT-44.7* INR(PT)-1.2* [**2199-9-22**] 05:06AM BLOOD ESR-15 [**2199-9-9**] 04:50PM BLOOD ESR-60* [**2199-9-2**] 05:45PM BLOOD Glucose-87 UreaN-13 Creat-1.1 Na-139 K-3.5 Cl-104 HCO3-23 AnGap-16 [**2199-9-3**] 05:20AM BLOOD Glucose-99 UreaN-10 Creat-1.0 Na-140 K-3.6 Cl-107 HCO3-21* AnGap-16 [**2199-9-3**] 06:06PM BLOOD K-4.8 [**2199-9-14**] 05:23AM BLOOD Glucose-102 UreaN-5* Creat-1.2* Na-136 K-3.3 Cl-105 HCO3-22 AnGap-12 [**2199-9-15**] 07:00AM BLOOD Glucose-105 UreaN-4* Na-135 K-3.1* Cl-105 HCO3-20* AnGap-13 [**2199-9-16**] 04:39AM BLOOD UreaN-4* Creat-1.2* Na-137 K-3.7 Cl-106 HCO3-20* AnGap-15 [**2199-9-24**] 04:26AM BLOOD Glucose-105 UreaN-11 Creat-1.3* Na-130* K-4.2 Cl-100 HCO3-21* AnGap-13 [**2199-9-25**] 04:06AM BLOOD Glucose-109* UreaN-11 Creat-1.4* Na-129* K-4.5 Cl-98 HCO3-21* AnGap-15 [**2199-9-26**] 11:18AM BLOOD Glucose-86 UreaN-14 Creat-1.5* Na-131* K-5.2* Cl-103 HCO3-18* AnGap-15 [**2199-9-26**] 11:42PM BLOOD Glucose-90 UreaN-12 Creat-1.5* Na-130* K-4.6 Cl-100 HCO3-19* AnGap-16 [**2199-9-27**] 05:30AM BLOOD Glucose-79 UreaN-13 Creat-1.6* Na-130* K-4.5 Cl-99 HCO3-20* AnGap-16 [**2199-9-28**] 05:12AM BLOOD Glucose-54* UreaN-17 Creat-1.5* Na-129* K-4.4 Cl-100 HCO3-15* AnGap-18 [**2199-9-28**] 05:57PM BLOOD Glucose-103 UreaN-24* Creat-2.0* Na-129* K-4.2 Cl-100 HCO3-16* AnGap-17 [**2199-9-29**] 05:04AM BLOOD Glucose-101 UreaN-24* Creat-2.0* Na-128* K-4.0 Cl-100 HCO3-16* AnGap-16 [**2199-9-30**] 05:26AM BLOOD Glucose-82 UreaN-19 Creat-2.0* Na-129* K-4.0 Cl-102 HCO3-17* AnGap-14 [**2199-10-1**] 07:59AM BLOOD Glucose-98 UreaN-18 Creat-1.8* Na-135 K-3.6 Cl-105 HCO3-18* AnGap-16 [**2199-10-2**] 04:05AM BLOOD Glucose-92 UreaN-17 Creat-1.6* Na-135 K-4.1 Cl-108 HCO3-19* AnGap-12 [**2199-10-2**] 04:05AM BLOOD Calcium-9.0 Phos-3.0 Mg-1.8 [**2199-9-13**] 02:25AM BLOOD TSH-28* [**2199-9-16**] 06:45PM BLOOD Prolact-58* [**2199-9-15**] 07:00AM BLOOD Free T4-1.5 [**2199-9-22**] 05:06AM BLOOD CRP-1.3 [**2199-9-9**] 04:50PM BLOOD CRP-2.6 [**2199-9-15**] 07:00AM BLOOD Vanco-21.1* [**2199-9-9**] 08:09PM BLOOD Vanco-20.1* [**2199-9-16**] 01:08PM BLOOD tTG-IgA-3 [**2199-9-13**] 02:50AM BLOOD Type-ART pO2-92 pCO2-27* pH-7.46* calTCO2-20* Base XS--2 [**2199-9-12**] 07:09PM BLOOD Type-ART pO2-104 pCO2-30* pH-7.42 calTCO2-20* Base XS--3 [**2199-9-13**] 02:36AM BLOOD Lactate-1.1 [**2199-9-13**] 02:50AM BLOOD Lactate-0.9 [**2199-9-13**] 02:50AM BLOOD freeCa-1.13 Brief Hospital Course: # Gastrointestinal The patient was admitted to the hospital for partial small bowel obstruction. Patient initially refused a NGT and foley catheter. She was maintained NPO and started on maintenance fluid. She underwent serial examinations with improvement in her abdominal pain. In the emergency department, she had a KUB performed: HISTORY: 67-year-old female with history of small bowel obstructions, now with similar symptoms. Evaluate for obstruction. COMPARISON: CT [**2199-5-23**]. ABDOMEN, SUPINE AND LEFT LATERAL DECUBITUS: Spinal fusion hardware is noted at L4-L5. There are gas-filled loops of small bowel, with several bowel loops borderline in size, similar to the prior study. Though there is a relative paucity of bowel gas in the colon, air is evident in the rectum. No free air or pneumatosis is identified. IMPRESSION: Borderline dilated small bowel loops, which can be seen with an ileus, though an early and/or partial small bowel obstruction cannot be excluded. Patient was started on pain control with Dilaudid. Patient had persistent diarrhea during her hospitalization and had at least 8 C. Difficile samples sent to the laboratory, all of which have returned negative. The GI service was consulted for persistent diarrhea. They initially recommended stool cultures (negative), a clear liquid diet, and observation for clinical improvement. The patient was later ordered for an MR enterography, however, her diarrhea improved prior to obtaining the study. An Anti-transglutaminase was sent to evaluate for Celiac disease and was in the normal range. Disease The patient # Infectiouswas maintained on her home dose of Vancomycin for her previous MRSA bacteremia and MRSA L2-L3 osteomyelitis. The Infectious Disease service was consulted on [**2199-9-4**] and followed her for several weeks. Patient had been on vancomycin since [**2199-5-24**]. ID recommended continuing vancomycin. On [**2199-9-12**], the patient was found to have a urinary tract infection. she was started on Ciprofloxacin, though this was changed to Bactrim as cipro can lower the seizure threshold. The sensitivities returned on the urine culture, and was resistant to Bactrim. Ultimately, she completed her treatment for UTI with macrobid. There was no further dysuria, frequency, or urgency. On HD # 20, her vancomycin was discontinued and she was started on Bactrim DS for her discitis This was discontinued after 3 days due to worsening renal function. Infectious disease did not feel as though additional antibiotics were necessary for the discitis. On HD # 11, blood cultures were sent and returned with [**Female First Name (un) 564**] Parapsilosis. Unfortunately, the sensitivities showed that the [**Female First Name (un) **] was resistant to fluconazole and oral therapy was not available. The patient was started on Micafungin 100mg IV daily on [**2199-9-16**]. ID recommended last dose of Micafungin on [**2199-9-28**]. Micafungin was discontinued prior to discharge. On [**2199-9-20**], the patient was brought to the operating room to have her existing tunnelled catheter removed due to the fungemia and a new Hickman catheter was placed without incident. Due to the fungemia, the patient had an Ophthalmology consult and was evaluated. They found no evidence of fungal endophthalmitis. . She also had a TTE performed: The left atrium and right atrium are normal in cavity size. The estimated right atrial pressure is 0-5 mmHg. Left ventricular wall thicknesses and cavity size are normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is low normal (LVEF 50%). The estimated cardiac index is normal (>=2.5L/min/m2). Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). Right ventricular chamber size and free wall motion are normal. The diameters of aorta at the sinus, ascending and arch levels are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic stenosis. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild to moderate ([**12-28**]+) mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is high normal. There is no pericardial effusion. Compared with the prior study (images reviewed) of [**2199-5-27**], left ventricular systolic function is less dynamic and increased PCWP is now suggested. # Renal on [**2199-9-24**] the patient was noted to have hyponatremia with a sodium of 130. She had a nadir of 129. She further was noted to have worsening of her creatinine (baseline 1.0-1.2). As the creatinine continued to elevate, nephrology was consulted. Nephrology recommended discontinuation of the bactrim as this was likely contributing to her worsening creatinine level. Further, the hyponatremia was attributed to SIADH likely secondary to the patient's opiate use. Her opiate use was curtailed and her free fluid was limited and her hyponatremia resolved. Renal service also made recommendations regarding the patient's labile blood pressures. She had intermittent periods where her systolic blood pressure was 220s with diastolics in the 110s. She was being treated with IV lopressor and ultimately with IV hydralazine. She was started on metoprolol by mouth and this was titrated to effect. Renal recommended the discontinuation of all IV blood pressure medications as they were likely causing relative hypotension and hypoperfusion of her kidneys. She was maintained on Coreg and started on amlodipine 2.5 mg PO daily. If her blood pressure is not well controlled, we would recommend increasing her amlodipine to 5 mg PO daily. The patient's urine output was low on occasion and she did require small boluses of IVF. The IVF likely worsened her hyponatremia, however. In her extended care facility, she should be encouraged to drink fluids. If she does require a fluid bolus, would recommend a 500ml bolus given over 5 hours. Her creatinine peaked at 2.0 and has continued to trend down. Her most recent creatinine was 1.6 on [**2199-10-2**]. Her sodium and creatinine should be monitored in her extended care facility. # Hematology The patient was maintained on Lovenox 60mg SC BID for her recent LUE DVT (~[**2199-5-27**]). During the admission, she complained of RUE numbness and tingling and had a negative duplex ultrasound performed. After her Hickman line placement on [**2199-9-20**], she was noted to have oozing around the insertion site. Shortly thereafter, her lovenox was discontinued for several days. After the oozing resolved, she was restarted on Lovenox, but at a prophylactic dose only. On [**2199-9-21**], the patient was noted to have a hematocrit of 21.1 due to blood loss on top of anemia of chronic disease and she was transfused 2units of pRBCs with appropriate increase in hematocrit. # Neurologic On HD # 10, a trigger was called as the patient was exhibiting seizure like behavior. Nursing staff and the patient's husband report [**Name2 (NI) 97262**] but rhythmic contractions and relaxations of her upper extremities. This reportedly lasted for two minutes at which point she appeared to have a blank stare and was non-verbal. Two minutes later her confusion cleared. She showed no evidence of tongue laceration or incontinence. At that time she obtained a head CT: HISTORY: 67-year-old female with small-bowel obstruction, now with tonic- clonic seizure. Here to assess for intracranial process. COMPARISON: CT head, most recently of [**2199-8-3**]. TECHNIQUE: MDCT axial imaging was performed through the brain before and after administration of 90 mL of IV Optiray 350. CT HEAD BEFORE AND AFTER IV CONTRAST: No evidence of acute intracranial hemorrhage, edema, mass effect, hydrocephalus, or large vascular territory infarction is seen. Periventricular white matter hypodensities are mild, likely due to chronic microangiopathic ischemic change. After administration of gadolinium, no abnormally enhancing mass is seen. Vascular calcifications are noted along the dominant right vertebral artery, as well as the carotid siphons. While the current study is not tailored towards the study of such, there is apparent normal enhancement of the vessels of the circle of [**Location (un) 431**]. There is also normal enhancement of the venous sinuses. The soft tissues, orbits, and skull appear unremarkable. The mastoid air cells and middle ear cavities are normally aerated. Minimal layering fluid or mucosal thickening is noted along the sphenoid sinus, which was not present on [**2199-8-3**]. IMPRESSION: No evidence of acute intracranial process nor abnormal enhancing mass seen. If there remains concern for subtle process, MRI would be recommended for more sensitive evaluation While down at CT, the patient reportedly exhibited further seizure activity and she received Ativan. She was transferred to the Trauma-Surgery ICU where she had a Neurology evaluation. Neurology commented on how the postictal period was remarkably short and atypical for a tonic-clonic seizure. They recommended a 24 hour EEG with video as well as a lumbar puncture. The patient continues to refuse lumbar puncture. EEG on [**2199-9-14**]: FINDINGS: ROUTINE SAMPLING: Showed a 9 Hz predominant biposterior rhythm in the most awake parts of this recording. There were no areas of prominent focal slowing or epileptiform features seen. SLEEP: The patient progressed from wakefulness to sleep with no additional findings. CARDIAC MONITOR: Showed a generally regular rhythm. SPIKE DETECTION PROGRAMS: Showed no clear epileptiform features. SEIZURE DETECTION PROGRAMS: There were eight entries in this file for muscle and movement artifacts, rhythmic alpha activity but no ongoing seizure activity. PUSHBUTTON ACTIVATIONS: There were none. IMPRESSION: This telemetry captured no pushbutton activations and no interictal epileptiform activity. The background activity was normal. EEG [**2199-9-15**]: FINDINGS: ROUTINE SAMPLING: Showed a 9 Hz predominant biposterior rhythm in wakefulness. There were no areas of prominent focal slowing or epileptiform features seen. SLEEP: The patient progressed from wakefulness to sleep with no additional findings. CARDIAC MONITOR: Showed a generally regular rhythm. SPIKE DETECTION PROGRAMS: There were no entries in this file. SEIZURE DETECTION PROGRAMS: There were three entries in this file for movement and muscle artifacts. There was no ongoing seizure activity seen. PUSHBUTTON ACTIVATIONS: There were none. IMPRESSION: This telemetry captured no pushbutton activations and no ictal or interictal epileptiform activity. The background activity was normal. An MRI/MRA of the brain was ordered, however, the patient was not able to comply with the study for several days. The study was obtained on [**2199-9-19**]: HISTORY: 67-year-old female patient with osteomyelitis and discitis. Patient with mental status changes and new onset seizures. TECHNIQUE: MRI of the head was performed with and without IV contrast and MRA of the brain was also performed. COMPARISON: CT scan dated [**2199-9-12**]. No previous MRI. FINDINGS: MRI BRAIN: There are nonspecific non-enhancing T2/FLAIR hyperintense foci within the bilateral centra semiovale and periventricular regions likely representing chronic small vessel ischemic changes in a patient of this age. There is an ill-defined focus of FLAIR-hyperintensity, with no enhancement, within the medial inferior right cerebellar hemisphere/lateral vermis, with no evidence for restricted diffusion likely representing chronic infarction. There is moderate diffuse parenchymal volume loss with associated proportionate prominence of the ventricles and sulci, likely reflecting age-related volume loss. There is no evidence of acute infarction, hemorrhage, abnormal enhancement, or hydrocephalus. No mesial temporal sclerosis, cortical dysplasia or heterotopia is seen. The visualized major vascular flow voids are normal. Orbital structures are unremarkable. There is mucosal thickening of the bilateral ethmoid air cells and a mucus-retention cyst in the right sphenoid sinus. Otherwise, the remainder of the paranasal sinuses as well as mastoid air cells are clear. MRA BRAIN: ANTERIOR CIRCULATION: The bilateral MCAs and ACAs are unremarkable without evidence for aneurysm (greater than 3 mm), AVM, or stenosis. Incidental note is made of fenestration at the ACA-ACom complex, a normal variant. POSTERIOR CIRCULATION: Bilateral PCAs and basilar artery are unremarkable. The right vertebral artery is dominant. The left vertebral artery is non-dominant and becomes more diminutive, just distal to the takeoff of the left PICA, also a normal variant. There is no evidence for aneurysm (greater than 3 mm), AVM, or stenosis. IMPRESSION: 1. No acute infarction or hemorrhage, and no pathologic focus of enhancement. 2. Right inferior cerebellar/lateral vermian chronic infarction, and likely mild chronic small vessel infarction in a patient of this age. 3. Fenestration of the ACom complex, a normal variant. No significant neurovascular abnormality identified. After this extensive workup, it was ddecided that the patient had pseudoseizures rather than a true seizure disorder and that anticonvulsants were not required. During the hospitalization, the patient had waxing and [**Doctor Last Name 688**] mentals status. She reportedly was seen talking to her finger and calling out for her mother (who is deceased) on multiple occasions. Psychiatry was consulted for her abnormal behavior. Psychiatry recommended antidepressant -- sertraline begin at 50 mg qd, after 4 days increase to 100 mg daily. Further, they recommended that the patient would benefit from outpt psychiatry or therapy. # Musculoskeletal The patient was evaluated by Orthopaedics/Spine due to her recent L2-L3 osteomyelitis. A L spine MRI was obtained: LUMBAR SPINE MRI. HISTORY: 67-year-old female presents with history of lumbar osteomyelitis. COMPARISON: Prior lumbar spine MRIs, [**2191-4-11**] through [**2199-7-24**]. FINDINGS: The patient was unable to tolerate the examination, only a sagittal T2 sequence was acquired. The configuration of the lumbar spine appears similar, with marked abnormality of the disc space at L2-L3 with an associated fluid cleft. Fusion is noted just inferior to this. There is likely at least moderate narrowing of the spinal canal at the L3 level. There is slightly increased prevertebral soft tissue, displacing the aorta anteriorly. This may relate to progressive inflammatory change, though is incompletely evaluated. Again noted is a kyphotic deformity at T10 associated with the disc protrusion and associated osteophytes. IMPRESSION: Incomplete examination demonstrates grossly similar appearance to the previous MRI from [**7-24**] on limited sagittal T2 seqeunce. Complete study to be performed when pt. is co-operative for complete assessment. Severe central canal stenosis with possible compression on the cauda at L2-3 and L3-4 levels, incompletely assessed. A repeat lumbar spine MRI is recommended as an outpatient if clinically indicated. Medications on Admission: 1. Carvedilol 3.125 mg PO BID 2. Lisinopril 10 mg PO DAILY 3. Omeprazole 40 mg PO DAILY 4. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY 5. Cholecalciferol 1000u PO DAILY 6. Sertraline 100 mg PO DAILY 7. Alendronate 70 mg PO QSUN 8. Lorazepam 0.5 mg PO Q6H as needed for anxiety. 9. Senna 8.6 mg 10. Fentanyl 100 mcg/hr Patch Q72H 11. Calcium Carbonate 500 mg PO QID 12. Levothyroxine 150 mcg PO DAILY 13. Zoloft 100mg PO DAILY 14. Vicodin 5/500mg 1-2 tabs QID prn pain 15. Lovenox 1mg/kg [**Hospital1 **] 16. Vancomycin 500mg IV daily Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for fever or pain. 2. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime) as needed for constipation. 3. Carvedilol 3.125 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 4. Miconazole Nitrate 2 % Powder Sig: One (1) Appl Topical QID (4 times a day). 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 6. Levothyroxine 75 mcg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 7. Sertraline 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 8. Amlodipine 2.5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO every 6-8 hours as needed for pain for 10 days. 10. Simvastatin 40 mg PO daily 11. Heparin Flush (10 units/ml) 2 mL IV PRN line flush Tunneled Access Line (e.g. Hickman), heparin dependent: Flush with 10 mL Normal saline followed by Heparin as above daily and PRN per lumen. Discharge Disposition: Extended Care Facility: [**Location (un) 33039**] - heathwood Discharge Diagnosis: partial small bowel obstruction hyponatremia acute renal failure fungemia pseudoseizures depression Discharge Condition: stable, afebrile Discharge Instructions: You were evaluated and treated for a partial small bowel obstructions. You had a lengthy hospitalization with multiple other treatments. Please adhere to a renal diet. You are encouraged to drink fluids. Please call your primary care physician or return to the emergency department for any of the following: * Fever greater than 101 * Severe abdominal pain * Persistent nausea/vomiting * confusion * seizure activity * any new or concerning symptom Followup Instructions: Please make an appointment to see Dr. [**Last Name (STitle) **] in 2 weeks. His office number is ([**Telephone/Fax (1) 39326**]. You should also schedule an appointment to see your regular physician. You should also follow up with the Infectious Disease clinic in [**1-30**] weeks. Their telephone number is [**Telephone/Fax (1) 457**]. Completed by:[**2199-10-2**] ICD9 Codes: 5849, 4254, 2930, 4019, 2449, 311
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Medical Text: Admission Date: [**2146-1-22**] Discharge Date: [**2146-2-7**] Date of Birth: [**2067-7-11**] Sex: F Service: SURGERY Allergies: Penicillins / Percodan / Percocet / Codeine / Talwin / Demerol / Valium / Aspirin Attending:[**First Name3 (LF) 2836**] Chief Complaint: Abdominal Pain Major Surgical or Invasive Procedure: Exploratory laparotomy with lysis of adhesions. History of Present Illness: This is a 78 y/o female admitted on after 1 1/2 days of abdominal pain, right groin pain, and N/V. EMS was called for respiratory distress and hypotension and she was intubated in the ED. On arrival, she was volue resuscitated and started on pressors. Her initial physical exam revealed focal peritoneal signs in the RLQ. A CT was done showing complete small-bowel obstruction, with transition point at the level of the ileocecal valve. Past Medical History: # Aortic stenosis - valve area 1.1 on [**2144-4-3**] # CHF (EF of 60%) # atrial fibrillation - on warfarin # s/p femur fx [**8-17**] # s/p R BKD [**2144-10-28**] # COPD # Rheumatoid arthritis - on prednisone # RA/SLE/positive [**Doctor First Name **] antibody - in remission # osteoporosis # venous stasis # peripheral neuropathy # h/o Clostridium difficile in the past # spinal stenosis # SBO Social History: lives alone in home, able to do ADL's, has [**Name (NI) 269**], PT, home aid at home. +tob hx, quit 40 years ago, no ETOH, no drugs Family History: arthritis, mother - liver cancer, father - CVA Physical Exam: Intubated, awake, in moderate distess CV: irregularly irregular, tachycaardic Chest: breath sounds course bilat and diminished at left Abd: soft, obese, minimally distended and tympanitis. Localized tenderness to the RLQ with guarding, no rebound. Ext: mild cyanosisof left toes, +edema Pertinent Results: [**2146-1-22**] 02:50PM BLOOD WBC-23.4*# RBC-3.84* Hgb-12.6 Hct-37.6 MCV-98 MCH-32.9* MCHC-33.6 RDW-14.1 Plt Ct-338 [**2146-1-25**] 03:48AM BLOOD WBC-18.0* RBC-3.25* Hgb-10.5* Hct-31.9* MCV-98 MCH-32.2* MCHC-32.8 RDW-14.1 Plt Ct-302 [**2146-1-31**] 07:20AM BLOOD WBC-15.3* RBC-3.23* Hgb-10.6* Hct-31.7* MCV-98 MCH-32.7* MCHC-33.3 RDW-14.2 Plt Ct-369 [**2146-1-31**] 07:20AM BLOOD PT-15.1* PTT-41.5* INR(PT)-1.3* [**2146-1-31**] 07:20AM BLOOD Glucose-74 UreaN-25* Creat-0.8 Na-138 K-3.6 Cl-99 HCO3-31 AnGap-12 [**2146-1-22**] 02:50PM BLOOD ALT-14 AST-23 AlkPhos-47 Amylase-80 TotBili-0.9 [**2146-1-25**] 03:48AM BLOOD ALT-15 AST-21 LD(LDH)-242 AlkPhos-44 Amylase-98 TotBili-0.6 [**2146-1-25**] 03:48AM BLOOD Lipase-47 [**2146-1-31**] 07:20AM BLOOD Calcium-8.8 Phos-3.0 Mg-2.1 . CT PELVIS W/CONTRAST [**2146-1-22**] 3:48 PM IMPRESSION: 1. Complete small-bowel obstruction, with transition point at the level of the ileocecal valve. Taking into account the recent hernia reduction, it is unclear whether these findings could represent slow passage of fecalized small bowel contents into the cecum following the hernia reduction. 2. No sign of incarcerated hernia. Fluid-filled hernia sac seen in the right inguinal region. This may be related to recent reduction of the inguinal hernia. 3. Right lower lobe atelectasis, and a few nodular areas of right lower lobe opacity which could represent aspiration, less likely an infectious process. 4. Extensive thoracolumbar spine degenerative change, and multiple vertebral body compression fractures as described above. . Cardiology Report ECG Study Date of [**2146-1-22**] 2:43:36 PM Atrial fibrillation with a rapid ventricular response. Extensive ST-T wave changes which are likely due to rate or myocardial ischemia. Compared to the previous tracing of [**2145-12-22**] the rate has increased significantly and there are now diffuse ST-T wave changes. Clinical correlation is suggested. Intervals Axes Rate PR QRS QT/QTc P QRS T 113 0 76 360/452 0 47 -155 . CHEST (PORTABLE AP) [**2146-1-30**] 4:15 AM [**Hospital 93**] MEDICAL CONDITION: 78 year old woman s/p LOA for obstruction w/ elevated WBC COMPARISON: [**2146-1-26**]. FINDINGS: The NGT, left CVL and ETT have been removed. Large retrocardiac density with air-fluid level was consistent with hiatal hernia. Adjacent atelectasis is seen. There are no new focal consolidations and the pulmonary [**Month/Day/Year 1106**] markings appear normal. There is stable cardiomegaly. IMPRESSION: No new consolidations. Brief Hospital Course: This is a 78 year old female with 1 1/2 days of abdominal pain, right groin pain, and N/V. EMS was called for respiratory distress and she was intubated in the ED. She had peritoneal signs on exam and a SBO was found on CT and the pt went to the OR for ex-lap + LOA. CV: She received beta blockers when appropriate for rate control. She continued in A-fib. When appropriate, her Coumadin was restarted. Her cardiologist recommended IV Lasix for 24-48 hours to assist with diuresis and then to resume her home PO dose. She responded well to the IV Lasix. Resp: She was intubated and comfortable. As she improved clinically, she was weaned to extubate. She was extubated on [**2146-1-26**]. She had CXR at time of discharge to assess volume status and she was not fluid overloaded. Abd/GI: She was NPO with IVF and a NGT. She had a Dobhoff placed, but it remained in the stomach. She was started on trophic tubefeeds. She was seen by speech and swallow and cleared for a PO diet. Her NGT was removed, Dobhoff removed, and her diet was advanced along. Her incision was C/D/I, with a small amount of redness along the incision. Renal: Her BUN/Cr were monitored and stable. She had good urine output and her volume status was watched closely. She received occasional fluid bolus for hypovolemia. As she continued to improved, she was started back on Lasix for diuresis due to her CHF. ID: She was started on broad coverage ABX, including Vanco, Zosyn, and Flagyl. Her antibiotics were tailored and she grew E.coli from her urine and completed a 7 day course of Meropenum. The patient's daughter was concerned about recurrent [**Name (NI) 14870**] and was requesting prophylactic ABX. Atrial Fibrillation: She continued in A-fib with a controlled rate. She was started back on her Coumadin. PT: It was recommended that she be discharged to a rehab facility for further strength and stability training. Medications on Admission: Prednisone 10', warfarin 3', gabapentin 400''', lisinopril 10', lasix 40''', metop 50'SR, ibandronate 150 q month, morphine 15q6h prn, omeprazole 20' Discharge Medications: 1. Prednisone 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 3. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed. 4. Gabapentin 300 mg Capsule Sig: Two (2) Capsule PO TID (3 times a day). 5. Latanoprost 0.005 % Drops Sig: One (1) Drop Ophthalmic HS (at bedtime): 1 DROP RIGHT EYE HS . 6. Brimonidine 0.15 % Drops Sig: One (1) Drop Ophthalmic Q8H (every 8 hours): DROP RIGHT EYE Q8H . 7. Dorzolamide 2 % Drops Sig: One (1) Drop Ophthalmic [**Hospital1 **] (2 times a day): 1 DROP RIGHT EYE [**Hospital1 **] . 8. Warfarin 3 mg Tablet Sig: One (1) Tablet PO ONCE (Once): Monitor INR. 9. Furosemide 40 mg Tablet Sig: Three (3) Tablet PO BID (2 times a day). 10. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Warfarin 6 mg Tablet Sig: One (1) Tablet PO ONCE (Once): Please dose daily and adjust accordingly. Discharge Disposition: Extended Care Facility: [**Hospital3 7**] & Rehab Center - [**Hospital1 8**] Discharge Diagnosis: Right groin pain, Palpable hernia (nonreducible) Small Bowel Obstruction Respiratory distress CHF Sepsis Discharge Condition: Good Discharge Instructions: Weigh yourself every morning, [**Name8 (MD) 138**] MD if weight > 3 lbs. Adhere to 2 gm sodium diet Fluid Restriction: Incision Care: Keep clean and dry. -You may shower, and wash surgical incisions. -Avoid swimming and baths until your follow-up appointment. -Please call the doctor if you have increased pain, swelling, redness, or drainage from the incision sites. . Please call your doctor or return to the ER for any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. * Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your skin, or the whites of your eyes become yellow. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. . * Please resume all regular home medications and take any new meds as ordered. * Do not drive or operate heavy machinery while taking any narcotic pain medication. You may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. * Continue to increase activity daily and work towards daily ambulation. * No heavy lifting (>[**10-26**] lbs) until your follow up appointment. Followup Instructions: Please follow-up with Dr. [**First Name (STitle) **] in 2 weeks. Call ([**Telephone/Fax (1) 6347**] to schedule an appointment. Provider: [**First Name8 (NamePattern2) 1903**] [**Last Name (NamePattern1) 1904**], [**MD Number(3) 1240**]:[**Telephone/Fax (1) 3512**] Date/Time:[**2146-3-15**] 1:00 Provider: [**Name10 (NameIs) 2352**] ECHO Phone:[**Telephone/Fax (1) 15347**] Date/Time:[**2146-4-8**] 2:30 Completed by:[**2146-2-7**] ICD9 Codes: 0389, 5990, 4280, 4241, 496, 2859
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Medical Text: Admission Date: [**2159-5-3**] Discharge Date: [**2159-5-7**] Date of Birth: [**2084-7-29**] Sex: F Service: OBSTETRICS/GYNECOLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 18051**] Chief Complaint: malignant ascites Major Surgical or Invasive Procedure: Bilateral salpingo-oophorectomy, omentectomy, total abdominal hysterectomy, radical dissection for debulking. History of Present Illness: 74 P0 referred for ascites. Presented with vague GI sxs and constipation. Colonscopy wnl. US demonstrated large ascites that contained malignant cells on paracentesis. CT previously negative. Nl [**Last Name (un) 3907**]. Nl renal US. Elevated CA125 and CA [**73**]-9 Past Medical History: OB: nulliparous Gyn: nl [**Last Name (un) 3907**], nl pap, last period [**2134**] PMH: HA, asthma, spastic colon, scoliosis PSH: back [**Doctor First Name **], cosmetic Social History: quit tobacco, occasional alcohol Family History: paternal first cousin with breast ca no ovarian, colon, endometrial Physical Exam: Initial exam notable for: No LAD Abdomen distedned with ascites, no masses nl vulva, vagian, cervix Biman limited no masses nl rectum/cul-de-sac Pertinent Results: [**2159-5-6**] 06:20AM BLOOD WBC-12.0* RBC-3.68* Hgb-10.0* Hct-30.8* MCV-84 MCH-27.2 MCHC-32.5 RDW-12.0 Plt Ct-529* [**2159-5-6**] 06:20AM BLOOD UreaN-5* Creat-0.4 K-4.3 [**2159-5-6**] 06:20AM BLOOD Calcium-7.9* Phos-3.0 Mg-2.1 Brief Hospital Course: The patient was admitted to the SICU following her procedure on [**5-3**]. Her surgery was complicated by laryngeal edema and intraoperative hypertension requiring ICU admission. Otherwise the surgery was uncomplicated - see operative report for details. Her ICU course was unremarkable, she was extubated and transferred to the floor on post op day 1 without complication. The remainder of her post operative course was uncomplicated. She advanced to regular diet without difficulty. On day of discharge she was voiding and ambulating without assitance. Her pain was well controlled with oral medication. Medications on Admission: flovent, atrovent Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. Disp:*40 Tablet(s)* Refills:*0* 2. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. Disp:*50 Capsule(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: adenocarcinoma Discharge Condition: good. stable Discharge Instructions: no heavy lifting, no exercise, nothing in vagina 6wks no driving 2 weeks Followup Instructions: Provider: [**Name10 (NameIs) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **]/GYN NON-PPS CC8 Where: [**Hospital 4054**] OBSTETRICS & GYNECOLOGY Phone:[**Telephone/Fax (1) 2664**] Date/Time:[**2159-5-28**] 1:45 Provider: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Name Initial (NameIs) **]. [**Telephone/Fax (1) 5777**] Call to schedule appointment ICD9 Codes: 5119
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Medical Text: Admission Date: [**2129-6-14**] Discharge Date: [**2129-6-17**] Date of Birth: [**2062-12-17**] Sex: M Service: ORTHOPAEDICS Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 64**] Chief Complaint: L Knee Pain Major Surgical or Invasive Procedure: L TKA History of Present Illness: The patient is a 66 yo M with long-standing history of L knee pain, limited ROM and difficulties with activities of daily living. The patient has met the clinical and radiographic indications for joint arthroplasty and wished to proceed with the above procedure. Prior to admission the patient has been feeling well with no recent illness, no shortness of breath, no chest pain and has been cleared medically for the surgical procedure. Patient has a history of tracheomalacia and OSA - all precautions have been discussed with the anesthesia team and the patient will be monitored closely post-operatively for apneic episodes. Past Medical History: DM II, HTN, hyperlipidemia, obesity, OSA/tracheomalacia, BPH, GERD Social History: non contrib Family History: non contrib Physical Exam: Afebrile VSS, A/Ox3 LCTA bilaterally RRR ABD soft, NTND, +BS BLE fully NVI distally with 2+ DP pulses and full strength throughout Painful and limited ROM of L knee Pertinent Results: [**2129-6-16**] 07:45AM BLOOD WBC-9.3 RBC-3.53* Hgb-10.3* Hct-29.3* MCV-83 MCH-29.2 MCHC-35.1* RDW-13.7 Plt Ct-161 [**2129-6-15**] 02:30AM BLOOD WBC-9.7 RBC-4.18* Hgb-12.0* Hct-34.5* MCV-83 MCH-28.7 MCHC-34.7 RDW-13.6 Plt Ct-188 [**2129-6-17**] 06:55AM BLOOD Plt Ct-163 [**2129-6-16**] 07:45AM BLOOD Plt Ct-161 [**2129-6-15**] 02:30AM BLOOD Plt Ct-188 [**2129-6-15**] 02:30AM BLOOD Glucose-192* UreaN-18 Creat-0.9 Na-138 K-3.9 Cl-104 HCO3-26 AnGap-12 [**2129-6-15**] 02:30AM BLOOD Calcium-8.4 Phos-3.7 Mg-1.5* Brief Hospital Course: The patient was admitted on [**2129-6-14**] and taken to the operating room by Dr. [**Last Name (STitle) **] where the patient underwent left knee total joint arthroplasty. The procedure was well tolerated there were no complications. Please see the separately dictated operative report for details regarding the surgery. The patient was subsequently transferred to the post-anesthesia care unit in stable condition and transferred to the ICU later that day for close monitoring of his oxygen status. Overnight, the patient was placed on a ketamine drip for pain control dictated by the acute pain service. The patient did not tolerate CPAP but had O2 saturations in the high 90's on shovel mask. IV antibiotics were continued for 24 hours postoperatively for prophylaxis. Lovenox was started the morning of POD#1 for DVT prophylaxis. The patient was placed in a CPM machine with range of motion set at 0-45 degrees of flexion up to 90 degrees as tolerated. On postoperative day 1, the drain and foley were removed without incident. The patient was transferred to the floor in stable condition with continuous O2 sat, telemetry, and the ketamine drip. On postoperative day 2, the ketamine was d/c'd and the patient was placed on low dose oxycodone. The surgical dressing was also removed, and the surgical incision was found to be clean, dry, and intact without erythema nor purulent drainage. During the hospital course the patient was seen daily by physical therapy. Labs were checked both post-operatively and throughout the hospital course and repleted accordingly. The patient was tolerating regular diet and otherwise feeling well. Prior to discharge the patient was afebrile with stable vital signs. Hematocrit was stable and pain was adequately controlled on a PO regimen. The operative extremity was neurovascularly intact and the wound was benign. The patient was discharged to inpatient rehabilitation in a stable condition Medications on Admission: lipitor, lisinopril, metoprolol, ranitidine, mvt, calan, metformin Discharge Medications: 1. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 2. Enoxaparin 40 mg/0.4 mL Syringe Sig: One (1) syringe Subcutaneous once a day for 3 weeks. 3. Aluminum-Magnesium Hydroxide 225-200 mg/5 mL Suspension Sig: 15-30 MLs PO Q6H (every 6 hours) as needed. 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 6. Magnesium Hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO BID (2 times a day) as needed. 7. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 8. Ferrous Sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 11. Metformin 850 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Verapamil 240 mg Tablet Sustained Release Sig: 0.5 Tablet Sustained Release PO Q24H (every 24 hours). 13. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 14. Metoprolol Tartrate 50 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 15. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 16. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 17. Oxycodone 5 mg Tablet Sig: 1-2 Tablets PO Q3H (every 3 hours) as needed. Discharge Disposition: Extended Care Facility: [**Hospital3 2558**] - [**Location (un) **] Discharge Diagnosis: L Knee OA Discharge Condition: Stable Discharge Instructions: Please seek medical attention if you have any nausea, vomiting, fever greater than 101.5, chest pain, shortness of breath, increased pain/redness/drainage from your incision site, numbness/tingling, or any other concerning symptoms. Take all medications as prescribed and resume home medications, please take a stool softener if taking narcotic pain medications, please taper down pain medication use as tolerated. No driving nor operating heavy machinery while using narcotic pain medications. You should take iron supplementation to boost your blood count for 4 weeks. Ferrous sulfate 325mg once a day. ANTICOAGULATION: Take lovenox injections (40mg) once a day x 3 weeks and then take aspirin 325 mg twice a day x 3 weeks. [**Month (only) 116**] discontinue all blood thinners 6 weeks post-operatively. WOUND CARE: Keep your incision clean and dry. Okay to shower after POD#5 but do not tub-bath or submerge your incision. Please place a dry sterile dressing to the wound each day if there is drainage, leave it open to air. Check wound regularly for signs of infection such as redness or thick yellow drainage. Staples will be removed by VNA on POD 14. IF going to rehab, then rehab can remove staples @ 2 weeks. ACTIVITY: Weight bearing as tolerated to operative leg, CPM machine advance as tolerated. No strenuous exercise or heavy lifting until follow up appointment, at least. VNA (after home): Home PT/OT, dressing changes as instructed, and wound checks, staple removal on POD 14. Physical Therapy: WBAT, CPM advance as tolerated, no prolonged bedrest, ambulation encouraged Treatments Frequency: Staples to be D/C'd POD14 Followup Instructions: You have a follow-up appointment with Dr. [**Last Name (STitle) **] office in one month. Please call to confirm/schedule your appointment. Completed by:[**2129-6-17**] ICD9 Codes: 4019, 2724
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Medical Text: Admission Date: [**2199-2-7**] Discharge Date: [**2199-2-25**] Date of Birth: [**2116-5-9**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 165**] Chief Complaint: Dyspnea on exertion Major Surgical or Invasive Procedure: [**2199-2-8**] Aortic Valve Replacement(21mm Pericardial), Two Vessel Coronary Artery Bypass Grafting(left internal mammary to left anterior descending artery, vein graft to ramus), and Aortic Endarterectomy. History of Present Illness: Mr. [**Known lastname 61512**] is a 82 year old gentleman with symptomatic coronary artery disease and aortic stenosis. In [**2198-7-3**], Dr. [**Last Name (STitle) **] deemed him to be too high risk for surgery due to extensive aortic calcification. He subequently underwent aortic valvuloplasty in [**2198-10-3**]. Due to recurrent symptoms, he underwent repeat cardiac cathterization in [**2199-1-2**] which revealed left main disease with an instent restenosis of ramus. Given his severe aortic stenosis and left main lesion, he was deemed too high risk for percutaneous intervention. He was subquently referred to Dr. [**First Name (STitle) **] for off pump CABG, with the possibility of aortic valve replacement. After extensive discussion with the patient and his family, he agreed to proceed with high risk surgery. Past Medical History: Severe Aortic Stenosis, s/p aortic valvuloplasty [**2198-10-3**] Coronary Artery Disease, s/p BMS to Ramus in [**2196**] History of TIA [**2196**] ESRD requiring hemodialysis Pulmonary Hypertension Chronic Diastolic Congestive Heart Failure Hypertension Dyslipidemia Type II Diabetes Mellitus Anemia History of Bladder Calculi Renal Osteodystrophy Social History: Lives with: wife Occupation: retired Tobacco: denies ETOH: social Family History: No family history of early MI or sudden cardiac death Physical Exam: Admission Physical Exam: Pulse: 85 Resp: 18 O2 sat: 100%RA B/P Right: Left: 144/76 Height: 5'5" Weight: 64kg General: Elderly male in no acute distress Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [] Irregular [] Murmur III/VI SEM Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [] Neuro: Grossly intact [X] Left Upper Arm Fistula Pulses: Femoral Right: 2+ Left: 2+ DP Right: 2+ Left: 2+ PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Carotid Bruit Right:- Left:- Pertinent Results: Admits Labs: [**2199-2-7**] WBC-7.2 RBC-4.52* Hgb-10.5* Hct-32.0* Plt Ct-117* [**2199-2-7**] PT-12.7 PTT-25.3 INR(PT)-1.1 [**2199-2-7**] Glucose-187* UreaN-33* Creat-4.8*# Na-136 K-4.0 Cl-91* HCO3-33* [**2199-2-7**] ALT-22 AST-21 LD(LDH)-252* AlkPhos-57 Amylase-118* TotBili-0.6 [**2199-2-7**] Lipase-53 [**2199-2-8**] Albumin-2.5* [**2199-2-7**] %HbA1c-6.5* . [**2199-2-8**] Intraop TEE: PRE-CPB: The left atrium is mildly dilated. No thrombus is seen in the left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. There is mild symmetric left ventricular hypertrophy. Overall left ventricular systolic function is low normal (LVEF 50-55%). Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The aortic root and ascending aorta have focal calcifications. There are simple atheroma in the descending thoracic aorta. No thoracic aortic dissection is seen. A guidewire is seen in the descending aorta during femoral cannulation. There are three aortic valve leaflets. The aortic valve leaflets are severely thickened/deformed. There is critical aortic valve stenosis (valve area <0.8cm2). Mild (1+) aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is significant mitral annular calcification. There is prolapse of the anterior mitral leaflet with a posteriorly directly MR jet with coanda effect. At least moderate (2+) mitral regurgitation is seen. POST-CPB: A bioprosthetic valve is present in the aortic position. The leaflets appear to move normally. The peak gradient across the aortic valve is 29mmHg, the mean gradient is 12mmHg. There is a small paravalvular leak which improved with protamine administration. LV systolic function appeared severely depressed immediately after separation from bypass and slowly improved with administration of inotropes. Estimated EF after chest closure is 30-35%. The MR remains an eccentric jet with coanda effect. There is moderate to severe MR. There is no evidence of aortic dissection. . [**2199-2-15**] Postop Portable TTE: There is mild symmetric left ventricular hypertrophy. The left ventricular cavity size is normal. Overall left ventricular systolic function is low normal (LVEF 50%). The right ventricular free wall is hypertrophied. Right ventricular chamber size is normal. A bioprosthetic aortic valve prosthesis is present. The mitral valve leaflets are mildly thickened. An eccentric, posteriorly directed jet of Moderate (2+) mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] Due to the eccentric nature of the regurgitant jet, its severity may be significantly underestimated (Coanda effect). The tricuspid valve leaflets are mildly thickened. Moderate [2+] tricuspid regurgitation is seen. There is no pericardial effusion. . Brief Hospital Course: Mr. [**Known lastname 61512**] was admitted and underwent routine preadmission testing and hemodialysis. On [**2199-2-8**] he was taken to the operating room and underwent Aortic Valve Replacement(21mm Pericardial)/Two Vessel Coronary Artery Bypass Grafting(left internal mammary to left anterior descending artery, vein graft to ramus), and Aortic Endarterectomy. Cardiopulmonary Bypass time= 245 minutes. Cross Clamp time=180 minutes. Please see operative note for surgical details. He tolerated the procedure well and was transferred to the CVICU intubated and sedated on multiple pressors and inotropy to optimize cardiac function. Renal continued to follow postoperatively for his ESRD/dialysis needs. Mr.[**Known lastname 61512**] was kept intubated to protect his airway while maintaining stable hemodynamics until POD# 5. Pressors and inotropy were weaned off. Beta-blockers/Statin/Aspirin and diuresis was initiated. Postoperative atrial fibrillation was treated with Amiodarone and beta-blocker. Prolonged conversion pauses and tachy-brady syndrome became apparant. Electrophysiology was consulted and a temporary transvenous wire was placed. Beta-blockade and Amio were held to allow for recovery. Per EP these agents were slowly reintroduced and tolerated. Transvenous pacing wire was discontinued on [**2-19**]. Ultimately a permanent pacemaker was deemed unnecessary. Anticoagulation was initiated with Coumadin secondary to paroxysmal atrial fibrillation. Supratherapeutic INR was treated with holding anticoagulation, reversal with vitamin K and fresh frozen plasma, and gentle dosing with Coumadin was resumed. All lines and drains were discontinued in a timely fashion. Antibiotics for Clostridium Difficile was initiated. A Midline was placed for access. Speech and swallow was consulted for swallowing evaluation. POD# 11 he was transferred to the step down unit for further monitoring. Physical Therapy was consulted for evaluation of strength and mobility. Hemodialysis was conducted per Renal. He continued to progress and on POD# 17 he was cleared for discharge to [**Hospital **] [**Hospital **] Rehabilitation at [**Doctor Last Name 1263**] for further progress in strength, mobility, and daily activities. Dr.[**Last Name (STitle) 85178**] to follow Coumadin dosing/INR once Mr [**Known lastname 61512**] has been discharged from rehab. All follow up appointments were advised.Target INR 2.0-2.5 for A Fib. Medications on Admission: RENAL CAPS - 1 mg Capsule - 1 Capsule(s) by mouth every morning LABETALOL - 200 mg Tablet - 1 Tablet(s) by mouth every evening SIMVASTATIN - 40 mg Tablet - 1 Tablet(s) by mouth at night VALSARTAN [DIOVAN] - 160 mg Tablet - 1 Tablet(s) by mouth every morning (held on dialysis days) ASPIRIN - 81 mg Tablet, Chewable - 1 Tablet(s) by mouth every morning Discharge Medications: 1. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 2. B complex-vitamin C-folic acid 1 mg Capsule Sig: One (1) Cap PO DAILY (Daily). 3. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 4. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. metoprolol tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 6. amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. lanthanum 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 8. valsartan 80 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 9. Coumadin 1 mg Tablet Sig: Dose for goal INR of 2.0-2.5 Tablets PO once a day: dose today 1 mg only;all further dosing per rehab provider;Goal INR is 2.0-2.5 for atrial fibrillation. 10. Insulin sliding Scale and Daily Dose Please see attached sliding scale and daily insulin dose. 11. telemetry please keep on telemetry 12. vancomycin 125 mg Capsule Sig: One (1) Capsule PO every six (6) hours for 8 days: dosing through [**3-5**]; for a 2 week course. Discharge Disposition: Extended Care Facility: [**Hospital1 **] @ [**Hospital **] HOSPITAL Discharge Diagnosis: Aortic Stenosis, Coronary Artery Disease - s/p AVR and CABG Heavily Calcified Aorta End Stage Renal Disease, requires Hemodialysis Pulmonary Hypertension Chronic Diastolic Congestive Heart Failure Hypertension Dyslipidemia Type II Diabetes Mellitus Anemia Postop Sick Sinus Syndrome postop C. difficile Discharge Condition: Alert and oriented x3 nonfocal Ambulating with steady gait Incisional pain managed with oral analgesics Incisions: Sternal - healing well, no erythema or drainage Leg Right/Left - healing well, no erythema or drainage. 1+ Edema Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please resume hemodialysis on Tuesday/Thursday/Saturday Schedule. Please call with any questions or concerns [**Telephone/Fax (1) 170**] . **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** **VNA to draw daily INR and call/fax results to [**Hospital 197**] Clinic Followup Instructions: You are scheduled for the following appointments Surgeon: Dr. [**Last Name (STitle) **] Phone:[**Telephone/Fax (1) 170**] Date/Time:[**2199-3-18**] 1:00 Cardiologist: Dr. [**Last Name (STitle) 85179**] # [**Telephone/Fax (1) 7164**], appointment arranged for [**2199-3-5**] at 9am. Please call to schedule appointments with your Primary Care Dr. [**Last Name (STitle) 36361**] in [**5-7**] weeks Dr.[**Last Name (STitle) 85179**] to follow INR/Coumadin dosing via [**Hospital 197**] Clinic **once discharged from rehab. [**Hospital 197**] Clinic # [**Telephone/Fax (1) 85180**] daily labs: PT/INR for Coumadin ?????? indication: Paroxysmal Atrial Fibrillation Goal INR 2-2.5 Please Fax- [**Telephone/Fax (1) 7165**] Coumadin doses/INR levels to the [**Hospital 197**] Clinic upon discharge Results to phone fax [**Telephone/Fax (1) 7165**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2199-2-25**] ICD9 Codes: 5856, 9971, 4241, 4280, 4168, 2724, 2875
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Medical Text: Admission Date: [**2142-12-27**] Discharge Date: [**2143-1-1**] Date of Birth: [**2086-7-17**] Sex: M Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 922**] Chief Complaint: dyspnea on exertion Major Surgical or Invasive Procedure: [**12-27**] MVR (25/33 ON-X mechanical valve) History of Present Illness: 55 yo M with long history of myxomatous MV and chronic MR. Serial echos showed increased LA/LV dimensions and and severe MR and normal EF. Referred for surgery. Past Medical History: MR/MVP, Migraines, Ankylosing spondylitis, GI bleed (10 years ago), Hyperlipidemia, HTN, B hernia repair Social History: works as architect quit tobacco 27 years ago no etoh Family History: mother with MVR @ age 70 father with MI/CVA @ age 87 Physical Exam: NAD HR 70 RR 12 BP 118/70 NAD Lungs CTAB Heart RRR 3/6 Systolic Abdomen benign Extrem no edema, warm Superficial BLE aricosities Pertinent Results: [**2143-1-1**] 08:20AM BLOOD WBC-10.4 RBC-4.26* Hgb-13.0* Hct-36.3* MCV-85 MCH-30.4 MCHC-35.7* RDW-14.0 Plt Ct-385 [**2142-12-30**] 08:05AM BLOOD WBC-13.8* RBC-4.31* Hgb-13.0* Hct-37.5* MCV-87 MCH-30.1 MCHC-34.6 RDW-13.9 Plt Ct-327# [**2143-1-1**] 08:20AM BLOOD Plt Ct-385 [**2143-1-1**] 08:20AM BLOOD PT-30.7* PTT-52.6* INR(PT)-3.2* [**2142-12-31**] 07:35AM BLOOD PT-21.9* INR(PT)-2.1* [**2142-12-30**] 08:05AM BLOOD PT-20.8* PTT-33.7 INR(PT)-2.0* [**2142-12-29**] 07:10AM BLOOD PT-19.4* INR(PT)-1.9* [**2142-12-28**] 09:03AM BLOOD PT-14.4* PTT-27.8 INR(PT)-1.3* [**2143-1-1**] 08:20AM BLOOD Glucose-102 UreaN-25* Creat-0.7 Na-134 K-4.3 Cl-96 HCO3-30 AnGap-12 CHEST (PA & LAT) [**2142-12-31**] 9:16 AM CHEST (PA & LAT) Reason: r/o inf, eff [**Hospital 93**] MEDICAL CONDITION: 56 year old man s/p mvr REASON FOR THIS EXAMINATION: r/o inf, eff HISTORY: 56-year-old male status post mitral valve replacement. Evaluate for infection, effusion. COMPARISON: [**2142-12-12**]. CHEST, PA AND LATERAL: Retrosternal gas and a small air-fluid level are seen on the lateral view, probably related to recent sternotomy. The left basilar atelectasis has improved. However, there is a persistent small left pleural effusion. There is also a probable small right pleural effusion. The lung fields are clear. Cardiomediastinal contours are normal. Sternotomy wires and artificial mitral valve are unchanged. IMPRESSION: 1. Retrosternal gas and air-fluid level, probably related to recent sternotomy. 2. Persistent small left pleural effusion and probable small right pleural effusion. [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 3887**]TTE (Complete) Done [**2142-12-27**] at 4:01:56 PM PRELIMINARY Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) 177**] [**Hospital Unit Name 927**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Outpatient DOB: [**2086-7-17**] Age (years): 56 M Hgt (in): BP (mm Hg): / Wgt (lb): HR (bpm): BSA (m2): Indication: Left ventricular function. Mitral valve disease. Mitral valve prolapse. Preoperative assessment. ICD-9 Codes: 424.1, 424.0 Test Information Date/Time: [**2142-12-27**] at 16:01 Interpret MD: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 168**], MD Test Type: TTE (Complete) Son[**Name (NI) 930**]: Doppler: Full Doppler and color Doppler Test Location: Echo Lab Contrast: None Tech Quality: Adequate Tape #: Machine: Echocardiographic Measurements Results Measurements Normal Range Findings RIGHT ATRIUM/INTERATRIAL SEPTUM: No ASD or PFO by 2D, color Doppler or saline contrast with maneuvers. LEFT VENTRICLE: Moderately dilated LV cavity. [Intrinsic LV systolic function likely depressed given the severity of valvular regurgitation.] RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal ascending, transverse and descending thoracic aorta with no atherosclerotic plaque. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). Mild to moderate ([**1-30**]+) AR. Eccentric AR jet directed toward the anterior mitral leaflet. MITRAL VALVE: Mildly thickened mitral valve leaflets. Moderate/severe MVP. Severe (4+) MR. TRICUSPID VALVE: Normal tricuspid valve leaflets with trivial TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. Brief Hospital Course: He was taken to the operating room on [**12-27**] where he underwent a mechanical MVR. He was transferred to the ICU in stable condition. He was extubated later that day. He was transferred to the floor on POD #1. He was started on coumadin for his mechanical mitral valve. He had some atrial fibrillation for which his beta blocker was increased and he converted to sinus rhythm. He did well postoperatively. He awaited a therapeutic INR and was ready for discharge on POD #5. Dr. [**Last Name (STitle) 3888**] (Spoke to [**Doctor First Name **] at his office) will follow his coumadin. Medications on Admission: Remicade Q6W, Folate 1mg QD, Methotrexate 10mg QW, Univasc 15mg QD, Zantac 150 QD, Lipitor 10mg [**Last Name (LF) 244**], [**First Name3 (LF) **] 81 QD, MVI 1 QD Vit E 1000 IU QD, Fish oil 1000mg QD, Fioricet 50-325-40 1-2PRN, Celebrex 100mg QD Discharge Medications: 1. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 2. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*0* 3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 4. Folic Acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 5. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*60 Tablet(s)* Refills:*0* 6. Coumadin 5 mg Tablet Sig: One (1) Tablet PO once a day: Check INR [**1-3**] with results to Dr. [**Last Name (STitle) 3888**]. Disp:*30 Tablet(s)* Refills:*0* 7. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 8. Moexipril 7.5 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 9. Multi-Vitamin HP/Minerals Capsule Sig: One (1) Capsule PO once a day. 10. Vitamin E 1,000 unit Capsule Sig: One (1) Capsule PO once a day. 11. Fish Oil 1,000 mg Capsule Sig: One (1) Capsule PO once a day. 12. Propoxyphene N-Acetaminophen 100-650 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours) as needed. Disp:*50 Tablet(s)* Refills:*0* 13. Potassium Chloride 20 mEq Packet Sig: One (1) Packet PO Q12H (every 12 hours) for 5 days. Disp:*10 Packet(s)* Refills:*0* 14. Furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 5 days. Disp:*10 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: MR/MVP, Migraines, Ankylosing spondylitis, GI bleed (10 years ago), Hyperlipidemia, HTN, B hernia repair Discharge Condition: Good. Discharge Instructions: Call with fever, redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week. Shower, no baths, no lotions, creams or powders to incisions. No lifting more than 10 pounds or driving until follow up with surgeon. Coumadin to be followed by Dr. [**Last Name (STitle) 3888**]. Have INR checked [**1-3**] with results called to Dr. [**Last Name (STitle) 3888**]. Goal INR 2.5-3.5 for mechanical mitral valve. Followup Instructions: Dr. [**Last Name (STitle) 3888**] 2 weeks Dr. [**Last Name (STitle) 914**] 4 weeks Dr. [**Last Name (STitle) **] 2 weeks Already scheduled appointments: [**First Name11 (Name Pattern1) 177**] [**Last Name (NamePattern4) 2310**], MD (Rheumatologist) Phone:[**Telephone/Fax (1) 2226**] Date/Time:[**2143-4-22**] 5:00 Completed by:[**2143-1-1**] ICD9 Codes: 4240, 4019, 2724
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Medical Text: Admission Date: [**2130-12-5**] Discharge Date: [**2130-12-19**] Date of Birth: [**2056-4-5**] Sex: F Service: TRANSPLANT SURGERY HISTORY OF PRESENT ILLNESS: Mrs. [**Known lastname 1557**] is a 74 year-old female with a history of ulcerative colitis, and primary sclerosing cholangitis resulting in cirrhosis of the liver who presented to the hospital for liver transplantation. Her most recent hospital admission had been in [**2130-10-15**] for cholangitis. The patient currently denies any fevers or chills, nausea, vomiting, diarrhea, or constipation. She also denies any changes in her bowel habits, weight loss or cough. She denies any rhinorrhea, sore throat, earaches, shortness of breath, chest pain, bright red blood per rectum, dysuria, vaginal infections or rashes. PAST MEDICAL HISTORY: 1. Ulcerative colitis. 2. Primary sclerosing cholangitis resulting in cirrhosis. 3. Hepatitis B. 4. Cholangitis. 5. Anemia. 6. Anxiety disorder. 7. Status post total abdominal hysterectomy. MEDICATIONS ON ADMISSION: 1. Ursodiol. 2. Asacol. 3. Folic acid. 4. Levaquin. 5. Flagyl. 6. Lopresor. 7. Tums. 8. Multivitamin. 9. Lasix. ALLERGIES: Penicillin, which causes rash and swelling and Azulfidine, which causes a fever. SOCIAL HISTORY: The patient denies any alcohol, tobacco or drugs. PHYSICAL EXAMINATION ON ADMISSION: The patient was found to have a temperature of 98.4 degrees Fahrenheit with a heart rate of 80 and a blood pressure of 112/68. She was in no acute distress and alert and oriented. Her pupils are equal, round and reactive to light and accommodation. Her extraocular movements intact. She was found to have some scleral icterus and her mucous membranes are moist. Her neck was supple with no lymphadenopathy. Heart showed a regular rate and rhythm with a grade 2 out of 6 systolic ejection murmur. Her lungs were clear to auscultation bilaterally with no crackles, wheezes or rales. Her abdomen was soft, nontender and mildly distended with an evident umbilical hernia. She had a well healed infraumbilical midline surgical scar. Her extremities were warm and well perfuse with 2+ palpable radial and pedal pulses. Her skin was notable for being jaundiced. PERTINENT STUDIES: Her electrocardiogram showed normal sinus rhythm and her chest x-ray was unremarkable and her lung fields were clear. Her hematocrit at the time of admission was 43.6. Her ALT was 91, AST 249, alkaline phosphatase 670, and her total bilirubin was 10.5. HOSPITAL COURSE: Mrs. [**Known lastname 1557**] was taken to the Operating Room on [**2130-12-5**] where she underwent orthotopic liver transplant along with Roux-en-Y hepaticojejunostomy. Please refer to the dictated operative note for full details of this procedure. She tolerated the procedure well and was transferred in stable condition to the Surgical Intensive Care Unit. She remained intubated on the night of the operative day with a slow ventilator wean being started. She was started on Mycophenolate, Cyclosporin in Solu-Medrol. Her liver function tests began to trend downward. She was seen in consultation by the Infectious Disease and [**Hospital **] Clinic consult services for management of her postoperative antibiotics and her postoperative blood sugars. She was extubated on postoperative day number two, which she tolerated well and without incident. She was also transfused 3 units of fresh frozen platelets to help correct her coagulopathy. She was subsequently started on total parenteral nutrition so that she would be able to maintain her nutritional balance during the postoperative period. On postoperative day number three she was doing quite well and deemed stable and ready for transfer to the regular floor from the Intensive Care Unit. On postoperative day number four the patient was started on tube feeds via nasal jejunal tube. The patient continued to improve, increasing strength and mobility and continuing to show downward trends in her liver function enzymes. Her total bilirubin at the time had decreased to 2.3. She was transfused 2 units of packed red blood cells on postoperative day number seven for a hematocrit of 25.8 to which she appropriately responded. She continued to improve and gain strength while on the floor. Her nutritional status continued to improve her and hematocrit remained stable. She began to slowly redevelop her appetite. She tolerated oral intake without any difficulty, and tube feeds were cycled to be overnight, which she tolerated well. Her liver function tests continued to improve and by postoperative day number twelve her total bilirubin was 1.1. Her hematocrit remained stable at that time at 36%. She was actively diuresed at that time using Lasix to which she responded well and appropriately. One of her [**First Name8 (NamePattern2) 1661**] [**Last Name (NamePattern1) 1662**] drains was removed at that time as well. On postoperative day number fourteen she was deemed stable and ready for discharge to home. It was planned that she would be discharged home with visiting nurses so that they would be able to assist her in the rather immediate postoperative period. CONDITION ON DISCHARGE: Stable. DISCHARGE STATUS: Home with visiting nurses. DISCHARGE DIAGNOSES: 1. Status post orthotopic liver transplant on [**2130-12-5**]. 2. Primary sclerosing cholangitis resulting in cirrhosis. 3. Ulcerative colitis. 4. Hepatitis B. 5. Chronic anemia. 6. Status post umbilical hernia repair. MEDICATIONS ON DISCHARGE: 1. Lasix 20 mg po q.d. 2. Calcium carbonate 500 mg po q.i.d. 3. Mycophenolate mofetil 1000 mg po b.i.d. 4. Valgancyclovir 450 mg po q day. 5. Prednisone 15 mg po q.d. 6. Neoral 100 mg po b.i.d. 7. Percocet one to two tablets po q 6 hours prn for pain. 8. Protonix 40 mg po q 12 hours. FOLLOW UP: Follow up was scheduled for the following week with the transplant center and Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 707**], M.D.,Ph.D. 02-366 Dictated By:[**First Name3 (LF) 13689**] MEDQUIST36 D: [**2131-4-20**] 09:21 T: [**2131-4-20**] 10:04 JOB#: [**Job Number 103603**] & [**Numeric Identifier 103604**] ICD9 Codes: 5715, 2859
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Medical Text: Admission Date: [**2185-4-20**] Discharge Date: [**2185-4-23**] Date of Birth: [**2131-3-30**] Sex: M Service: MEDICINE Allergies: Benadryl Allergy / Ambisome / Flomax Attending:[**Last Name (NamePattern1) 4377**] Chief Complaint: renal failure Major Surgical or Invasive Procedure: None History of Present Illness: 53 year old man with h/o AML s/p allo cord transplant (now day +516) complicated by chronic GVHD with arthritis, BOOP, who presented to the BMT floor from clinic with worsening renal function(2.3) and hyperkalemia, and worsening odynophagia on [**2185-4-20**]. On arrival to the BMT floor, as he was transitioning into the bed, he became mom[**Name (NI) 11711**] unresponsive to verbal stimuli and physical stimuli. No jerking movements or incontience were noted. A code blue was called. On arrival of the code team, BP 124/80, Hr 70s, satting 100% on 5L NC. He was responsive to verbal stimuli and answering questions appropriately. He does not recall only seconds of the entire episode; wife notes that his eyes were closed. 1 amp of D50, 10units regular insulin, and abuterol nebs were given for known hyperkalemia. An EKG was obtained which showed isolated peaked T waves. CXR showed no interval change when accounted for technique from prior in the day. During this time, he did experience a headache that was located in the forhead, temples and described as a pressure / squeeze that he has experienced with prior tension headaches. He was then transferred to the [**Hospital Unit Name 153**] for further cardiac monitoring. During this time, he was also noted to have some tremors in hands and legs, but this was not associated with any loss of consciousness or loss of consciousness. These episodes will occur for only seconds at a time and tend to occur when he is holding objects in his hands / intention tremor. He has not had formal workup for this, but there was no clear etiology to this tremor (which has been present intermittently over the past 2 years) to date. His wife also relays the presence of intermittent episodes of unresponsiveness over the past x2 years ago at a frequency of 1-2x per week lasting only seconds at a time. This has not been formally evaluated to date. Past Medical History: Past Medical History (taken from previous notes) 1) AML, M5b diagnosed 07/[**2182**]. - Received induction chemotherapy with 7 + 3(ARA-C and idarubicin)-[**2182-7-23**] until [**2182-8-22**]. The patient achieved a CR after this therapy. - High-dose ARA-C x 2 cycles from [**2182-8-28**] until [**2182-9-27**]. - Pt found to have relapsing dz and reinduced with Mitoxantrone and Ara-C [**Date range (1) 39624**]. Pt was found to have relapsing dz on bone marrow bx [**2183-9-2**] with 16% blasts, then was admitted between [**Date range (1) 39625**] for Mitoxantrone, Etopiside and Cytarabine. - s/p myeloablative sequential unrelated double cord blood transplant, now D+334. Day 100 bone marrow biopsy showed no siagnostic morphologic features of involvement by acute leukemia, with cytogenetics revealing karyotype 46XX, consistent with that of female donor. 2) hepatic insufficiency due to secondary hemochromatosis and steatosis 3) Aspergillosis of the sinus/nares on voriconazole. 4) Bacillary angiomatosis 5) Acute appendicitis deep into his nadir during transplant that was successfully treated with daptomycin, meropenem, levofloxain and metronidazole 6) Incidental HHV6 IgG-positive, without disease 7) Hx of post chemo-induced cardiomyopathy; TTE [**6-19**] with preserved EF. 8) Sarcoid - diagnosed in [**2172**], received intermittent steroids 9) GERD 10) HTN 11) Hypercholesterolemia 12) s/p cholecystectomy in [**6-/2180**] complicated by sinus tract to the abdominal wall 13) Hepatic and splenic microabscesses/candidiasis ([**8-/2182**]) 14) BOOP requiring extended ICU/hospital course in [**3-/2184**] and home oxygen 15) Peripheral neuropathy Social History: Formerly worked as auto mechanic, now disabled econdary to AML and GVHD. Lives with wife, teenage son. Past tobacco use, but non currently. Family History: Father- CAD s/p CABG. Type II Diabetes Mother- Type [**Name (NI) **] Diabetes. Multiple paternal uncles with heart disease. 2 siblings in good health. Physical Exam: GENERAL: Middle-aged, Cushingoid, overweight man in NAD HEENT: EOMI, PERRLA, mucous membranes moist, no cervical LAD, no JVD, neck supple w/out tenderness CARDIAC: RRR no m/g/r, S1, S2 nl CHEST: kyphotic LUNG: few bilateral crackles at bases, no wheezes, rhonchi ABDOMEN: obese, soft, NT, ND, unable to appreciate HSM [**2-14**] body habitus, no rebound or guarding EXT: warm, + bilateral 2+ pitting edema to knees, DP+ bilaterally, no cyanosis - L elbow medial epicondyle tenderness w/ effusion, no joint erythema or effusion NEURO: CNII-XII intact, motor symmetric strength, hyperesthetic sensation bilateral LE/feet, no evidence of toe nail erythema DERM: ecchymoses on abdomen [**2-14**] insulin, no other lesions. Psych: Mood liabile, affect appropriate, intermittently tearing up to labs draws, movement to ICU Pertinent Results: CBC: [**2185-4-20**] 11:11AM BLOOD WBC-5.3 RBC-2.84* Hgb-9.3* Hct-29.3* MCV-103* MCH-32.7* MCHC-31.7 RDW-15.2 Plt Ct-101* [**2185-4-23**] 06:10AM BLOOD WBC-2.5* RBC-2.79* Hgb-9.2* Hct-29.1* MCV-104* MCH-33.1* MCHC-31.7 RDW-15.3 Plt Ct-88* [**2185-4-20**] 11:11AM BLOOD Neuts-84.9* Lymphs-4.7* Monos-7.5 Eos-2.9 Baso-0 [**2185-4-23**] 06:10AM BLOOD Neuts-70.4* Lymphs-11.9* Monos-13.8* Eos-3.7 Baso-0.2 Chemistries: [**2185-4-20**] 11:11AM BLOOD Glucose-156* UreaN-91* Creat-2.3* Na-137 K-5.5* Cl-103 HCO3-22 AnGap-18 [**2185-4-20**] 07:49PM BLOOD Glucose-108* UreaN-74* Creat-2.1* Na-136 K-4.8 Cl-126* HCO3-18* AnGap--3* [**2185-4-21**] 04:18AM BLOOD Glucose-112* UreaN-83* Creat-2.2* Na-137 K-5.7* Cl-108 HCO3-23 AnGap-12 [**2185-4-21**] 08:18AM BLOOD Na-139 K-6.8* Cl-109* [**2185-4-21**] 08:18AM BLOOD Na-142 K-5.6* Cl-110* [**2185-4-21**] 02:12PM BLOOD Na-140 K-5.7* Cl-108 [**2185-4-22**] 05:14AM BLOOD Glucose-88 UreaN-72* Creat-2.0* Na-142 K-4.8 Cl-108 HCO3-24 AnGap-15 [**2185-4-23**] 06:10AM BLOOD Glucose-88 UreaN-61* Creat-1.9* Na-142 K-4.0 Cl-108 HCO3-26 AnGap-12 LFTs: [**2185-4-20**] 11:11AM BLOOD ALT-35 AST-28 LD(LDH)-246 AlkPhos-189* TotBili-0.2 [**2185-4-21**] 04:18AM BLOOD ALT-33 AST-27 CK(CPK)-17* AlkPhos-168* TotBili-0.1 Cardiac Enzymes: [**2185-4-20**] 06:29PM BLOOD CK-MB-3 cTropnT-<0.01 [**2185-4-21**] 04:18AM BLOOD CK-MB-3 cTropnT-<0.01 [**2185-4-20**] 11:11AM BLOOD Calcium-8.4 Phos-3.9 Mg-2.6 [**2185-4-23**] 06:10AM BLOOD Calcium-8.3* Phos-3.4 Mg-2.2 Antibody Titers: [**2185-4-20**] 11:11AM BLOOD IgG-412* IgA-54* IgM-17* ABG: [**2185-4-20**] 06:30PM BLOOD Type-ART pO2-134* pCO2-39 pH-7.38 calTCO2-24 Base XS--1 Intubat-NOT INTUBA [**2185-4-20**] 06:30PM BLOOD Glucose-442* Lactate-1.7 Na-132* K-6.5* Cl-100 [**2185-4-20**] 06:30PM BLOOD freeCa-1.13 Blood and urine cultures from [**4-20**] negative. Head CT ([**4-21**]): IMPRESSION: No acute intracranial hemorrhage. Paranasal sinus disease in the left maxillary and sphenoid sinus, as described above. CXR: ([**4-21**]) : FINDINGS: Allowing for differences in technique there has been no interval change in appearance of the chest since the recent study with no acute cardiopulmonary abnormality identified. Brief Hospital Course: Summary of Hospital Course: 53 year old man with h/o AML s/p allo cord transplant (day +516 on admission) complicated by chronic GVHD with arthritis, BOOP, who now presents to clinic with acute on chronic renal failure. Hospital course complicated by syncopal episode the day of admission resulting in Code Blue and hyperkalemia, requiring brief ICU admission. #Syncope: Patient had syncopal episode the day of admission, where he was unresponsive for ~1 minute while lying flat. Unclear etiology, possible due to orthostatic hypotension (noted to have orthostatic physiology in the ICU and on the floor) vs arrythmia vs seizure activity. Of note, (per wife), patient has had many of these episodes recently (~2 years, ~1-2 episodes per week). Patient denied any heralding symptoms and was not post-ictal afterwards, but was noted to have a resting tremor in the MICU. His history of tremor is not consistent wtih seizure activity. It appears to be an intention tremor that gets worse when holding on to objects and is low in amplitude while high in frequency, bilateral and not associated with change in consciousness or incontinence. Noted to be hyperkalemic during the code, given amp D50 and 10 U insulin peri-code and kayexalate in the ICU, with drop in potassium down to 4.0 on discharge. Neurology consulted on patient who recommended EEG and possible midodrine or fluorinef support. Held patient's lisinopril, but continued him on his carvedilol 12.5 mg PO BID as this was recently decreased in the setting of light headedness/dizziness by his cardiologist on [**3-21**], although informed him not to take the medication if he had any pre-syncopal symptoms. Medication can be decreased at the discretion of his cardiologist. Patient had no further syncopal episodes or events on telemetry in the ICU or on the floor. Neurology was consulted who recommended an EEG, possible blood pressure support with midodrine or fluorinef, at the discretion of the patient's outpatient oncologist and nephrologist. Was noted to not have any telemetry events or syncopal events while ambulating, with appropriate increase in pulse and blood pressure. and requested to be discharged with outpatient syncope work-up. Outpatient TTE, EEG, carotid U/S, and holter monitering were arranged prior to discharge. #Acute on chronic renal failure: Noted to have mildly elevated Cre to 2.3 in clinic the day of admission. Creatine has fluctuated over the past two years, with several episodes of acute renal failure while hospitalized. Followed by nephrology as an outpatient. Per outpatient notes, etiology of CKD thought to be [**2-14**] ATN that has not resolved, medication effect in the setting of bactrim, voriconazole, lisinopril, or AIN. Less likely due to AML infiltration of kidneys (very rare) or chemotherapy. Unlikely progressive glomerular disease given patient only has scant proteinuria. Patient has refused renal biopsy in the past. Baseline Cre has been 1.4-2.0 over the past few months. Lisinopril was held. Cellcept was decreased to [**Telephone/Fax (3) 39636**] as GFR was ~30. Oral fluid intake encouraged. Renal failure resolved to baseline creatinine (1.9) on discharge. Renal did not have chance to formally consult on patient since he requested discharge, but stated informally that they had no further recommendations as an inpatient since he was refusing renal biopsy, and he could be accommodated very soon in renal clinic with his current outpatient nephrologist. #Congestive Heart Failure: Euvolemic to mildly hypervolemic on exam. Requested TTE as outpatient. Continued home meds including aspirin, beta-blocker. Held ACEI due to hyperkalemia. #AML: allo SCT +519 days. counts stable. continued prophylactic medications. Arranged to follow up with outpatient oncologist. #Epigastric discomfort: Gastritis, likely in setting of prednisone. Patient has tried and failed Nexium, reporting it has not helped his gastritis for 3 months. Relieved with protonix, which was added to med list on discharge. Can obtain prior authorization from PCP [**Name Initial (PRE) 5564**]. Medications on Admission: -Acyclovir 400 [**Hospital1 **] -Carvedilol 12.5 [**Hospital1 **] -Cyanocobalamin 1000mcg IM 1xmonth -Nexium 20mg PO BID -Furosemide 40mg PO BID -Gabapentin 300 cap 3caps tid -Insulin Novolog 4xday, sliding scale -Glargine 10u qhs -Lisinopril 5mg daily -Montelukast 10mg PO daily -Morphine 15mg PO q6-8 hrs prn pain -MMF 500mg TID -Nitro 0.3mg tab SL -zofran 4-8mg q8 hrs prn nausea -Oxycodone SR 10mg PO BID -Prednisone 20mg daily -Bactrim 800-160 MWF -Voriconazole 200mg tab, 1.5 tab q12h -AA Magnesium Sulfate OTC 1tab daily -Vit C 500mg tab daily -Aspirin 81 mg tab Enteric coated -Cal Carb 1000mg tab [**Hospital1 **] -Vit D3 400u daily -Hexavitamin 1 tab daily -Miconazole 2% powder to affected areas [**Hospital1 **] -Thiamine 50mg PO daily -Docusate 100mg PO BID -Senna 1 tab [**Hospital1 **] prn Discharge Medications: 1. Acyclovir 200 mg Capsule [**Hospital1 **]: Two (2) Capsule PO Q12H (every 12 hours). 2. Gabapentin 300 mg Capsule [**Hospital1 **]: One (1) Capsule PO three times a day. 3. Montelukast 10 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 4. Prednisone 20 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 5. Furosemide 40 mg Tablet [**Hospital1 **]: One (1) Tablet PO BID (2 times a day). 6. Docusate Sodium 100 mg Capsule [**Hospital1 **]: One (1) Capsule PO BID (2 times a day). 7. Senna 8.6 mg Tablet [**Hospital1 **]: One (1) Tablet PO BID (2 times a day). 8. Trimethoprim-Sulfamethoxazole 160-800 mg Tablet [**Hospital1 **]: One (1) Tablet PO 3X/WEEK (MO,WE,FR). 9. Oxycodone 10 mg Tablet Sustained Release 12 hr [**Hospital1 **]: One (1) Tablet Sustained Release 12 hr PO Q12H (every 12 hours). 10. Morphine 15 mg Tablet [**Hospital1 **]: One (1) Tablet PO every 6-8 hours as needed for pain. 11. Voriconazole 200 mg Tablet [**Hospital1 **]: 1.5 Tablets PO Q12H (every 12 hours). 12. Calcium Carbonate 500 mg Tablet, Chewable [**Hospital1 **]: Two (2) Tablet, Chewable PO BID (2 times a day). 13. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) [**Hospital1 **]: One (1) Tablet, Delayed Release (E.C.) PO every twenty-four(24) hours. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 14. Aspirin 81 mg Tablet, Chewable [**Hospital1 **]: One (1) Tablet, Chewable PO DAILY (Daily). 15. Thiamine HCl 100 mg Tablet [**Hospital1 **]: 0.5 Tablet PO DAILY (Daily). 16. Nitroglycerin 0.3 mg Tablet, Sublingual [**Hospital1 **]: One (1) Tablet, Sublingual Sublingual PRN (as needed) as needed for chest pain. 17. Nystatin 100,000 unit/mL Suspension [**Hospital1 **]: Five (5) ML PO QID (4 times a day). 18. Carvedilol 12.5 mg Tablet [**Hospital1 **]: One (1) Tablet PO twice a day: HOLD if patient loses consciousness or has systolic blood pressure less than 100. 19. Hexavitamin Tablet [**Hospital1 **]: One (1) Tablet PO once a day. 20. Vitamin D-3 400 unit Tablet [**Hospital1 **]: One (1) Tablet PO once a day. 21. Vitamin C 500 mg Tablet [**Hospital1 **]: One (1) Tablet PO once a day. 22. Insulin Aspart 100 unit/mL Solution [**Hospital1 **]: One (1) as directed Subcutaneous four times a day: per sliding scale. 23. Insulin Glargine 100 unit/mL Solution [**Hospital1 **]: One (1) syringe Subcutaneous at bedtime: 10 Units at bedtime. 24. Zofran 4 mg Tablet [**Hospital1 **]: 1-2 Tablets PO every eight (8) hours as needed for nausea. 25. Mycophenolate Mofetil 250 mg Capsule [**Hospital1 **]: Two (2) Capsule PO BID (2 times a day). 26. Mycophenolate Mofetil 250 mg Capsule [**Hospital1 **]: One (1) Capsule PO DAILY (Daily): please administer at noon . Discharge Disposition: Home Discharge Diagnosis: 1' Diagnosis Acute on Chronic Renal Failure Hyperkalemia Syncope 2' Diagnosis Congestive Heart Failure Hypertension Acute Myelogenous Leukemia Discharge Condition: afebrile, hemodynamically stable, without syncopal episode x48 hours Discharge Instructions: You were admitted with a diagnosis of acute on chronic renal failure, high potassium levels, and syncope. Your kidney function resolved back to it's baseline, and your potassium levels normalized with some kayexalate. We wanted to run some lab tests to evaluate the reason for your syncope, but you felt well and wanted to go home and have the testing done as an outpatient. Please take your medications as directed - Please hold your lisinopril as this medication can cause elevated potassium levels. Please restart at the discretion of your PCP or cardiologist. - Your Cellcept was decreased as noted on the medication list. - We started you on protonix for your heart burn in place of the Nexium. You may need prior authorization from your primary care physician or oncologist for this medications. Please return to the hospital if you have fever > 100.4, any further fainting episodes, chest pain, palpitations, or any other symptoms not listed here concerning enough to warrant physician [**Name Initial (PRE) 2742**]. Followup Instructions: Provider: [**Name Initial (NameIs) 455**] 5-HEM ONC 7F [**Name Initial (NameIs) **]/ONCOLOGY-7F Date/Time:[**2185-4-25**] 9:00 Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4380**], MD Phone:[**Telephone/Fax (1) 3237**] Date/Time:[**2185-4-25**] 2:00 Provider: [**Name10 (NameIs) 3310**],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **]/ONCOLOGY-7F Date/Time:[**2185-4-25**] 2:00 with your cardiologist as an outpatient. The phone number is [**Telephone/Fax (1) 62**]. with renal as an outpatient. Please call ([**Telephone/Fax (1) 773**] to make an appointment. to get your trans-thoracic echocardiogram, your carotid ultrasound, your holter monitoring, and your EEG. They have all been ordered and your outpatient oncologist should follow up on the results. - Please call [**Telephone/Fax (1) 327**] to schedule your carotid ultrasound. - Please call [**Telephone/Fax (1) 62**] to schedule your trans-thoracic ultrasound. - Please call [**Telephone/Fax (1) 3104**] to schedule your holter monitoring. - Please call [**Telephone/Fax (1) 5285**] to schedule your EEG. Completed by:[**2185-4-25**] ICD9 Codes: 5849, 2767, 5859, 2720
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Medical Text: Admission Date: [**2109-3-9**] Discharge Date: [**2109-3-9**] Service: MICU HISTORY OF PRESENT ILLNESS: This is an 84-year-old gentleman sent from [**Hospital3 **] with advanced Parkinson disease who developed acute respiratory distress and was found to have a low oxygen saturation at rehabilitation. Vital signs at rehabilitation were a heart rate of 72, blood pressure was 140/60, respiratory rate was 24, and temperature was 100.2. In the Emergency Department, the patient received Lasix secondary to rales, and a head computed tomography was ordered for a change in mental status. Antibiotics were also given for a question of aspiration pneumonia. The patient was started on levofloxacin and Flagyl. In the Emergency Department, the patient suddenly became hypotensive and hypoxic requiring intubation and a dopamine drip. PAST MEDICAL HISTORY: (Past medical history is significant for) 1. Advanced Parkinson disease. 2. Status post left pallidotomy in [**2102-2-20**]. 3. Upper gastrointestinal bleed in [**2107-4-22**]. 4. Constipation. 5. Benign prostatic hypertrophy; status post transurethral resection of prostate in [**2090**]. 6. Left rotator cuff tear. 7. Left distal radius fracture. 8. Low back pain. 9. Weight loss. 10. Anemia. ALLERGIES: The patient is allergic to ADVIL and VALPROATE. MEDICATIONS ON ADMISSION: Medications at the nursing home consisted of Tylenol, calcium, vitamin D, Sinemet, Cardizem, Imdur, Mirapex, Seroquel, Senna, Sorbitol, and Neurontin. SOCIAL HISTORY: The patient is a holocaust survivor. He is married with children in the area. FAMILY HISTORY: Family history was noncontributory. PHYSICAL EXAMINATION ON PRESENTATION: Physical examination revealed temperature was 98.2, heart rate was 114, blood pressure was 94/26, respiratory rate was 26, and oxygen saturation was 100% on 100% FIO2. In general, he was a thin cachectic elderly white male responsive only to noxious stimuli. Head, eyes, ears, nose, and throat examination revealed pupils were equal, round, and reactive to light and accommodation. Sclerae were anicteric. The oropharynx was dry. Neck examination revealed there was no jugular venous distention. No lymphadenopathy. The neck was supple. The chest had poor inspiratory effort but clear to auscultation otherwise. Heart examination revealed normal first heart sounds and second heart sounds. A 2/6 systolic murmur. The abdomen was soft and nontender. No hepatosplenomegaly. There was a right easily reducible inguinal hernia. Extremities were warm with good bilateral pulses and with no edema. Neurologic examination revealed pupils were 3 mm and reactive. The patient moved all extremities but was unable to cooperate with examination. PERTINENT LABORATORY VALUES ON PRESENTATION: Laboratories on admission revealed a white blood cell count was 4.5, hematocrit was 32.8, and platelets were 423. Partial thromboplastin time was 27.3 and INR was 1.3. Sodium was 138, potassium was 4.5, chloride was 99, bicarbonate was 20, blood urea nitrogen was 69, creatinine was 2.1, and blood glucose was 84. Creatine kinase was 199. Troponin was less than 0.3. His blood gas once intubated was 7.07, PCO2 was 61, and a PO2 was 170; and this was on 100% FIO2. PERTINENT RADIOLOGY/IMAGING: Electrocardiogram showed a normal sinus rhythm at 90 with no acute ischemic changes. A chest x-ray showed diffuse bilateral infiltrates which was later read as metastatic disease. A head computed tomography showed no acute process but had old left-sided burr holes. HOSPITAL COURSE: The patient was admitted to the Medical Intensive Care Unit for his respiratory failure and shock. While in the Intensive Care Unit, the patient remained intubated and was continued on his levofloxacin and Flagyl with the addition of ceftriaxone for a question of aspiration pneumonia and sepsis. The patient became increasingly hypotensive requiring vasopressin, dopamine, and norepinephrine drips. The patient remained persistently acidemic. The patient's condition continued to decline. At approximately 7 p.m. on the day of admission, the patient went into asystole and received cardiopulmonary resuscitation, atropine, and epinephrine with a transient return of his heart rate and blood pressure; however, this once again deteriorated and the patient again went into asystole. He was continued with cardiopulmonary resuscitation, atropine, and epinephrine without a response. The patient expired at [**2045**], and family members were notified. The case was declined by Medical Examiner, and the family opted not to have an autopsy performed. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 4561**] Dictated By:[**Last Name (NamePattern1) 13577**] MEDQUIST36 D: [**2109-3-10**] 01:03 T: [**2109-3-12**] 18:14 JOB#: [**Job Number 97474**] ICD9 Codes: 5070, 5849, 0389, 2762, 4280
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Medical Text: Admission Date: [**2153-8-12**] Discharge Date: [**2153-8-15**] Service: CCU HISTORY OF PRESENT ILLNESS: The patient is a 77 year-old woman status post three vessel coronary artery bypass graft who presented to outside hospital on [**2153-8-12**] after awakening from sleep with 7 out of 10 substernal chest pain associated with nausea and diaphoresis. No electrocardiogram changes were noted and cardiac enzymes were cycled and remained flat. The patient was then transferred to [**Hospital1 190**] for cardiac catheterization. Upon arrival the patient was denying any chest pain, shortness of breath, nausea or diaphoresis. However, overnight on [**8-12**] the patient developed one episode of crushing 10/10 chest pain worse ever associated with shortness of breath. The pain was resolved with two sublingual nitroglycerin tabs. At the time the patient's blood pressure was elevated to 190/70 and an electrocardiogram showed lateral ST depressions. Cardiac catheterization was performed the following morning. Cardiac catheterization showed reocclusion of a saphenous vein graft to obtuse marginal graft, which was stented. The native obtuse marginal was attempted to be stented also, but had no reflow. The patient subsequently developed chest pain and electrocardiogram changes while in the catheterization laboratory, which improved with nitroglycerin, 2 liters intravenous fluid bolus and an intraaortic balloon pump was placed. Once stabilized a Swan was floated, which demonstrated a PA diastolic pressure of 38. The patient was then aggressively diuresed and transferred to the Coronary Care Unit Service. PAST CARDIAC HISTORY: 1. Three vessel coronary artery bypass graft in [**2143**] with left internal mammary coronary artery to left anterior descending coronary artery, saphenous vein graft to right coronary artery, saphenous vein graft to obtuse marginal. 2. Percutaneous intervention with a stent to the right coronary artery in [**2149**]. 3. Catheterization [**2151-7-15**], which showed saphenous vein graft to obtuse marginal take off with no intervention taken place. 4. Catheterization [**2151-10-15**], saphenous vein graft to obtuse marginal roto with no reflow and TIMI two reflow. 5. TTE in [**2151-8-14**] left ventricular hypertrophy with global hypokinesis and severely decreased systolic function, mild AS. 6. Persantine MIBI [**2151-5-15**] moderate anterior mild lateral ischemia. PAST MEDICAL HISTORY: Coronary artery disease, diabetes, hyperlipidemia, hypertension, anterior lateral myocardial infarction in [**2151-10-15**]. PAST SURGICAL HISTORY: 1. Coronary artery bypass graft in [**2143**]. 2. Right CEA. 3. Cholecystectomy. SOCIAL HISTORY: No alcohol or tobacco use. Lives with daughter and granddaughter in [**Name (NI) 1411**]. FAMILY HISTORY: Significant for a father who died of an myocardial infarction at age 68 and a mother who died of heart disease at age 80. PHYSICAL EXAMINATION ON TRANSFER TO CCU: Temperature 97.6. Blood pressure 112/36. Heart rate 83. Respirations 17. SAO2 98% on 3 liters nasal cannula. Intraaortic balloon pump one to one, heart rate 89 (NSR). General, no acute distress. The patient is somnolent, but answers questions appropriately. HEENT oropharynx clear. Mucous membranes are moist. Jugulovenous pressure 6 to 8 cm. Neck supple. Chest is clear to auscultation anteriorly (the patient is lying flat due to intraaortic balloon pump). Cardiovascular regular rate. Normal S1 and S2. [**3-21**] holosystolic murmur best heard at right upper sternal border, which radiates to the apex. Abdomen soft, nontender, nondistended. Normoactive bowel sounds. Extremities right groin site without oozing or hematoma. 2+ pedal pulses bilaterally. Skin warm and dry. LABORATORY VALUES: White blood cell count 7.5, hemoglobin 12, hematocrit 35, platelets 234, sodium 131, potassium 4.1, chloride 96, bicarb 29, BUN 15, creatinine .9, glucose 212. PTT 87, INR 1.2, total cholesterol 187, HDL 45, LDL 107, triglycerides 168. Electrocardiogram done after catheterization showed normal sinus rhythm, heart rate 88, normal axis, Q wave in 3, which was old, .5 ST elevation in 3, .5 ST depression in V6. IMPRESSION: The patient is a 72 year-old female with coronary artery disease status post coronary artery bypass graft with subsequent graft failure with intervention on saphenous vein graft to obtuse marginal and with attempt to fix native obtuse marginal lesion. Presentation consistent with unstable angina, but without cardiac enzyme bump. HOSPITAL COURSE: 1. Cardiovascular: A: Coronary artery disease, following the catheterization the patient was started on aspirin, Plavix and Integrilin, which was continued for approximately 24 hours. The intraaortic balloon pump, which was placed in the catheterization laboratory due to hypotension was continued until the following morning where it was slowly weaned and discontinued. Cardiac enzymes were cycled and peaked with a CK of 237, CKMB 15 and index of 6.3 on [**8-14**] at 1:00 in the morning. B: Congestive heart failure, the patient with known systolic dysfunction who was transiently hypotensive in the catheterization laboratory, which responded well to 2 liters of intravenous fluid. Pulmonary artery diastolic pressure was elevated indicating the patient had received adequate amount of fluid and Lasix intravenous was administered with greater then 2 liters of output and prompt improvement of the patient's symptoms. The patient had no symptoms of volume overload for the remainder of the hospital course. C: Rhythm and rate: Normal sinus rhythm was monitored on telemetry throughout the course of her hospitalization, which showed no ectopy or arrhythmias. 2. Pulmonary: The patient had no active issues. Oxygen saturations remained in high 90s throughout the hospital course. 3. Renal: the patient's creatinine remained within normal limits throughout hospital course. 4. Hematology: The patient initially was with a hematocrit of 35 dropped as low as 30.0 believed to be dilutional from the fluid received within the catheterization laboratory. No sites of bleeding were noted. Good hemostasis was achieved at the groin site. After catheterization the sheath was pulled. 5. Endocrine: The patient is on Metformin as an outpatient, which was held for two days due to risk of complications in the pericatheterization period and Metformin was restarted on the day of discharge. The patient was maintained on a regular insulin sliding scale throughout her hospital course. 6. Cardiac rehabilitation: The patient was evaluated in house by physical therapy and found be back to baseline condition and deemed safe for discharge to home. CONDITION ON DISCHARGE: Improved and stable. DISCHARGE DIAGNOSES: 1. Hypertension. 2. Unstable angina. 3. Status post catheterization with stent placement. 4. Diabetes. 5. Hyperlipidemia. DISCHARGE MEDICATIONS: The patient is to resume regular outpatient medications, which include Toprol XL 50 mg po b.i.d., Norvasc 10 q.d., Quinapril 20 q.d., Imdur 60 b.i.d., Prevacid 30 b.i.d., Niacin 50 q.d., Plavix 75 q.d., enteric coated aspirin 325 q.d., Metformin 500 b.i.d. FOLLOW UP: The patient is to follow up with her primary cardiologist Dr. [**Last Name (STitle) 23392**] in one to two weeks. The patient is to schedule an appointment. [**First Name11 (Name Pattern1) 420**] [**Last Name (NamePattern4) 421**], M.D. [**MD Number(1) 422**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2153-8-16**] 15:27 T: [**2153-8-17**] 07:38 JOB#: [**Job Number 23393**] ICD9 Codes: 4111, 4240, 4019, 412
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7526 }
Medical Text: Admission Date: [**2172-11-30**] Discharge Date: [**2172-12-22**] Date of Birth: [**2097-11-24**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5790**] Chief Complaint: s/p mechcanical [**2097**] w/ right clavicular fracture and right rib fractures [**2-18**] and right hemothorax Major Surgical or Invasive Procedure: Trach, Peg, IVC filter History of Present Illness: 75 yo F s/p mechcanical fall transferred from [**Hospital **] hospital w/ right clavical frcature and right rib fractures [**2-18**], right hemothorax. Past Medical History: Diverticulitis, osteoarthritis, osteoporosis, hypothyroidism, hyperchol, Afib (post-op in 04, resolved), depression, shingles, L Foot post-herpetc neuralgia Family History: non- contributory Physical Exam: general; well appareing female w/ trach and passey muir valve in place HEENT: trach in place, speaks clearly w/ passey muir. COR: RRR S1, S2 chest: CTA bilat abd: Soft, NT, ND, +BS. peg tube in place. extrem: no c/c/e neuro: intact. Pertinent Results: CXR [**2172-12-20**] IMPRESSION: Persistent airspace opacity involving both lungs. Small right-sided pleural effusion. The findings represent pulmonary edema and are unchanged. Pneumonia is not excluded. Right-sided rib fractures, unchanged. ECHO [**2172-12-14**] Conclusions The left atrium is normal in size. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF >55%) Transmitral Doppler and tissue velocity imaging are consistent with normal LV diastolic function. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. IMPRESSION: Normal biventricular function. Mild mitral regurgitation. [**2172-12-5**] 5:00 pm SPUTUM Site: ENDOTRACHEAL Source: Endotracheal. **FINAL REPORT [**2172-12-8**]** GRAM STAIN (Final [**2172-12-5**]): >25 PMNs and <10 epithelial cells/100X field. 4+ (>10 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS AND CLUSTERS. RESPIRATORY CULTURE (Final [**2172-12-8**]): OROPHARYNGEAL FLORA ABSENT. STAPH AUREUS COAG +. MODERATE GROWTH. swallow eval [**2172-12-21**] SUMMARY / IMPRESSION: The pt did not have any overt signs of aspiration and can continue on the current regular diet with thin liquids. She will benefit from wearing the PMV during POs, but noted she has been tolerating POs without the PMV in place. She can swallow her pills whole with water. She reported her intake has been limited b/c she fatigues, so she may continue to need small amounts of tube feeds until she can take in more by mouth . This swallowing pattern correlates to a Dysphagia Outcome Severity Scale (DOSS) rating of 7, wfl. RECOMMENDATIONS: 1. Continue on current PO diet of thin liquids and regular solids. 2. Pills whole with thin liquids. 3. Pt will benefit from wearing the PMV throughout the day, including when taking Pos. These recommendations were shared with the patient, nurse and medical team. ____________________________________ [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], M.S., CCC-SLP Pager #[**Numeric Identifier 2622**] Brief Hospital Course: Pt was admitted to the SICU [**2172-11-30**] for resp compromise d/t rib fractures, clavicular fractures. Neuro: awake, alert on arrival. head CT neg for acute process. Sedated after intubation. Presently wake conversant and approp. Resp: Required intubation on HD#3 after failing BIPAP and CPAP support. Failure to wean from the vent d/t ARDS and required trach and peg on [**2172-12-9**]. Weaned from vent. Trach down sized [**2172-12-20**]. Passey muir valve placed and [**Last Name (un) 1815**] well. CTA was done to r/o PE which was neg. IVC filter was placed prophlactically given relative risk on [**2172-12-13**]. Right hemothorax was drained and a chest tube was placed for continued drainage and PTX. Chest tube was removed [**2172-12-10**] after resolution of PTX and fluid collection drained. COR: approp tachy initially controlled w/ betablockaide. TEE nl w/ EF 60% intermittant lasix diuresis and pressor requirement. OF note, during removal of arterial line - line cut and slipped into artery. plastics consulted and line tip retrived w/adeq profusion. Nutrition: Dobhoff placed for nutritional support and then peg tube placed. currently [**Last Name (un) 1815**] TF and reg diet after being seen by speech and swallow pathology. Can wean from tube feed after approp po nutrition established. Heme/ID: Transfused PRBCs for HCT 23.1 w/ approp stabilzation of HCT- presumed source of loss - right hemothorax. Cipro was started prophlactically and d/c'd after neg culture data. Pt spiked on HD #8 pan cultured and started on broad spectrum IVAB for suspected VAP- vanco, cipro, ceftaz. sputum [**12-6**]- staph coag postive- sensitive to vanco. cipro cetaz d/c'd and completed vanco course. Pain:An epidural was placed for pain control, PCA and toradol were added. Now on metadone w/ good coverage. Rehab: working w/ PT to return to baseline level of functioning. Medications on Admission: Atenolol 25', ASA 325, Zoloft 200, lipitor 10, levoxyl 100 mcg, MVI, Calcium 600", glycolax 17 Discharge Medications: 1. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 2. Senna 8.6 mg Tablet Sig: 1-2 Tablets PO BID (2 times a day) as needed. 3. Methadone 5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 4. Levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Atorvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Sertraline 100 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). 7. Docusate Sodium 50 mg/5 mL Liquid Sig: One (1) PO BID (2 times a day). 8. Famotidine 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. Acetaminophen 160 mg/5 mL Solution Sig: 325-650 mgs PO Q6H (every 6 hours) as needed for pain. 10. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) dose Injection TID (3 times a day). 11. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 12. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Discharge Disposition: Extended Care Facility: RHCI - [**Hospital **] Hospital of [**Location (un) **] and Islands Discharge Diagnosis: s/p fall w/ right clavical fx, right rib fractures [**2-18**] , right hemothorax Discharge Condition: deconditioned [**Last Name (un) 1815**] Passey Muir valve and tube feeds. Discharge Instructions: Call Dr.[**Name (NI) 2347**] office [**Telephone/Fax (1) 170**] if you develop chest pain, shortness of breath, fever, chills, or if you have issues with your feeding tube. If you feeding tube falls out, have it replaced immediately or if the sutures break, tape the tube securely in place until it can be resutured. Followup Instructions: You have a follow up appointment with Dr. [**Last Name (STitle) **] on [**2173-1-5**] at 10am on the [**Hospital Ward Name **], [**Hospital Ward Name 121**] building [**Hospital1 **] one Chest disease center. plaese arrive 45 minutes prior to your appointment and report ot the [**Hospital Ward Name **] clinical center [**Location (un) **] rdaiology for a CXR. Completed by:[**2172-12-28**] ICD9 Codes: 2851, 2720, 4019, 2449
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7527 }
Medical Text: Admission Date: [**2141-4-11**] Discharge Date: [**2141-4-18**] Date of Birth: [**2063-3-28**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 5123**] Chief Complaint: T6 burst fracture Major Surgical or Invasive Procedure: [**2141-4-11**]: T3-T9 posterior instrumented fusion History of Present Illness: 78 y/o female with PMHx Parkinsons disease, COPD on home O2 2L, 4.2cm thoracic aortic aneurysm, CHF, depression, hypercholesterolemia, hx L5-S1 discectomy, R TKA years ago, peripheral neuropathy who is POD #3 s/p T3-T9 arthrodesis and instrumentation. The patient has had multiple visits to OSH EDs for low back pain starting in mid [**Month (only) **] and was initially treated with rehabilitation. At the rehab facility, she developed progressive weakness of her lower extremity and bowel and bladder incontinence. She was transfered back to the ED of [**Hospital **] hospital where CXR done showed burst fracture of T6 with retropulsed fragment causing narrowing of the canal in that area. She was then transfered to [**Hospital1 **] on [**2141-4-11**]. There was marked blood loss in surgery but she was hemodynamically stable the entire long surgery. She was transfused 2 PBRCs for oozing from surgical site. (No hct drop). She self extubated the morning after surgery. Ortho felt that surgery was done too late. She has intact sensation but toes are upgoing B/L, and she is now paralyzed from waist down. . Other complicating factors since she has been in the TICU include UTI, A fib, and hypoxia. She is being treated with Augmentin for the UTI. The patient had an episode of Afib last night (first known episode). This was thought to be secondary to overdiuresis. The patient's heart rate never got above 105bpm. The ICU team gave intermittent lopressor 5 mg IV, then started lopressor 12.5 mg tid PO. Currently more hypoxic than baseline felt to be [**2-21**] to volume overload (on 4L). She diuresed 1L to 20 IV lasix. She received an IVC filter today prophylactically (no DVTs). The patient was to be called out of the unit yesterday, however had an episode of hypotension, unclear etiology, possibly not correlating non-invasive to invasive monitoring. Hypotension has resolved and the patient is being transferred to medicine for continued care. . On transfer vs were 97.2 82 103/56 17 98% on 3L. Patient complains of some back pain, but is otherwise feeling well. Very frustrated about her current situation. Feels bloated and gassy as well. Past Medical History: 1) S/p reduction of fracture dislocation T5-6 and T6-7, posterior arthrodesis T3-4, T4-5, T5-6, T6-7, T7-8 and T8-9, posterior instrumentation T3 to T9, and arthroplasty in same region. 2) Parkinsons disease 3) COPD on home O2 4) 4.2cm thoracic aortic aneurysm 5) Depression 6) hypercholesterol 7) hx L5-S1 discectomy 8) R TKA years ago 9) peripheral neuropathy 10) CHF Social History: Was at [**Hospital 5682**] Rehab for a week prior to this admission, but was previously living at [**Location (un) 583**] [**Hospital3 400**]. Denies any current tobacco or ETOH use. Smoked for 35 yrs and quit [**2126**]. Son [**Name (NI) **] lives in the [**Location (un) **] area and is quite involved in the care of the mother. Family History: NC Physical Exam: PHYSICAL EXAM: Vitals - 97.2, 82, 103/56, 17, 98% on 3L. GEN: elderly female, lying still, in mild discomfort HEENT: EOMI, PERRLA, MMM, no LAD, neck supple CV: S1S2, RRR, no m/r/g RESP: CTA b/l, no w/r/r ABD: soft, distended, NT, + BS, no guarding/rebound GU: catheter in place Back: dressing dry and intact SKIN : no rash, no ulceration, no erythema in decubiti NEURO: CNII-XII grossly intact, 5/5 strength in UE, 0/5 strength in LE's. Sensation intact in LE's. Pertinent Results: CT C/T/L spine ([**2141-4-11**]) IMPRESSION: 1. Severe compression fracture of T6 vertebral body with retropulsion causing narrowing of the spinal canal. 2. Bilateral sixth rib fractures at the costovertebral junctions. 3. Right sacral fracture. Recommend a pelvis CT to assess for associated fractures. This was discussed with Dr. [**First Name (STitle) **] in the MICU at 8:50 am on [**2141-4-11**]. 4. Lumbar spondylosis with moderate multilevel neural foraminal narrowing. Grade I anterolisthesis at L3-4 is likely related to facet arthropathy. Grade I anterolisthesis at L5-S1 secondary to bilateral L5 pars defects. 5. Left renal cystic lesion is incompletely evaluated. If there are no previous studies to confirm its stability, then further characterization with an ultrasound is suggested. . MRI T-spine ([**2141-4-10**]) IMPRESSION: Burst fracture at T6 with greater than 50% loss of height and involvement of the anterior, middle and posterior columns as well as retropulsion and spinal canal compromise. . CBC [**2141-4-15**] 05:45AM BLOOD WBC-7.8 RBC-3.02* Hgb-8.7* Hct-26.6* MCV-88 MCH-28.7 MCHC-32.6 RDW-16.2* Plt Ct-304 [**2141-4-14**] 01:48AM BLOOD WBC-9.1 RBC-3.21* Hgb-8.8* Hct-27.7* MCV-86 MCH-27.3 MCHC-31.7 RDW-15.3 Plt Ct-218 [**2141-4-13**] 01:53PM BLOOD WBC-10.9 RBC-3.58* Hgb-9.7* Hct-30.6* MCV-86 MCH-27.0 MCHC-31.6 RDW-15.6* Plt Ct-235 [**2141-4-13**] 02:44AM BLOOD WBC-9.3 RBC-3.38* Hgb-9.6* Hct-29.5* MCV-87 MCH-28.5 MCHC-32.6 RDW-16.0* Plt Ct-246 [**2141-4-12**] 03:04AM BLOOD WBC-9.4 RBC-3.35* Hgb-9.7* Hct-29.1* MCV-87 MCH-28.8 MCHC-33.2 RDW-16.3* Plt Ct-260 [**2141-4-11**] 10:50PM BLOOD WBC-9.1 RBC-3.71* Hgb-10.3* Hct-32.4* MCV-87 MCH-27.7 MCHC-31.7 RDW-16.0* Plt Ct-285 [**2141-4-11**] 10:13AM BLOOD WBC-10.9 RBC-3.87* Hgb-10.3* Hct-33.1* MCV-86 MCH-26.7* MCHC-31.2 RDW-15.9* Plt Ct-296 [**2141-4-10**] 05:25PM BLOOD WBC-11.1* RBC-4.26 Hgb-11.7* Hct-36.7 MCV-86 MCH-27.6 MCHC-31.9 RDW-15.8* Plt Ct-299 . Coag [**2141-4-15**] 05:45AM BLOOD PT-11.0 PTT-28.4 INR(PT)-0.9 [**2141-4-13**] 02:44AM BLOOD PT-10.5 PTT-25.9 INR(PT)-0.9 [**2141-4-11**] 10:50PM BLOOD PT-11.2 PTT-23.1 INR(PT)-0.9 [**2141-4-11**] 08:00PM BLOOD PT-11.4 PTT-22.0 INR(PT)-0.9 [**2141-4-11**] 05:10PM BLOOD PT-11.2 PTT-23.4 INR(PT)-0.9 [**2141-4-11**] 12:10PM BLOOD PT-10.6 PTT-23.3 INR(PT)-0.9 . Chemistry [**2141-4-15**] 05:45AM BLOOD Glucose-91 UreaN-9 Creat-0.4 Na-143 K-3.7 Cl-105 HCO3-32 AnGap-10 [**2141-4-14**] 01:48AM BLOOD Glucose-92 UreaN-12 Creat-0.4 Na-140 K-4.2 Cl-103 HCO3-35* AnGap-6* [**2141-4-13**] 01:53PM BLOOD Glucose-139* UreaN-10 Creat-0.5 Na-141 K-4.0 Cl-101 HCO3-34* AnGap-10 [**2141-4-13**] 02:44AM BLOOD Glucose-122* UreaN-11 Creat-0.5 Na-141 K-3.6 Cl-104 HCO3-30 AnGap-11 [**2141-4-12**] 03:04AM BLOOD Glucose-133* UreaN-21* Creat-0.6 Na-142 K-4.0 Cl-108 HCO3-28 AnGap-10 [**2141-4-11**] 10:50PM BLOOD Glucose-124* Creat-0.7 Na-143 K-4.1 Cl-108 HCO3-28 AnGap-11 [**2141-4-11**] 10:13AM BLOOD Glucose-106* UreaN-21* Creat-0.6 Na-143 K-4.2 Cl-105 HCO3-29 AnGap-13 [**2141-4-10**] 05:25PM BLOOD Glucose-119* UreaN-19 Creat-0.9 Na-142 K-4.1 Cl-97 HCO3-36* AnGap-13 [**2141-4-14**] 01:48AM BLOOD Calcium-8.3* Phos-3.5 Mg-2.1 [**2141-4-13**] 02:44AM BLOOD Calcium-8.1* Phos-3.8 Mg-1.9 [**2141-4-12**] 03:04AM BLOOD Albumin-2.9* Calcium-8.4 Phos-4.3 Mg-1.9 [**2141-4-11**] 10:50PM BLOOD Calcium-9.5 Phos-4.4 Mg-2.0 [**2141-4-11**] 10:13AM BLOOD Calcium-8.7 Phos-3.0 Mg-2.3 Brief Hospital Course: This is a 78 year old female with PMH of Parkinson's, COPD, CHF, h/o L5-S1 discectomy presents with progressive LE weakness and bowel and bladder incontinence, found to have a nontraumatic T6 burst fracture with retropulsed fragment. Now s/p T3-T9 arthrodesis but with paralysis of bilateral lower extremities. . #. T6 burst fracture - nontraumatic compression fracture now s/p emergent T5-7 posterior decompression and T3-9 fusion on [**2141-4-11**]. Patient is now paralyzed from the waist down, although sensation in her legs remains intact. She seems to not have sensation of her abdomen and has developed some abrasions there, likely from her scratching the area. Uncertain what precipitated the fracture, T6 vertebral body was sent to pathology to evaluate for pathologic fracture and only showed fragments of trabecular bone with focal remodelling and fibrocartilage with degenerative changes. Ortho does not recommend bracing her spine following this procedure. Patient has pain well managed with oxycodone 5 mg q6h standing. . #. Anemia - Patient had significant blood loss during surgical procedure and also oozing from wound. She was transfused 2 units of pRBCs, but was never documented to have a drop in hematocrit. No current signs of bleeding and hematocrit has remained stable around 27. . #. Neurogenic bladder - PM&R recommends d/c foley catheter and start intermittent catheterization every 4-6 hours. However, having to reposition her legs for straight cath every 4-6 hours is very painful for patient, and so foley was left in for the time being. Foley can be discontinued in rehab. . #. Neurogenic bowel - Patient was started on an aggressive bowel regimen of colace, senna, bisacodyl suppository, miralax, and lactulose. During this admission, patient was also given enemas to help with passing bowel movements. On discharge, patient's abdomen still remains distended. She should get enemas as needed to ensure that she has a bowel movement everyday. . #. UTI - urine culture shows E.coli sensitive to Augmentin. Patient was started on Augmentin on [**4-12**] for a planned 7 day course for treatment of UTI. . #. Decubitus ulcer prophylaxis - patient was turned q2hrs for prevention of decubitus ulcer formation. . #. DVT prophylaxis - had an IVC filter placed on [**4-13**] prophylactically. PM&R recommends anticoagulation with Lovenox 30 mg [**Hospital1 **] for 12 weeks despite having IVC filter placed as patient has just had orthopedic surgery. . # Stress ulcer prophylaxis - Patient was started on a PPI while in perioperative period. Can be discontinued 4 weeks out from surgery. . #. Parkinson's - patient was continued on sinemet, requip, and comtan . #. Depression - patient was continued on Cymbalta and Remeron . #. COPD - patient uses 2L of O2 at home at baseline. Patient was continued on spiriva, ipratropium, albuterol Medications on Admission: Sinemet 25/100 one tab PO BID (0530 and 1030) Sinemet 25/100 PO 0.5 tabs [**Hospital1 **] (1400 and 1900) Sinemet CR 25/100 one tab QID (0530, 0730, 1400, 1900) Comtan 200mg PO one tab FIVE Times per day (0530, 0730, 1030, 1400, 1900) Requip 8 mg, 2 tabs daily Furosemide 40mh\g PO daily MOM 30ml PRN Dulcolox PR PRN Tylenol 650 mg Q6 PRN Fleets EAnema PRNSimvastatin 40mg daily Cymbalta 60mg daily ASA 81 mg daily KCL 10 Meq daily Clonazepam 0.5 mg [**Hospital1 **]:PRN MVI one tab daily Prilosec 20mg [**Hospital1 **] Remeron 15mg qHS Naprosyn 500mg [**Hospital1 **]:PRN Vicodin one tab [**Hospital1 **]:PRN Spiriva 18mcg daily Flovent 110mg 2 puffs daily Albuterol IH 1 puff Q4 PRN Discharge Medications: 1. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). 2. Albuterol Sulfate 5 mg/mL Solution for Nebulization Sig: One (1) nebulizer Inhalation every four (4) hours as needed for shortness of breath, wheezing. 3. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 4. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 5. Mirtazapine 15 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 6. Carbidopa-Levodopa 25-100 mg Tablet Sig: One (1) Tablet PO QID (4 times a day): Take at 05:30AM, 07:30AM, 2:00PM, 7:00PM . 7. Carbidopa-Levodopa 25-100 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day): take at 2PM and 7PM. 8. Carbidopa-Levodopa 25-100 mg Tablet Sig: One (1) Tablet PO BID (2 times a day): take at 5:30AM and 10:30AM. 9. Entacapone 200 mg Tablet Sig: One (1) Tablet PO FIVE TIMES PER DAY (). 10. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours). 11. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 12. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 13. Multivitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 14. Ropinirole 1 mg Tablet Sig: Sixteen (16) Tablet PO QAM (once a day (in the morning)). 15. Ipratropium Bromide 0.02 % Solution Sig: One (1) nebulizer Inhalation Q6H (every 6 hours) as needed for shortness breath. 16. Amoxicillin-Pot Clavulanate 875-125 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) for 2 days. 17. Metoprolol Tartrate 25 mg Tablet Sig: 0.5 Tablet PO TID (3 times a day). 18. Enoxaparin 30 mg/0.3 mL Syringe Sig: Thirty (30) mg Subcutaneous Q12H (every 12 hours) for 12 weeks. 19. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime). 20. Oxycodone 5 mg Tablet Sig: One (1) Tablet PO Q6H (every 6 hours): please hold for oversedation or RR<10. Patient may refuse . 21. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 22. Lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO TID (3 times a day). 23. Polyethylene Glycol 3350 17 gram/dose Powder Sig: Seventeen (17) grams PO DAILY (Daily). 24. Calcium Carbonate 1,000 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO three times a day. 25. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: Two (2) Capsule, Delayed Release(E.C.) PO BID (2 times a day). 26. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for gas. 27. Lorazepam 0.5 mg Tablet Sig: Two (2) Tablet PO Q4H (every 4 hours) as needed for anxiety. 28. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: Primary Diagnosis: Flaccid paralysis T6 burst fracture . Secondary Diagnosis: 1) S/p reduction of fracture dislocation T5-6 and T6-7, posterior arthrodesis T3-4, T4-5, T5-6, T6-7, T7-8 and T8-9, posterior instrumentation T3 to T9, and arthroplasty in same region. 2) Parkinsons disease 3) COPD on home O2 4) 4.2cm thoracic aortic aneurysm 5) Depression 6) hypercholesterol 7) hx L5-S1 discectomy 8) R TKA years ago 9) peripheral neuropathy 10) CHF Discharge Condition: Mental Status: Clear and coherent Level of Consciousness: Alert and interactive Activity Status: Bedbound Discharge Instructions: You were admitted to [**Hospital1 69**] for leg weakness and inability to hold urine and stool. You were found to have a T6 fracture for which you had spine surgery and had your T3-T9 vertebrae were fused. Unfortunately even after the surgery, you have not been able to move your legs. You are being discharged to a rehabilitation facility to see if there is a chance at regaining some motor function in your legs. . Your new medication list has been forwarded to [**Hospital3 **] center. Followup Instructions: Please keep all of your outpatient follow-up appointments listed below: . 1. Please follow-up with [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 711**], NP at your primary care doctor's office on [**4-28**] at 2PM. . 2. Department: ORTHOPEDICS When: MONDAY [**2141-5-1**] at 9:00 AM With: ORTHO XRAY (SCC 2) [**Telephone/Fax (1) 1228**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage . 3. Department: SPINE CENTER When: MONDAY [**2141-5-1**] at 9:20 AM With: DR. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] [**Telephone/Fax (1) 3736**] Building: [**Hospital6 29**] [**Location (un) 551**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage . o At this follow-up visit your incision will be checked and baseline X-rays and questions will be answered. ICD9 Codes: 5990, 2851, 4280, 496
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7528 }
Medical Text: Admission Date: [**2177-3-10**] Discharge Date: [**2177-3-12**] Date of Birth: [**2122-3-1**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 1711**] Chief Complaint: Pericardial effusion. Major Surgical or Invasive Procedure: Pericardiocentesis and pericardial drain placement. History of Present Illness: The patient is a 52-year old female with a history of metastatic breast cancer, s/p lt. mastectomy now enrolled in clinical trial "05-395" (lapatinib monotherapy 1500 mg), who noted lt. arm swelling [**2-28**]. Doppler neg for clot, but CT (routine, restaging) revealed pericardial effusion. Echo [**3-3**] revealed: small to moderate sized circumferential pericardial effusion, most prominently inferolateral to the left ventricle and around the right atrium, but ~1cm anterior to the right ventricle. There is mild right ventricular diastolic collapse consistent with increased pericardial pressure/early tamponade physiology. . [**3-5**]: Compared with the prior study (images reviewed) of [**2177-3-3**], the pericardial effusion appears similar to slightly larger. There is right ventricular diastolic collapse, consistent with impaired fillling/tamponade physiology. . [**3-7**]: There is subtle RV diastolic compression without collapse (no overt tamponade). Compared with the prior study (images reviewed) of [**2177-3-5**], there is slightly less pericardial fluid anteriorly. Otherwise no change. . A pericardial drain was placed with return of approximately 250 cc of serosanginous fluid and normalization of right heart pressures. She is admitted to the CCU for further monitoring. Past Medical History: ONCOLOGY HISTORY: She was initially diagnosed in [**2164**] with a 3.5 cm infiltrating ductal carcinoma, lymph node positive, LVI positive, ER positive. She is status post left mastectomy with reconstruction, CAF followed by tamoxifen. She recurred in [**7-/2169**], with metastasis to her left supraclavicular node and lung. Biopsy documented HER-2/neu over expression by immunohistochemistry. ER positive. She was treated with Arimidex for six months, which was followed by Taxol and Herceptin. She was then treated with high-dose chemo and Herceptin followed by transplant as part of the clinical trial. This chemo included thiotepa, [**Doctor Last Name **], and Taxol. In [**9-/2173**], she was treated with letrozole and Herceptin and was then switched to Aromasin and Herceptin in 11/[**2174**]. Upon progression [**Male First Name (un) **] was switched to the lapatinib phase II trial in [**7-28**], and herceptin was discontinued. She has received 8 cycles of lapatinib. . PAST MEDICAL HISTORY: 1. Metastatic breast cancer as above. 2. Autologous bone marrow transplant in [**2169**]. 3. History of meningoceles. 4. Hyperlipidemia. Social History: A single parent. She lives with her 13-year-old daughter. [**Name (NI) **] tobacco, alcohol, or drugs. Family History: Father has lymphoma. Physical Exam: Blood pressure was 116/66 mm Hg while seated. Pulse was 73 beats/min and regular, respiratory rate was 15 breaths/min. Generally the patient was well developed, well nourished and well groomed. The patient was oriented to person, place and time. The patient's mood and affect were not inappropriate. . There was no xanthalesma and conjunctiva were pink with no pallor or cyanosis of the oral mucosa. The neck was supple with JVP of less than 6 cm. The carotid waveform was normal. There was no thyromegaly. The were no chest wall deformities, scoliosis or kyphosis. The respirations were not labored and there were no use of accessory muscles. The lungs were clear to ascultation bilaterally with normal breath sounds and no adventitial sounds or rubs. . Palpation of the heart revealed the PMI to be located in the 5th intercostal space, mid clavicular line. There were no thrills, lifts or palpable S3 or S4. The heart sounds revealed a normal S1 and the S2 was normal. There were no rubs, clicks or gallops. There was a slight [**1-28**] HSM. . There is a pericardial drain in place in the sub-xiphoid position. Drainage bag connected, contains approx 10 cc of serosanguinous fluid. . The abdominal aorta was not enlarged by palpation. There was no hepatosplenomegaly or tenderness. The abdomen was soft nontender and nondistended. The extremities had no pallor, cyanosis, clubbing. There is slight (1+), diffuse, Lt. UE edema. There were no abdominal, femoral or carotid bruits. Inspection and/or palpation of skin and subcutaneous tissue showed no stasis dermatitis, ulcers, scars, or xanthomas. . Pulses: Right: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Left: Carotid 2+ Femoral 2+ Popliteal 2+ DP 2+ PT 2+ Pertinent Results: Labwork on admission: [**2177-3-10**] 04:15PM WBC-4.2 RBC-3.40* HGB-10.8* HCT-31.0* MCV-91 MCH-31.9 MCHC-35.0 RDW-14.8 [**2177-3-10**] 04:15PM PLT COUNT-161 [**2177-3-10**] 04:15PM GLUCOSE-99 UREA N-12 CREAT-0.7 SODIUM-139 POTASSIUM-3.9 CHLORIDE-106 TOTAL CO2-25 ANION GAP-12 . Labwork on admission: C.CATH Study Date of [**2177-3-10**] *** Not Signed Out *** BRIEF HISTORY: This 55 year old female with known diagnosis of metastatic breast cancer presented with pericardial effusion diagnosed on echocardiogram with significant respiratory mitral flow variation. Patient was therefore referred for pericardiocentesis. INDICATIONS FOR CATHETERIZATION: Pericardial effusion. PROCEDURE: Right Heart Catheterization: was performed by percutaneous entry of the right femoral vein, using a 7 French pulmonary wedge pressure catheter, advanced to the PCW position through an 8 French introducing sheath. Cardiac output was measured by the Fick method. Pericardiocentesis: was performed via the subxyphoid approach, using an 18 gauge thin-wall needle, a guide wire, and a drainage catheter. Conscious Sedation: was provided with appropriate monitoring performed by a member of the nursing staff. HEMODYNAMICS RESULTS BODY SURFACE AREA: m2 HEMOGLOBIN: gms % FICK **PRESSURES RIGHT ATRIUM {a/v/m} 14/12/10 RIGHT VENTRICLE {s/ed} 35/12 PULMONARY ARTERY {s/d/m} 35/15/21 PULMONARY WEDGE {a/v/m} 16/16/12 AORTA {s/d/m} 140/65/95 PERICARDIUM {m} 12 **CARDIAC OUTPUT HEART RATE {beats/min} 70 RHYTHM SINUS OTHER HEMODYNAMIC DATA: The oxygen consumption was assumed. TECHNICAL FACTORS: Total time (Lidocaine to test complete) = 45 minutes. Arterial time = 45 minutes. Fluoro time = 2.3 minutes. Contrast injected: Non-ionic low osmolar (isovue, optiray...), vol 20 ml, Indications - Renal Anesthesia: 1% Lidocaine subq. Cardiac Cath Supplies Used: - [**Company **], PERICARDIOSENTISIS SET - ALLEGIANCE, CUSTOM STERILE PACK COMMENTS: 1. Resting hemodynamics were performed. The right sided filling pressures were mildly elevated (mean RA pressure was 12mmHg and RVEDP was 12mmHg). The pulmonary artery pressures were mildly elevated measuring 35/15mmHg. The left sided filling pressures were equalized to the right (mean PCW pressure was 12mmHg). There was significant respiratory variation of systemic arterial pressure up to 20mmHg. There was equalization of RA and pericardial pressures. 2. Pericardiocentesis was performed under fluoroscopy guidance. Pericardial drain was subsequently placed with 240cc serosanguinous fluid removed. Repeat measurement of pericardial pressure and RA pressure demonstrated clear seperation. FINAL DIAGNOSIS: 1. Elevated right sided filling pressures with equlization of RA/LA/pericardial pressures. 2. Successful placement of pericardial drain. . ECHO Study Date of [**2177-3-10**] Conclusions: Overall left ventricular systolic function is low normal (LVEF 50-55%). There is a trivial/physiologic pericardial effusion. Compared with the prior study (images reviewed) of [**2177-3-7**], there is now minimal residual pericardial effusion. . ECG Study Date of [**2177-3-10**] 1:00:10 PM Sinus rhythm Normal ECG Since previous tracing, no significant change . CHEST (PORTABLE AP) [**2177-3-11**] IMPRESSION: AP chest, small right pleural effusion is present. Right lower lobe atelectasis is new since [**2-28**]. Consolidation in the anterior segment of the right upper lobe and a right apical paramediastinal mass are unchanged. Left lung is clear. Several loops of pericardiocentesis catheter projecting over the subxiphoid midline, the base of the heart and superiorly to the level of the pulmonary outflow tract, are acutely coiled and should be evaluated clinically to see if they are draining properly. No pneumothorax. . ECHO Study Date of [**2177-3-11**] Conclusions: Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There is a small circumferential pericardial effusion primarily inferolateral to the left ventricle with minimal effusion anterior to the right ventricle. No echocardiographic signs of tamponade physiology are seen. Compared with the prior study (images reviewed) of [**2177-3-10**], the inferolateral effusion is more prominent. . Labwork on discharge: [**2177-3-12**] 09:25AM BLOOD WBC-5.6 RBC-3.67* Hgb-11.9* Hct-36.0 MCV-98# MCH-32.3* MCHC-32.9 RDW-14.2 Plt Ct-185 [**2177-3-12**] 09:25AM BLOOD Glucose-108* UreaN-8 Creat-0.7 Na-136 K-3.7 Cl-104 HCO3-21* AnGap-15 Brief Hospital Course: 55 year-old female with metastatic breast cancer presenting with pericardial effusion. . 1. Pericardial effusion. Likely malignant. Pericardiocentesis was performed with approximately 250 cc of serosanguinous fluid output and normalization of right heart pressures. A pericardial drain was placed with 320 cc of serosanguinous fluid output the first 12 hours, then 75 cc over 6 hours, then no output. A repeat echocardiogram showed a small pericardial effusion without evidence of tamponade as above. The pericardial drain was removed. An echocardiogram the next morning showed stable small pericardial effusion. Cultures were negative at the time of discharge and cytology was pending. The patient will have a repeat echocardiogram five days after discharge and will follow-up with her oncologist. The patient may need a pericardial window or balloon pericardiotomy procedure if the effusion increases in size. . 2. Infectious disease. The patient had a temperature to 100.8 the second day of admission. The patient's only localizing symptom was a nonproductive cough the patient has complained of for the past three weeks, overall improved since that time. Chest x-ray showed atelectasis but no new consolidations. Urinalysis negative for infection. Urine, blood, and pericardial fluid cultures without growth at the time of discharge. The fever was likely secondary to atelectasis or the patient's underlying malignancy. . 3. Breast cancer. The patient is now off the lapatinib study. The patient is followed by oncology. . 4. Anemia. The patient's hematocrit remained stable at 31-36 during admission. The patient's iron studies showed an iron to TIBC ratio of 5%, although ferritin was within normal limits. Folate and B12 were within normal limits. Further management deferred to the patient's primary physician. Medications on Admission: Simvastatin 20 mg QD Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Discharge Disposition: Home Discharge Diagnosis: Primary: Pericardial effusion status post pericardiocentesis and pericardial drain placement/removal . Secondary: 1. Metastatic breast cancer 2. Autologous bone marrow transplant in [**2169**] 3. History of meningoceles 4. Hyperlipidemia Discharge Condition: Afebrile, vital signs stable. Discharge Instructions: You were hospitalized after a procedure to remove fluid from your pericardial sac. You will need a repeat echocardiogram to assess for fluid reaccumulation. The office of your oncologist, Dr. [**Last Name (STitle) **], [**First Name3 (LF) **] contact you regarding scheduling of your repeat echocardiogram and follow-up with oncology. . You spiked a fever during admission without any localizing symptoms. Your oncologist should follow-up the urine, blood, and pericardial fluid cultures drawn during this admission. . Please contact a physician if you experience fevers, chills, chest pain, shortness of breath, palpitations, or any other concerning symptoms. . Please take your medications as prescribed. There were no changes made to your medications. . Please keep your follow-up appointments as below. Followup Instructions: The office of your oncologist, Dr. [**Last Name (STitle) **], [**First Name3 (LF) **] contact you regarding scheduling of your repeat echocardiogram and follow-up with oncology on Monday, [**3-17**]. Please call the office at ([**Telephone/Fax (1) 21188**] with any questions or concerns or if you do not hear from a representative by this Friday. . Previously scheduled appointments: Provider: [**Name10 (NameIs) 706**] Phone:[**Telephone/Fax (1) 327**] Date/Time:[**2177-3-17**] 10:45 ICD9 Codes: 5180, 2724, 2859
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Medical Text: Admission Date: [**2101-10-3**] Discharge Date: [**2101-10-6**] Date of Birth: [**2052-8-11**] Sex: F Service: MEDICINE Allergies: Penicillins / Iodine; Iodine Containing Attending:[**First Name3 (LF) 25876**] Chief Complaint: SOB Major Surgical or Invasive Procedure: Implantation of L-sided pleural bases pigtail catheter. History of Present Illness: 49 yo female with metastatic melanoma dx in [**2093**], found to have mets to the lung by CXR in [**2099-11-18**], CT confirmed a right lower lobe and left lower lobe nodules. She underwent bilateral VATS resection with pathology consistent with melanoma. In [**2101-1-19**], follow-up CT revealed a right pleural abnormality and she underwent a repeat bronc and right VATS with talc poudrage on [**2101-2-18**]. Biopsy confirmed recurrent melanoma. Pt presented to ED today with increasing dyspnea for the past 3-4 days and new cough productive of white sputum. Pt did note blood in sputum on one occasion over the weekend. Denies fevers or chills, chest pain. Has had poor appetite and decreased po intake. No black or bloody stools reported. Further ROS negative. . In the [**Name (NI) **], pt was found to have B/L multi-loculated pleural effusions, with L>R. IP was consulted and pt underwent thoracentesis with placement of pigtail catheter under CT guidance. Patient was admitted to MICU for further observation given episodes of tachycardia, transient hypotension, tachypnea. Past Medical History: metastatic melanoma s/p Flex Bronch, VATs, TALC, Pleurex Cath PMH/PSH:HChol, Migraines, metastatic melanoma, s/p L vats c pleural bx and bilateral lower lobe nodule wedges [**9-22**], s/p L-heel excision c STSG '[**93**], s/p R VATS w/ pleural biopsies and talc pleurodesis [**2101-2-18**] Social History: lives in [**Location 686**] w/ 2 sons separated from husband, has 3 sons. Pt lives in [**Location 686**]. former smoker- quit [**2083**], glass of wine 3x/week Family History: NC Physical Exam: PE: vitals 99.2/hr 100/bp 152/90/ rr 30/ 100% oxygen sat GEN: thin, pale, anxious female HEENT: atraumatic, anicteric, EOMI, mmm, PERRLA, OP clear NECK: no JVD CV: tachy, no murmurs, no rubs LUNGS: decreased BS at bases, + conversational dyspnea, + wheeze ABD: soft, nt, hypoactive BS, non-distended EXT: warm, dry. No [**Location (un) **]. Proximal muscle strength 5/5 and intact B/L in both UE and LE. DP pulses palpable B/L NEURO: A/O X3, CN II-XII grossly intact, no focal deficits Pertinent Results: [**2101-10-3**] 10:15AM BLOOD WBC-3.0* RBC-2.67*# Hgb-7.4*# Hct-20.7*# MCV-78* MCH-27.9 MCHC-35.8* RDW-15.4 Plt Ct-81*# [**2101-10-3**] 10:15AM BLOOD Neuts-64.9 Lymphs-24.0 Monos-11.0 Eos-0.2 Baso-0 [**2101-10-3**] 10:15AM BLOOD PT-14.8* PTT-22.0 INR(PT)-1.3* [**2101-10-3**] 10:15AM BLOOD Glucose-145* UreaN-18 Creat-0.7 Na-133 K-4.0 Cl-93* HCO3-23 AnGap-21* [**2101-10-3**] 10:15AM BLOOD CK(CPK)-45 [**2101-10-3**] 10:15AM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2101-10-4**] 03:45AM BLOOD Calcium-7.9* Phos-2.9 Mg-1.2* [**2101-10-3**] 09:14PM URINE Blood-LG Nitrite-NEG Protein-TR Glucose-NEG Ketone-50 Bilirub-NEG Urobiln-0.2 pH-5.0 Leuks-NEG Brief Hospital Course: The patient with past medical history as detailed above with initially admitted to the ICU for shortness of breath. She had a placement of a L pleural based pigtail catheter for palliative purposes. She was transferred to OMED and while on the floor, it was decided that the patient was to receive comfort measures. While being made comfortable the patient passed on [**2101-10-6**]. . Family was present at the bedside. Medications on Admission: Discharge Disposition: Home With Service Facility: VistaCare Discharge Diagnosis: Primary Diagnosis: Metastatic Melanoma Discharge Condition: Expired Completed by:[**2101-10-11**] ICD9 Codes: 4589
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Medical Text: Admission Date: [**2130-12-6**] Discharge Date: [**2130-12-18**] Date of Birth: [**2074-3-1**] Sex: F Service: CARDIOTHORACIC Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 165**] Chief Complaint: CHEST PAIN Major Surgical or Invasive Procedure: [**12-8**] CABGx5(LIMA->LAD, SVG->Diag, Ramus, OM, PLV) History of Present Illness: 56 yo F presented to MWMC wiht chest pain and underwent cardiac cath which showed 3VD. Referred for CABG. Past Medical History: DM, HTN, HChol, DOE/Angina, [**Month/Year (2) **] (L ICA) GERD CCY [**10-15**], TAH, CSXN x 2 Family History: NC Physical Exam: AAOx3 RRR no M/R/G, 2/6 SEM CTAB Abdomen soft, minimally tender in RUQ (recent CCY) No CCE Pertinent Results: [**2130-12-14**] 06:15AM BLOOD WBC-11.3* RBC-2.98* Hgb-9.0* Hct-25.9* MCV-87 MCH-30.2 MCHC-34.7 RDW-15.1 Plt Ct-227 [**2130-12-13**] 03:21AM BLOOD WBC-11.4* RBC-2.88* Hgb-8.7* Hct-25.2* MCV-88 MCH-30.3 MCHC-34.6 RDW-15.2 Plt Ct-173# [**2130-12-14**] 06:15AM BLOOD Plt Ct-227 [**2130-12-10**] 02:16AM BLOOD PT-13.0 PTT-33.5 INR(PT)-1.1 [**2130-12-14**] 06:15AM BLOOD UreaN-15 Creat-0.7 K-3.4 [**2130-12-13**] 03:21AM BLOOD Glucose-58* UreaN-22* Creat-0.8 Na-141 K-3.4 Cl-104 HCO3-27 AnGap-13 CHEST (PORTABLE AP) [**2130-12-13**] 12:03 PM CHEST (PORTABLE AP) Reason: ? Pneumothorax post CT removal [**Hospital 93**] MEDICAL CONDITION: 56 year old woman s/p bilateral pectoral flap [**12-10**] REASON FOR THIS EXAMINATION: ? Pneumothorax post CT removal SINGLE AP PORTABLE VIEW OF THE CHEST REASON FOR EXAM: Assess for pneumothorax. Patient is post bilateral pectoral flap. Comparison is made with prior study performed a day earlier. Right IJ line remains in place with tip in the lower SVC. No clear pneumothorax is identified. Bibasilar opacities obscuring the hemidiaphragms consistent with atelectasis are new on the right and slightly increased on the left. There has been interval increase in now mild-to-moderate pulmonary edema. Small bilateral pleural effusions. Patient is post median sternotomy and CABG. CAROTID SERIES COMPLETE [**2130-12-13**] 1:44 PM CAROTID SERIES COMPLETE Reason: assees for stenosis [**Hospital 93**] MEDICAL CONDITION: 56 year old woman s/p cabg w neuro changes REASON FOR THIS EXAMINATION: assees for stenosis CAROTID STUDY. HISTORY: Neurologic changes after cardiac bypass. FINDINGS: No significant plaque or wall thickening involving the right carotid system. Some predominantly hyperechoic left ICA and CCA and ECA wall thickening. The peak systolic velocities on the left are 131, 108, 94, 73 and 112 cm/sec for the proximal, mid and distal ICA and CCA and ECA respectively. There is antegrade flow involving the left vertebral artery. The right vertebral artery was not visualized, presumed hypoplastic or occluded. The ICA/CCA ratio is 0.89 on the right and 1.7 on the left. IMPRESSION: Findings as stated above which indicate: 1. Normal right carotid system. 2. 40-59% left ICA stenosis. 3. Non-visualized right vertebral artery, presumed hypoplastic or occluded. CT HEAD W/O CONTRAST [**2130-12-11**] 11:02 AM CT HEAD W/O CONTRAST Reason: r/o cva [**Hospital 93**] MEDICAL CONDITION: 56 year old woman s/p CABG(POD3)now with neuro changes REASON FOR THIS EXAMINATION: r/o cva CONTRAINDICATIONS for IV CONTRAST: None. INDICATION: Status post CABG, now with neural changes. Rule out CVA. COMPARISON: None. TECHNIQUE: MDCT acquired images of the head obtained without IV contrast. CT HEAD WITHOUT CONTRAST: There is a hypodensity in the right frontal lobe white matter as well as hypodensity in the region of the left basal ganglia and adjacent to the left lateral ventricle within the white matter consistent with chronic ischemic change/infarction. No evidence of acute intra- or extra-axial hemorrhage. There is no shift of normally midline structures. There is no sulcal effacement. [**Doctor Last Name **]-white matter differentiation appears preserved. There is minimal bilateral maxillary sinus opacification. There appears to be a skin thickening in the left frontal region. IMPRESSION: 1. Evidence of chronic infarction. 2. Left frontal skin thickening. Correlate clinically. [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 75973**] (Complete) Done [**2130-12-8**] at 11:34:03 AM PRELIMINARY Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] Division of Cardiothoracic [**Doctor First Name **] [**First Name (Titles) **] [**Last Name (Titles) **] [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2074-3-1**] Age (years): 56 F Hgt (in): 64 BP (mm Hg): / Wgt (lb): 163 HR (bpm): BSA (m2): 1.79 m2 Indication: Intraoperative TEE for CABG ICD-9 Codes: 410.91, 440.0, 424.1, 424.0, 424.2 Test Information Date/Time: [**2130-12-8**] at 11:34 Interpret MD: [**First Name8 (NamePattern2) 6506**] [**Name8 (MD) 6507**], MD Test Type: TEE (Complete) 3D imaging. Son[**Name (NI) 930**]: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 5740**], MD Doppler: Full Doppler and color Doppler Test Location: Anesthesia West OR cardiac Contrast: None Tech Quality: Adequate Tape #: 2007AW4-: Machine: 4 Echocardiographic Measurements Results Measurements Normal Range Left Atrium - Peak Pulm Vein S: 0.3 m/s Left Atrium - Peak Pulm Vein D: 0.3 m/s Left Atrium - Peak Pulm Vein A: 0.1 m/s < 0.4 m/s Left Ventricle - Ejection Fraction: 55% to 60% >= 55% Left Ventricle - Lateral Peak E': *0.05 m/s > 0.08 m/s Left Ventricle - Ratio E/E': *20 < 15 Aorta - Annulus: 2.0 cm <= 3.0 cm Aorta - Sinus Level: 3.2 cm <= 3.6 cm Aorta - Sinotubular Ridge: 2.6 cm <= 3.0 cm Aorta - Ascending: 3.4 cm <= 3.4 cm Aorta - Descending Thoracic: 2.4 cm <= 2.5 cm Mitral Valve - E Wave: 1.0 m/sec Mitral Valve - A Wave: 0.5 m/sec Mitral Valve - E/A ratio: 2.00 Findings Multiplanar reconstructions were generated and confirmed on an independent workstation. RIGHT ATRIUM/INTERATRIAL SEPTUM: A catheter or pacing wire is seen in the RA and extending into the RV. Normal interatrial septum. No ASD by 2D or color Doppler. LEFT VENTRICLE: Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Normal ascending aorta diameter. Normal aortic arch diameter. Simple atheroma in aortic arch. Normal descending aorta diameter. Simple atheroma in descending aorta. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). Trace AR. MITRAL VALVE: Myxomatous mitral valve leaflets. Moderate mitral annular calcification. Calcified tips of papillary muscles. Trivial MR. TRICUSPID VALVE: Mildly thickened tricuspid valve leaflets. Mild [1+] TR. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflets with physiologic PR. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. The patient was under general anesthesia throughout the procedure. No TEE related complications. The patient appears to be in sinus rhythm. Results were personally reviewed with the MD caring for the patient. Conclusions PRE-BYPASS: 1. No atrial septal defect is seen by 2D or color Doppler. 2. Overall left ventricular systolic function is normal (LVEF>55%). 3. Right ventricular chamber size and free wall motion are normal. 4. There are simple atheroma in the aortic arch. There are simple atheroma in the descending thoracic aorta. 5. The aortic valve leaflets (3) are mildly thickened. Trace aortic regurgitation is seen. 6. The mitral valve leaflets are myxomatous. Trivial mitral regurgitation is seen. 7. The tricuspid valve leaflets are mildly thickened. POST-BYPASS: Pt removed from CPB on phenylephrine infusion and epinephrine infusion and AV paced. 1. Initially post-bypass, mitral and tricuspid regurgitation increased to moderate and resolved soon thereafter. 2. Biventricular function is maintained, LVEF>55%. 3. Aortic contours are intact post-decannulation. Brief Hospital Course: She underwent preop work up and was taken to the operating room on [**12-8**] where she underwent a CABG x 5. She was transferred to the ICU in critical but stable condition. She was given 48 hours of perioperative prophylactic vancomycin as she was in the hospital preoperatively. She was extubated on POD #1, her epinephrine was weaned and she was started on milrinone. She was started on amiodarone for Vtach postop. On POD #3 she was found to have right hemiparesis and neurology was consulted, head CT was negative and the weakness improved. Her milrinone was weaned and she was transferred to the floor on POD #4. Bedside swallow was performed, she tolerated thin liquids and ground solids. She was ready for discharge to rehab on POD # 6. Medications on Admission: Zocor 80', Zetia 10', Toprol XL 50', Enalapril 20", ASA 81', Plavix 75' (cath), HCTZ 25', Reglan 10', Humulin 70 qAM, RISS Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*60 Capsule(s)* Refills:*0* 2. Simvastatin 40 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 3. Ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*0* 5. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 6. Enalapril Maleate 10 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). 7. Insulin NPH Human Recomb 100 unit/mL Suspension Sig: Thirty Five (35) units Subcutaneous once a day. 8. Insulin Regular Human 300 unit/3 mL Insulin Pen Sig: sliding scale Subcutaneous four times a day. 9. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Tablet(s) 10. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily) for 3 days: 400 daily x 3 days then decrease to 200 daily ongoing until dc'd by cardiologist . Tablet(s) 11. Furosemide 40 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours) for 2 weeks. 12. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: Two (2) Tab Sust.Rel. Particle/Crystal PO Q12H (every 12 hours) for 2 weeks. Discharge Disposition: Extended Care Facility: [**Hospital6 1293**] - [**Location (un) 1294**] Discharge Diagnosis: s/p CABGx5 PMH: DM,HTN,^[**Last Name (LF) **],[**First Name3 (LF) **](L ICA stenosis),GERD PSH: CCY,TAH, C-section x2 Discharge Condition: good Discharge Instructions: keep wounds clean and dry. OK to shower, no bathing or swimming. Take all medications asprescribed. Call for any fever, redness or drainage from wounds. No heavy lifting or driving Followup Instructions: [**Hospital Ward Name 121**] 6 for wound check 2 weeks Dr [**First Name (STitle) **] 4 weeks Dr [**Last Name (STitle) 73**] 2 weeks [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2130-12-14**] ICD9 Codes: 4271, 2720, 4019
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Medical Text: Admission Date: [**2132-4-27**] Discharge Date: [**2132-5-1**] Date of Birth: [**2065-10-16**] Sex: F Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 148**] Chief Complaint: (R)UQ abdominal and epigastic pain radiating to the back. Major Surgical or Invasive Procedure: None History of Present Illness: Ms. [**Known lastname 31303**] is a 66 yo F with CLL s/p multiple rounds of chemotherapy, last in [**10-9**] (Campath), with ongoing bulky adenopathy and splenomegaly who presents today with [**Date Range 5283**] and epigastric pain that radiates to her back. The pain started an hour or so after dinner and grew progressively worse throughout the evening. The pain is sharp and constant, rated as a [**9-11**] on arrival and [**6-11**] out of 10 currently. She has been nauseated throughout the evening and morning as well. She reports one episode of emesis. She denies fevers or chills. She has been having regular BM's. She denies melena, hematochezia, or [**Male First Name (un) 1658**]-colored stools. She knows that she has cholelithiasis, but denies any history of biliary colic. Past Medical History: Oncologic Hx: She completed two cycles of R-CVP back in [**7-/2130**] as part of her initial treatment for CLL. She did not have a significant response to treatment though her white count did normalize after treatment. However, the patient remained with a predominance of lymphocytes. She continued to have bulky lymphadenopathy both above and below the diaphragm following this treatment, did have slight interval decrease overall with the exception of a slight increase in the size of her lymph nodes in the right supraclavicular chain. She has remained with massive splenomegaly. She had an extended hospitalization in [**8-/2130**] for further workup for fever and night sweats. Her disease status was reassessed with a bone marrow biopsy, which confirmed her known history of CLL. She also had a lymph node biopsy of the right supraclavicular node in order to rule out transformation of her disease, which was also consistent with CLL without any evidence of transformation. However, there was note of caseating granuloma concerning for TB. She did have a PPD placed, which was positive. Of note, she also developed a rash in this setting, which eventually resolved. However, it was thought to be related to TB, noted to be granuloma annulare on biopsy. Ultimately, it was felt that she had extrapulmonary TB. She was ultimately started on TB medication regimen with rifampin, INH, ethambutol, and pyrazinamide. The patient was started on that at the time of discharge from hospital on [**2130-8-18**]. At that point, she was still having high fevers. After a few days of being on this regimen, her high fevers improved. Of note, due to a poor tolerability with anorexia, nausea, weight loss, and fatigue, we switched her regimen. The ethambutol and pyrazinamide were discontinued on [**2130-8-28**] and moxifloxacin was added. She completed a six-month course of her TB medicines, which she completed back in 02/[**2131**]. The patient refused to take the medications any longer. She then had a slowly rising white blood count over the past couple of months. Also has had a depressed platelet count. Her CT scans have overall been stable, but remained with persistent bulky disease above and below the diaphragm with massive splenomegaly. Our recommendation had been to proceed with a fludarabine-based regimen given her bulky disease, but until recently the patient refused any treatment and we had been monitoring her off treatment. She noted at the beginning of [**2-/2131**] of her plans to go to [**Country 27587**] in [**Month (only) 116**] for five or six months. As a result, she agreed to receive treatment with FCR regimen, which she began on [**2131-2-14**]. The goal of this was to cytoreduce her disease before she leaves for [**Country 27587**]. Our plan is to try to get two cycles in with time to recover prior to her departure. She presents today for evaluation and countcheck following her second cycle. . OTHER Past Medical History: 1. CLL. Please refer to OMR note [**2131-4-4**] for extensive details. 2. Extrapulmonary TB diagnosed [**8-8**], now s/p 6 months of 4-drug therapy with rifampin, INH, ethambutol, and pyrazinamide. 3. Hypothyroidism 4. OA 4. OA Social History: From [**Country 27587**]. Tobacco: [**1-6**] PPD x 45 years, no alcohol, other drugs. Lives at home with her husband, daughter, and grandson. Owns and works at her own business "Helping hands" as a home health aide. Family History: Non-contributory Physical Exam: VS: T: 99.3 PO,BP: 134/64, HR: 81, RR: 18, SaO2: 96% RA GEN: Well appearing, pleasant female in NAD. HEENT: Sclerae anicteric. O-P intact. NECK: Supple. No lympadenopathy. LUNGS: CTA(B). CARDIAC: RRR; nl S1/S2 w/o m/c/r. ABD: Normoactive BSX3. Soft/NT/ND. EXTREM: No c/c/e. NEURO: A+Ox3. Non-focal/grossly intact. SKIN: Intact. Pertinent Results: [**2132-4-27**] 04:55PM GLUCOSE-87 UREA N-11 CREAT-0.6 SODIUM-141 POTASSIUM-4.4 CHLORIDE-114* TOTAL CO2-22 ANION GAP-9 [**2132-4-27**] 04:55PM ALT(SGPT)-134* AST(SGOT)-148* ALK PHOS-138* AMYLASE-1756* TOT BILI-0.6 [**2132-4-27**] 04:55PM LIPASE-2693* [**2132-4-27**] 04:55PM ALBUMIN-3.3* CALCIUM-7.8* PHOSPHATE-3.3 MAGNESIUM-1.7 [**2132-4-27**] 04:55PM IgG-597* [**2132-4-27**] 04:55PM WBC-1.2* RBC-2.94* HGB-9.2* HCT-27.1* MCV-92 MCH-31.4 MCHC-34.1 RDW-14.1 [**2132-4-27**] 04:55PM PLT COUNT-46* [**2132-4-27**] 03:42AM LACTATE-1.1 . [**2132-4-27**] Abdominal U/S: 1. Cholelithiasis with mild intrahepatic biliary dilatation. Common bile duct is dilated measuring up to 9 mm but appears to taper distally. This is likely due to mass effect from surrounding lymph nodes and could be confirmed with CT. 2. Fatty infiltration of the liver. 3. Multiple pathologic enlarged lymph nodes at porta hepatis consistent with patient's known CLL. Brief Hospital Course: Patient admitted to SICU on [**2132-4-27**] for abdominal pain and hypotension. Hypotension responded to multiple IV fluid boluses. Made NPO. Status post ERCP with sphincterotomy and sludge/stone removal from CBD; tolerated well. Foley placed. Given IV Dilaudid for pain with good effect. Started on IV Zoysn. Hemodynamically stable. Oncology consulted during this admission; recommendations appreciated and followed. [**2132-4-28**]: Diet advanced to sips; tolerated well. Transferred to [**Hospital Ward Name 121**] 9 inpatient floor. Remained stable. Labs improved. [**2132-4-29**]: Diet advanced to clears; continued good tolerability. Foley discontinued. Ambulated frequently. [**2132-4-30**]: Advanced to regular diet with good intake. Started on Neupogen for leukopenia with associated total granulocyte count of 380. [**2132-5-1**]: Total granulocyte count 1600. IV antibiotics discontinued. Voiding, ambulating independently. Tolerating regular diet. Discharged home on Augmentin for three remaining days. Has follow-up this Saturday at the [**Hospital **] Clinic; follow-up labs to be done at that time to determine if futher Neupogen dose needed. patient hemodynamically stable. Medications on Admission: Levothyroxine 137mcg Po daily; Vitamin D Discharge Medications: 1. Colace 100 mg Capsule Sig: One (1) Capsule PO twice a day. Disp:*60 Capsule(s)* Refills:*2* 2. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 3. Levoxyl 137 mcg Tablet Sig: One (1) Tablet PO once a day. 4. Augmentin 500-125 mg Tablet Sig: One (1) Tablet PO three times a day for 3 days. Disp:*9 Tablet(s)* Refills:*0* 5. Omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. Disp:*30 Capsule, Delayed Release(E.C.)(s)* Refills:*2* 6. Dilaudid 2 mg Tablet Sig: One (1) Tablet PO every four (4) hours as needed for pain. Disp:*10 Tablet(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Primary: Gallstone Pancreatitis and cholangitis. Secondary: CLL s/p multiple rounds of chemotherapy Discharge Condition: Stable Discharge Instructions: Please call your doctor or nurse practitioner or return to the Emergency Department for any of the following: *You experience new chest pain, pressure, squeezing or tightness. *New or worsening cough, shortness of [**Hospital 1440**], or wheeze. *If you are vomiting and cannot keep down fluids or your medications. *You are getting dehydrated due to continued vomiting, diarrhea, or other reasons. Signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *You see blood or dark/black material when you vomit or have a bowel movement. *You experience burning when you urinate, have blood in your urine, or experience a discharge. *Your pain in not improving within 8-12 hours or is not gone within 24 hours. Call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *Any change in your symptoms, or any new symptoms that concern you. Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than [**5-11**] lbs until you follow-up with your surgeon. Avoid driving or operating heavy machinery while taking pain medications. Followup Instructions: You have an appointment THIS SATURDAY [**5-3**] at Heme/[**Hospital **] clinic: BED 4-HEM ONC 7F HEMATOLOGY/ONCOLOGY-7F Date/Time:[**2132-5-3**] 10:30 You have an appointment with Dr. [**Last Name (STitle) **] (Surgery) on [**2132-5-12**] at 11:45am; Location: [**Hospital Ward Name 23**] 3, [**Hospital Ward Name 516**]. Tel: ([**Telephone/Fax (1) 2828**]. Other appointments: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 7779**], MD Phone:[**Telephone/Fax (1) 3241**] Date/Time:[**2132-5-12**] 9:00 Provider: [**First Name11 (Name Pattern1) 3750**] [**Last Name (NamePattern4) 3885**], [**MD Number(3) 1240**]:[**Telephone/Fax (1) 3241**] Date/Time:[**2132-5-12**] 9:00 Completed by:[**2132-5-1**] ICD9 Codes: 2449
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Medical Text: Admission Date: [**2157-10-13**] Discharge Date: [**2157-10-21**] Date of Birth: [**2102-1-13**] Sex: F Service: CARDIOTHORACIC Allergies: Phenobarbital / Percocet / Percodan / Demerol / Nsaids Attending:[**First Name3 (LF) 922**] Chief Complaint: Chest discomfort, dyspnea Major Surgical or Invasive Procedure: [**2157-10-14**] Three Vessel Coronary Artery Bypass Grafting utilizing the left internal mammary to left anterior descending, vein grafts to obtuse marginal and right coronary artery. History of Present Illness: Mrs. [**Known lastname 18252**] presented to outside hospital with seven day history of exertional chest pain associated with dyspnea. On the morning of admission, she awoke with chest pain. EKG on admission showed new lateral T wave abnormalities. She ruled for myocardial infarction with positive troponin. Stress MIBI revealed anterior apical defect consistent with ischemic heart disease. Subsequent cardiac catheterization showed severe three vessel coronary artery disease including an 80% ostial left main lesion. Given her critical coronary anatomy, she was transferred to the [**Hospital1 18**] for surgical intervention. Past Medical History: Coronary Artery Disease Hypertension Hypercholesterolemia Diabetes Mellitus Type II History of Herpes Zoster Osteoarthritis Gout Gastroesophogeal Reflux Disease History of Asthma(Cold-induced) s/p Laminectomy s/p Bilateral Total Knee Replacements s/p Bilateral Shoulder Surgery s/p Cholecystectomy s/p Cervical Fusion s/p Lasery Eye Surgery s/p Carpal Tunnel Surgery Social History: Works as [**Name8 (MD) **] RN, lives alone. Denies tobacco and ETOH. Family History: Father has history of MI. Sister underwent PTCA at age 60. Physical Exam: Vitals: T 98.0, BP 139/77, HR 72, RR 16, SAT 96% 2L General: WDWN femaile in no acute distress HEENT: Oropharynx benign, EOMI Neck: Supple, no JVD Lungs: CTA bilaterally Heart: Regular rate and rhythm, normal s1s2, no murmur or rub Abdomen: Soft, nontender with normoactive bowel sounds Ext: Warm, no edema Pulses: 1+ distally Neuro: Alert and oriented, CN 2- 12 grossly intact, no focal deficits noted Pertinent Results: [**2157-10-20**] 04:45PM BLOOD WBC-11.3*# RBC-4.24 Hgb-12.6 Hct-35.4* MCV-84 MCH-29.7 MCHC-35.6* RDW-13.6 Plt Ct-520* [**2157-10-13**] 10:59AM BLOOD WBC-7.8 RBC-4.27 Hgb-12.9 Hct-36.1 MCV-85 MCH-30.2 MCHC-35.7* RDW-13.4 Plt Ct-342 [**2157-10-20**] 04:45PM BLOOD Plt Ct-520* [**2157-10-14**] 12:31PM BLOOD PT-13.5* PTT-34.3 INR(PT)-1.2* [**2157-10-13**] 10:59AM BLOOD Plt Ct-342 [**2157-10-13**] 10:59AM BLOOD PT-12.8 PTT-57.6* INR(PT)-1.1 [**2157-10-14**] 11:13AM BLOOD Fibrino-122* [**2157-10-20**] 04:45PM BLOOD Glucose-159* UreaN-17 Creat-1.0 Na-137 K-4.1 Cl-94* HCO3-31 AnGap-16 [**2157-10-13**] 10:59AM BLOOD Glucose-218* UreaN-24* Creat-1.0 Na-140 K-4.0 Cl-103 HCO3-27 AnGap-14 [**2157-10-20**] 04:45PM BLOOD ALT-89* AST-58* LD(LDH)-243 AlkPhos-105 Amylase-49 TotBili-0.4 [**2157-10-20**] 04:45PM BLOOD Lipase-52 [**2157-10-13**] 10:59AM BLOOD cTropnT-0.01 [**2157-10-20**] 04:45PM BLOOD Albumin-3.7 Calcium-10.0 Phos-4.7* Mg-1.6 [**2157-10-13**] 10:59AM BLOOD %HbA1c-6.5* RADIOLOGY Final Report CHEST (PA & LAT) [**2157-10-18**] 3:45 PM CHEST (PA & LAT) Reason: eval ptx s/p CT d/c [**Hospital 93**] MEDICAL CONDITION: 55 year old woman s/p CABG REASON FOR THIS EXAMINATION: eval ptx s/p CT d/c REASON FOR EXAM: S/P CABG, chest tube removed. PA AND LATERAL VIEWS OF THE CHEST, THREE RADIOGRAPHS: Patient is post median sternotomy and CABG. Cardiac size is normal. Left lower lobe atelectasis has improved, almost completely resolved. Otherwise, the lungs are clear. There is a questionable small apical left pneumothorax. DR. [**First Name (STitle) 3901**] [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 3902**] DR. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 4392**] Approved: WED [**2157-10-19**] 9:37 AM Cardiology Report ECG Study Date of [**2157-10-15**] 2:07:26 PM Sinus rhythm. Findings are as previously described on the tracing of [**2157-10-14**] and are probably without change, although baseline artifact makes comparison difficult. TRACING #2 Read by: [**Last Name (LF) **],[**First Name3 (LF) 177**] W. Intervals Axes Rate PR QRS QT/QTc P QRS T 95 118 94 326/387 11 23 67 Cardiology Report ECHO Study Date of [**2157-10-14**] PATIENT/TEST INFORMATION: Indication: Intraoperative TEE for CABG procedure Height: (in) 66 Weight (lb): 193 BSA (m2): 1.97 m2 BP (mm Hg): 156/78 HR (bpm): 67 Status: Inpatient Date/Time: [**2157-10-14**] at 10:32 Test: TEE (Complete) Doppler: Full Doppler and color Doppler Contrast: None Tape Number: 2007AW1-: Test Location: Anesthesia West OR cardiac Technical Quality: Adequate REFERRING DOCTOR: DR. [**First Name11 (Name Pattern1) 177**] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] MEASUREMENTS: Left Ventricle - Inferolateral Thickness: *1.4 cm (nl 0.6 - 1.1 cm) Left Ventricle - Diastolic Dimension: 5.0 cm (nl <= 5.6 cm) Left Ventricle - Ejection Fraction: 55% (nl >=55%) Aorta - Ascending: 2.8 cm (nl <= 3.4 cm) Mitral Valve - E Wave: 0.7 m/sec Mitral Valve - A Wave: 0.8 m/sec Mitral Valve - E/A Ratio: 0.88 TR Gradient (+ RA = PASP): >= 19 mm Hg (nl <= 25 mm Hg) INTERPRETATION: Findings: RIGHT ATRIUM/INTERATRIAL SEPTUM: A catheter or pacing wire is seen in the RA and extending into the RV. No ASD by 2D or color Doppler. LEFT VENTRICLE: Normal regional LV systolic function. Overall normal LVEF (>55%). No resting LVOT gradient. RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal ascending aorta diameter. Normal aortic arch diameter. Normal descending aorta diameter. Simple atheroma in descending aorta. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). No AS. No AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Mild (1+) MR. GENERAL COMMENTS: A TEE was performed in the location listed above. I certify I was present in compliance with HCFA regulations. No TEE related complications. The patient appears to be in sinus rhythm. Results were Conclusions: Prebypass 1.No atrial septal defect is seen by 2D or color Doppler. 2.Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). 3.Right ventricular chamber size and free wall motion are normal. 4. There are simple atheroma in the descending thoracic aorta. 5.The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. 6.The mitral valve leaflets are mildly thickened. Mild (1+) mitral regurgitation is seen. Post Bypass 1. Biventricular systolic function is unchanged. 2. Mild mitral regurgitation persists. 3. Aorta intact post decannulation Electronically signed by [**Name6 (MD) 1509**] [**Name8 (MD) 1510**], MD on [**2157-10-14**] 11:54. [**Location (un) **] PHYSICIAN: Brief Hospital Course: Mrs. [**Known lastname 18252**] was admitted to the cardiac surgical service and underwent routine preoperative evaluation. She remained pain free on intraveous therapy. Workup was unremarkable and she was cleared for surgery. On [**10-14**], she underwent coronary artery bypass grafting by Dr. [**Last Name (STitle) 914**]. For surgical details, please see seperate dicatated operative note. Following the operation, she was brought to the the CSRU for invasive monitoring. Within 24 hours, she awoke neurologically intact and was extubated without incident. Due to hypertension, she initially required Nitro drip. Over several days, medical therapy was titrated accordingly and she transferred to the SDU for further care and recovery. Chest tubes and pacing wires were removed without complication. She had several episodes of agitation and confusion after receiving dilaudid and IV ativan, the confusion resolved after discontinuing the medications. However On POD # 5 was seen by psychiatry for disorientation and agitation after receing ambien for sleep. She was given Haldol and she improved over a few hours. She was pleasant and cooperative in the afternoon and interacting with visitors. She was ready for discharge to rehab on POD 7. Medications on Admission: IV Heparin, Aspirin 81 qd, Lasix 40 qd, Glyburide 2.5 [**Hospital1 **], Lopressor 50 [**Hospital1 **], Cytotec 200 [**Hospital1 **], Relafen, Protonix 40 qd, Crestor 10 qd, Effexor XL 150 qd, Calan 240 qd, Citracal Discharge Medications: 1. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 4. Rosuvastatin 5 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime). 5. Ezetimibe 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. Venlafaxine 75 mg Capsule, Sust. Release 24 hr Sig: Two (2) Capsule, Sust. Release 24 hr PO DAILY (Daily). 7. Misoprostol 200 mcg Tablet Sig: One (1) Tablet PO BID (2 times a day). 8. Furosemide 40 mg Tablet Sig: One (1) Tablet PO once a day. 9. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. Glyburide 2.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 11. Metformin 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 13. Insulin Glargine 100 unit/mL Solution Sig: Fourteen (14) units Subcutaneous once a day. 14. Insulin Regular Human 100 unit/mL Solution Sig: sliding scale Injection four times a day. Discharge Disposition: Extended Care Facility: [**Location (un) 38640**] [**Doctor Last Name **] Discharge Diagnosis: Coronary Artery Disease. Acute MI - s/p CABG Hypertension Hypercholesterolemia Diabetes Mellitus Type II Discharge Condition: Good Discharge Instructions: 1)Please shower daily. No baths. Pat dry incisions, do not rub. 2)Avoid creams and lotions to surgical incisions. 3)Call cardiac surgeon if there is concern for wound infection [**Telephone/Fax (1) 170**]. 4)No lifting more than 10 lbs for at least 10 weeks from surgical date. 5)No driving for at least one month. Followup Instructions: Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 914**] in [**5-19**] weeks, call for appt [**Telephone/Fax (1) 170**] Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 39975**] in [**3-19**] weeks, call for appt Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] in [**3-19**] weeks, call for appt [**Telephone/Fax (1) 74697**] Completed by:[**2157-10-21**] ICD9 Codes: 4019, 2749, 2720
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Medical Text: Admission Date: [**2158-11-4**] Discharge Date: [**2158-11-12**] Date of Birth: [**2094-3-2**] Sex: F Service: HISTORY OF PRESENT ILLNESS: This is a 64-year-old female with a history of MDS diagnosed in [**2157-2-18**] requiring serial platelet and RBC transfusions every two weeks presenting with a history of bronchitis, who was treated as an outpatient with Augmentin, who was then admitted to the Medicine service on the [**3-4**]. Patient was initially treated with the following antibiotics: Zithromax, cefepime, and Vancomycin. Her chest x-ray was consistent with pneumonia on the right side and mild volume overload. The patient was persistently febrile with a cough and had new onset atrial fibrillation with hypoxic episodes. There was concern regarding her relative immunosuppression and therefore, the patient was started on Bactrim treatment and was transferred to the MICU for management of hypoxia, possible intubation, and concern for PCP [**Name Initial (PRE) 1064**]. In the MICU, the patient's oxygen saturations fluctuated. She was 93% on 100% nonrebreather. She continued to complain of sensation of shortness of breath, but denied any chest pain, nausea, vomiting, abdominal pain. She was delirious and somewhat confused at her initial presentation in the MICU. PAST MEDICAL HISTORY: As noted above. 1. MDS. 2. CHF. 3. AFib. 4. CVA diagnosed in [**2156**]. FAMILY HISTORY: Noncontributory. SOCIAL HISTORY: No alcohol abuse. No tobacco. She has two grown children and lives at home. PHYSICAL EXAMINATION: Her physical exam was notable for a T max of 102.6. She was tachycardic, atrial fibrillation at 126-136 was her ventricular rate, blood pressure ranged from 95-111/48-55. Her respiratory rate ranged from 33-40. She was 93-94% on 100% nonrebreather. Her exam was notable for elderly appearing frail female, who was oriented x1. She had regular tachycardia, S1, S2. Pulmonary examination: Bronchial breath sounds with bibasilar crackles. Abdominal examination was soft, obese. Extremity examination was unremarkable. Her EKG showed sinus tachycardia with normal axis and intervals. She had old T-wave inversions in V1 through V4, otherwise no evidence of acute ischemia. LABORATORY STUDIES: Remarkable for platelets of 13,000 and hematocrit of 28.3. Upon admission to the MICU, her ABG was 7.52, 23, 66. Lactate 2, TSH 1.4, fibrinogen 818. Echocardiogram from the [**2-23**]: Ejection fraction 60%, left atrial dilatation, [**12-22**]+ TR, no vegetations. RADIOGRAPHIC DATA: Showed pulmonary congestion with possible infiltrates. CT of her abdomen from the [**3-4**] notable for ground-glass opacities at the lung bases, otherwise it was unremarkable. HOSPITAL COURSE BY PROBLEM: 1. Respiratory failure, pneumonia, and CHF: The patient had persistent temperature spikes. She was maintained on triple antibiotic regimen, however, persistently spiked and without any change in her chest x-ray or symptoms. In the setting of her immunosuppression, there is a higher suspicion for PCP and fungal etiologies, therefore, the patient was maintained on Vancomycin, azithromycin, cefepime, and Bactrim. The patient had a history of oral herpetic lesions in the past and was started on acyclovir as well. Given the patient's poor respiratory status as well as overall poor prognosis. The patient's family agreed to pursue comfort measures only. 2. MDS: The patient's platelets remained below 15,000 despite multiple transfusions. There is no evidence of active bleeding. 3. Change in mental status and fever: CT of the head was performed to evaluate any evidence of an acute intracranial hemorrhage. There was no evidence of that. CTA was also performed to evaluate for any evidence of a pulmonary embolus given the patient's ongoing hypoxia. In summary, given the patient's overall poor prognosis and ongoing hypoxia despite very broad coverage with antimicrobials, a family meeting confirmed the patient's code status DNR/DNI as well as pursuing comfort measures only. The patient proceeded to become more tachypneic and tachycardic throughout her hospital course. All of her antibiotics were withdrawn and the patient was put on a Morphine drip titration to comfort measures. On [**2158-11-11**], patient was sedated and reportedly unresponsive to verbal stimuli, and was persistently tachycardic. On the [**11-12**], the patient died. Family members were present at the time of death which was 4:20 a.m. Family declined an autopsy. CAUSE OF DEATH: Respiratory distress secondary to pneumonia and myelodysplastic syndrome. Immediate cause of death was respiratory failure. [**First Name8 (NamePattern2) 1176**] [**Name8 (MD) 1177**], M.D. [**MD Number(1) 1178**] Dictated By:[**Last Name (NamePattern1) 1600**] MEDQUIST36 D: [**2158-11-27**] 12:58 T: [**2158-11-29**] 06:29 JOB#: [**Job Number 97463**] ICD9 Codes: 486, 4280, 2875, 2859
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Medical Text: Admission Date: [**2160-12-6**] Discharge Date: [**2160-12-7**] Date of Birth: [**2091-1-12**] Sex: F Service: Neurology CHIEF COMPLAINT: Basal ganglia hemorrhage. HISTORY OF PRESENT ILLNESS: This is a 69-year-old woman with a past medical history of hypertension, who complained of a stiff neck and headache for days, and then suddenly collapsed at home with slurred speech, left arm weakness, left facial droop, and progressive had headache, nausea, vomiting, and rapid progressive loss of consciousness. She was seen at [**Hospital3 3765**], intubated there. She was med flighted to [**Hospital1 69**] for further care and had a CT scan at the [**Hospital1 190**] ED which showed roughly 200 cc sized right sided basal ganglia hemorrhage. PAST MEDICAL HISTORY: Hypertension. MEDICATIONS: None. ALLERGIES: None. HABITS: Not known. SOCIAL HISTORY: Currently lives at home, married, and two sons. FAMILY HISTORY: Noncontributory. PHYSICAL EXAMINATION: Temperature 94.8 axillary, blood pressure 143/86 on Nipride drip, heart rate 53, respiratory rate 14 on mechanical ventilation. General: Elderly woman intubated. Mental status: Patient is comatosed, turning her head to nasopharyngeal stimulation, but not responding to sternal rub, voice, or pain. Cranial nerves: Does not blink to threat. Pupils fixed at roughly 6 mm and do not respond to night. Subtle corneal responses bilaterally. Head turn to nasopharyngeal stim. No oculocephalic reflexes. No gag. There is, however, some gagging with deep suctioning by the respiratory therapist. Motor and sensory: Tone decreased throughout all four limbs. There is slight dorsiflexion and hip flexion with nailbed stim on the right lower extremity. There is slight dorsiflexion on the left lower extremity to nailbed stimulation. Otherwise, there is no movement elsewhere. Reflexes: Mute toes bilaterally. LABORATORIES UPON PRESENTATION: Chem-7 normal except for a potassium of 3.1. Coags normal with an INR of 0.98. White blood cell count 8.2, hematocrit 38.9, platelets 200. IMAGING: CT of the head: 6 x 7 cm bleed on 11 slices with interventricular blood in the third, fourth, and occipital horns of the lateral ventricles. HOSPITAL COURSE: Basal ganglia hemorrhage: The estimated volume of the bleed was approximately 200 cc and as explained to the family, the size of the bleed was virtually unsurvivable. She already had minimal brain stem reflexes and for that reason, it was explained to the family that she would progressively loose those brain stem reflexes given the amount of swelling and blood in the intracranial space. The family did agree for comfort measures only, however, they did want to pursue the possibility of organ donation. For this reason, she was admitted to the ICU on the ventilator and a Nipride drip to maintain her hemodynamics until brain death was declared. She had an arterial line placed for blood pressure monitoring. She maintained a good urine output. By the following morning, she only had one cornea that was reactive and had minimal triple flexion on the right lower extremity to nailbed stimulation. The family was updated and they wished that the patient be extubated, and did not want to wait further for brain death or harvesting of organs. The patient was declared at 2:09 p.m. after extubation and she died of apnea within minutes. [**Name6 (MD) **] [**Name8 (MD) **], M.D. [**MD Number(1) 12114**] Dictated By:[**Name8 (MD) 4064**] MEDQUIST36 D: [**2160-12-8**] 13:46 T: [**2160-12-8**] 14:12 JOB#: [**Job Number 53820**] ICD9 Codes: 431, 4019
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Medical Text: Admission Date: [**2186-12-14**] Discharge Date: [**2186-12-23**] Date of Birth: [**2116-4-8**] Sex: M Service: SURGERY Allergies: Vancomycin / Shellfish Derived Attending:[**First Name3 (LF) 2777**] Chief Complaint: Non-productive cough, lethargy and 13 point drop in Hct, CXR from PCP showed no acute process. Major Surgical or Invasive Procedure: [**2186-12-14**] Endovascular repair of aortic psuedoaneurysm and placement R renal stent for aortic graft leak. [**2186-12-16**] Oral exploration and extraction of infected foreign body and teeth #s 2, 3, 4, 5 and 6. History of Present Illness: 70 y-o gentleman presents as transfer from [**Hospital1 6687**] for low HCT. The patient initially presented to his PCP today with [**Name Initial (PRE) **] new non-productive cough and lethargy. The PCP obtained [**Name Initial (PRE) **] CXR that showed no acute process. During the patient's workup, the patient's HCT was found to be 18.1. His baseline is low 30's, and the most recent documented HCT before today was 31 in 5/[**2186**]. Even though the patient had no complaints of abdominal pain or vomiting, an NGT was placed in the patient in [**Hospital1 6687**] - lavage was guaiac negative. The patient was transferred to [**Hospital1 18**] for further eval, given his history of recent surgery at this hospital. On arrival the patient reports no chest pain or abdominal pain. He has no leg pain and he says he walks around with a cane without any cramps in his legs. He occasionally feels pain in his left foot when in bed at nighttime. He denies any recent fevers or chills. His last BM was yesterday, and the patient states there was no blood in his stool. Of note, the patient was admitted to [**Hospital1 18**] in [**2186-2-10**] for melanotic stools - UGI and colonoscopy obtained at the time were normal. [**Year (4 digits) **] surgery was consulted for potential aorto-enteric fistula in this patient, given his history of aorta repair and his seemingly sudden drop in HCT. Of note, the patient received 2 units of pRBCs prior to transfer to [**Hospital1 18**]. Past Medical History: Hyperlipidemia HTN Embolic stroke history, with extended hospitalization and rehabilitation after bowel surgery [**4-/2185**] CAD w/ severe 3-vessel disease shown in [**2166**] AAA - infrarenal 4.8cm s/p repair PVD CRI CHF - reported in prior echo as "depressed EF" without exact quanitification Afib s/p ablation [**12-11**] SDH fall in [**10-16**] Right fem [**Doctor Last Name **] in situ (93) s/p Left fem [**Doctor Last Name **] in situ (93) Vein angioplasty of left femoral artery 01 Hearing impairment Ischemic bowel s/p SB resection [**4-17**] with MSA stent Past history EtOH abuse Social History: Heavy drinker in past, indicates stopped drinking 1 year ago, 1ppd tobacco for many years until 1 year ago, used to work as a lawyer (real estate property) and retired in his 50s, now lives in [**Hospital1 6687**] with wife, who is a school teacher. Family History: NC Physical Exam: VS T 98.8 P 68 BP 128/48 RR 16 O2 sat 93% on 2 L O2 Gen: NAD, alert and oriented Heart: RRR, no murmur Lungs: exp. wheezes b/l, diminished bases Abd: distended, soft, non-tender, positive bowel sounds Ext: well perfused b/l Pulses: DP PT R Dop palp L palp palp Pertinent Results: [**2186-12-19**] 05:23AM BLOOD WBC-6.7 RBC-3.21* Hgb-9.3* Hct-27.9* MCV-87 MCH-28.9 MCHC-33.3 RDW-17.5* Plt Ct-94* [**2186-12-18**] 06:00AM BLOOD WBC-5.1 RBC-3.07* Hgb-9.4* Hct-26.8* MCV-87 MCH-30.5 MCHC-34.9 RDW-18.2* Plt Ct-88* [**2186-12-19**] 05:23AM BLOOD Plt Ct-94* [**2186-12-19**] 05:23AM BLOOD Glucose-95 UreaN-26* Creat-1.6* Na-140 K-3.4 Cl-103 HCO3-30 AnGap-10 [**2186-12-19**] 05:23AM BLOOD Calcium-7.6* Phos-2.3* Mg-1.7 Cardiology: ECG Study Date of [**2186-12-13**] 5:31:56 PM Sinus bradycardia. Poor R wave progression. Lateral ST-T wave changes suggest myocardial ischemia. Compared to the previous tracing of [**2186-3-9**] the lateral T wave inversions are new. RADIOLOGY: Radiology Report CHEST (PORTABLE AP) Study Date of [**2186-12-13**] 8:57 PM Final Report: Comparison is made with a prior study from [**2186-3-10**]. IMPRESSION: Adequate position of right IJ and NG tubes. Mild congestion with increased retrocardiac density which may reflect atelectasis or pneumonia. Small left pleural effusion. CTA PELVIS W&W/O C & RECONS Study Date of [**2186-12-14**] 12:00 AM IMPRESSION: 1. Interval development of a large amount of intraperitoneal fluid measuring 10 Hounsfield units. Althouhg this could be related to cirrhotic liver, differential diagnostic consideration includes blood tracking into the peirtoneum from the presumed retroperitoneal fluid (?blood) collection. The low attenuation of the peritoneal fluid low may be due to patient's anemia. 2. Low-density fluid collection along the left psoas muscle is highly suspicious for a retroperitoneal bleeding. 3. Abdomanial aortic thrombus at the superior aspect of the graft. The findings were discussed with Dr. [**Last Name (STitle) 31549**] at the time of interpretation. CHEST (PORTABLE AP) Study Date of [**2186-12-14**] 8:24 PM The patient was intubated in the meantime interval with the ET tube tip being 6.5 cm above the carina. The right internal jugular line tip is in distal SVC. The NG tube tip is in the stomach. There is interval worsening of aeration of the left lower lung and bilateral increase in pleural effusion. There is no significant change in perihilar interstitial opacities most likely representing pulmonary edema since they have been absent on the study from [**2185-5-31**], and demonstrates fluctuating on several subsequent radiographs including [**2186-3-10**]. the appearance on [**2186-12-13**] study suggests acute origin of the findings rather than chronic interstitial changes. The aortic graft is noted in the abdomen. Brief Hospital Course: [**2186-12-14**] 70 y-o gentleman transfer from [**Hospital1 6687**] for low HCT. Days prior presented to his PCP today with [**Name Initial (PRE) **] new non-productive cough and lethargy. Work-up CXR showed no acute process. HCT was found to be 18.1. His baseline is low 30's. [**Name Initial (PRE) **] surgery was consulted for potential aorto-enteric fistula given his history of aorta repair and his sudden drop in HCT. Patient received 2 units of pRBCs from OSH prior to transfer to [**Hospital1 18**]. - CT pelvis- showed large amount of intraperitoneal fluid measuring 10 Hounsfield units from Leaking of pseudoaneurysm from proximal aortic graft anastomosis. - Pre-oped and taken to OR for: 1. Ultrasound-guided puncture of right common femoral artery. 2. Ultrasound-guided puncture of left brachial artery. 3. Introduction of catheter into aorta. 4. Abdominal aortogram. 5. Proximal cuff extension placement x 2 to previously placed aortobifemoral bypass graft. 6. Right renal artery stent. 7. Selective renal arteriogram. 8. Percutaneous groin closure of right common femoral arteriotomy. - Post-op admitted to CV ICU - Transfused with 2 units FFP post-op. - Intubated - Sedated - serial HCT - DVT prophylaxis [**2186-12-15**] Remains sedate,intubated. Weaned and extubated later. Nitro drip for BP control. - Hepatology consult- for elevated LFT's -likely 2nd to liver cirrhosis- following. [**2186-12-16**] Serial Hct, transfused with 1 unit PRBC's for Hct 24.8. Noted to have rash throughout body. - Started Lasix [**Hospital1 **]. - Started on Cipro for E-coli in urine - Pain control - Transferred to [**Hospital Ward Name 121**] 5 VICU - Oral surgery consulted for infected tooth/upper quadrant bridge, consented and taken to the OR for eploration and removal of infected foreign body (upper quadrant bridge) and #'s 2, 3, 4, 5 and 6 teeth and roof fixation. [**Date range (1) 106728**] VSS. Monitoring Hct-27.9. - continued to diurese with Lasix - Floor status, A-line d/c'd, central line kept - Physical therapy consult, out of bed - Diet advanced t o as tolerated, aspiration precaution [**2186-12-19**] No acute events, extra Lasix dose given for respiratory congestion and diminished breath sounds. - CXR-Probable no interval change in left pleural effusion and left lower lobe atelectasis. - Electrolytes repleted. - INR persist to be elevated- Hepatology re-consulted, will follow. - Continues on Cipro- urine culture came back with E-coli sensitive to Cipro. [**12-20**] - [**12-22**] [**Hospital 25403**] rehab, coordination of transportation by ambulance/ferry to [**Hospital1 6687**]. Stable for DC Medications on Admission: Keppra 500 mg [**Hospital1 **] Lamotrigine 50 mg qhs Lipitor 80 mg qd Venlafaxine 25 mg [**Hospital1 **] Lomotil 2.5 mg tid prn Metoprolol ER 200 mg qd Plavix 75 mg qd Mirtazapine 15 mg qd Trazodone 25 mg prn qhs Discharge Medications: 1. Levetiracetam 250 mg Tablet [**Hospital1 **]: Two (2) Tablet PO BID (2 times a day). 2. Aspirin 325 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 3. Lamotrigine 25 mg Tablet [**Hospital1 **]: Two (2) Tablet PO HS (at bedtime). 4. Diphenhydramine HCl 25 mg Capsule [**Hospital1 **]: One (1) Capsule PO Q6H (every 6 hours) as needed. 5. Acetaminophen 325 mg Tablet [**Hospital1 **]: Two (2) Tablet PO Q6H (every 6 hours) as needed. 6. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) [**Hospital1 **]: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 7. Oxycodone-Acetaminophen 5-325 mg Tablet [**Hospital1 **]: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 8. Docusate Sodium 100 mg Capsule [**Hospital1 **]: One (1) Capsule PO BID (2 times a day). 9. Senna 8.6 mg Tablet [**Hospital1 **]: One (1) Tablet PO BID (2 times a day). 10. Allopurinol 100 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 11. Lipitor 80 mg Tablet [**Hospital1 **]: One (1) Tablet PO once a day. 12. Venlafaxine 25 mg Tablet [**Hospital1 **]: One (1) Tablet PO twice a day. 13. Keppra 500 mg Tablet [**Hospital1 **]: One (1) Tablet PO twice a day. 14. Mirtazapine 15 mg Tablet [**Hospital1 **]: One (1) Tablet PO once a day. 15. Trazodone 50 mg Tablet [**Hospital1 **]: 0.5 Tablet PO at bedtime. 16. Metoprolol Succinate 200 mg Tablet Sustained Release 24 hr [**Hospital1 **]: One (1) Tablet Sustained Release 24 hr PO once a day. 17. Lomotil 2.5-0.025 mg Tablet [**Hospital1 **]: One (1) Tablet PO three times a day: prn. Tablet(s) 18. Trimethoprim-Sulfamethoxazole 160-800 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily) for 10 days. Tablet(s) 19. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) [**Hospital1 **]: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 20. Ipratropium Bromide 0.02 % Solution [**Hospital1 **]: One (1) NEB IH Inhalation Q6H (every 6 hours). 21. Furosemide 20 mg Tablet [**Hospital1 **]: One (1) Tablet PO BID (2 times a day). 22. Oxycodone 5 mg Tablet [**Hospital1 **]: 1-2 Tablets PO every 4-6 hours as needed for pain. 23. Venlafaxine 25 mg Tablet [**Hospital1 **]: One (1) Tablet PO BID (2 times a day). 24. Albuterol Sulfate 2.5 mg /3 mL (0.083 %) Solution for Nebulization [**Hospital1 **]: One (1) NEB INH Inhalation Q6H (every 6 hours). 25. Heparin (Porcine) 5,000 unit/mL Solution [**Hospital1 **]: One (1) injection Injection TID (3 times a day). 26. Insulin Sliding Scale Discharge Disposition: Extended Care Facility: [**Hospital6 **] Discharge Diagnosis: Primary: Aortic psuedoaneurysm aortic graft leak UTI Acute on chronic systolic CHF - requiring Lasix Infected foreign body and teeth #s 2, 3, 4, 5 and 6. Secondary: PVD Hyperlipidemia HTN Embolic CVA (after SBR in [**2185**]) CAD CRI PMH: SDH ([**2184**]), ischemic colitis PSH: Aortobifem bypass [**2173**], SB resection ([**Doctor Last Name **]) & SMA Stent [**2185**], A Fib s/p ablation [**12/2179**], R SFA occlusive disease, L SFA occlusive disease s/p angioplasty [**2179**] Discharge Condition: Stable Discharge Instructions: Division of [**Year (4 digits) **] and Endovascular Surgery Stent Discharge Instructions Medications: ?????? Take Aspirin 325mg (enteric coated) once daily ?????? If instructed, take Plavix (Clopidogrel) 75mg once daily ?????? Continue all other medications you were taking before surgery, unless otherwise directed ?????? You make take Tylenol or prescribed pain medications for any post procedure pain or discomfort What to expect when you go home: It is normal to have slight swelling of the legs: ?????? Elevate your leg above the level of your heart (use [**2-12**] pillows or a recliner) every 2-3 hours throughout the day and at night ?????? Avoid prolonged periods of standing or sitting without your legs elevated ?????? It is normal to feel tired and have a decreased appetite, your appetite will return with time ?????? Drink plenty of fluids and eat small frequent meals ?????? It is important to eat nutritious food options (high fiber, lean meats, vegetables/fruits, low fat, low cholesterol) to maintain your strength and assist in wound healing ?????? To avoid constipation: eat a high fiber diet and use stool softener while taking pain medication What activities you can and cannot do: ?????? When you go home, you may walk and go up and down stairs ?????? You may shower (let the soapy water run over groin incision, rinse and pat dry) ?????? Your incision may be left uncovered, unless you have small amounts of drainage from the wound, then place a dry dressing or band aid over the area that is draining, as needed ?????? No heavy lifting, pushing or pulling (greater than 5 lbs) for 1 week (to allow groin puncture to heal) ?????? After 1 week, you may resume sexual activity ?????? After 1 week, gradually increase your activities and distance walked as you can tolerate ?????? No driving until you are no longer taking pain medications ?????? Call and schedule an appointment to be seen in [**3-14**] weeks for post procedure check and ultrasound What to report to office: ?????? Numbness, coldness or pain in lower extremities ?????? Temperature greater than 101.5F for 24 hours ?????? New or increased drainage from incision or white, yellow or green drainage from incisions ?????? Bleeding from groin puncture site SUDDEN, SEVERE BLEEDING OR SWELLING (Groin puncture site) ?????? Lie down, keep leg straight and have someone apply firm pressure to area for 10 minutes. If bleeding stops, call [**Date Range 1106**] office [**Telephone/Fax (1) 1237**]. If bleeding does not stop, call 911 for transfer to closest Emergency Room. Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 3469**], MD Phone:[**Telephone/Fax (1) 1237**] Date/Time:[**2187-1-18**] 11:45 Completed by:[**2186-12-23**] ICD9 Codes: 5180, 5990, 2851, 2724, 5859, 4439, 4280
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Medical Text: Admission Date: [**2143-3-9**] Discharge Date: [**2143-3-12**] Date of Birth: [**2069-7-1**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern1) 7539**] Chief Complaint: Chest pain Major Surgical or Invasive Procedure: Left and right heart catheterization from right femeral artery Drug eluting stent placement to RCA History of Present Illness: 73 y/o F w/ no previous PMH, on no home meds. Was shopping w/ daughter when developed acute onset of CP, assoc w/ SOB & diaphoresis. Described CP as band-like tightness. Denies n/v. Presented to OSH, found to have inferior STE on EKG and positive troponins. She was started on ASA, plavix, lopressor, and aggrestat. She was placed on a nitro gtt for SBP in 200s. She was then transferred to [**Hospital1 18**] for intervention. . Of note, daughter won $10,000 scratch lottery on Monday. . ROS: Active, cares for grandchild. Denies PND, orthopnea. Past Medical History: s/p vaginal hysterectomy Social History: Retired, previously worked in housekeeping at [**Hospital 1474**] Hospital. Is widowed. Husband was murdered 30+ years ago, so she raised her 7 children on her own. She is a prior smoker, though she quit around age 60. She has a 60 pack-year history. Denies EtOH or illicits. Is very active and takes care of her grandchildren. Of note, her daughter won $10,000 on a scratch ticket earlier in the week (? cause of her excitement/surprise/stress) Family History: 7 grown children, all healthy. Brother had first MI at age 40. Physical Exam: PE (post-cath): VS - T 97.5, HR 61, BP 129/74, RR 20, O2 sat 100% 3L NC general - in bed, comfortable, NAD HEENT - OP clr, MMM, JVP difficult to assess supine CV - RRR, nl s1 s2, no m/r/g chest - CTAB abd - NABS, soft, NT, no g/r ext - no edema, 1+ DP/PT pulses R groin - dressing intact, small hematoma, no bruit, R femoral venous catheter intact Pertinent Results: Labs on admission: WBC 8.7, Hgb 12.2, Hct 36.1, MCV 90, Plt 316 PT 13.9*, PTT 138.6*, INR(PT) 1.2* Na 137, K 4.1, Cl 105, HCO3 21, BUN 17, Cr 0.6, Glu 118 Ca 8.6, Phos 3.8, Mg 1.9, ALT 11, AST 35 ABG: pO2-138* pCO2-39 pH-7.41 calHCO3-26 . [**2143-3-9**] 07:23PM BLOOD CK(CPK)-153* CK-MB-18* MB Indx-11.8* cTropnT-0.68* [**2143-3-10**] 03:16AM BLOOD CK(CPK)-143* CK-MB-17* MB Indx-11.9* . [**2143-3-11**] 05:30AM BLOOD Chol 179, TG 90, HDL 56, CHOL/HD 3.2, LDLcalc 105 . Labs on discharge: WBC 7.7, Hgb 11.6*, Hct 34.5*, MCV 88, Plt 284 Na 142, K 4.3, Cl 106, HCO3 27, BUN 18, Cr 0.7, Glu 86, Mg 2.1 . Imaging: CARDIAC CATH [**2143-3-9**]: 1. Coronary angiography revelaed a right dominant system. The LMCA showed no significant stenoses. The LAD showed a smooth 60% midsegment stenosis and a smooth 50% distal segment stenosis. The LCX showed no significant stenoses with minimal luminal irregularities. The RCA showed serial 60% mid and 60% distal stenoses which appeared irregular and potentially consistent with resolution of previously ruptured plaques. 2. Hemodynamic studies demonstrated normal filling pressures with severely reduced cardiac index initially measured at 1.6 L/min/m2, which was likely altered by falsely elevated initial hemoglobin measurement. 3. Left ventriculography was notable for symmetric anterolateral, apical, and inferior wall akinesis suggestive of apical ballooning syndrome. The anterobasal and inferobasal regions were hyperkinetic with estimated ejection fraction of 40-50%. There was no evidence of mitral regurgitation. 4. Successful placement of two overlapping Cypher drug-eluting stents (3.5 x 28 mm proximally with 3.5 x 23 mm distally) in the mid-RCA. Final angiography demonstrated minimal residual stenosis in the proximal stent, moderate disease in the jailed acute marginal, no angiographically apparent dissection, and normal flow (See PTCA Comments). . FINAL DIAGNOSIS: 1. Two vessel coronary artery disease in setting of possible RCA plaque rupture. 2. Normal filling pressures suggestive of normal diastolic function. 3. Severely abnormal systolic function suggestive of apical ballooning syndrome. 4. Successful placement of drug-eluting stents in mid-RCA. . ECHO [**2143-3-12**]: The left atrium is normal in size. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are normal. The left ventricular cavity size is normal. The left ventricle appears hyperdynamic in all segments except for the apex, which is hypokinetic (but not akinetic or dyskinetic) relative to the rest of the left ventricle. The overall left ventricular ejection fraction is approximately 70 percent. No left ventricular aneurysm is seen. No masses or thrombi are seen in the left ventricle. There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Trivial mitral regurgitation is seen. There is borderline pulmonary artery systolic hypertension. There is no pericardial effusion. Impression: apex is hypokinetic relatiive to the rest of the left ventricle (hyperdynamic). Brief Hospital Course: 73 yo F, with no previously known CAD, here for CP, ECG changes, and troponin leak - ? STEMI vs Takatsubo. . # Ischemia - Mrs. [**Known lastname 3068**] was taken straight to the cath lab and her cath showed RCA & LAD lesions, but nothing that looked suspicious for the cause of her acute chest pain. A DES was placed in her RCA, but then hemodynamic measurements were taken and were significant for a depressed cardiac index. A subsequent LV-gram showed apical akinesis consistent with Takotsubo cardiomyopathy. The PA catheter was left in overnight so that her PA pressures could be monitored. She was continued on aggrestat until the morning after her catheterization. She did well overnight, her PA catheter was pulled the next morning, and she was transferred out to the floor. Daily ECGs were checked and Mrs. [**Known lastname 3068**] had resolution of inferior ECG changes but persistent lateral ST elevations and deepening T wave inversions. She was started on ASA, plavix, bblocker, ACE-i and a statin. Her lipid panel was checked and was significant for an LDL of 105 so she was kept on high dose lipitor. Her cardiac enzymes were cycled x2 after her catheterization and were trending down. On arrival to the OSH, she already had a troponin leak so it was unclear if her infarction happened earlier than the actual onset of her pain. She had no further episodes of chest pain during her admission, but it was recommended that she have a stress test as an outpatient to look for other areas of ischemia. . # Pump - Mrs. [**Known lastname 3068**] had a depressed EF and CO by LV-gram, with apical akinesis being the most prominent finding. This was felt to be more consistent with Takotsubo cardiomyopathy than MI, but an exact etiology was not able to be determined. By exam, she remained euvolemic and her cardiac function improved. Prior to discharge, an ECHO revealed a restored EF (LV was hyperdynamic w/ EF of 70% and only hypokinetic apex). She will continue the bblocker and ACE-i until she follows up with her new outpatient cardiologist, Dr. [**Last Name (STitle) 7047**], at [**Hospital 5164**] Medical on [**2143-3-22**]. . # Rhythm - She was monitored on telemetry throughout her hospital stay and remained in NSR. Her daily EKGs showed persistent ST elevations in the lateral leads with deepening T wave inversions but she remained chest pain free. . # Glycemic control - She was started on HISS on admission for tight glycemic control during her acute coronary syndrome, but since she has no h/o DM and her cardiac function was improving, the HISS and fingersticks were discontinued after 48 hours. She only had one elevated serum glu throughout her stay (glu was 118 on admission). . # FEN - She was given a regular, low sodium, cardiac, heart healthy diet. She received no IVF. Her electrolytes were checked daily and were repleted prn to keep K >4 and Mg >2. . # PPX - Heparin SC for DVT ppx, no need for PPI, bowel regimen. . # Code - Presumed full . # Dispo - To home, with f/u appts scheduled with her PCP and [**Name Initial (PRE) **] new outpt cardiologist, Dr. [**Last Name (STitle) 7047**]. Medications on Admission: Tylenol prn Discharge Medications: 1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*90 Tablet(s)* Refills:*2* 3. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Metoprolol Succinate 25 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 5. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary diagnosis: Acute coronary syndrome Takotsubo cardiomyopathy Discharge Condition: Good. Afebrile, BP 109/59, HR 93. EKG shows persistent ST elevations in lateral leads with deepening T wave inversions. She is chest pain free. Discharge Instructions: 1. Please call your PCP or go to the ER if you develop any of the following symptoms: fever, chills, dizziness, headaches, chest pain, chest pressure, shortness of breath, nausea, vomiting, leg numbness, tingling or swelling, or any other worrisome symptoms. 2. Please take all your new medications as prescribed. It is very important that you take plavix and aspirin EVERY DAY because they will help keep your stent open. Do not stop these medications unless your cardiologist instructs you to. 3. Please follow-up with your PCP and your new cardiologist as directed below. Followup Instructions: 1. You have an appointment with Dr. [**Last Name (STitle) **], your PCP, [**Name10 (NameIs) **] [**3-21**] at 3:45pm. Please call her office at [**Telephone/Fax (1) 3183**] if you have any questions or need to reschedule. 2. You have an appointment with Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 7047**], your new cardiologist, on Friday [**2142-3-22**] at 1:45 pm. His office is located at [**Hospital 5164**] Medical, [**Street Address(2) 34489**], [**Hospital1 1474**], MA. His phone number is ([**Telephone/Fax (1) 29561**]. Please call his office with any questions or re-scheduling needs. You should have a stress test performed as an outpatient and Dr. [**Last Name (STitle) 7047**] will be able to help you set this up. ICD9 Codes: 4111
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7537 }
Medical Text: Unit No: [**Numeric Identifier 70078**] Admission Date: [**2192-12-5**] Discharge Date: [**2193-1-26**] Date of Birth: [**2192-12-5**] Sex: F Service: NB IDENTIFICATION: Baby Girl [**Known lastname 70079**] #I is a 7.5 week old former 30-5/7 week premature twin who is being discharged from the [**Hospital1 69**] Neonatal Intensive Care Unit. HISTORY: Baby Girl [**Known lastname 70079**] #I was born on [**2192-12-5**] as the 1680 gram product of a 30-5/7 week twin gestation pregnancy to a 34 year-old gravida I, para 0 to II mother. Prenatal screens included blood type A positive, antibody negative, RPR nonreactive, rubella immune, hepatitis B surface antigen negative and group B strep unknown. Pregnancy was notable for monochorionic-diamniotic twin gestation with early ultrasound showing mildly discordant growth. However, subsequent ultrasounds showed resolution of growth discrepancy and concordant growth thereafter. Fetal surveys were otherwise unremarkable. The pregnancy was complicated by gestational diabetes and cervical shortening noted around 26 weeks, prompting a course of betamethaone. Mother experienced intermittent preterm contractions since that time and presented on the day of admission with preterm premature rupture of membranes. Given twin gestation, mother was taken for cesarean section delivery. Family and social history is notable for father with a limb abnormality and a history of cystic fibrosis in the father's family. Mother is of [**Name (NI) 70080**] origin. At delivery twin #I emerged vigorous with Apgars of 9 and 9. Infant was brought to the Neonatal Intensive Care Unit for prematurity. PHYSICAL EXAMINATION ON ADMISSION: Notable for weight of 1680 grams or 75th percentile, length of 42 cm, 50th to 75th percentile and head circumference of 29.5 cm, 75th percentile. Infant was pink and active in no significant distress. Features were nondysmorphic. Red reflex was present bilaterally. Palate was intact. Neck was supple. Lungs were clear with mild intermittent retractions. Cardiac was regular rate and rhythm without murmurs. Abdomen was soft without masses or hepatosplenomegaly. Anus was patent. Genitalia was that of normal preterm female. Hips and back were normal. Extremities were warm and well perfused. Tone and activity were appropriate. HOSPITAL COURSE BY SYSTEMS: 1. Respiratory: Infant initially exhibited minimal respiratory insufficiency and was maintained in room air for the first several days of life. Over the first 2 to 3 weeks of life infant did require intermittent treatment with nasal cannula and CPAP therapy for mild respiratory distress and frequent apnea spells. The infant never required significant oxygen and was maintained on CPAP for a total of 9 days. The infant was weaned to room air alone by day of life 20 and has remained in room air since that time. Moderate apnea of prematurity was noted treated with caffeine. Caffeine was discontinued at approximately 34 weeks corrected gestational age. Since that time intermittent spells have been noted, with slow resolution. By the time of discharge, the infant has been without spells for 5 days. 2. Cardiovascular: The infant has remained hemodynamically stable since birth without need for cardiovascular support. An intermittent murmur was heard although no other signs of a patent ductus arteriosus were noted. Over the last several weeks of hospitalization the murmur became more persistent and evaluation was performed on [**1-15**] to [**1-16**] including a chest x-ray, 4 extremity blood pressures and an electrocardiogram, all of which were within normal limits. Cardiology was consulted on [**2193-1-25**], and thought the murmur was consistent with a flow murmur; routine monitoring by pediatrician was recommended. 3. Fluids and nutrition: The infant was initially maintained on IV fluids with introduction of enteral feeds on day of life 2. Enteral feeds were advanced without difficulty to full volume and eventually 28 calories per ounce. Infant was fed primarily breast milk supplemented with additional calories as well as some Similac Special Care formula. On day of life 26, [**2192-12-31**], the infant was noted to have grossly bloody stools. Infant was otherwise well appearing and evaluation including CBC, blood culture and KUB were reassuring. The infant was monitored for 48 hours off of enteral feeds and examination remained reassuring. Enteral feedings were restarted after 48 hours, but using nutramigen. Feedings were then advanced to maximum caloric density of Nutramigen 24 calories per ounce without difficulty. Since that time the infant has tolerated feedings well without evidence of abdominal distention or significant aspirates. Stools have remained intermittently heme positive although otherwise normal in appearance. The infant was initially fed via gavage feedings and gradually transitioned to oral feedings as tolerated. By the time of discharge the infant has been feeding all p.o. for over 2 weeks with intake of 150 to 200 ml per kilogram per day and with steady weight gain. The infant was maintained on multivitamins during hospitalization but will not be discharged on these as the infant will be receiving primarily formula. In the future if the infant remains well appearing a transition back to breast milk from Nutramigen can be considered. Weight at the time of discharge was 3065 gm. 4. Gastrointestinal: Infant did experience mild hyperbilirubinemia of prematurity requiring phototherapy for 48 hours. The maximum bilirubin level was 9.0/0.4 on day of life 3. As described above, the infant also experienced presumed allergic colitis or protein intolerance. 5. Heme: The infant was noted to develop anemia of prematurity requiring a blood transfusion on day of life 17 for hematocrit of 26. The infant was maintained on iron and hematocrit following transfusion was 33. Hematocrit was noted to gradually decline since that time, with the last hematocrit on [**1-17**] of 24.7 with a reticulocyte count of 2.4. Repeat hematocrit on [**2193-1-21**] was 23.2 with retic 2.7. Given this anemia iron dose was increased to 4 mg per kilograms per day; hematocrit will need to be monitored as an outpatient. 6. Infectious disease: Infant underwent a sepsis evaluation at birth with an unremarkable CBC and a negative blood culture. The infant was treated with ampicillin and gentamicin for 48 hours at that time. On day of life 7 to 8 repeat sepsis evaluation was performed due to frequent spells. Blood culture eventually grew staph streptococcus- non-aureus species. Infant was treated for 1 week with vancomycin and gentamicin. A lumbar puncture was performed and was unremarkable. As described above a repeat sepsis evaluation was performed on day of life 26 due to bloody stools; blood cultures were negative and infant was treated with 48 hours of ampicillin and gentamicin. No other infectious disease issues have been noted. 7. Neurology: Infant has maintained an appropriate neurologic examination throughout admission. Head ultrasound was performed on 1 week of age and again at 1 month of age and both of these were within normal limits. 8. Sensory: Ophthalmology examination was performed for screening for retinopathy of prematurity, revealing initially immature retinas and then mature retinas without evidence of ROP. Examination at 9 months of age is recommended. Hearing screen was performed and passed bilaterally. CONDITION ON DISCHARGE: Stable. DISCHARGE DISPOSITION: Home. PRIMARY PEDIATRICIAN: Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], phone #[**Telephone/Fax (1) 43818**] at [**Hospital1 2025**] at [**Location (un) **]. CARE RECOMMENDATIONS: A. Feedings: Infant will be discharged on Nutramigen 24. A trial of breast milk can be considered in 2 to 4 weeks. B. Medications: Fer-In-[**Male First Name (un) **] 4 mg per kilogram per day, equivalent to 0.5 mL per day. C. Car seat positioning screening was performed and passed. D. Newborn screens were sent per protocol. Initial newborn screen on [**2192-12-8**] was normal with exception of an elevated 17OH progesterone level. A repeat newborn screen on [**12-20**] was within normal limits. E. Immunizations received: The infant received hepatitis B vaccine on [**2192-12-30**]. Synagis was given on [**2193-1-24**]. F. Immunizations recommended: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following 3 criteria: 1) Born at less 32 weeks, 2) Born between 32 and 35 weeks with 2 of the following: Day care during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities or school age siblings, or 3) with chronic lung disease. Influenza immunizations recommended annually in the fall for all infants once they reach 6 months of age. Before this age and for the first 24 months of the child's life immunization against influenza is recommended for household contacts and out of home care-givers. FOLLOW-UP: Infant will follow up with primary pediatrician 2 to 3 days following discharge. VNA referral will be made. DISCHARGE DIAGNOSES: 1. Prematurity at 30-5/7 weeks. 2. Twin gestation. 3. Mild respiratory distress syndrome. 4. Apnea of prematurity. 5. Presumed allergic colitis. 6. Staph streptococcus non-aureus sepsis. 7. Physiologic murmur. [**First Name8 (NamePattern2) **] [**Name8 (MD) **], MD [**MD Number(2) 56682**] Dictated By:[**Name8 (MD) **] MEDQUIST36 D: [**2193-1-18**] 09:56:34 T: [**2193-1-18**] 12:15:45 Job#: [**Job Number 70081**] ICD9 Codes: 769, 7742, V053
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Medical Text: Admission Date: [**2197-8-28**] Discharge Date: [**2197-9-9**] Date of Birth: [**2113-6-14**] Sex: F Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 8388**] Chief Complaint: Painless jaundice Major Surgical or Invasive Procedure: ERCP with precut sphincterotomy [**2197-8-28**] EGD [**2197-8-31**] History of Present Illness: 84 yo F with history HTN, HL, and Type 2 DM who presented with fatigue, nausea, was noted to be jaundiced at initial presentation to [**Hospital3 **] on [**8-26**]. Patient reports eating avocados from [**Country 149**], which triggered her nausea and vomiting about 2 weeks ago. She has had increased confusion over past few weeks, forgetting her way home once, so that her husband took her license away. No longer able to do daily 1 hour walk. At OSH, she was found to have Total bilirubin of 8.7, direct bilirubin 5.7, AST=2319, ALT=[**2144**], alk phos 132, and INR 1.9. RUQ ultrasound showed gallbladder wall thickening but no stones in GB or bile ducts, no CBD dilation, and question of intrahepatic bile duct dilation. Acetaminophen level was negative. She had a U/A showing [**5-15**] WBC and received one dose of Ceftriaxone and Flagyl for asymptomatic bacteriuria. She underwent ERCP and small sphincterotomy at [**Hospital1 18**] on [**8-28**], which showed only mildly dilated CBD 8 mm. Hepatitis serologies were sent. AST and ALT continued to trend down to 1808 and 1632, respectively. Her T. Bili was 10.7, D. Bili was 7.7, and alk phos was 113. Hepatology was consulted on [**8-29**]. Per report, patient was found to be encephalopathic with food all over her and asterixis. She has had no recent changes in meds. FSG was 106. Per PCP, [**Name10 (NameIs) **] only has very very mild cognitive deficit at baseline. She was transferred to ICU for management of altered mental status in setting of fulminant liver failure. On the floor, her VS were T 99.3, HR 77, BP 133/51, 18, 94% RA. She was AOx3. She has lost 10 pounds in past 2 weeks due to lost appetite. She denies nausea, vomiting, abdominal pain, constipation, or diarrhea. Past Medical History: Hypertension Hyperlipidemia Hard of Hearing Anemia Cataracts s/p surgery Type II DM - diet controlled Social History: Lives with her husband; previous homemaker. Has several adult children who live nearby. Life-long non-smoker. No ETOH use. Family History: Sister died of ovarian cancer. No family history of liver disease. Physical Exam: ADMISSION EXAM T=96 BP=114/56 HR=60 RR=16 SaO2=97%RA Pleasant, alert, awake, in NAD. Jaundiced. HEENT negative. Neck - no adenopathy or masses Lungs-CTAB CV-RR, grade II/VI systolic murmur at base Abd-soft, non-tender, non-distended, NABS. No HSM. Extr-non-pitting symmetric edema bilaterally in both LE (not acute, per patient). Neuro-A&Ox3. Negative neuro exam. Mild asterixis . DISCHARGE EXAM 97.8 131/63 72 18 98% RA General: Alert, oriented, jaundiced HEENT: Sclera icteric, ecchymosis over L. eye MMM, oropharynx clear Neck: supple, JVP not elevated, no LAD Lungs: inspiratory crackles at bases b/l. Good air movement. No respiratory distress. CV: RRR normal S1 + S2, II/VI systolic murmur at apex Abdomen: obese, soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding GU: foley Ext: warm, well perfused, 2+ pulses, trace edema in LE. Neuro: A&Ox3, CN II-XII intact. Strength 4/5 in upper and lower extremities Skin: jaundiced Pertinent Results: At [**Hospital3 **]: [**2197-8-27**] Creat = 0.6 T. Bili=9.3 D. Bili=5.2 AST=2319 ALT=[**2144**] Troponin I <0.06 x2 Alk phos = 120 Amylase =74 WBC=8400 Hct=37.3 Acetaminophen level = negative UA=[**5-15**] WBC Hepatitis serologies as per OSH ([**Hospital1 **]): - Hep A Ag Total - reactive - HbSAg - reactive - HbSAb- non-reactive - Hb core Ab: reactive - HCV Ab: non-reactive CA-19 33 (ref value 33) --- At MICU: ALT 1632-->752 AST 1808-->619 Alk Phos 113-->81 T. Bili 10.7-->9.5 Lipase 188 GGT 114 AMA neg, Smooth pos (1:20) [**Doctor First Name **] neg AFP 23.3 HIV neg calTIBC-243* Ferritn-1266* D-Dimer-296 TRF-187* Hapto-50 IgM HBc-POSITIVE* HBcAb-POSITIVE IgM HAV-NEGATIVE HBsAg-POSITIVE* HBsAb-NEGATIVE IgM HAV-NEGATIVE IgG-1871* IgA-699* IgM-114 . OTHER IMAGING/STUDIES Liver ultrasound with Dopplers [**2197-8-29**] - Normal appearance of the liver parenchyma and liver vasculature. No ascites. . Liver biopsy Liver, transjugular needle core biopsy: Markedly fragmented biopsy demonstrating: 1. Nodular hepatic parenchyma with cholangiolar proliferation, septal and bridging fibrosis with multifocal incomplete nodule formation and paucity of identifiable central veins, suspicious for cirrhosis (trichrome and reticulin stains evaluated). 2. Moderate portal/septal, periseptal and lobular mixed inflammation consisting of lymphocytes, plasma cells, neutrophils and few eosinophils with scattered apoptotic hepatocytes and focal hepatocyte necrosis with drop-out/minimal collapse. 3. Moderate cholestasis with focally prominent feathery degeneration of hepatocytes. 4. No viral inclusions or granulomata identified on H&E; immunostains for CMV, HSV, HBSAg and HBCAg are in progress and will be reported in an addendum. 5. Iron stain is negative for significant iron deposition. . Head CT without contrast [**8-30**] 1. Left cerebral hemisphere hyperdensity likely due to calcification but hemorrhage can not be excluded. Repeat non-contrast CT of the head is recommended. 2. Symmetric ventriculomegaly with prominent sulci and preservation of white/[**Doctor Last Name 352**] matter differentiation. Most likely secondary to normal age-related volume loss. Diffuse periventricular and deep white matter hypodensities most likely secondary to chronic small vessel ischemic disease. . Head CT without contrasts [**9-7**] (after fall) 1. Hematoma overlying the superior aspect of the left orbit. 2. Punctate focus of hyperdense material in the right parietal lobe within an extra-axial location. Although this may be due to streak, given its location, this would be concerning for a tiny focus of subarachnoid hemorrhage. 3. Stable calcification or mineralization within the left cerebellum. 4. Stable atrophy and small vessel microvascular change 6. Focal steatosis present; no areas of hemorrhagic necrosis seen. Note: The features are suspicious for cirrhosis (within the limits of evaluation given specimen fragmentation), with a superimposed significant active hepatitis. The differential includes viral, drug or autoimmune-mediated etiologies. Further correlation with clinical and serologic findings is needed to distinguish amongst these entities. . Repeat Head CT 1. No hemorrhage. 2. Hematoma over left supraorbital ridge, unchanged. . ERCP Multiple ulcers were seen in duodenum. Major papilla was floppy. There was a long intramural course of distal CBD. Deep cannulation of CBD was not successful. Given the rising bilirubin and reported intrahepatic ductal dilatation on ultrasonogram, the decision was made for precut sphincterotomy. Because of the elevated INR, only small sphincterotomy was performed. The intrahepatic ducts were partially opacified. They appeared normal. CBD was normal and measured 8 mm. The pancreatic ducts of the head, neck and body of pancreas were normal. No filling defect was seen. Otherwise normal ercp to third part of the duodenum. . EGD [**8-31**] No esophageal varices. Friability and erythema in the whole stomach compatible with gastritis Blood in the second part of the duodenum coming from the ampulla; consistent with hemobilia. Ulceration in the first part of the duodenum compatible with superficial ulceration without stigmata of recent bleeding. Otherwise normal EGD to third part of the duodenum . EGD [**9-3**] Ulcer in the stomach body Ulcer in the duodenal bulb Active bleeding from ampulla was noted, most likely hemobilia from transjugular liver biopsy, 4cc Epi injection was performed in the setting of prior pre-cut at the ampulla. (injection) Otherwise normal EGD to third part of the duodenum . DISCHARGE LABS: [**2197-9-9**] 05:26AM BLOOD WBC-7.9 RBC-3.62* Hgb-11.6* Hct-33.1* MCV-92 MCH-32.0 MCHC-35.0 RDW-19.2* Plt Ct-79* [**2197-9-9**] 05:26AM BLOOD PT-19.5* PTT-38.2* INR(PT)-1.8* [**2197-9-9**] 05:26AM BLOOD Glucose-101* UreaN-19 Creat-0.5 Na-139 K-3.4 Cl-104 HCO3-30 AnGap-8 [**2197-9-9**] 05:26AM BLOOD ALT-81* AST-80* AlkPhos-81 TotBili-15.8* [**2197-9-9**] 05:26AM BLOOD Calcium-7.7* Phos-2.3* Mg-1.7 Brief Hospital Course: 84yo F p/w painless jaundice to OSH transferred to [**Hospital1 18**] for further workup found to have serologies indicative of active Hepatitis B infection, hospital course complicated by GI bleed secondary to transjugular liver biopsy. . # Liver failure - Patient initially admitted with painless jaundice, found to have marked tranaminitis >1000 and Tbili 10.7. She also had mild encephalopathy with asterixis on exam. RUQ u/s without concern for obstruction or cholecystitis. Tylenol level 0. ERCP was unremarkable except for multiple duodenal ulcers; hepatitis serologies demonstrated HBsAg positive, HBsAb negative, HBcAb positive, suggesting new HBV infection vs reactivation. Patient underwent transjugular liver biopsy, which demonstrated cirrhosis and active hepatitis; it was felt this was consistent with reactivation of infection. Patient was started on tenofovir. LFTs trended down. Encephalopathy improved. . # GI Bleed - Patient's course was complicated by melena and acute anemia following transjugular liver biopsy. EGD showed hemobilia. Angiogram during active bleeding was negative, and thus her bleed was thought to be venous. The patient was followed by liver, IR, and surgery for persistent bleed. The patient was stabilized with transfusions. On day 6 of admission, patient had large episode of BRBPR. Massive transfusion protocol was intitiated. She underwent repeat EGD that showed persistent hemobilia. The ampulla was injected with epinephrine and bleeding remained stable. During admission, the patient received a total of 13 U PRBC, 11 FFP, 2 platelets, 4 cryoprecipitate, and Vit K. HCT remained stable in the 30s prior to discharge with no additional evidence of rebleeding. Remained on protonix [**Hospital1 **] on discharge until further follow up. . #H. pylori - EGD showed ulcers in stomach and duodenum. H. pylori antibody positive. Patient was started on triple therapy with clarithromycin, amoxicillin, and pantoprazole for 2 weeks. . #HTN - Blood pressures remained stable. Home medications (lisinopril, HCTZ/triamterene, and diltiazem) were held initially. Lisinpril was restarted prior to discharge. #DM - Patient on Janumet at home. D/C'ed janumet for question of drug-related injury and risk of lactic acidosis with underlying hepatic dysfunction. Patient placed on SS humalog while inpatient. A1c most recently of 5.7 and therefore, well controlled. Can continue to hold Janumet after discharge with plans to follow up blood sugars with PCP. . TRANSITIONAL ISSUES: - liver enzymes should be checked in 1 week and faxed to Dr. [**Last Name (STitle) **] - patient should follow up in liver clinic as [**Last Name (STitle) 1988**] - Blood pressures will need to be followed. Diltiazem and HCTZ/triamterene were stopped on this admission and may need to be restarted if blood pressures remain elevated. - Janumet was stopped. Patients blood sugars will need to be followed. - Patient will need to complete treatment for H. pylori (ends [**9-16**]). She will need an H. pylori stool antigen checked to ensure eradication after completion of treatment. - Pantoprazole 40 mg [**Hospital1 **] should be continued until follow up with primary care or liver doctor. At this point, she may be able to decrease dose back to once daily. - Patient will need a follow up EGD in [**6-14**] weeks. - Aspirin was stopped in the setting of GI bleed. If blood counts remain stable, can consider restarting at follow up appointment. Medications on Admission: ASA 81 mg/day Protonix 40mg/d HCTZ/triamterene (37.5/25) qday Diltiazem CD 120mg qd MOM [**Name (NI) **] PRN constipation NTG sl prn cp Lisinopril 10 mg qd Janumet (sitagliptin/metformormin) Discharge Medications: 1. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO twice a day. 2. rifaximin 550 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. tenofovir disoproxil fumarate 300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. lactulose 10 gram/15 mL Syrup Sig: Thirty (30) ML PO Q4H (every 4 hours) as needed for encephalopathy. 6. amoxicillin 250 mg Capsule Sig: Four (4) Capsule PO Q12H (every 12 hours) for 7 days. 7. clarithromycin 250 mg Tablet Sig: Two (2) Tablet PO Q12H (every 12 hours) for 7 days. 8. insulin lispro 100 unit/mL Solution Sig: per sliding scale units Subcutaneous ASDIR (AS DIRECTED): administer QACHS as per sliding scale . Discharge Disposition: Extended Care Discharge Diagnosis: Primary diagnoses: Hepatitis B reactivation, GI bleed, H. pylori infection Secondary diagnoses: Hypertension, Diabetes Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: Dear Ms. [**Known lastname 91568**], You were admitted with weakness, jaundice, and elevated liver enzymes in your blood suggesting some injury to your liver. You had a procedure called an ERCP with sphincterotomy and this did not show any blockage in your bile ducts. It did not show the reason behind the liver injury. It did, however, show that you have ulcers in your small intestine. You also were found to be positive for an infection called H. pylori which can cause these ulcers, and you were started on 3 medications which you will need to take for a total of 14 days. You were also found to be bleeding likely from the site of your liver biopsy and had 2 upper endoscopies to help fix this. In the process, you were given a lot of blood products. Your liver blood work studies revealed that you have a reactivation of Hepatitis B. You were started on a medication called tenofovir. You should continue taking this medication and you will need to follow up with your liver doctor [**First Name (Titles) 3**] [**Last Name (Titles) 1988**]. You also fell and hit your head. You had a scan of your head which did not show any evidence of a bleed. The following changes have been made to your medication regimen: You should STOP taking: - Janumet - HCTZ/triamterene - diltiazem - milk of magnesia - aspirin (You can discuss restarting Aspirin with your primary care doctor if your blood counts continue to remain stable) You should START - tenofovir - lactulose - rifaxamin - clarithromycin (until [**9-7**]) - amoxicillin (until [**9-7**]) Please start taking pantoprazole twice daily You should STOP taking the medication Janumet. The metformin component in this medication can cause a serious (potentially fatal) complication called lactic acidosis if your liver is not working normally. Your diabetes was controlled reasonably well by diet alone here. Please continue following a diabetic diet, check your blood sugars at home, keep a log of the results and bring the log to your primary care physician to determine what, if any, medications you need to switch to for your diabetes. You should avoid medications such as aspirin, advil (ibuprofen), alleve (naproxen), and other medications in this family (NSAIDs) as it can worse or cause additional stomach ulcers. If you need to use Tylenol (acetaminophen) for pain or fever, do NOT exceed [**2186**] mg per day (500 mg four times per day) as higher doses can cause further liver injury. Followup Instructions: Department: LIVER CENTER When: FRIDAY [**2197-9-22**] at 9:00 AM With: [**Last Name (LF) **],[**First Name3 (LF) **] (LIVER CENTER) [**Telephone/Fax (1) 2422**] Building: LM [**Hospital Unit Name **] [**Location (un) 858**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage You will need to follow up with your primary care doctor within 7 days of discharge from your extended care facility. Name: [**Last Name (LF) **],[**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] Location: [**Hospital3 **] MEDICAL ASSOCIATES Address: [**Apartment Address(1) 41731**], [**Location (un) **],[**Numeric Identifier 17464**] Phone: [**Telephone/Fax (1) 17503**] Completed by:[**2197-9-10**] ICD9 Codes: 2761, 2851, 5715, 4019, 2724
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Medical Text: Admission Date: [**2135-11-14**] Discharge Date: [**2135-11-19**] Date of Birth: [**2077-7-15**] Sex: M Service: HISTORY OF THE PRESENT ILLNESS: The patient is a 58-year-old man who reports earlier in this past year he began to develop severe exertional chest discomfort associated with shortness of breath. It has been progressive over the past several months and now is occurring at rest. He describes it as severe chest pain that is associated with bilateral arm tingling. He has used over 100 sublingual nitroglycerin over the past few months. PAST MEDICAL HISTORY: 1. Status post anterior MI. 2. Hypertension. 3. Hyperlipidemia. 4. Arthritis. 5. Severe back pain. 6. No TIA. 7. No CVA. PAST SURGICAL HISTORY: Negative. ALLERGIES: The patient has no known drug allergies. ADMISSION MEDICATIONS: 1. Aspirin 325 mg p.o. q.d. 2. Amitriptyline 25 mg p.o. q.h.s. 3. Flexeril 10 mg p.o. q.h.s. 4. Naproxen 500 mg p.o. b.i.d. 5. Atenolol 100 mg p.o. q.d. 6. Imdur 30 mg p.o. q.d. 7. Hydrochlorothiazide 25 mg p.o. q.d. 8. Lipitor 10 mg p.o. q.d. LABORATORY DATA ON ADMISSION: White count 8.2, hematocrit 46, platelets 262,000. Chem-7 140/4.2/101/31/12/1.0. HOSPITAL COURSE: The patient was admitted and was noted to have severe three vessel coronary artery disease. The patient was taken to the Operating Room on [**2135-11-15**] and underwent a four vessel CABG with LIMA to LAD, saphenous vein graft to OM-I, saphenous vein graft to OM-II and saphenous vein graft to PDA. The patient did well postoperatively and was transferred to the CSRU where he was extubated on the evening of [**2135-11-15**]. On postoperative day number two, the patient was transferred to the floor and was up ambulating with physical therapy. On postoperative day number three, the patient had his chest tube and wires removed. On postoperative day number four, the patient was ambulating at a level V and was discharged home in good condition. The patient was discharged on the following medications. DISCHARGE MEDICATIONS: 1. Lopressor 50 mg p.o. b.i.d. 2. Atorvostatin 10 mg p.o. q.d. 3. Cyclobenzaprine 10 mg p.o. q.h.s. 4. Amitriptyline 25 mg p.o. q.h.s. 5. Percocet one to two tablets p.o. q. 4-6 hours p.r.n. 6. Aspirin 325 mg p.o. q.d. 7. Lasix 20 mg p.o. b.i.d. times seven days. 8. [**First Name5 (NamePattern1) 233**] [**Last Name (NamePattern1) 1002**] 20 mEq p.o. b.i.d. times seven days. FOLLOW-UP: The patient is to follow-up with Dr. [**Last Name (STitle) **] in four weeks. DISCHARGE DIAGNOSIS: Status post coronary artery bypass graft times four. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 3113**] Dictated By:[**Last Name (NamePattern1) 6067**] MEDQUIST36 D: [**2135-11-19**] 22:08 T: [**2135-11-21**] 09:05 JOB#: [**Job Number 105132**] ICD9 Codes: 4241, 4111, 4019, 2724
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Medical Text: Admission Date: [**2200-2-6**] Discharge Date: [**2200-2-13**] Date of Birth: [**2114-4-19**] Sex: M Service: CARDIOTHORACIC Allergies: Levaquin / Macrodantin / Propranolol / ibuprofen Attending:[**First Name3 (LF) 1406**] Chief Complaint: Coronary artery disease. Major Surgical or Invasive Procedure: [**2200-2-7**]: Coronary artery bypass grafting x3 with a left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to the distal right coronary artery and obtuse marginal artery. History of Present Illness: 85 year old male that presented to [**Hospital3 **] hospital after awaking from sleep [**2-3**] night with severe cough, nausea, and chest discomfort. In the emergency room he was treated for rapid atrial fibrillation and with Duonebs, unasyn, azithromycin, and IV solumedrol due to wheezing. On [**2-4**] he became acutely short of breath in the hospital and was placed on bipap and treated with IV lasix due to pulmonary edema. He ruled in for non st elevation myocardial infarction with troponin 4.01 and was referred for cardiac catheterization that he had [**2-7**] which revealed significant coronary artery disease. He is now transferred for surgical evaluation Past Medical History: Congestive heart failure Atrial fibrilliation no Coumadin high risk of falls Non ST elevation myocardial infarction ([**Hospital3 **] [**1-/2200**]) Hypothyroid Lumbar stenosis Compression fracture L5 Right Thyroid nodule Hypertension CKD stageIII GERD Hypercholesterolemia Osteoarthritis Diabetes mellitus type 2 Neurogenic bladder(chronic Foley) Past Surgical History Rt carpel tunnel Total hip replacment, right [**2195**] TURP [**2186**] Appendectomy Biliary bypass [**2193**] decompressive laminectomy at L4 and L5,microdiskectomy at L4 L5 Kyphoplasty L5 [**2-/2197**] Social History: Lives with: wife and son (at son's home) Contact: [**Name (NI) **] (wife) Phone # [**Telephone/Fax (1) 92469**] Occupation: retired firefighter Cigarettes: Smoked no [] yes [x] last cigarette 50 years ago ther Tobacco use: denies ETOH: < 1 drink/week [x] Family History: mother deceased 82 diabetes, father deceased 48 [**Name2 (NI) 92470**], brother DM, heart disease deceased ? 60's, brother sudden death 70's, brother diabetes deceased 85, brother mastoid cancer deceased in 50's, sister diabetes, coronary disease s/p stent alive, brother alzheimer alive, brother diabetes, vascular disease deceased 60's, son s/p cabg in his 40's Physical Exam: Pulse: 38 Resp: 18 O2 sat: 97 RA B/P Right: 107/65 Left: 115/63 General: Resting in be no acute distress Skin: Dry [x] intact [x] right groin cath site HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [] Irregular [x] Murmur none Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema none Varicosities: None [x] Neuro: Grossly intact [x] HOH Pulses: Femoral Right: +2 Left: +2 DP Right: +1 Left: +1 PT [**Name (NI) 167**]: +1 Left: +1 Radial Right: +2 Left: +2 Carotid Bruit Right: no bruit Left: no bruit Pertinent Results: Admission Labs: [**2200-2-6**] 01:18PM URINE RBC-3* WBC-29* BACTERIA-NONE YEAST-NONE EPI-3 [**2200-2-6**] 01:18PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-TR GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.5 LEUK-MOD [**2200-2-6**] 01:18PM PT-11.6 PTT-25.7 INR(PT)-1.1 [**2200-2-6**] 01:18PM NEUTS-61.4 LYMPHS-29.8 MONOS-5.9 EOS-2.5 BASOS-0.4 [**2200-2-6**] 01:18PM WBC-8.7 RBC-3.28* HGB-10.2* HCT-30.5* MCV-93 MCH-31.1 MCHC-33.5 RDW-13.7 [**2200-2-6**] 01:18PM %HbA1c-7.8* eAG-177* [**2200-2-6**] 01:18PM ALBUMIN-3.2* CALCIUM-8.6 PHOSPHATE-2.7 MAGNESIUM-2.1 [**2200-2-6**] 01:18PM CK-MB-5 cTropnT-0.64* [**2200-2-6**] 01:18PM ALT(SGPT)-52* AST(SGOT)-69* LD(LDH)-244 CK(CPK)-78 ALK PHOS-61 TOT BILI-0.3 [**2200-2-6**] 01:18PM GLUCOSE-182* UREA N-54* CREAT-1.4* SODIUM-139 POTASSIUM-3.7 CHLORIDE-100 TOTAL CO2-34* ANION GAP-9 Discharge labs: [**2200-2-13**] 04:20AM BLOOD WBC-14.0* RBC-3.10* Hgb-9.6* Hct-28.7* MCV-93 MCH-31.0 MCHC-33.4 RDW-14.7 Plt Ct-203 [**2200-2-13**] 04:20AM BLOOD Plt Ct-203 [**2200-2-13**] 04:20AM BLOOD Glucose-114* UreaN-39* Creat-1.6* Na-138 K-4.5 Cl-103 HCO3-28 AnGap-12 [**2200-2-13**] 04:20AM BLOOD Calcium-8.5 Phos-2.8 Mg-2.0 [**2200-2-11**] 04:20AM BLOOD ALT-26 AST-39 AlkPhos-73 Amylase-12 TotBili-0.4 TTE [**2200-2-7**] Results Measurements Normal Range Left Ventricle - Ejection Fraction: 50% to 55% >= 55% Aorta - Annulus: 2.1 cm <= 3.0 cm Aorta - Sinus Level: 3.2 cm <= 3.6 cm Aorta - Sinotubular Ridge: 2.8 cm <= 3.0 cm Aorta - Ascending: 3.3 cm <= 3.4 cm Aorta - Arch: 2.8 cm <= 3.0 cm Aorta - Descending Thoracic: 2.4 cm <= 2.5 cm Aortic Valve - LVOT diam: 2.0 cm Findings LEFT ATRIUM: No spontaneous echo contrast or thrombus in the body of the [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) **] LAA. RIGHT ATRIUM/INTERATRIAL SEPTUM: RA not well visualized. No spontaneous echo contrast in the RAA. No ASD by 2D or color Doppler. RIGHT VENTRICLE: Normal RV systolic function. AORTA: Normal aortic diameter at the sinus level. Focal calcifications in ascending aorta. Complex (>4mm) atheroma in the aortic arch. Complex (>4mm) atheroma in the descending thoracic aorta. AORTIC VALVE: Mildly thickened aortic valve leaflets (3). Cannot exclude AS. Trace AR. MITRAL VALVE: Moderately thickened mitral valve leaflets. Mild mitral annular calcification. No MS. Mild to moderate ([**2-10**]+) MR. TRICUSPID VALVE: Mild [1+] TR. PULMONIC VALVE/PULMONARY ARTERY: Pulmonic valve not visualized. No PS. Physiologic PR. GENERAL COMMENTS: The patient was under general anesthesia throughout the procedure. No TEE related complications. Suboptimal image quality. Results were personally reviewed with the MD caring for the patient. Conclusions Due to the patient's history of dysphagia and resistance felt at 40cm, the probe was not advanced past 40cm. PRE-BYPASS: No spontaneous echo contrast or thrombus is seen in the body of the left atrium or left atrial appendage. No atrial septal defect is seen by 2D or color Doppler. The left ventricle was assessed in the mid esophageal views. There is mild LV septal hypokineses. The remaining segments move and thicken well, estimated EF 50-55% from limited study. There are complex (>4mm) atheroma in the aortic arch. There are complex (>4mm) atheroma in the descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened. The study is inadequate to exclude significant aortic valve stenosis but leaflets appear to have normal motion in the available views. Trace aortic regurgitation is seen. The mitral valve leaflets are moderately thickened. Mild to moderate ([**2-10**]+) mitral regurgitation is seen. Radiology Report CHEST (PA & LAT) Study Date of [**2200-2-12**] 1:56 PM Final Report FINDINGS: As compared to the previous radiograph, there is substantially increased ventilation of the lung parenchyma. No pulmonary edema. On the left, a small retrocardiac atelectasis persists and on the right, seen mainly on the lateral radiograph, a small pleural effusion is present. No other pleural or parenchymal changes. Borderline size of the cardiac silhouette. Radiology Report VIDEO OROPHARYNGEAL SWALLOW Study Date of [**2200-2-12**] 1:55 [**Hospital 93**] MEDICAL CONDITION:85 year old man s/p CABG REASON FOR THIS EXAMINATION: eval for aspiration Preliminary Report Swallowing video fluoroscopy: oropharyngeal swallowing video fluoroscopy was Preliminary Reportperformed in conjunction with the speech and swallow division. Multiple Preliminary Reportconsistencies of barium were administered. Oral and pharyngeal swallow delay were observed. There was aspiration of thin liquids and penetration with nectar. Brief Hospital Course: 85 year old male that presented to OSH after awaking from sleep [**2-3**] night with severe cough, nausea, and chest discomfort. In the emergency room he was treated for rapid atrial fibrillation and with Duonebs, Unasyn, azithromycin, and IV solumedrol due to wheezing. He ruled in for non st elevation myocardial infarction with troponin 4.01 and was referred for cardiac catheterization. He underwent cath on [**2-7**] which revealed significant coronary artery disease. He was now transferred for surgical evaluation to [**Hospital1 18**]. After preoperative work up was complete, he was brought to the operating room on [**2-8**] where the patient underwent a coronary artery bypass grafting x3 with a left internal mammary artery to left anterior descending artery and reverse saphenous vein graft to the distal right coronary artery and obtuse marginal artery. CROSS-CLAMP TIME:69 minutes PUMP TIME:79 minutes. See operative note for full details. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. POD 1 found the patient extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable on no inotropic or vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. He was in a atrial fibrillation/flutter with rates from 60-120's. Lopressor was titrated and he was placed back on his home dose of Digoxin for better rate control. He had up to 2.6 second pauses in his chronic atrial fibrillation and EP was consulted. Digoxin was stopped and Lopressor was titrated. He was not anticoagulated for his atrial fibrillation due to his high risk of falls. He had a chronic Foley in place for a history of neurogenic bladder. He also had a swallow evaluation postop due to a preoperative history of dysphagia which showed possible aspiarion and he underwent a video study which showed aspiration of thin liquids, penetration of nectar, and he was put on a modified diet. He had a poor oral intake and was started on supplements. His po intake improved at the time of discharge. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued per cardiac surgery protocol without complication. The patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD 6 the patient was able to stand at bedside with assistance, but required [**Doctor Last Name 2598**] lift to get OOB to chair. His wound was healing and pain was controlled with oral analgesics(Tylenol). He failed to void after Foley catheter removal and required reinsertion of catheter, of note patient with neurogenic bladder had chronic foley for 5 years prior to surgery. The patient was discharged to [**Hospital 38**] rehab on POD 6 in good condition with appropriate follow up instructions. Medications on Admission: Simvastatin 5 mg daily Prilosec 20 mg daily Neurontin 600 mg [**Hospital1 **] Levothyroxine 25 mcg daily Ferrous sulfate 325 mg daily Glipizide 2.5 mg [**Hospital1 **] Aspirin 325 mg Daily Diltiazem 120 mg daily Digoxin 0.125 mg daily Bethanechol 25 mg TID Centrum silver daily Calcium 500 with Vitamin D [**Hospital1 **] Medications outside hospital at transfer: Unasyn 1.5 gm q12h Heparin gtt Aspirin 81 mg daily zocor 5 mg daily multivitamin 1 tab daily glipizide 2.5 mg [**Hospital1 **] Gabapentin 600 mg [**Hospital1 **] Diltazem 120 mg daily Digoxin 0.125 mg daily Calcium/vitamin D 2 tabs daily Bethanechol 25 mg TID Insulin SS Lopressor 5 mg q6h Protonix 40 mg IV daily Levothyroxine 12.5 mcg IV daily Atrovent nebs prn Albuterol nebs prn Nitrostat prn Discharge Medications: 1. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 2. levothyroxine 25 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. gabapentin 300 mg Capsule Sig: Two (2) Capsule PO BID (2 times a day). 4. simvastatin 10 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 5. bethanechol chloride 25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 6. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 7. magnesium hydroxide 400 mg/5 mL Suspension Sig: Thirty (30) ML PO HS (at bedtime) as needed for constipation. 8. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO DAILY (Daily). 9. bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal DAILY (Daily) as needed for constipation. 10. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 11. tramadol 50 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 12. heparin (porcine) 5,000 unit/mL Solution Sig: 5000 (5000) units Injection TID (3 times a day). 13. metoprolol tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 14. nystatin 100,000 unit/mL Suspension Sig: Five (5) ML PO TID (3 times a day). 15. acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain/temp. 16. glipizide 10 mg Tablet Sig: One (1) Tablet PO twice a day. 17. furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 18. potassium chloride 10 mEq Tablet Extended Release Sig: Two (2) Tablet Extended Release PO once a day. 19. Lantus 100 unit/mL Solution Sig: Ten (10) units Subcutaneous once a day. 20. insulin regular human 100 unit/mL Solution Sig: sliding scale units Injection Q AC&HS. Discharge Disposition: Extended Care Facility: [**Hospital3 1107**] [**Hospital **] Hospital - [**Location (un) 38**] Discharge Diagnosis: [**Last Name (un) 72255**] Artery disease s/p CABG x3 Congestive heart failure Atrial fibrilliation no Coumadin-high risk of falls Non ST elevation myocardial infarction ([**Hospital3 **] [**1-/2200**]) Hypothyroid Lumbar stenosis Compression fracture L5 Right Thyroid nodule Hypertension CKD stageIII GERD Hypercholesterolemia Osteoarthritis Diabetes mellitus type 2 Neurogenic bladder(chronic Foley) Past Surgical History Rt carpel tunnel Total hip replacment, right [**2195**] TURP [**2186**] Appendectomy Biliary bypass [**2193**] decompressive laminectomy at L4 and L5,microdiskectomy at L4 L5 Kyphoplasty L5 [**2-/2197**] Discharge Condition: Alert and oriented x3 nonfocal Able to stand at bedside w/assistance. Requires [**Doctor Last Name **] lift to get OOB-chair Sternal pain managed with oral analgesics-Tramadol Sternal Incision - healing well, no erythema or drainage Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for one month or while taking narcotics. Driving will be discussed at follow up appointment with surgeon. No lifting more than 10 pounds for 10 weeks **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: You are scheduled for the following appointments: Wound Check at 1/12 at 10:15am, Cardiac Surgery [**Hospital Ward Name 92471**] Medical Office Building [**Hospital Unit Name **] [**Telephone/Fax (1) 170**] Surgeon Dr. [**Last Name (STitle) **] [**Telephone/Fax (1) 170**] on [**3-20**] at 1:00pm, Cardiac Surgery [**Hospital Ward Name 92471**] Medical Office Building [**Hospital Unit Name **] [**Telephone/Fax (1) 170**] Cardiologist Dr. [**Last Name (STitle) **] on [**3-5**] at 11:00am Please call to schedule the following: Primary Care Dr. [**Last Name (STitle) 25693**] in [**5-15**] weeks [**Telephone/Fax (1) 25694**] ****Needs outpatient video swallow before advancing diet**** **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Completed by:[**2200-2-13**] ICD9 Codes: 2875, 4280, 5990, 4240, 2859, 2720, 2449
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Medical Text: Admission Date: [**2124-1-11**] Discharge Date: [**2124-1-14**] Date of Birth: [**2049-2-1**] Sex: M Service: SURGERY Allergies: Ambien Attending:[**First Name3 (LF) 371**] Chief Complaint: rectal bleeding and rectal pain Major Surgical or Invasive Procedure: none History of Present Illness: CC:[**CC Contact Info 107401**] HPI: This is a 74M with a history of a rectosigmoid polyp resection and subsequent rectal bleeding with multiple sigmoidoscopies c/b perforation requiring a Hartmann procedure [**2123-10-25**]. He came back to the clinic today to discuss reversing his colostomy but was found to have new bright red rectal bleeding since this past Thursday. The bleeding soaks four 4x4 gauzes per day. The patient denies any dizziness or LOC associated with the bleeding. He does report rectal pain and a feeling of rectal fullness that has been present since his surgery in [**Month (only) **]. He also complains of new pain to the left of the ostomy. He denies F/C/N/V. The ostomy is functioning well. Of note, the patient has a mechanical AV and MV for which he is on coumadin. His INR today was 2.9. Past Medical History: 1. CARDIAC RISK FACTORS: Dyslipidemia, Hypertension 2. CARDIAC HISTORY: # Mechanical MVR/AVR ([**2098**]) [**1-12**] rheumatic fever # Atrial fibrillation s/p AV node ablation, biventricular pacer ([**2115**]) on anticoagulation # Biventricular pacer . 3. OTHER PAST MEDICAL HISTORY: # COPD # Asthma # GERD # Osteoarthritis # Bilateral total knee replacements [**1-12**] OA # Gout # Hypothyroidism [**1-12**] amiodarone # Chronic Kidney Disease Stage II, baseline cr 1.6 # anemia # Melanoma # obesity # ETOH use # insomnia # hemorrhoids # h/o cellulitis # h/o MRSA PNA # osteopenia # # s/p Cholecystectomy # s/p Appendectomy Social History: Social Hx: Lives with wife. Family History: # Mother d 85: Asthma # Father d 99 [**10-21**]: PAD, HTN # Siblings (5B, 2S): HTN, unknown, rheumatic fever Physical Exam: PE: upon admission [**2124-1-11**] 97.1 69 132/70 20 98%RA Gen NAD, AAOx3, mentating well CV RRR, audible clicks Pulm CTAB, no w/r/r Abd soft, obese, TTP to L of ostomy and inferior to ostomy, no G/R, no hernias noted, incisions healing well but area of panniculitis inferior to ostomy, minimal erythema; ostomy retracted but functioning - brown stool and air in bag Ext wwp, 2+ edema bilaterally in LE DRE: stricture ~4cm from anal verge, BRB; on anoscopy, clots can be seen but no identifiable source of bleeding Pertinent Results: [**2124-1-14**] 06:00AM BLOOD WBC-8.3 RBC-3.44* Hgb-9.5* Hct-29.5* MCV-86 MCH-27.7 MCHC-32.3 RDW-17.3* Plt Ct-154 [**2124-1-13**] 03:30PM BLOOD WBC-7.5 RBC-3.47* Hgb-9.6* Hct-29.4* MCV-85 MCH-27.6 MCHC-32.6 RDW-17.2* Plt Ct-151 [**2124-1-13**] 01:52AM BLOOD WBC-7.5 RBC-3.34* Hgb-9.6* Hct-28.4* MCV-85 MCH-28.7 MCHC-33.8 RDW-17.8* Plt Ct-156 [**2124-1-12**] 11:10AM BLOOD Hct-30.5* [**2124-1-11**] 09:59PM BLOOD Hct-26.5* [**2124-1-14**] 06:00AM BLOOD Plt Ct-154 [**2124-1-13**] 03:30PM BLOOD Plt Ct-151 [**2124-1-13**] 03:30PM BLOOD PT-24.0* PTT-30.5 INR(PT)-2.3* [**2124-1-13**] 01:52AM BLOOD Plt Ct-156 [**2124-1-13**] 01:52AM BLOOD PT-30.0* PTT-33.7 INR(PT)-3.0* [**2124-1-12**] 04:18AM BLOOD PT-34.8* PTT-35.5* INR(PT)-3.6* [**2124-1-14**] 06:00AM BLOOD Glucose-101* UreaN-17 Creat-0.8 Na-138 K-3.7 Cl-104 HCO3-26 AnGap-12 [**2124-1-13**] 03:30PM BLOOD Glucose-131* UreaN-16 Creat-0.8 Na-137 K-3.6 Cl-102 HCO3-25 AnGap-14 [**2124-1-14**] 06:00AM BLOOD Calcium-8.8 Phos-2.6* Mg-1.8 [**2124-1-13**] 03:30PM BLOOD Calcium-8.9 Phos-2.4* Mg-1.9 [**2124-1-11**]: Cat scan of abdomen and pelvis: IMPRESSION: 1. No evidence of leak of the Hartmann pouch or pelvic fluid collection. 2. Filling defects along the lower rectum/anus. This may represent hemorrhoids, hemorrhage, or other intraluminal lesions. Please correlate clinically. 3. Small fat-containing ventral hernia/abdominal wall defect. [**2124-1-12**]: EKG: Ventricular paced rhythm. Underlying atrial rhythm is uncertain, probably atrial fibrillation. Since the previous tracing of [**2123-10-8**] no significant change. Brief Hospital Course: 74 year old gentleman who presented to the Acute Care clinic with rectal bleeding. Upon admission he was made NPO, had intravenous fluids started and had imaging study done. He was monitored in the intensive care unit where he had serial hematocrits. The GI service was consulted. A cat scan of his abdomen did show a possible soft tissue mass within the rectum. He was taken to the operating room on [**1-13**] where he had a rectal examination and sigmoidoscopy under anesthesia. He tolerated the procedure well without evidence of bleeding. He is preparing for discharge home with VNA services. His vital signs are stable. He is tolerating a regular diet and has been ambulating. He is not having any active bleeding from his rectum. His hematocrit is stable at 29.5. He has resumed his pre-hospital medications including his coumadin. He has been evaluated by physical therapy for recommendations for his deconditioning. He has also been seen by the ostomy nurse. His last INR is 2.3. He will follow-up with his primary care provider for monitoring of his INR. Medications on Admission: [**Last Name (un) 1724**]: 1. warfarin 5 mg Tablet Sig: One (1) Tablet PO once a day: 1 tab on [**Last Name (un) 766**] and Friday, 1.5 tabs on all other days. 2. metoprolol succinate 50 mg Tablet Sustained Release 24 hr Sig: One (1) Tablet Sustained Release 24 hr PO once a day. 3. enalapril maleate 20 mg Tablet Sig: One (1) Tablet PO twice a day. 4. furosemide 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. levothyroxine 88 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. allopurinol 300 mg Tablet Sig: One (1) Tablet PO once a day. 7. colchicine 0.6 mg Tablet Sig: One (1) Tablet PO once a day as needed for gout. 8. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO twice a day. 9. ciclopirox 0.77 % Gel Sig: One (1) application to abdomen folds Topical twice a day. 10. fluticasone 50 mcg/Actuation Spray, Suspension Sig: Two (2) Spray Nasal DAILY (Daily). 11. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 12. ipratropium-albuterol 18-103 mcg/Actuation Aerosol Sig: [**12-12**] Puffs Inhalation Q6H (every 6 hours) as needed for SOB. 13. ipratropium-albuterol 0.5 mg-3 mg(2.5 mg base)/3 mL Solution for Nebulization Sig: One (1) neb Inhalation four times a day as needed for shortness of breath or wheezing. 14. loratadine 10 mg Tablet Sig: One (1) Tablet PO once a day. 15. orphenadrine citrate 100 mg Tablet Sustained Release Sig: One (1) Tablet Sustained Release PO twice a day as needed for back pain. 16. sildenafil 50 mg Tablet Sig: One (1) Tablet PO once as needed for sexual activity. 17. ferrous sulfate 325 mg (65 mg Iron) Tablet Sig: One (1) Tablet PO once a day. 18. trazodone 50 mg Tablet Sig: [**12-12**] to 1 Tablet PO at bedtime as needed for insomnia. 19. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day): hold for diarrhea. 20. sodium chloride 0.65 % Aerosol, Spray Sig: Three (3) Spray Nasal TID (3 times a day). 21. tamsulosin 0.4 mg Capsule, Sust. Release 24 hr Sig: One (1) Capsule, Sust. Release 24 hr PO HS (at bedtime). 22. senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed for constipation: hold for diarrhea. 23. nitrofurantoin Discharge Medications: 1. allopurinol 300 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. fluticasone 50 mcg/Actuation Spray, Suspension Sig: Two (2) Spray Nasal DAILY (Daily). 3. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 4. ipratropium bromide 0.02 % Solution Sig: One (1) nebulizer Inhalation Q6H (every 6 hours) as needed for wheeze. 5. ipratropium bromide 17 mcg/Actuation HFA Aerosol Inhaler Sig: Two (2) Puff Inhalation QID (4 times a day) as needed for wheeze. 6. colchicine 0.6 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)) as needed for gout. 7. warfarin 5 mg Tablet Sig: 1.5 Tablets PO 5X/WEEK ([**Doctor First Name **],TU,WE,TH,SA). 8. warfarin 5 mg Tablet Sig: One (1) Tablet PO 2X/WEEK (MO,FR). 9. levothyroxine 50 mcg Capsule Sig: One (1) Capsule PO once a day. 10. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 11. nitrofurantoin (macrocryst25%) 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) for 5 days. Disp:*10 Capsule(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: Rectal bleeding, stricture Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hospital with rectal bleeding. You were monitored in the intensive care unit. During your stay, you had a blood transfusion. Your vital signs and hematocrit are normal and you are now preparing for discharge home with VNA services. Please follow these instructions upon discharge: Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1882**], MD Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2124-1-25**] 12:50 Provider: [**Name10 (NameIs) **] Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2124-1-26**] 9:00 Provider: [**Name10 (NameIs) 676**] CLINIC Phone:[**Telephone/Fax (1) 62**] Date/Time:[**2124-1-26**] 10:00 ICD9 Codes: 2724, 2749
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Medical Text: Admission Date: [**2106-2-10**] Discharge Date: [**2106-2-23**] Date of Birth: [**2044-3-28**] Sex: M Service: SURGERY Allergies: Demerol / Ativan Attending:[**First Name3 (LF) 1234**] Chief Complaint: Severe ischemia of lower extremities/ s/p R. ilio-femoral and femoral-femoral bypass graft. Major Surgical or Invasive Procedure: Thrombectomy of right iliofemoral graft, femoral-femoral graft, patch angioplasty of right femoral artery and left femoral artery with saphenous vein. History of Present Illness: The patient is a 60M with history of right sided stage III laryngeal cancer diagnosed in [**2099**] and treated with chemotherapy (adjuvant taxol and cisplatin followed by taxol, cisplatin and etoposide for three total cycles) and radiation (62g to right neck and vocal cords). He was last admitted to [**Hospital1 18**] [**2105-6-29**] with disabling claudication and rest pain in his bilateral lower extremities. For this, right common iliac artery to common femoral artery bypass and femoral-femoral cross-over graft were performed. Past Medical History: Hyperlipidemia laryngeal CA basal cell ca peptic ulcer dz hx. of esophageal stricture ETOH abuse Known aortic dissection Iliac stent with fem - fem graft Social History: Pos alcohol pos smoker Family History: non contributary Physical Exam: PE: AFVSS NEURO: PERRL / EOMI MAE equally Answers simple commands Neg pronator drift Sensation intact to ST 2 plus DTR Neg Babinski HEENT: NCAT Neg lesions nares, oral pharnyx, auditory Supple / FAROM neg lyphandopathy, supra clavicular nodes LUNGS: CTA b/l CARDIAC: RRR without murmers ABDOMEN: Soft, NTTP, ND, pos BS, neg CVA tenderness EXT: Groins dressed so femoral nodes not assessed Fem pulses present b/l Bil LE warm; + pulses by doppler Pertinent Results: CHEST (PORTABLE AP) [**2106-2-15**] 9:06 AM CHEST: AP portable semi-upright view. The nasogastric tube and the left internal jugular central venous catheter remain in good positions. There is interval worsening of bilateral perihilar and basilar opacities, consistent with increasing congestive heart failure. There are persistent opacities in the right and left upper lobe, consistent with pneumonia or aspiration. Multiple surgical clips are again seen in the upper mid abdomen and just above the gastroesophageal junction. IMPRESSION: 1. Worsening congestive heart failure. 2. Unchanged right and left upper lobe pneumonia versus aspiration. CT CHEST W/CONTRAST [**2106-2-15**] 4:20 PM CHEST CT WITH INTRAVENOUS CONTRAST: Emphysema is again noted, with multiple bullae in the middle and upper lobes. There are confluent ground-glass opacities as well as interlobular septal thickening in both upper lobes, right middle lobe, lingula, and the superior and anterior portions of the lower lobes. The opacities are most dense in the upper lobes. Small peripheral centrilobular ground-glass opacities are present throughout both lower lobes, similar in appearance to [**2104-7-16**]. While the centrilobular and confluent ground glass opacities are consistent with aspiration or pneumonia, presence of interstitial septal thickening also suggest pulmonary edema. While there is some nodularity within the opacities, nodular opacities that were seen in the left upper and right lower lobes on [**2105-7-16**] are no longer present. There is no evidence of an abscess. The trachea, right and left main stem bronchi are mildly dilated. Mild-to- moderate bronchiectasis is noted in the upper lobes, right middle lobe and lingula. Dependent secretions are noted in the trachea. There are numerous enlarged mediastinal lymph nodes, increased in number and size compared to [**2104-7-16**]. The largest right superior mediastinal node measures 12 mm in short axis diameter. The largest upper right paratracheal node measures 11 mm. The largest lower right paratracheal node measures 9 mm. The largest right para-aortic node measures 12 mm. The largest subcarinal node measures 15 mm. The largest right para-esophageal node measures 13 mm. Numerous subcentimeter nodes are present in both hila. There are small bilateral pleural effusions. There is no pericardial effusion. Scattered atherosclerotic calcifications are present in the thoracic aorta. Mural thrombus is noted in the proximal abdominal aorta. There is an unchanged ill-defined hypodensity in the right lobe of the thyroid gland, measuring approximately 2 x 1 cm. There is an approximately 4 cm hypodense lesion in the lower pole of the spleen, unchanged compared to the [**2106-2-13**] abdominal CT, which may represent a splenic infarction. Scattered calcified granulomas are again noted in the liver. Stones are again seen in the gallbladder. Surgical clips are again noted in the porta hepatis and in the region of the gastroesophageal junction. The imaged portions of the pancreas, adrenal glands, and kidneys appear unremarkable. The imaged bones appear unremarkable. IMPRESSION: 1. Diffuse bilateral pulmonary opacities, confluent in the upper and middle lobes, consistent with aspiration or pneumonia. Recurrent interlobular septal thickening is consistent with superimposed pulmonary edema. Given foci of nodularity, follow-up is recommended after treatment. No evidence of an abscess. 2. Small bilateral pleural effusions. 3. Mild central tracheal dilatation. Diffuse mild-to-moderate bronchiectasis in the upper and middle lobes. 4. Increased number and size of mediastinal and bilateral hilar lymph nodes, which may be reactive. However, metastatic disease cannot be excluded, and follow-up after treatment is recommended. 5. Hypodense splenic lesion, unchanged since [**2106-2-13**], compatible with an infarct. 6. Cholelithiasis. 7. Unchanged hypodense lesion in the right lobe of the thyroid. [**2106-2-13**] 11:08:22 PM EKG Sinus tachycardia. Right bundle-branch block. Compared to tracing #1, no diagnostic change. [**2106-2-13**] 3:20 PM CTA ABD W&W/O C & RECONS; CT ABDOMEN W/CONTRAST CT ABDOMEN WITHOUT AND WITH IV CONTRAST: Hazy nodular opacities about the airways within the lower lungs have increased since the prior study consistent with small airways disease. There is mild hazy opacity within the lung bases which could represent normal lung at expiration, however mild ground glass airspace disease cannot be excluded. There is a hepatic granuloma within the dome of the liver. No concerning hepatic lesions. There are multiple small gallstones dependently within the gallbladder. No gallbladder wall thickening. No biliary ductal dilatation or choledocholithiasis evident. There is a choledochojejunostomy, which is normal in appearance. Within the inferior aspect of the spleen, there is a large hypodense lesion, without enhancement measuring 4.4 x 4.3 x 3.9 cm that has significantly increased since the [**5-7**] study. There is an adjacent smaller similar- appearing lesion lateral to this larger lesion. These are nonspecific but considerations would include a splenic infarct. There is no stranding around these lesions, however infection of the lesions cannot be excluded. Small splenic hemangioma is also again noted unchanged. The pancreas is normal in appearance. The patient has undergone gastric bypass with a gastrojejunostomy. Adrenal glands are normal in appearance. No bowel wall thickening. No evidence of bowel wall thickening or bowel obstruction. The appendix contains contrast within it and gas, possibly from prior CT scan. No evidence for appendicitis. Small amount of fluid within the right lower quadrant is nonspecific. The kidneys show heterogeneous hypoenhancement symmetrically in a patchy geographic pattern in some locations. These areas have heterogeneous enhancement still on nephrographic phase. There is no persistent staining on the delayed images, nor is there contrast within the kidneys on the pre- contrast CT remaining from [**2106-2-11**] angiogram. These findings are nonspecific but considerations would include embolic phenomenon such as cholesterol or other emboli. Of note, there is a large calcified plaque within the right renal artery just beyond its origin with at least moderate narrowing of the right renal artery. There is also moderate narrowing of the left renal artery at its origin. There are multiple cysts within the kidneys bilaterally. There are multiple hypoattenuating lesions which are too small to characterize but likely cysts. No lymphadenopathy or ascites. CT PELVIS WITHOUT AND WITH IV CONTRAST: The urinary bladder has a Foley catheter within it and is incompletely distended. No definite urinary bladder abnormality. There is a small amount of free fluid within the pelvis. Bowel within the pelvis is within normal limits. There is a rectal tube with balloon inflated within the rectum. Subsequent administration of rectal contrast shows no leakage of contrast and no other abnormality. No lymphadenopathy. CT ARTERIOGRAM WITH IV CONTRAST: There is diffuse atherosclerotic plaque within the aorta with a large amount of plaque within the infrarenal aorta. There is an ulcerated plaque within the infrarenal aorta with a small neck. This does not extend beyond the normal contour of the aorta. The left common iliac artery is occluded, as before. There is reconstitution of the left external iliac artery from retrograde flow and there is minimal flow within the left internal iliac artery. The right common iliac artery is patent at its origin and then there is a bypass graft from the right common iliac artery to the right common femoral artery. Native right common iliac artery distally and the external iliac artery is occluded with an old stent in place. The iliac-femoral graft is widely patent. Just distal to its insertion within the right common femoral artery, there is a right to left femoral-femoral bypass graft which is widely patent. This is just superior to an excluded partially thrombosed old femoral- femoral bypass graft which contains gas within it, likely from recent surgery. Bilateral superficial femoral arteries are patent proximally though diminutive. There are small fluid collections about bilateral common femoral arteries near the graft origin/insertions, both of which contain small amounts of gas, likely related to recent surgery. Just distal to the insertion site of the femoral-femoral bypass graft on the left is a round fluid collection that on pre-contrast images is heterogeneous in density and post-contrast images shows a small amount of contrast outside the lumen of the adjacent arteries with progressive increased density dependently within the collection seen, making this highly suspicious for a pseudoaneurysm. This is best demonstrated on series 2, 3, and 4, images 90-94 and series 6 B, images 186-189. The arteries distal to the graft sites are patent within the visualized portions. SMA, [**Female First Name (un) 899**], and celiac artery are all patent and without evidence of proximal stenoses. As mentioned above, the right renal artery has a large calcified plaque just beyond its origin with at least moderate stenosis. The left renal artery has moderate stenosis at its origin. BONE WINDOWS: There is multilevel lumbar disc degeneration. No suspicious bone lesions. IMPRESSION: 1. Aortic atherosclerosis with ulcerated plaque in the infrarenal aorta. Occluded left common iliac artery with external iliac artery reconstitution from retrograde flow from fem-fem bypass graft. Patent right common iliac- femoral bypass graft and right to left femoral-femoral bypass graft with patent superficial femoral artery distal to the bypass grafts in the visualized portions. 2. Just distal to the left insertion of the fem-fem bypass graft with findings are highly suspicious for a pseudoaneurysm. [**Female First Name (un) **] ultrasound of this area is recommended to further evaluate. 3. Gas and fluid about the bilateral femoral [**Female First Name (un) 1106**] operative sites and gas within the old thrombosed fem-fem bypass graft likely related to surgery. 4. Increased size of hypodense splenic lesions that could represent infarcts. No secondary signs of infection, however this cannot be excluded. 5. Patent SMA and [**Female First Name (un) 899**] without evidence of bowel abnormality. 6. Bilateral patchy heterogeneous perfusion abnormalities within the kidneys suggesting recent bilateral renal insult, possibly from embolic phenomenon such as cholesterol emboli. There is also bilateral renal artery stenosis, slightly worse on the right than the left, at least a moderate degree. 7. Bilateral pulmonary small airways disease, worse in the bases than in [**2105-5-3**]. If clinically indicated, high resolution chest CT could be performed. [**2106-2-23**] 04:30AM COMPLETE BLOOD COUNT White Blood Cells 8.3 Red Blood Cells 3.76* Hemoglobin 11.2* g/dL MCV 89 MCH 29.9 MCHC 33.7 RDW 16.4* Platelet Count 298 K/uL 150 - 440 [**2106-2-23**] 12:01PM PT 15.8* PTT 34.2 INR(PT) 1.4* [**2106-2-20**] 06:00AM RENAL & GLUCOSE Glucose 86 mg/dL Urea Nitrogen 14 mg/dL Creatinine 0.7 mg/dL Sodium 137 mEq/L Potassium 3.9 mEq/L Chloride 104 mEq/L Bicarbonate 24 mEq/L Anion Gap 13 CHEMISTRY Calcium, Total 7.8* Phosphate 2.5* Magnesium 2.1 GENERAL URINE INFORMATION Urine Color Amber Urine Appearance Cloudy Specific Gravity 1.049* 1.001 - 1.035 DIPSTICK URINALYSIS Blood LG Nitrite NEG Protein 30 mg/dL Glucose NEG mg/dL Ketone NEG mg/dL Bilirubin NEG EU/dL Urobilinogen NEG mg/ pH 6.5 Leukocytes NEG MICROSCOPIC URINE EXAMINATION RBC >50 WBC 1 # Bacteria MOD Yeast NONE Epithelial Cells 0 #/hpf Transitional Epithelial Cells 1 #/hpf Granular Casts 0-2 #/lpf 0 - 0 Amorphous Crystals FEW [**2106-2-15**] SWAB No VRE isolated. Brief Hospital Course: Patient was admitted and started on anti-coagulation secondary to LE graft coagulopathy. Patient was started on a heparin gtt with goal of 60-80. Patients Coumadin was initially held. Patient had groin exploration/angiogram. Patient was given an epidural. Patient tolerated procedure and in PACU area it was noticed that Hct levels had come down. Patient was transfused 2 units. Patient's anticoags were held while he got his transfusion and then was re-started. Heme was consulted for this and suggested HIT. Patient most-likely was sub-therapeutic on lovenox. Typical dosing for Lovenox is 1mg/kg [**Hospital1 **] and he was only on 30mg/day. Patient was admitted to SICU. Patient was continued on broad spctrum antibiotics(Vanco/Clinda/Ceftaz/Flagyl). Patient's groin dressings were continually monitored during this time while in the unit where it was noticed to be draining. Patient was screened for HIT and started on Argatroban. Patients Argatroban was started/stopped [**Hospital 58097**] hospital stay. Patients epidural and NG-tube were DC's post-op day 4 and Clinda was DC'd as per IS requests. Patient transferred to VICU and Argatroban and Coumadin were re-started. Through-out the patients entire hospital stay the goal was to acquire a therapeutic state between (2.0-3.0) Patient was started on Lovenox sq on final hospital day and it was explained to patient that when he get's discharged from hospital he won't be able to check his lovenox levels. It was suggested to patient that he stay in the hospital until his PT becomes therapeutic but the patient requested he leave and go home on Lovenox sub-q. Patient was instructed to f/u w/ PCP(Dr. [**Last Name (STitle) 5456**] qod for coag checks. Patient wwas also Dc'd on Coumadin 3mg hs, ASA 81mg qd. Patient was also given Abx- (Levo/Flagyl). Medications on Admission: Coumadin, asa, percocet Discharge Medications: 1. Fluticasone-Salmeterol 250-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). Disp:*60 Disk with Device(s)* Refills:*2* 2. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). Disp:*30 Cap(s)* Refills:*2* 3. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation Q6H (every 6 hours). Disp:*4 inhalers* Refills:*2* 4. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours). Disp:*4 inhalers* Refills:*2* 5. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution Sig: 5-10 MLs PO Q4-6H (every 4 to 6 hours) as needed. Disp:*100 ML(s)* Refills:*0* 6. Aspirin 81 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 7. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Disp:*90 Tablet(s)* Refills:*2* 8. Lovenox 60 mg/0.6 mL Syringe Sig: One (1) Subcutaneous twice a day for 4 days. Disp:*8 Lovenox (Subcutaneous) 60 mg/0.6 mL Syringe* Refills:*1* 9. Coumadin 3 mg Tablet Sig: One (1) Tablet PO at bedtime. Disp:*30 Tablet(s)* Refills:*6* 10. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 11. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 12. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) for 3 weeks. Disp:*63 Tablet(s)* Refills:*0* 13. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO once a day for 14 days. Disp:*14 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: South Eastern [**State 350**] VNA Discharge Diagnosis: Thrombosed femoral-femoral graft and iliofemoral graft with bilateral extremity ischemia. Hypercoagulable state. Discharge Condition: Stable Discharge Instructions: Please restart your home medications. You may shower regularly, but no tub baths. Pat your incisions dry. If there continues to be drainage from your incision, place dry gauze over it. Call a physician or go to the emergency room if you experience fever >101.4F, pain unrelieved by medication, or foul-smelling drainage coming from your incision. Discharge Instructions: You are to be discharged on coumadin. You must have your INR followed. This measures the level of coumadin in the blood. This level must be between [**2-5**]. Your PCP [**Name9 (PRE) **] been [**Name (NI) 653**]. [**Name2 (NI) **] will follow your INR. You are also on Lovenox this is again a blood thinner, You must give yourself shots twice a day. You are to take Lovenox untill the Coumadin (INR ) is between [**2-5**]. When your coumadin level is appropriate. You may stop the Lovenox. WOUND CARE: PLEASE CALL US IMMEDIATELY FOR ANY OF THE FOLLOWING PROBLEMS: Redness in or drainage from your wound(s). New pain, numbness or discoloration of your lower or upper extremities (notably on the side of the incision). Watch for signs and symptoms of infection. These are: a fever greater than 101 degrees, chills, increased redness, or pus draining from the incision site. If you experience any of these or bleeding at the incision site, CALL THE DOCTOR. OTHER INFORMATION: You may shower immediately upon coming home. No bathing. A dressing may cover you??????re wound / incision site and this should be left in place for three (3) days. Remove it after this time and wash your incision(s) gently with soap and water. You will have sutures, which are usually removed in 4 weeks. This will be done by the Surgeon on your follow-up appointment. Sutures / Staples may be removed before discharge. If they are not, an appointment will be made for you to return for removal.). When the sutures / staples are removed the doctor may or may not place pieces of tape called steri-strips over the incision. These will stay on about a week and you may shower with them on. If these do not fall off after 10 days, you may peel them off with warm water and soap in the shower. Avoid taking a tub bath, swimming, or soaking in a hot tub for two weeks after surgery. You may shower immediately upon coming home. No bathing. A dressing may cover you??????re wound / incision site and this should be left in place for three (3) days. Remove it after this time and wash your incision(s) gently with soap and water. You may have staples and or sutures, which are usually removed in 4 weeks. This will be done by the Surgeon on your follow-up appointment. Limit strenuous activity and or heavy lifting until the wound is well healed. Activity may prevent the wound from healing. Do not drive a car unless cleared by your Surgeon. Try to keep your affected limb elevated when not in use, This decreases swelling to the affected wound and helps in the healing process. You may have an ace wrap around the affected limb with the wound. This helps prevent swelling to the area. You may take this off at night. But when you are doing activity the ace wrap should be worn. ANTIBIOTICS: You may have a prescription for antibiotics. Take as directed. Be sure you take the full course even if the wound looks well healed. Failure to do so may lead to infection. Followup Instructions: Call Dr.[**Name (NI) 1720**] clinic at [**Telephone/Fax (1) 1241**] to schedule a follow-up appointment in [**2-5**] weeks. Provider: [**Name10 (NameIs) **] [**Name11 (NameIs) 3627**] [**Name12 (NameIs) 3628**] [**Name12 (NameIs) **] [**Name12 (NameIs) 3628**] (NHB) Date/Time:[**2106-4-15**] 10:00 Provider: [**Name10 (NameIs) **],[**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] SURGERY (NHB) Date/Time:[**2106-4-15**] 10:30 Test for consideration post-discharge: Activated Protein C Follow - up with Dr [**Last Name (STitle) 5456**] for your INR. VNA will moniter your INR. Dr [**Last Name (STitle) 5456**] will adjust your coumadin accordingly. VNA will fax the results to Dr [**Last Name (STitle) 5456**] office at [**Telephone/Fax (1) 32161**]. Completed by:[**2106-2-23**] ICD9 Codes: 4280, 5070, 2851, 2724
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7543 }
Medical Text: Admission Date: [**2128-1-22**] Discharge Date: [**2128-1-27**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern4) 290**] Chief Complaint: Aspiration Major Surgical or Invasive Procedure: PEG tube placement, trach tube replacement History of Present Illness: [**Age over 90 **]yo M w/ h/o endstage alzheimer's, afib, esophageal stricture s/p 3 diliataions, and recurrent aspiration who presented from nursing home for lethargy, and cough w/sputum over last couple days. Wife says 1 wk ago pt (?partially)pulled out his g-tube, and nurse put back in place. Pt was looking more emaciated and his feeds were increased from 12h to continuous over 24h, which is when she thinks pt started to decline, and may have been aspirating. Over the last couple days pt became more unresponsive and also developed a cough w/ sputum. Pt was on levoflox for pna as outpt. Of note pt was discharged on [**2127-11-27**] with asp pna, treated with vanco/cipro/zosyn. During that admission pt failed extubation twice due to mucous pluging and tracheostomy was placed. J-tube and G-tube were placed to prevent aspiration. (Also had C5-6 fusion then) Required bag masking at NH, hemodynamically stable, then transported to [**Location (un) **], cxr showed pna, no ivf, then transferred to [**Hospital1 18**]. In [**Hospital1 18**] ED, t99.8, 136/91, 104, 22, 99%ra, cachectic, non-responsive, rhonchi at R base, suctioning pus from lungs, abd soft, IVF initiated - given 1.5L, ceftaz, vanco, and azithro initiated. HR 88, sats 50% 15L, rr26, 149/94, T 100.8 on transfer. Past Medical History: Esophageal stricture ? s/p [**Hospital 81947**] Hiatal hernia Hypertension S/p aortic valve replacement 3 years ago bovine per wife Hip fracture s/p repair H/o aspiration pneumonia, ? recurrent aspiration H pylori gastritis Dementia Social History: Patient is a retired ENT surgeon per out side hospital report. He lives at home with his wife. Independent ADLs until last summer Family History: non contributory Physical Exam: GENERAL: late-stage alzheimer's - nonresponsive HEENT: Normocephalic, atraumatic. No conjunctival pallor. No scleral icterus. PERRL 2mm->1mm. MMM. OP clear. NECK: trach present. Neck Supple, No LAD, No thyromegaly. CARDIAC: Regular rhythm, normal rate. Normal S1, S2. No murmurs, rubs or [**Last Name (un) 549**]. JVP=flat LUNGS: course rhonchi, and rales throughout ABDOMEN: +BS Soft, NT, ND. No HSM EXTREMITIES: No edema or calf pain, 2+ dorsalis pedis/ posterior tibial pulses. SKIN: No rashes/lesions, ecchymoses. NEURO: Pt non-responsive to commands. Somnolent. Pertinent Results: [**2128-1-27**] 04:06AM BLOOD WBC-7.6 RBC-3.87* Hgb-11.3* Hct-33.5* MCV-87 MCH-29.3 MCHC-33.8 RDW-15.8* Plt Ct-373 [**2128-1-22**] 02:30PM BLOOD Neuts-85.0* Lymphs-10.6* Monos-4.0 Eos-0.2 Baso-0.2 [**2128-1-23**] 04:00PM BLOOD PT-13.7* PTT-24.9 INR(PT)-1.2* [**2128-1-27**] 04:06AM BLOOD Glucose-115* UreaN-19 Creat-0.7 Na-141 K-3.8 Cl-106 HCO3-28 AnGap-11 [**2128-1-22**] 02:30PM BLOOD CK(CPK)-16* [**2128-1-22**] 02:30PM BLOOD cTropnT-0.01 [**2128-1-27**] 04:06AM BLOOD Calcium-8.0* Phos-2.6* Mg-2.2 [**2128-1-22**] 03:30PM BLOOD Lactate-1.9 [**2128-1-27**] 04:49AM URINE Color-Pink Appear-Hazy Sp [**Last Name (un) **]-1.013 [**2128-1-27**] 04:49AM URINE Blood-LG Nitrite-NEG Protein-TR Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-7.0 Leuks-LG [**2128-1-27**] 04:49AM URINE RBC-756* WBC-87* Bacteri-FEW Yeast-NONE Epi-0 Sputum culture: MRSA Urine and blood cultures: neg [**2128-1-22**] CXR: 1. Patchy opacity in the right lower lobe concerning for pneumonia. 2. Dense retrocardiac opacity, which could represent second area of pneumonia or atelectasis. [**2128-1-26**] Replacement of G/J tube: Uncomplicated placement of gastrojejunostomy tube through the patient's existing tract. The tube may be used immediately. Brief Hospital Course: [**Age over 90 **]yoM htn, afib, esophageal stricture transferred from nursing home with lethary and fever, diagnosed at OSH ED with pna, transferred to [**Hospital1 18**], diagnosed with pna, admitted to [**Hospital Unit Name 153**] for tx of aspiration pna/HAP. # [**Name (NI) 10227**] Pt has had recurrent pneumonia. Pt had aspiration pneumonia on this admission. It is possible that pt had aspiration with increasing his feeds from 12h to continuous 24h. His trach was also replaced with one with a cuff to further prevent aspiration risk. He was treated w/ Vancomycin and Zosyn. Cipro was not started during this admission as there is no recorded Pseudomonas infection on cultures. Pt required frequent suctioning initially q1h, which is now improved. Pt is now afebrile and wbc is coming down. He showed moderate growth of STAPH AUREUS COAG +, and his zosyn was discontinued. Pt needs Vanc 1g IV q24 (as only coag + SA on cx data) x8 days ([**4-26**]) for two more days. # Hypernatremia - Pt's Na was 158, and improved with free water replacement. Now resovled at 141. # 1st degree AV block - overnight once, now resolved in sinus 60-80s HR #. H/o Atrial Fibrillation - currently not in afib, but rate controlled. #. Hypertension- currently controlled, will moniter #. UTI- UA with neg nitrates but pos leukocytes, few bacteria, WBC 21-50, 90 on repeat, Urine Culture with minimal yeast and GNR. Treated while pt was on Zosyn #. Hiatal hernia- gave home omezprazole Medications on Admission: Lasix 40 [**Hospital1 **] Aricept 10 QD ASA 81 Omep 40 QD KCl suspension 20 [**Hospital1 **] Levaquin 250 x9d Ativan 0.5mg q6 prn Twocal HN continuous @ 50ml/h via g-tube Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Primary: Aspiration Pneumonia, MRSA Secondary: Alzheimers dementia Discharge Condition: Stable, afebrile Discharge Instructions: You were admitted with fevers, increased secretions thought to be due to an aspiration pneumonia. We treated you with antibiotics to cover the bacteria which grew from your cultures. Followup Instructions: please follow up with your PCP as necessary [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Name8 (MD) **] MD [**MD Number(1) 292**] Completed by:[**2128-1-27**] ICD9 Codes: 5070, 5849, 2760, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7544 }
Medical Text: Admission Date: [**2175-9-21**] Discharge Date: [**2175-10-6**] Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4691**] Chief Complaint: s/p Motor vehicle crash Major Surgical or Invasive Procedure: Percutaneous gastrostomy tube placement History of Present Illness: [**Age over 90 **] yo female restrianed passenger s/p head on motor vehicle crash. No reported LOC. She was transported to [**Hospital1 18**] for further care. Past Medical History: HTN Legally blind Social History: Lives with son Family History: Noncontributory Pertinent Results: [**2175-9-21**] 10:53AM GLUCOSE-142* LACTATE-1.8 NA+-144 K+-4.1 CL--107 TCO2-21 [**2175-9-21**] 10:45AM UREA N-24* CREAT-0.9 [**2175-9-21**] 10:45AM WBC-12.2* RBC-4.30 HGB-12.8 HCT-37.6 MCV-88 MCH-29.7 MCHC-33.9 RDW-13.8 [**2175-9-21**] 10:45AM PLT COUNT-313 [**2175-9-21**] 10:45AM PT-14.3* PTT-38.6* INR(PT)-1.2* [**2175-9-21**] Head CT scan IMPRESSION: No acute intracranial pathology. Age-related atrophy. Periventricular white matter ischemic changes are chronic. [**2175-9-21**] Cervical spine CT scan IMPRESSION: 1. Fractures through the left C2 and C3 transverse processes extending into the foramen transversarium. These fractures put the patient at increased risk for possible vertebral dissection which could be better evaluated with a dedicated CTA or MRA (with T1 fat supression sequences) of the neck. 2. Nondisplaced fracture of the right lamina of C2. 3. Extensive degenerative changes of the cervical spine including C2-C3 moderate to severe spinal stenosis. In the setting of trauma, these degenerative changes put the patient at increased risk for ligamentous injury or cord injury, which cannot be fully evaluated by CT and would recommend MRI for further evaluation if clinical suspicion for neck injury persists. ECHO [**2175-9-22**] Results Measurements Normal Range Left Atrium - Long Axis Dimension: 3.6 cm <= 4.0 cm Left Atrium - Four Chamber Length: *5.3 cm <= 5.2 cm Left Atrium - Peak Pulm Vein A: *0.4 m/s < 0.4 m/s Right Atrium - Four Chamber Length: *5.6 cm <= 5.0 cm Left Ventricle - Septal Wall Thickness: 1.1 cm 0.6 - 1.1 cm Left Ventricle - Inferolateral Thickness: 1.1 cm 0.6 - 1.1 cm Left Ventricle - Diastolic Dimension: 3.5 cm <= 5.6 cm Left Ventricle - Ejection Fraction: 70% >= 55% Aorta - Sinus Level: 2.5 cm <= 3.6 cm Aorta - Ascending: 2.8 cm <= 3.4 cm Aortic Valve - Peak Velocity: *2.4 m/sec <= 2.0 m/sec Aortic Valve - Peak Gradient: *23 mm Hg < 20 mm Hg Aortic Valve - Mean Gradient: 13 mm Hg Mitral Valve - E Wave: 1.5 m/sec Mitral Valve - A Wave: 1.5 m/sec Mitral Valve - E/A ratio: 1.00 Mitral Valve - E Wave deceleration time: *282 ms 140-250 ms TR Gradient (+ RA = PASP): *43 to 62 mm Hg <= 25 mm Hg Findings LEFT ATRIUM: Elongated LA. RIGHT ATRIUM/INTERATRIAL SEPTUM: Mildly dilated RA. LEFT VENTRICLE: Normal LV wall thickness. Small LV cavity. Overall normal LVEF (>55%). RIGHT VENTRICLE: Normal RV chamber size and free wall motion. AORTA: Normal aortic diameter at the sinus level. Focal calcifications in aortic root. Normal ascending aorta diameter. Focal calcifications in ascending aorta. AORTIC VALVE: Three aortic valve leaflets. Moderately thickened aortic valve leaflets. Mild AS (AoVA 1.2-1.9cm2). Trace AR. MITRAL VALVE: Mildly thickened mitral valve leaflets. Severe mitral annular calcification. Mild thickening of mitral valve chordae. Calcified tips of papillary muscles. No MS. Mild to moderate ([**12-14**]+) MR. [Due to acoustic shadowing, the severity of MR may be significantly UNDERestimated.] TRICUSPID VALVE: Mildly thickened tricuspid valve leaflets. Normal tricuspid valve supporting structures. No TS. Moderate [2+] TR. Moderate PA systolic hypertension. PULMONIC VALVE/PULMONARY ARTERY: Normal pulmonic valve leaflet. No PS. Physiologic PR. Normal main PA. No Doppler evidence for PDA PERICARDIUM: No pericardial effusion. Conclusions The left atrium is elongated. Left ventricular wall thicknesses are normal. The left ventricular cavity is small. Overall left ventricular systolic function is normal (LVEF 70%). Right ventricular chamber size and free wall motion are normal. There are three aortic valve leaflets. The aortic valve leaflets are moderately thickened. There is mild aortic valve stenosis (area 1.2-1.9cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is severe mitral annular calcification. Mild to moderate ([**12-14**]+) mitral regurgitation is seen. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] The tricuspid valve leaflets are mildly thickened. Moderate [2+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. [**2175-9-22**] MR [**Name13 (STitle) **]; Thoracic Spine CERVICAL SPINE: Fractures of C2 and C3 are better visualized on the recent CT. Prevertebral soft tissue swelling extends from C2 to the inferior endplate of C4. While this implies ligamentous injury, no definite ligamentous injury is identified. Epidural hematoma is seen posteriorly, extending from C2 through the inferior endplate of T2. In addition, there are multiple disc herniations/bulges. These combined changes result in narrowing of the spinal canal, however, there is no cord signal abnormality to suggest cord compression. At C2-3, there is left paracentral disc protrusion. At C3-4, disc bulge compresses upon the ventral aspect of the thecal sac. At C4-5, there is canal narrowing due to midline and left foraminal disc protrusion that indents the cord and narrows the left neural foramen. At C5-6, high signal within the disc space anteriorly indicates an annular tear. Osteophyte indents the ventral aspect of the cord. This may be acute or chronic, although there is no associated prevertebral soft tissue swelling. At C6-7, disc herniation indents the cord, however, there is no cord signal abnormality. There is blood within the left occipital [**Doctor Last Name 534**], seen on the most superior axial images (5:2). THORACIC SPINE: An acute T12 compression fracture with retropulsed bone severely narrows the spinal canal, however, there is no cord deformity and the spinal cord demonstrates normal signal. There is acute compression fracture of T2, without retropulsion. A T4 compression deformity is chronic. At T6-7, disc protrusion results in cord compression, although this is not acute. IMPRESSION: 1. Blood in the left occipital [**Doctor Last Name 534**]. Followup head CT is recommended. 2. Prevertebral cervical hematoma. While this is suggestive of ligamentous injury, no ligamentous injury is identified. 3. Cervical prevertebral hematoma, epidural hematoma and disc herniations/protrusions result and narrowing of the cervical spinal canal, however, there is no evidence of cord compression. 4. Acute compression fracture of T2. 5. Acute T12 compression fracture with retropulsed bone, severely narrowing the canal. No cord deformity or cord signal abnormality is identified. FINDINGS: Previously placed left-sided PICC line cannot be identified at the present study in the left arm or chest. Left retrocardiac opacity is unchanged. Interval development of pleural effusion bilaterally. Old right- sided rib fractures are again seen. Compression deformity of a lower thoracic vertebral body again seen. The nasogastric tube was removed. A G-tube projects in the left upper quadrant. Brief Hospital Course: She was admitted to the Trauma Service. Orthopedic spine surgery was consulted given her injuries which were non operative. She was fitted for [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 36323**] brace (TLSO with a cervical extension) and began working with Physical therapy thereafter. Because of her rib fractures she remained in the Trauma ICU for several days because of concern for her pulmonary status. There were initial discussions regarding the possibility that she would require a tracheostomy for airway management. She was able to manage her airway effectively, maintaining oxygen saturations between 92-94% with 2 liter s of nasal oxygen. She also had episodes of paroxysmal atrial fibrillation during her ICU stay and required an Amiodarone drip; she was also started on beta blockade. Once her Amiodarone drip was stopped she was changed to the oral form; initially 400 mg [**Hospital1 **], the dose will need to be decreased over the next week. Because of dysphagia Speech and Swallow were consulted; a bedside swallow was done and it was recommended that she remain NPO because of risk for aspiration. Discussions took place for placement of PEG with patient and family. A percutaneous PEG was placed without complications. Her medications were all changed to via PEG; including her Amiodarone. Because of poor venous access a left arm PICC was placed for which patient removed as she reported it was causing her pain. She did develop arm swelling following this an underwent an upper extremity ultrasound which did reveal a thrombus in the left axillary and cephalic veins. Vascular Surgery was consulted an no further intervention was warranted. The area was monitored closely and did resolve over time. She did have intermittent blood pressure issues with SBP readings high 170's; her medications were adjusted several times; systolic blood pressure on morning of discharge after her morning medications was 138. She is being recommended for acute rehab after her hospital stay. Medications on Admission: Nifedipine Discharge Medications: 1. Hydrochlorothiazide 12.5 mg Capsule Sig: One (1) Capsule PO DAILY (Daily). 2. Amiodarone 200 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day) for 3 days. 3. Amiodarone 200 mg Tablet Sig: One (1) Tablet PO once a day: Begin on [**2175-10-10**]. 4. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 5. Isosorbide Dinitrate 20 mg Tablet Sig: 1.5 Tablets PO TID (3 times a day). 6. Acetaminophen 160 mg/5 mL Solution Sig: Fifteen (15) ML's PO every 4-6 hours as needed for pain. 7. Docusate Sodium 50 mg/5 mL Liquid Sig: Ten (10) ML's PO BID (2 times a day). 8. Senna 8.6 mg Tablet Sig: Two (2) Tablet PO at bedtime as needed for constipation. 9. Protonix 40 mg Susp,Delayed Release for Recon Sig: Forty (40) MG PO once a day. 10. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) ML Injection [**Hospital1 **] (2 times a day). 11. Albuterol Sulfate 0.63 mg/3 mL Solution for Nebulization Sig: One (1) NEB Inhalation every six (6) hours as needed for shortness of breath or wheezing. 12. Ipratropium Bromide 0.02 % Solution Sig: One (1) NEB Inhalation every six (6) hours as needed for shortness of breath or wheezing. 13. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 14. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**12-14**] Drops Ophthalmic PRN (as needed) as needed for dry eyes: both eyes. Discharge Disposition: Extended Care Facility: [**Hospital1 **] [**Location (un) 86**] Discharge Diagnosis: s/p Motor vehicle crash C2/C3 transverse process fracture C2 lamina fracture epidural hematoma C2-T2 T2 and T12 compression fracture Rib fractures - left 2-8,10 Small pneumothorax Secondary diagnosis: Hypertension Discharge Condition: Hemodynamically stable, tolerating tube feedings, pain adequately controlled. Discharge Instructions: The brace must be worn at all times while out of bed. Followup Instructions: Follow up with Dr. [**Last Name (STitle) 363**], Orthopedic Spine Surgery in 2 weeks, call [**Telephone/Fax (1) 3573**] fo an appointment. Follow up with Dr. [**Last Name (STitle) **], Trauma Surgery, in 2 weeks. Call [**Telephone/Fax (1) 6429**] for an appointment. Completed by:[**2175-10-6**] ICD9 Codes: 486, 5990, 4280, 4019
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Medical Text: Admission Date: [**2107-5-17**] Discharge Date: [**2107-6-10**] Date of Birth: [**2030-4-19**] Sex: M Service: MEDICINE Allergies: Heparin Agents Attending:[**First Name3 (LF) 1377**] Chief Complaint: Altered mental status Diarrhea Major Surgical or Invasive Procedure: none History of Present Illness: 77 y/o man with PMH significant for Crohn's disease and colon CA s/p resection on [**Hospital 3454**] transferred from the ICU after being admitted on [**5-17**] with confusion and weakness. On [**5-17**], the pt was admitted through the ED with five days of increased diarrhea (has chronic diarrhea at baseline) with new weakness and confusion. At that time, the pt reported decreased PO intake and some nausea but no vomiting. In the ED, the pt's VS were 98.7 88 133/56 16 95% 2 L NC. Labs were significant for a bicarb of less than 5 and a creatinine of 2.1 His VBG was 6.92/16/64. CT of the head was negative for acute process. The pt was admitted to the MICU for further care. . In the MICU, the pt was treated for his metabolic acidosis that was thought to be a combonation of gap acidosis from ARF and non gap acidosis from GI losses/diarrhea with a compensatory respiratory alkalosis. GI was consulted and has been following. The pt received bicarb for repleation. By [**5-18**], his bicarb had increased to 12 and his creatinine had improved to 1.4. However, the pt remained very agitated and confused. He received 1 unit PRBC for a Hct of 23.4. . His mental status then returned to baseline. Infectious workup of the diarrhea was negative. At the time of transfer to the floor, his bicarb had increased to 23 and his creatine to 0.7. Past Medical History: 1. Crohn's disease for 40 years 2. Type 2 diabetes mellitus 3. Colon CA s/p resection- Pt is on FOLFOX chemotherapy. He got his last dose of leucovorin and 5FU on [**5-9**]. His chronic diarrhea has been worse over the last 2 months while on chemo. 4. S/P testicular surgery 5. S/P appendectomy 6. Enterocutaneous fistula Social History: Pt lives with his wife. [**Name (NI) **] ETOH or tobacco use. Physical Exam: 97 112/p 80 14 Gen- Ill-appearing, lying in bed, eyes closed, responds appropriately HEENT- MMM Cardiac- RRR, normal s1s2, no murmurs Pulm- Decreased BS at R base, fine crackles at L base, o/w clear Abdomen- Soft, NT, ND, vertical midline scar well-healed, R sided hernia nontender and reducible Extremities- no edema, pneumoboots on Neuro- A+O x 3, appropriate, humorous but not talkative spontaneously. Moves all 4 extr spontaneously. Pertinent Results: . EKG [**2107-5-17**]: Sinus rhythm at 99 bpm, with atrial premature depolarizations. Left axis deviation. Left anterior fascicular block. Diffuse non-diagnostic repolarization abnormalities. Compared to the previous tracing of [**2106-9-15**] no definite change. . Stool studies: C diff ([**5-18**], [**5-19**], [**5-28**] and [**5-31**], 55)- Negative Other stool studies from [**5-18**] also negative. . Urine culture ([**5-18**])- 10,000 to 100,000 alpha hemolytic colonies consistent with alph strep or lactobacillis. . [**2107-5-17**]: No overt CHF or infiltrate. . ct abd/pelvis [**2107-5-24**]: 1. New small bilateral pleural effusions. 2. Anasarca. 3. Stable subcentimeter low attenuation lesions in the liver and left kidney. 4. Progression of severe pancreatic atrophy. Stable pancreatic cysts. New subcentimeter low attenuation lesions in the spleen, which appear nonspecific but may represent infarct. [**2107-5-17**] 10:00AM BLOOD WBC-8.1 RBC-3.28* Hgb-11.0* Hct-34.9* MCV-107* MCH-33.6* MCHC-31.6 RDW-22.2* Plt Ct-209 [**2107-5-17**] 10:00AM BLOOD Neuts-77* Bands-3 Lymphs-13* Monos-7 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2107-5-17**] 11:16PM BLOOD PT-17.4* PTT-31.4 INR(PT)-1.9 . [**2107-5-17**] 10:00AM BLOOD Glucose-215* UreaN-25* Creat-2.1*# Na-133 K-3.1* Cl-113* HCO3-<5.0 . [**2107-5-17**] 03:00PM BLOOD Acetone-MODERATE [**2107-5-17**] 03:08PM BLOOD Type-[**Last Name (un) **] pO2-130* pCO2-16* pH-6.92* calHCO3-4* Base XS--29 [**2107-5-17**] 07:48PM BLOOD Glucose-218* Lactate-3.3* Na-134* K-2.3* Cl-115* calHCO3-9* . [**2107-5-22**] 04:06PM BLOOD Ret Aut-5.8* [**2107-6-2**] 06:00AM BLOOD Ret Aut-0.6* . [**2107-5-22**] 04:06PM BLOOD Iron-18* calTIBC-138* VitB12-1516* Folate-18.7 Ferritn-170 TRF-106* [**2107-5-23**] 06:00AM BLOOD HEPARIN DEPENDENT ANTIBODIES- positive . [**2107-6-10**] 05:14AM BLOOD Glucose-44* UreaN-9 Creat-0.7 Na-137 K-3.6 Cl-103 HCO3-27 AnGap-11 Brief Hospital Course: 77 y/o man with PMH significant for Crohn's disease and colon CA admitted with severe metabolic acidosis due to diarrhea. Had had less diarrhea; on [**5-21**] starting to have more, and on [**5-23**] started on somatostatin. . 1. Severe diarrhea - The patient's diarrhea continued without significant change despite scheduled imodium for the last week in addition to escalating doses of somatostatin. CT of the abdomen was without evidence of Crohn's flare. The pt's diarrhea was initially attributed to a very common and severe complication of leukovorin/F5U treatment, per discussions with the pt's oncologist [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. He was sequentially started on standing imodium and questran. However, given that the diarrhea lasted longer than the [**3-3**] week expected time frame of chemo induced diarrhea despite the aggressive treatment, and with stool studies continuing to remain negative, he was ultimately titrated up on prednisone. The thought was that the initial chemotherapy induced diarrhea may have precipated a Crohn's flare. His diarrhea slowly began to improve and was at his baseline at discharge. He was maintained on a lactose free, low residue diet. . 2. Crohn's - - He was initially placed on cipro prophylaxis for Crohn's, but this was eventually discontinued. His Crohn's was thought to have flared after a severe bout of chemotherapy induced diarrhea. His home dose of prednisone 5mg qod was titrated up as above. . 3. Colon CA - Per discussion btw patient, family, and Dr. [**Last Name (STitle) **] on [**5-23**], the pt will not continue chemotherapy as the side effects are too severe. . 4. ARF - Resolved prerenal ARF with hydration; baseline .7; to peak of 2.1 on admission. . 5. DM2 - His blood sugars were wel controlled until he started on the high dose prednisone. He subsequentally had brittle BG on prednisone, with NPH added to his RISS regimen for better control. The titration of his insulin however was very difficult as he had multiple episodes of asymptomatic hypoglycemia when placed on more aggressive insulin regimens. It is expected that this should improve once his prednisone is tapered. . 6. Coagulopathy - On home Vitamin K 7.5mg qod. INR stable. . 7. Anemia - Hct slowly trending down. Iron studies show a mixed picture, likely combination of ACD and iron deficiency. We did not start epogen at this time. His hct trended down to 24 from 28 on [**5-31**], for which he got 2 units PRBC's. His post transfusion HCT stablized at 32-34. We continued home vit B12 and folate. Iron supplements were also given. . 8. Thrombocytopenia - HIT POSITIVE. We held all heparin products. . 9. UTI-the patient had leucocytosis to 11 on [**6-1**] w/ dysuria and hypoglycemia. Ua was grossly positive. repeated urine cx c/w skin flora-sent straight cath [**6-5**] which is still growing skin flora-isolated 2 types of enterococci. While the speciation was pending, we empirically started bactrim but persistently positive ua so this was d/c'd after 6 days. A straight cath ucx grew enterococci sensitive to ampcillin and macrodantin. We started macrodantin x 7 days on [**6-9**]. . 10. Proph - Pneumoboots, PPI. NO heparin products. . 11. Lines - PIV, portacath. . 12. FEN - Cardiac, DM diet, lactose free - Repleted lytes [**Hospital1 **]->now qd - Continued home Vitamin D/calcium. - started on po bicarb . 13. DNR/DNI Medications on Admission: 1. Ciprofloxacin 500 mg Q12H 2. Insulin SS 3. Prednisone 5 mg QOD PRNs- Tylenol Discharge Medications: 1. Loperamide HCl 2 mg Capsule Sig: One (1) Capsule PO Q4H (every 4 hours): Max of 16mg/day . Disp:*180 Capsule(s)* Refills:*2* 2. Nitrofurantoin Macrocrystal 100 mg Capsule Sig: One (1) Capsule PO QID (4 times a day) for 7 days. Disp:*28 Capsule(s)* Refills:*0* 3. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Phytonadione 5 mg Tablet Sig: 1.5 Tablets PO DAILY (Daily). 5. Cyanocobalamin 100 mcg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 6. Amylase-Lipase-Protease 33,200-10,000- 37,500 unit Capsule, Delayed Release(E.C.) Sig: One (1) Cap PO QIDWMHS (4 times a day (with meals and at bedtime)). Disp:*120 capsules* Refills:*2* 7. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO BID (2 times a day). 8. Cholestyramine-Sucrose 4 g Packet Sig: One (1) Packet PO DAILY (Daily). Disp:*30 Packet(s)* Refills:*2* 9. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 10. Prednisone 10 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily) for 2 weeks. Disp:*42 Tablet(s)* Refills:*0* 11. Sodium Bicarbonate 650 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*2* 12. Octreotide Acetate 500 mcg/mL Solution Sig: One (1) ml Injection three times a day. Disp:*21 mL* Refills:*0* 13. Insulin NPH Human Recomb 100 unit/mL Cartridge Sig: Five (5) units Subcutaneous qam: before breakfast. Disp:*300 units* Refills:*2* 14. Insulin Regular Human 300 unit/3 mL Syringe Sig: qs Subcutaneous before meals (breakfast, lunch, dinner): per attached sliding scale. 15. Syringe & Needle Dispenser Misc Sig: One (1) syringe and needle Miscell. three times a day. Disp:*30 syringe/needle* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Chemotherapy induced severe diarrhea Crohn's flare Metabolic acidosis Urinary tract infection Brittle Diabetes Mellitus Discharge Condition: stable with improved diarrhea and resolved metabolic acidosis Discharge Instructions: Please call your doctor or go to the ER if you have fever greater than 101, shaking chills, lethargy or change in your mentation, muscle cramps, palpitations, chest pain, shortness of breath, worsening diarrhea or other symptoms of concern to you. Followup Instructions: 1. Please follow up in Dr.[**Name (NI) 16937**] office on Thursday [**2107-6-16**] at 10:15 am. Call [**Telephone/Fax (1) 682**] if you need to reschedule. 2. Please follow up with your oncologist, Dr. [**Last Name (STitle) **], on Wednesday [**2107-6-22**] at 3:00 pm. Call [**Telephone/Fax (1) 6568**] if you need to reschedule. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] MD [**MD Number(1) 1379**] ICD9 Codes: 5849, 2765, 2875, 2762
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Medical Text: Admission Date: [**2176-3-13**] Discharge Date: Date of Birth: [**2117-2-17**] Sex: M Service: HISTORY OF THE PRESENT ILLNESS: This is a 59-year-old man, who was recently treated for endocarditis by Dr. [**First Name (STitle) 24344**]. He was referred to [**Hospital1 69**] for an outpatient cardiac catheterization prior to have mitral valve surgery. He was in his usual state of health until [**Month (only) 359**] of last year, when he was running and noticed chest tightness. He went to bed that night and had nightsweats throughout the night. He lost over 20 pounds over the next two months and he diagnosed with hypothyroidism and anemia at [**Hospital3 4527**] Hospital. He was diagnosed with endocarditis and an echocardiogram on [**2176-2-2**] showed moderate-to-severe mitral valve prolapse, partial mitral leaflet failure and severe mitral regurgitation, and a small pericardial effusion. He was discharged in early [**Month (only) 404**] and had one month of IV Ceftriaxone at home. Since then he has been feeling better. He denied any chest pain, shortness of breath, lightheadedness, and his lower extremity edema have all resolved. He denied claudication and edema, however, he had two plus pillow orthopnea. Risk factors for coronary artery disease included hypertension and heavy cigarette history. PAST MEDICAL HISTORY: 1. Rheumatic fever. 2. Renal calculus. PAST SURGICAL HISTORY: The patient has a past surgical history for tonsillectomy and adenoidectomy. He denied any blood in his stools, black stool, stroke, TIA, cancer. ALLERGIES: He had allergies to Ceftriaxone, which resulted in extreme rash and no shellfish or dye allergies. MEDICATIONS AT HOME: 1. Synthroid 50 mg a day. 2. Ferrous sulfate 325 mg three times a day. LABORATORY DATA: Laboratory data on [**2176-3-9**] revealed CBC of 7.5, 29.9, 202, chemistry of 139, 4.4, 102, 29, 19 and 1.4. The INR is 1. He is divorced. He denied any alcohol abuse. Cardiac catheterization done on [**2176-3-13**] showed three-vessel coronary artery disease with severe stenosis in the RCA, LAD, and the OM. He had 4+ MR. The patient was admitted to the cardiothoracic surgery under the care of Dr. [**Last Name (STitle) 70**]. The patient was taken to the operating room on [**2176-3-14**], where he has CABG times three and MVR #31 carbomedical mechanical valve. He was joined by Dr. [**Last Name (STitle) 70**] and [**Doctor Last Name **]. Dr. [**Last Name (STitle) 70**] was the attending of record. Postoperatively, the patient was transferred to the cardiothoracic Intensive Care Unit, where he was doing well. After three units of packed red blood cells, platelets were transfused, he was transferred to the floor. The patient had a good blood pressure. Vancomycin was infused to the patient secondary to a mitral valve Gram stain from the operative session, which showed gram-positive cocci. The Department of Infectious Disease recommended blood cultures and the continuation of the Vancomycin initially. Mitral valve cultures showed nothing and grew out negative. Blood cultures failed to show any growth. Multiple blood cultures, were sent off during the hospitalization. The patient continued on Vancomycin until [**2176-3-21**], when he was switched over to Penicillin. In light of his known allergy to Ceftriaxone, the patient was first evaluated by the allergy specialist who felt that his allergy to Ceftriaxone was not a real allergy and that he would tolerate Penicillin. With the consultation and expert advice, we gave him a test dose of Penicillin, which was tolerated well without incident. The patient had a MRI of the back done on [**2176-3-19**], which showed some osteal changes suggestive of osteomyelitis on T10 and then L5 to S1, possible small epidural collection around S1 to the right side. The Infectious Disease was aware of this and we did a CAT scan the following day. The abdomen failed to show any focal area of collection or lesions, however, multiple cyst were noted in the liver and spleen, which could not be ruled out as being microabscesses. However, the patient was afebrile and vital signs were stable. The patient had anticoagulation started during this admission to reach an INR of about 3 to 3??????, since the patient had a mechanical valve. The patient is on Lovenox, which will be discontinued until the INR is therapeutic. On [**2176-3-11**] it was noted that the patient's left leg was inflamed during the course of his admission. With antibiotics his leg showed some resolution and no signs of acute infection, which warranted a new opening of the wound. The ultrasound done the same day showed that there was no DVT and the patient had bruising and pain about the leg, most likely due to the slightly inflamed left incision, which at no time showed any pus or extensive cellulitis. During the course of this stay, the patient also had chest tube and wires discontinued, which was tolerated well with no pneumothorax. The patient is ready for discharge to home for a total of four weeks of antibiotics, Penicillin, after a PICC line was placed on [**3-19**] with cephalic vein position around the midclavicular area. The patient is being discharged home likely within the next two days. The patient will followup with MRI in four weeks with x-ray of the abdomen and spine. The patient will also have an appointment with the Department of Infectious Disease in four weeks for followup with Dr. [**Last Name (STitle) **]. The patient will also followup with the primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 29111**] [**Name (STitle) 24344**], who will manage his INR anticoagulation. CONDITION ON DISCHARGE: Afebrile, good health. The patient will go home with home VNA and infusion pump. DR.[**Last Name (STitle) **],[**First Name3 (LF) **] 02-358 Dictated By:[**Name8 (MD) 16758**] MEDQUIST36 D: [**2176-3-21**] 21:05 T: [**2176-3-22**] 09:15 JOB#: [**Job Number 38210**] ICD9 Codes: 2449, 2859, 4019
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Medical Text: Admission Date: [**2114-10-4**] Discharge Date: [**2114-10-8**] Service: [**Last Name (un) 7081**] ADMISSION DIAGNOSES: 1. Right pleural effusion. 2. Stage IV colon cancer (metastases to liver, pleura). 3. Chronic obstructive pulmonary disease (home oxygen dependent, steroid dependent). 4. Congestive heart failure. 5. Pulmonary hypertension. 6. Macular degeneration. 7. Hypertension. 8. Status post torn right rotator cuff. 9. Atrial fibrillation. DISCHARGE DIAGNOSES: 1. Acute respiratory failure. 2. Status post insertion of right thoracic PleurX catheter. 3. Right pleural effusion. 4. Stage IV colon cancer (metastases to liver, pleura). 5. Chronic obstructive pulmonary disease (home oxygen dependent, steroid dependent). 6. Congestive heart failure. 7. Pulmonary hypertension. 8. Macular degeneration. 9. Hypertension. 10.Status post torn right rotator cuff. 11.Atrial fibrillation. ADMISSION HISTORY AND PHYSICAL: Mr. [**Known lastname 30984**] is an 84-year-old man with stage IV colon cancer with metastases to his liver and his pleura, who has been accumulating large right-sided pleural effusions. He underwent a thoracentesis late in the summer of [**2113**], which drained over a liter of fluid. The cytology at that time was negative for malignancy. He had reaccumulated a large pleural effusion on his right side and was therefore admitted for elective drainage of this effusion, and insertion of a PleurX catheter for future management of his effusion. He was admitted electively in order to allow his INR to become subtherapeutic, as he had been on Coumadin for atrial fibrillation. HOSPITAL COURSE: The patient was admitted on [**2114-10-4**]. His INR had come down to 1.4 by then and the plan was for him to undergo an elective drainage of his effusion on [**10-5**]. The patient became acutely hypoxic on the evening of [**2114-10-4**] secondary to what was felt to be worsening pulmonary edema, given the patient had not been taking his Lasix for several days. He was diuresed aggressively with Lasix at which time his oxygenation improved, and his mental status and respiratory status improved. On the morning of [**2114-10-5**] the patient became increasingly confused and agitated. An arterial blood gas was drawn which showed a pCO2 of 112, indicating that the patient had developed some acute on chronic CO2 retention as his pH at that time was not significantly low (7.27). As the patient was DNR/DNI, his only option was positive pressure ventilation. Therefore, he was transferred to the ICU for drainage of his effusion and possible initiation of positive pressure ventilation if necessary. The patient stabilized with additional diuresis not requiring a BiPAP mask, and on that same day underwent drainage of his pleural effusion, at that time 2.4 liters of clear fluid were drained. There was no evidence of hemothorax or infection in the fluid. A PleurX catheter was placed. The patient's respiratory status still remained somewhat tenuous although he symptomatically felt better and his mental status improved. Extensive discussions were held with the family and eventually the palliative care service, who had been seeing the patient, met with the family and the decision was made that the patient would be placed in hospice palliative care without further aggressive intervention. He was transferred back to the floor on the [**10-6**] and since that time has been doing well, maintaining an oxygen saturation of 93% on 2 liters, which was his baseline. There was no significant reaccumulation of his catheter. He was then set up with discharge to hospice and palliative care on the [**2114-10-8**]. He was discharged afebrile with normal hemodynamics and as noted an oxygen saturation of 93% on 2 liters. DISCHARGE MEDICATIONS: Included albuterol nebulizer treatments q.6h. as needed, diltiazem extended release 240 mg p.o. once daily, fluticasone, Solu-Medrol inhaler 250/50 one inhalation b.i.d., Lasix 80 mg p.o. b.i.d., lisinopril 40 mg p.o. once daily, prednisone 40 mg p.o. once daily until [**10-13**], after that time taper down to 20 mg once daily and continue taper thereafter, Senna 2 mg p.o. at bedtime, tiotropium bromide 1 tablet inhaled daily. DISCHARGE CODE STATUS: DNR/DNI. [**Name6 (MD) **] [**Name8 (MD) **], MD [**MD Number(2) 286**] Dictated By:[**Doctor Last Name 3763**] MEDQUIST36 D: [**2114-10-8**] 10:46:38 T: [**2114-10-8**] 18:09:28 Job#: [**Job Number 102774**] ICD9 Codes: 4280, 4168, 4019, 496
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Medical Text: Admission Date: [**2188-4-19**] Discharge Date: [**2160-3-24**] Service: Trauma Surgery ADDENDUM: This Addendum is in regard to Neurosurgery recommendations. A repeat computed tomography of the head was reviewed with Radiology and Neurosurgery showing an unchanged left frontoparietal subdural hematoma. Neurosurgery recommendations included followup with Dr. [**First Name (STitle) **] in one month with a repeat head computed tomography. The patient was cleared by Neurosurgery to go back to nursing home. On discharge, the patient was stable. Afebrile with stable vital signs. Physical examination remarkable for ecchymosis of the left forehead which is stable. The patient was tolerating a regular diet and had good urine output; although incontinent at baseline. DISCHARGE DIAGNOSES: (Add to discharge diagnoses) 1. Status post fall. 2. Left frontoparietal subdural hematoma (stable). 3. Dementia. 4. Congestive heart failure. 5. Hypertension. 6. Degenerative joint disease. 7. History of cerebrovascular accident. 8. Depression. 9. History of breast cancer. 10. History of hiatal hernia. 11. Chronic anemia. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**], M.D. [**MD Number(1) 521**] Dictated By:[**Last Name (NamePattern1) 27744**] MEDQUIST36 D: [**2188-4-22**] 09:59 T: [**2188-4-22**] 10:10 JOB#: [**Job Number 39244**] ICD9 Codes: 5990, 4280, 311
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Medical Text: Admission Date: [**2120-12-20**] Discharge Date: [**2120-12-25**] Service: NEUROLOGY Allergies: Penicillins / Aspirin / Sulfa (Sulfonamides) / Duragesic Attending:[**First Name3 (LF) 5018**] Chief Complaint: sudden right sided weakness Major Surgical or Invasive Procedure: None History of Present Illness: 81 yo woman with a history of HTN and recent bout of bronchitis and [**First Name3 (LF) **] fractures who was in her USOH earlier today, about to eat lunch with her husband, when suddenly she slumped to the right at 12:20pm. She was weak on the right and nonverbal. EMS took patient to [**Hospital3 4107**] where she was noted to have right hemiplegia and aphasia. Vitals at [**Hospital1 **]: 171/114, 92 NSR, RR 18, 100% on 2LNC (at 14:10). She had a head CT negative for bleed, and was transferred to the [**Hospital1 18**] for IV t-PA. Patient arrived at [**Hospital1 18**] at 1448. Stroke team was notified at 1430 and responded at 1430. Labs were drawn at OSH. CT done at OSH and films available for our review. EKG ordered at 1450 and results available at 1505. IV t-PA was administered at 1510 based on her weight of 122 pounds. Initially, her exam by the [**Hospital1 18**] ED neurologist was as follows: she was awake, alert, following one step commands only, very dsyarthric but able to say, "Ahh...", unable to comprehend her speech output. She had a left gaze preference and eyes did not move past midline, right face droop. Right body flacid plegia without response to noxious stimuli. She did extend the right toe to noxious stimuli. Right foot with upgoing toe. After IV t-PA administration she was taken to MRI. MRI showed a large left MCA stroke. Her exam transiently improved in that she was able to lift her right arm to gravity. This improvement was short lived. Started on labetolol gtt in ED for SBP 190's. No vision loss (TIA), no weakness in the past. Past Medical History: -Hypertension - Renal cancer, s/p nephrectomy by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 2643**] at [**Hospital1 756**] 1.5 years ago, s/p chemotherapy (last dose 6 months ago) follwed by Dr. [**Last Name (STitle) 53761**] at [**Hospital3 328**]. Has a portacath over the right chest. - Bladder cancer vs spread of renal cancer, unclear - Recent bronchitis and [**Hospital3 **] fractures - Endometriosis with small bowel obstructions requiring surgery (last obstruction 3 yrs ago) - DJD Social History: Lives at home, married, one son estranged, never smoked, one glass of wine with dinner, no drugs, no alternative medicine. No aids to walk. Using visiting nurse [**First Name (Titles) **] [**Last Name (Titles) **] fracture/bronchitis. Retired head teller and book keeper at a bank. Director of volunteers at a library, not currently working. Lives in [**Location 5110**], MA. Family History: Husband unable to answer, has a twin brother who is obese and another brother and sister. Physical Exam: VITALS: FS 106, T 97, P 80, BP 170/80, 100% GEN: frail elderly appearing woman in NAD SKIN: no rash HEENT: NC/AT, anicteric sclera, mmm NECK: supple, no carotid bruits CHEST: normal respiratory pattern, course BS bilaterally CV: regular rate and rhythm with ? sys murmur ABD: softly distended, rare BS EXTREM: no edema NEURO: Mental status: Patient is alert, awake, pleasant. Oriented to person, place "hospital" when given a list of places to chose from, "[**2117**]" and "winter". Mildly inattentive. Language: speaks primarily with single words but will repeat and string 4 words together, good comprehension following multistep commands, marked dysarthria. Is aware that she had a stroke. Pays less attention to the right but is able to look to the right. Did not count one person standing far to the right. No left/right mismatch, recognizes her right arm as her own. Cranial Nerves: Visual fields: full to left/right/upper/lower fields. Pupils:3->2 mm, consenual constriction to light. EOMS full, gaze conjugate. No nystagmus or ptosis. Facial sensation intact over V1/2/3 to light touch. Both upper and lower face weakness on the right. Hearing decreased on the right. Marked dysarthria. Symmetric elevation of palate. Trapezius [**3-27**] bilaterally. Tongue midline without atrophy or fasciulations. Sensory: No sensation to touch right leg, decreased in the right arm, normal right face. No withdrawl to pain right arm but does withdrawl right leg to pain. Motor: Right flacid. No adventitious movements. Strength- - Left side is essentially full strength throughout. - Right side: lifts right arm to gravity but unable to provide any resistence. Right biceps weak [**12-28**]. Right triceps 4-/5 (provide minimal resistence). Right hand is completely weak unable to wiggle fingers/grasp/straighten fingers. Right leg is stronger - [**2-25**] IP/Ham/DF. Quads/plantar flexion full. Reflexes: [**Hospital1 **] BR Tri Pat Ach Toes RT: 1 0 0 0 0 down LEFT: 2 2 2 1 1 down Coordination: intact on left Gait: patient on bedrest Pertinent Results: Labs: CBC normal except Hct 33.7, chem7, coags and UA normal Cardiac enzymes negative. Risk factor screening: HbA1c 5.6 Triglyc 184 TChol 172 LDL 102 HDL 33 Radiology: BRAIN MRI: Acute left MCA infarct, sparing basal ganglia. MRA with occlusion of the posterior division of the left middle cerebral artery in its proximal portion. CT HEAD W/O CONTRAST (s/p tPA): No acute intracranial hemorrhage. CAROTID SERIES: Scattered bilateral ICA plaque, no appreciable associated stenosis, however (graded as less than 40% bilaterally). ELBOW (AP, LAT & OBLIQUE) RIGHT: Large elbow joint effusion. No distinct fracture line is identified. TTE: EF>55%. Trivial MR. Otherwise normal. Brief Hospital Course: 81 yo female with history of hypertension, renal and bladder cancer s/p chemotherapy p/w acute onset of lack of speech and right-sided weakness. Taken by EMS to [**Hospital3 **]. Presentation was concerning for new stroke. Noncontrast head CT was negative for a bleed and she was transferred to [**Hospital1 18**] for IV t-PA. Received t-PA on [**2120-12-20**] at 15:10 (2hrs 50 min after onset of symptoms). Transiently improved - able to lift right arm, attended to the right, followed commands, no verbal output. Transferred to SICU for 24 hour monitoring and post t-PA protocol. MRI confirmed large acute infarct in left MCA distribution with occlusion on MRA. Patient had no known history of stroke/seizure, no known cardiac arrhythmias, was a nonsmoker and nondiabetic. On [**2120-12-23**] she went into rapid afib with HR in 150's ~2am. 5mg IV lopressor was administered with conversion to sinus rhythm. She experienced a second episode of afib (HR 130's, SBP 160's) ~5:30am on [**2120-12-24**], which resolved before metoprolol administration. SBP's remained above 140, and [**Hospital1 **] dosing of 25 mg metoprolol was initiated and maintained until discharge with good rate control achieved. She was changed to toprol XL for easier dosing on day of discharge. Dose may need to be titrated as needed for rate control. Additionally, ACE inhibitor should be added as tolerated, with goal SBP<120. Coumadin 2mg was started on [**2120-12-23**] for secondary stroke prevention given the atrial fibrillation, with plan of allowing INR to rise slowly over 1 week due to size of infarct. Baseline INR on [**12-24**] was 1.0. Echocardiogram with normal LA size, normal LV systolic function and no thrombus. Carotid US without significant stenosis (< 40% stenosis bilaterally). Blood sugars remained between 85 and 130, with fingersticks discontinued on hospital day 5. HgbA1c was 5.6. Lipid screening revealed total cholesterol of 172, LDL 102, HDL 33 and triglycerides 184. Atorvastatin 20 mg QD started on [**12-23**] once she was cleared to take PO. Given severe dysarthria, speech and swallow evaluation was done to evaluate for aspiration. Video swallow study cleared her for pureed solids and nectar prethickened liquids with chin tuck, pills administered whole in puree. Patient complained of R elbow pain on [**12-24**]. Films revealed large joint effusion without fracture line. Additional history that patient's husband grabbed arm to prevent her from falling during onset of symptoms was elicited. Pain and effusion most likely secondary to traumatic hyperextension of elbow. Recommend ice and analgesics. In [**11-24**] weeks if pain not improved, her elbow should be re-evaluated. Can contact Dr. [**First Name5 (NamePattern1) 9527**] [**Last Name (NamePattern1) 9620**] in Rheumatology, [**Telephone/Fax (1) 2226**], for further assistance if needed. Patient was given standing percocets for [**Telephone/Fax (1) **] fractures with option of refusal, due to Broca's aphasia and inability to ask for meds when in pain. Neuro exam on discharge was somewhat improved. She was aware that she had a stroke, was oriented to person, place and date. She was able to repeat and name high frequency objects but was not fluent, had severe dysarthria, right face droop, with a very weak right hand but able to lift arm to gravity. On discharge she was able to move fingers and wrist slightly with gravity and was felt to be improving somewhat. She had decreased tone in R upper extremity. Lower extremities had full strength bilaterally. Medications on Admission: - Lorazepam 0.5mg twice a day prn for anxiety, Darvocet 100-650mg one to two tabs every 4 hours prn, albuterol and cough medicine with codeine for bronchitis, z-pack (completed [**2-25**] days), MVI - NOT TAKING ANTIHYPERTENSIVES, formerly took norvasc Discharge Medications: 1. Pantoprazole Sodium 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 2. Heparin Sodium (Porcine) 5,000 unit/mL Solution Sig: One (1) ml Injection TID (3 times a day) as needed for dvt prophylaxis. 3. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 4. Atorvastatin Calcium 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. Warfarin Sodium 2 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 6. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours): Pt may refuse, but please offer as Broca's aphasia makes it difficult for her to ask. 7. Zolpidem Tartrate 5 mg Tablet Sig: 1-2 Tablets PO HS (at bedtime) as needed. 8. Metoprolol Succinate 50 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). 9. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 10. Senna 8.6 mg Capsule Sig: One (1) Tablet PO BID (2 times a day) as needed. 11. Bisacodyl 5 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day) as needed: Alternatively, may give PR. Discharge Disposition: Extended Care Facility: [**Hospital3 **] TCU Discharge Diagnosis: Left middle cerebral artery infarction complicated by dysphagia Atrial fibrillation Hypertension Hypercholesterolemia [**Hospital3 **] fractures (prior to admission) Elbow pain, likely due to traumatic hyperextension Discharge Condition: Improved, though still with right hemiparesis with significant right arm and face weakness. Also still with Broca's aphasia and severe dysarthria. Discharge Instructions: Take all medicines as prescribed. We have started you on two new medications, lipitor for your cholesterol and coumadin to thin your blood. Keep all follow-up appointments. Call your doctor or return to the ED if you develop new weakness on your left side, difficulty seeing or understanding. Followup Instructions: Follow-up with your PCP 1-2 weeks after discharge from rehab. Dr. [**Last Name (STitle) 17669**] will continue to manage your blood pressure and coumadin dosing. Follow-up in [**Hospital 4038**] Clinic with Dr. [**First Name (STitle) **] [**Name (STitle) **] in about 3 months on [**2121-4-8**] at 1pm. Call [**Telephone/Fax (1) 2574**] for more information or to reschedule. [**Name6 (MD) 4267**] [**Last Name (NamePattern4) 4268**] MD, [**MD Number(3) 5023**] ICD9 Codes: 2720, 4019
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Medical Text: Admission Date: [**2151-5-27**] Discharge Date: [**2151-5-31**] Service: [**Last Name (un) **] DATE OF DEATH: [**2151-5-31**], at 5:38 p.m. CHIEF COMPLAINT: Status post fall. HISTORY OF PRESENT ILLNESS: An 84-year-old female after a fall from standing for unknown reason. The patient had respiratory arrest and brief asystole. The patient was intubated at the scene and brought to the emergency department. The patient was found to be flaccid on initial exam. The patient had a CT of the head and C-spine. C-spine showed a comminuted type 2 dense fracture nearly 30 degrees of leftward rotation of C1 on C2. PAST MEDICAL HISTORY: Hypertension, history of multiple PEs, interstitial lung disease on home O2, room air saturating around 88% to 89%, diabetes, pulmonary artery hypertension, DJD, history of stroke x2, the last one was [**2140**], without any residual effect, status post cholecystectomy. ALLERGIES: Vasotec. MEDICATIONS: At home, Coumadin, metoprolol, Lasix, glyburide, Protonix, Lipitor, Macrodantin. PHYSICAL EXAMINATION: On physical examination, her temperature was 98 degrees, heart rate was 43, blood pressure was 117/47, respirations 12, saturating 100%. Her pupils were 2 mm and reactive. She was intubated. She was moving both upper and lower extremities to pain. The patient had regular rate and rhythm. The patient's lungs were clear. Abdomen was soft, nontender, nondistended. The patient was guaiac negative. Normal tone. There were no step-offs on the examination of the spine. The patient had C-collar in place. The patient had a CT of the C-spine and CT of the head that showed no intracranial hemorrhage. CT of the C-spine showed the comminuted type 2 dense fracture. CTA of the neck showed no dissection. MR of the C-spine showed cord contusion at C2 and disruption of anterior ligaments. The patient's white count was 8.9, hematocrit was 44. BUN was 18, creatinine was 1.3. UA was negative. Toxicology was negative. HOSPITAL COURSE: The patient was admitted to the trauma surgery service and was taken to the intensive care unit. The patient was started on steroids with a bolus and a drip for the concern for spinal cord injury. Cardiology was consulted and recommended continuing supportive medical care. Ortho- spine was consulted who recommended continuing the collar. The patient had an elevated coag with 2.4 INR and that was reversed and the patient was continued on ventilation. On hospital day #2, the patient was continued on C-collar. The patient had echocardiogram that showed significant pulmonary artery hypertension with systolic around 80s with a very poor right ventricular function. Per cardiology, recommend to continue supportive care. The patient was kept NPO with a Foley and the patient was slowly weaned from the ventilation. On hospital day #3, the patient had acute change in ability to move the upper extremity. The patient was given vitamin K and FFP to reverse the coagulopathy for concern for possible hemorrhage into the C-spinal canal. CT of the C-spine showed a superior fragment of odontoid fracture, most posteriorly displaced but not impinging on the cord. MR of the spinal cord showed no cord compression but continued to have spinal cord edema. CT of the head showed no acute process. The patient also had acute respiratory decompensation where the patient had CTA that initially showed no PE. The patient was continued to be supported throughout. On hospital day #4, the patient remained afebrile with stable vital signs and was continued to be weaned from the propofol. The patient had decreased movement of the upper extremity and only moved the lower extremity with decreasing the vent support. The patient was placed on Augmentin for Enterococcus urinary tract infection. Approximately noon on hospital day #4, the patient developed a significant respiratory and cardiac decompensation. The patient was hypotensive, also tachycardic to 150s, and urgent echocardiogram was obtained which showed that the patient did not have a functioning right ventricle and also the patient desaturated which were clinically consistent with pulmonary emboli. At this time with her injuries and also development of a new pulmonary emboli, discussion was made with the family who made her DNR. The patient was continuously supported with pressors and full vent support and after subsequent discussion, the patient was then made CMO. After the patient was CMO, the patient expired at 5:38 p.m. on [**2151-5-31**]. CONDITION ON DISCHARGE: Death. DISCHARGE STATUS: Death. DISCHARGE DIAGNOSES: 1. Cervical spine fracture after a fall. 2. Pulmonary emboli. 3. Status post cholecystectomy. 4. Hypertension. 5. History of multiple pulmonary emboli. 6. Interstitial lung disease. 7. Diabetes. 8. Pulmonary artery hypertension. 9. Degenerative joint disease. 10. History of stroke. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5732**], [**MD Number(1) 5733**] Dictated By:[**Doctor Last Name 6052**] MEDQUIST36 D: [**2151-5-31**] 19:01:33 T: [**2151-5-31**] 20:07:36 Job#: [**Job Number 28464**] ICD9 Codes: 2760, 5990, 496, 4019, 2768, 4168
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Medical Text: Admission Date: [**2154-5-21**] Discharge Date: [**2154-5-28**] Date of Birth: [**2120-11-19**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 30**] Chief Complaint: RUE pain and SOB x 1 day Major Surgical or Invasive Procedure: None History of Present Illness: Pt is a 33yo male with ESRD on HD since [**12/2152**], HTN and h/o noncompliance who p/w RUE pain and SOB X1 day, the morning after dialysis. Pt was dialyzed the night before admission and then awoke 6/24AM with SOB and pain in his right arm. He describes the RUE pain as sharp, localized to site of port-a-cath. Pt admits to HTN medication non-compliance the night before admission. He denies associated chest pain/palpitations, fever/chills/cough. He notes some abdominal pain and nausea earlier in the day which had since resolved. No HA/dizziness. No diarrhea/constipation. At baseline is able to climb steps w/o SOB. Does not check his BP at home. In the ED he had a set of cardiac enzymes that was lower than his baseline and EKG unchanged from baseline. CTA was negative for acute PE, but did reveal chronic segmental PE in RUL. RUE U/S showed a non-occlusive thrombus in the R IJ and a heparin drip was started. Pt was noted to have BP of 205/144 in the ED and was subsequently treated with a nitro drip. CXR in the ED showed pulmonary edema. Past Medical History: -ESRD [**12-29**] HTN - started on dialysis in [**12/2152**] -HTN -medication non-compliance -h/o intubation in the setting of hypertensive urgency/flash pulmonary edema Social History: He used to work as a plasterer, but is now on disability. tobacco - 1PPD x 20 years, recently decreased to two cigarettes a day. no recent alcohol use, + cocaine- denies recent use, does endorse recent marijuana use, denies any intravenous drugs; spent time in jail. Family History: Father - dead at age 36 from unknown cancer Mother - alive, 56, + HTN maternal grandmother - on hemodialysis for end-stage renal disease. - The patient has a younger sister and an older brother, both alive and well. - son - 7, alive and well Physical Exam: T 97.4 BP 130-140/90-100 HR 64 RR 20 SaO2 99% on 4L N/C General: speaks in complete sentences, NAD HEENT: NCAT PERRL EOMI o/p clear +JVD Chest: no palpable cord/tenderness at site of line, no erythema/edema noted Heart: RRR, [**1-31**] holosystolic murmur radiating to L axilla Pulmonary: bilateral basilar crackles Abdomen: scar noted, S/NT/ND +BS Extremity: + ecchymoses RUE, no C/C/E Neuro: AOX3, CN3-12 intact Skin: no rashes, warm and dry Pertinent Results: [**2154-5-28**] 07:00AM BLOOD WBC-4.9 RBC-3.65* Hgb-10.6* Hct-32.8* MCV-90 MCH-28.9 MCHC-32.2 RDW-15.8* Plt Ct-257 [**2154-5-27**] 06:55AM BLOOD WBC-4.7 RBC-3.60* Hgb-10.5* Hct-32.6* MCV-91 MCH-29.3 MCHC-32.3 RDW-16.5* Plt Ct-265 [**2154-5-26**] 06:18AM BLOOD WBC-5.0 RBC-3.72* Hgb-10.8* Hct-33.8* MCV-91 MCH-29.2 MCHC-32.0 RDW-16.1* Plt Ct-240 [**2154-5-25**] 07:15AM BLOOD WBC-5.0 RBC-3.50* Hgb-10.2* Hct-32.5* MCV-93 MCH-29.0 MCHC-31.3 RDW-15.9* Plt Ct-231 [**2154-5-24**] 07:47AM BLOOD WBC-5.5 RBC-3.92* Hgb-11.1* Hct-35.6* MCV-91 MCH-28.4 MCHC-31.2 RDW-16.0* Plt Ct-237 [**2154-5-23**] 04:10AM BLOOD WBC-5.9 RBC-3.51* Hgb-10.4* Hct-31.2* MCV-89 MCH-29.7 MCHC-33.5 RDW-16.4* Plt Ct-220 [**2154-5-22**] 05:09AM BLOOD WBC-7.6 RBC-3.58* Hgb-10.3* Hct-31.9* MCV-89 MCH-28.8 MCHC-32.4 RDW-16.0* Plt Ct-225 [**2154-5-21**] 02:58PM BLOOD WBC-6.7 RBC-3.77* Hgb-11.2* Hct-33.7* MCV-90 MCH-29.7 MCHC-33.2 RDW-16.1* Plt Ct-238 [**2154-5-28**] 07:00AM BLOOD PT-20.5* PTT-70.3* INR(PT)-1.9* [**2154-5-27**] 06:55AM BLOOD PT-18.7* PTT-102.3* INR(PT)-1.7* [**2154-5-26**] 06:18AM BLOOD PT-16.9* PTT-95.7* INR(PT)-1.5* [**2154-5-25**] 07:15AM BLOOD PT-15.1* PTT-84.9* INR(PT)-1.3* [**2154-5-24**] 07:30AM BLOOD PT-13.3 PTT-65.3* INR(PT)-1.1 [**2154-5-23**] 04:10AM BLOOD PT-13.3 PTT-92.6* INR(PT)-1.1 [**2154-5-21**] 10:54PM BLOOD PT-14.3* PTT-130.0* INR(PT)-1.2* [**2154-5-21**] 02:58PM BLOOD Glucose-106* UreaN-53* Creat-11.1*# Na-145 K-4.7 Cl-102 HCO3-26 AnGap-22* [**2154-5-21**] 02:58PM BLOOD ALT-42* AST-31 LD(LDH)-384* CK(CPK)-261* AlkPhos-76 Amylase-97 TotBili-0.3 [**2154-5-21**] 02:58PM BLOOD Lipase-24 [**2154-5-21**] 02:58PM BLOOD cTropnT-0.07* [**2154-5-28**] 07:00AM BLOOD Calcium-9.1 Phos-5.0* Mg-2.6 [**2154-5-22**] 05:09AM BLOOD Calcium-7.4* Phos-8.2*# Mg-2.0 [**5-21**] CXR (Portable AP): Pulmonary edema without evidence of focal infiltrate. [**5-21**] U/S: Findings suggestive of a nonocclusive thrombus within the right internal jugular vein, immediately upstream from the expected location of the hemodialysis catheter. [**5-21**] CTA Chest: 1. Diffuse ground-glass opacities bilaterally, with intralobular septal thickening. These findings are similar to prior CT from [**2154-5-6**], with marked improvement on subsequent radiograph of [**2154-5-7**]. Given these time course of findings, as well as a history of end-stage renal disease on hemodialysis, these findings likely reflect pulmonary edema. 2. Previously noted chronic segmental pulmonary embolism in the right upper lobe is not fully assessed on this study due to respiratory motion. No large central or large segmental pulmonary embolism identified. 3. Large calcified right upper pole renal lesion, incompletely evaluated, and appears largely unchanged. [**5-23**] Renal U/S: Limited study with delayed systolic upstroke in the left parenchymal arteries. Renal artery stenosis in the setting cannot be excluded. Brief Hospital Course: In the MICU: Pt continued his heparin gtt from the ED for his R IJ tunneled-cath clot. Blood pressure elevated to 205/144 and was controlled with a labetalol gtt and a nitro gtt. Pt presented in pulmonary edema and was subsequently taken to HD the night of admission - pt did not require additional intervention. Pt developed one episode of bloody emesis and was taken off of his heparin gtt. By the time of transfer the pt was weaned off of his labetalol/nitro gtt and was down to 4L of O2 with adequate sats. . On the general medicine floor: . Nonocclusive right IJ thrombus: Pt was treated with heparin to coumadin bridge. The plan was discussed with Vascular and Renal and it was decided that the R IJ tunneled-cath would be left in place. The catheter was accessed for HD throughout the pt's stay. Transplant surgery will evaluate the pt for placement of a fistula. Pt has missed last 5 appointments as an outpatient. Social work was contact[**Name (NI) **] and will help facilitate the outpatient appointment. Scheduled appointment with transplant surgery on [**6-6**] with Dr. [**Last Name (STitle) 816**]. The pt was treated with warfarin 5mg x 3 days, warfarin 7.5mg x 3 days and finally warfarin 10mg x 1 day to reach the target INR. On the day of discharge pt had been therapeutic on heparin for 7 days, had an INR of 1.9 and was given lovenox 30mg x 1 dose before leaving. This plan was discussed with renal and they approved the use of lovenox in the setting of this pt's end stage renal disease managed with dialysis. Pt will follow with Dr. [**Last Name (STitle) **] in dialysis for coumadin management until he sees his PCP (pt never had a regular PCP, [**Name10 (NameIs) **] appointment) Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 12101**] this Thursday for further management. . Bloody emesis: The pt had only 1 episode in the MICU [**5-22**]. Heparin and coumadin were briefly held and restarted once the pt's HCT was stable. Pt was placed on pantoprazole [**Hospital1 **] and had no further issues on the floor. . Fluid overload: Pt initially presented with a BNP >[**Numeric Identifier **] and with pulmonary edema. Once stabilized in the MICU pt was able to maintain adequate O2 sats on the floor without supplemental O2 and demonstrated no clinical evidence of pulmonary congestion. . Hypertension: Pt was weaned off of nitro gtt and labetalol gtt in the MICU. Pt typically with BP 160s/100s on the floor with elevation to 180-200/110-120 in the early AM. Pt asymptomatic with these episodes. BP responded to hydralazine IV prn. Pt was initially treated with nifedipine 40mg q6h, labetalol 300mg [**Hospital1 **] and lisinopril 40mg [**Hospital1 **]. Given the pt's history of non-compliance and difficult to control BP within the hospital, the pt's nifedipine was switched to 90mg [**Hospital1 **] to facilitate compliance and minoxidil 5mg qdaily was added for better BP control. Renal doppler was ordered for RAS w/u and could not r/o RAS on the L. MRA was not pursued in the setting of ESRD [**12-29**] the risk of NSF. Pt may continue w/u as an outpatient with renal. . ESRD: Pt tolerated HD throughout hospital stay without issues. Pt was maintained on nephrocaps and sevelamer. Pt required increased dosing of both nephrocaps and sevelamer. Appreciate input from Renal - no new recommendations. Pt will resume outpatient regimen of MWF at the [**Hospital **] Clinic. . FEN: Pt tolerated PO intake. Electrolytes managed with HD. . PPX: Maintained on heparin, coumadin (once HCT stabilized) and PPI. . # Access: PIV and tunneled R IJ for HD . # Code: FULL Medications on Admission: Calcium Acetate 667 mg Capsule Sig: Two (2) Capsule PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 2. Sevelamer HCl 800 mg Tablet Sig: Three (3) Tablet PO TID W/MEALS (3 TIMES A DAY WITH MEALS). 3. Lisinopril 40 mg Tablet Sig: One (1) Tablet PO twice a day. 4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 5. Labetalol 200 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Disp:*90 Tablet(s)* Refills:*2* 6. Nifedipine 10 mg Capsule Sig: Four (4) Capsule PO Q6H (every 6 hours). Discharge Medications: 1. Calcium Acetate 667 mg Capsule Sig: Two (2) Capsule PO TID W/MEALS (3 TIMES A DAY WITH MEALS). Disp:*180 Capsule(s)* Refills:*2* 2. Sevelamer HCl 800 mg Tablet Sig: Three (3) Tablet PO three times a day. Disp:*270 Tablet(s)* Refills:*2* 3. Lisinopril 20 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day). Disp:*120 Tablet(s)* Refills:*2* 4. Labetalol 300 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO once a day. 6. Nifedipine 90 mg Tablet Sustained Release Sig: Two (2) Tablet Sustained Release PO DAILY (Daily). Disp:*60 Tablet Sustained Release(s)* Refills:*2* Discharge Disposition: Home Discharge Diagnosis: Primary: Right internal jugular vein thrombus Hypertension Pulmonary edema End stage renal disease Discharge Condition: Good, hemodynamically stable, adequate O2 sats. Discharge Instructions: You were diagnosed with a blood clot in the neck vein that contains your dialysis catheter and also had an elevated blood pressure which caused fluid to accumulate in your lungs. You were started on a blood thinner for your blood clot with a medication called coumadin and received dialysis to remove the excess fluid from your body. You will need to continue coumadin (blood thinner) until further notified to prevent future blood clots from forming. You will need to get blood tests at your dialysis clinic to monitor your coumadin levels. This will be done by Dr. [**Last Name (STitle) **] until you see your new PCP. Your blood test should be drawn tomorrow at dialysis. The following changes were made to your medications: Your Nifedipine, renagel and PhosLo regimens were changed. You were also started on a new BP med called minoxidil. Please continue with your outpatient dialysis regimen MWF at the [**Hospital **] clinic. Please follow-up with your PCP [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] on Thursday. Please follow-up with your transplant clinic appointment so that you can be evaluated to have new dialysis access placed. Please call your doctor or go to the ED for worsening symptoms including headache, blurry vision, shortness of breath, chest pain, arm pain or other concerning symptoms. Followup Instructions: Please continue your outpatient dialysis regimen at the [**Hospital **] clinic beginning this Wednesday ([**5-29**]). Dr. [**Last Name (STitle) **] at the dialysis clinic will monitor your coumadin levels and adjust your medication as necessary. Please follow-up with your PCP [**Last Name (NamePattern4) **]. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 12101**] on [**5-30**] at 2:00 PM. Your appointment is in the [**Hospital Ward Name 23**] Building, [**Location (un) 6750**], North Suite. Please call ([**Telephone/Fax (1) 1300**] with any questions. Please follow-up at the [**Hospital 1326**] clinic with Dr. [**Last Name (STitle) 816**] on [**6-6**] at 10AM. Please call [**Telephone/Fax (1) 5537**] with any questions. Completed by:[**2154-5-28**] ICD9 Codes: 5856, 4280
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Medical Text: Admission Date: [**2185-2-17**] Discharge Date: [**2185-2-20**] Date of Birth: [**2119-1-11**] Sex: F Service: NEUROLOGY Allergies: Penicillins / Dilantin Attending:[**First Name3 (LF) 8850**] Chief Complaint: Left flank pain and urosepsis. Major Surgical or Invasive Procedure: Percutaneous nephrostomy tube placement on [**2185-2-17**]. History of Present Illness: [**Known firstname 1439**] [**Known lastname **] is a 66-year-old woman, with history of left temporal lobe glioblastoma, status post gross total resection, and currently on daily temozolomide chemotherapy and radiation therapy, who presented to [**Hospital3 417**] Hospital with left flank pain for one day duration. Yesterday afternoon, after her radiation treatment, she starting complaining of abrupt onset pain in her left flank with an intensity of [**8-6**], which was gradually moving up left side, worse with cough. By report, she was in her usual state of health until 1 day prior to presentation. She presented to [**Hospital3 417**] Hospital, where she developed temperature of 102 F, and underwent CT of the abdomen and pelvis showing mild to moderate left kidney hydronephrosis, pyelonephritis, UPJ obstruction and peri-renal stranding. She was given morphine 2 mg IV, Zofran 4 mg IV, Levaquin 750 mg IV and 1L normal saline. She was transferred to the emrgency department at [**Hospital1 69**] for further management, as she receives her oncology care here. In the emergency department, initial vitals were: Temperature 102.2 F, pulse 103, blood pressure 94/69, respiration 18, and oxygen saturation 94% in room air. Laboratory studies on arrival were significant for leukocytosis 16, Hct 34, lactate 1.4 and positive urinalysis. Shortly after arrival, the patient's blood pressure dropped to 80/50s, she was given Zosyn, Reglan, Tylenol 1 gm PO, Valium 5 mg PO and Ativan 1 mg IV for agitation, Hydrocortisone 100 mg IV, and 5 L IVF. Blood pressure transiently improved to low 100s, but again declined to 80s. A right subclavian was placed for central access. Patient was evaluated by urology, who suggested a percutaneous nephrostomy tube be placed by Interventional Radiology given her high grade obstruction and risk over lowering seizure threshold with general anesthesia. While in the emergency department, she was awake, alert, and oriented times 2, intermittently confused and forgetful (per husband, this is not her baseline - since surgery has been [**Doctor Last Name 11506**], but generally oriented). She was transferred to the [**Hospital 332**] Medical ICU for further management. Currently, patient complaining that she feels cold, but declining to answer other questions. States she does not know where she is or what the date is. Denies pain, difficulty breathing. Review of systems: Unable to obtain, patient refusing to answer most questions. Past Medical History: - Osteoporosis - Glioblastoma - resected in a gross total fashion from the left temporal lobe glioblastoma approximately 3 weeks ago, currently undergoing chemo and radiation (surgery at [**Hospital3 2005**], Dr. [**First Name (STitle) **] [**Doctor Last Name 60420**]). - s/p hysterectomy in [**2151**] for fibroids and endometriosis Social History: She is retired. She smoked less than 1 pack of cigarettes per day for 38 years. She drank 1 pint of alcohol per day for 5 years until her seizure. She does not use illicit drugs. Family History: Her mother died at age 78 from pancreatic cancer. Her father died of complications from an abdominal aortic aneurysm. She has one sister and 2 brothers; one of the brothers had a stroke. She has 3 sons and they are healthy. Physical Exam: Physical Examination On Admission: Vital Signs: Temperature 97.8 F, pulse 78, blood pressure 85/42, respiration 18, oxygen saturation 97% on 2 liters via nasal cannula, and CVP 5 General: Somnolent, opens eyes to light physical stimuli, declines to answer orientation questions Skin: Fine papular rash over abdomen HEENT: Sclera anicteric, MMM, oropharynx clear Neck: Supple Lungs: Unable to perform adequate exam [**12-29**] patient not cooperating. Generally clear anteriorly Cardiovascular: Regular rate and rhythm, normal S1 + S2, no murmurs, rubs, gallops Abdomen: Soft, non-tender, mildly distended, hypoactive bowel sounds present, no rebound tenderness or guarding Genitourinary: Foley in place draining clear yellow fluid, no left CVA tenderness (wouldn't roll over) Extremities: Warm, well perfused, 2+ DP pulses, no clubbing, cyanosis or edema Neurological Examination on Hospital Day 1 ([**2185-2-17**]): Her Karnofsky Performance Score is 90. She is awake, alert, and oriented times 3. Her language is fluent with good comprehension, naming, and repetition. Her recent recall is good. Cranial Nerve Examination: Her pupils are equal and reactive to light, 4 mm to 2 mm bilaterally. Extraocular movements are full; there is no nystagmus or saccadic intrusion. Visual fields are full to confrontation. Her face is symmetric. Facial sensation is intact bilaterally. Her hearing is intact bilaterally. Her tongue is midline. Palate goes up in the midline. Sternocleidomastoids and upper trapezius are strong. Motor Examination: She does not have a drift. Her muscle strengths are [**3-31**] at all muscle groups. Her muscle tone is normal. Her reflexes are 2- and symmetric bilaterally. Her ankle jerks are absent. Her toes are down going. Sensory examination is intact to touch and proprioception. Coordination examination does not reveal dysmetria. Gait and stance are deferred. Pertinent Results: Labs On Admission: [**2185-2-17**] 04:45AM BLOOD WBC-16.0* RBC-3.23* Hgb-11.9* Hct-33.7*# MCV-104* MCH-36.8* MCHC-35.4* RDW-12.0 Plt Ct-314 [**2185-2-17**] 04:45AM BLOOD Neuts-89.8* Lymphs-4.4* Monos-1.9* Eos-3.7 Baso-0.2 [**2185-2-17**] 05:54AM BLOOD PT-14.3* PTT-31.1 INR(PT)-1.2* [**2185-2-17**] 04:45AM BLOOD Glucose-85 UreaN-9 Creat-0.7 Na-136 K-3.5 Cl-103 HCO3-23 AnGap-14 [**2185-2-17**] 04:45AM BLOOD ALT-12 AST-21 LD(LDH)-154 AlkPhos-57 TotBili-0.7 [**2185-2-17**] 04:45AM BLOOD Albumin-3.1* [**2185-2-17**] 03:00PM BLOOD Calcium-7.8* Phos-3.9 Mg-1.2* [**2185-2-17**] 04:45AM BLOOD Cortsol-26.8* [**2185-2-17**] 03:05PM BLOOD Type-[**Last Name (un) **] pH-7.34* [**2185-2-17**] 04:45AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.035 [**2185-2-17**] 04:45AM URINE Blood-TR Nitrite-NEG Protein-30 Glucose-NEG Ketone-10 Bilirub-NEG Urobiln-NEG pH-5.5 Leuks-MOD [**2185-2-17**] 04:45AM URINE RBC-8* WBC-51* Bacteri-NONE Yeast-NONE Epi-<1 [**2185-2-17**] 04:45AM URINE Mucous-RARE DISCHARGE: [**2185-2-19**] 06:05AM BLOOD WBC-9.5 RBC-3.25* Hgb-11.4* Hct-33.4* MCV-103* MCH-35.0* MCHC-34.1 RDW-11.7 Plt Ct-296 [**2185-2-19**] 06:05AM BLOOD Glucose-83 UreaN-3* Creat-0.6 Na-138 K-3.5 Cl-105 HCO3-26 AnGap-11 Brief Hospital Course: The patient is a 66-year-old woman with recent diagnosis of left temporal glioblastoma, status post resection, currently undergoing temozolomide chemotherapy and radiation, who presented with UPJ obstruction, pyelonephritis, and hypotension suggestive of urosepsis, with improvement after percutaneous nephrostomy tube and antibiotics. Patient was intially admitted to the [**Hospital 332**] Medical ICU for management of septic shock. (1) Hypotension/Shock: The patient met criteria for septic shock on admission. She initially required norepinephrine for blood pressure support, but her blood pressure quickly improved after antibiotic treatment and fluid resuscitation of about 6 liter. She was weaned off pressors after several hours. She initially had significant mental status changes, suggesting end organ dysfunction, although other parameters such as lactate remained normal. This had improved by the next day. The most likely source remains urinary given her CT findings. Her urinary obstruction and pyelonephritis were treated with meropenem 500 mg IV Q6H and percutaneous nephrostomy tube placement. (2) Urinary Obstruction: She had a left percutaneous nephrostomy tube placed on [**2185-2-17**] with drainage of clear urine. Her creatinine was normal on admission and has remained stable. - The etiology of her obstruction remains unclear. She will have an outpatient CT abdomen and pelvis to evaluate the cause further. - She will follow up with Interventional Radiology and Urology for further management of her nephrostomy tube and potential for any further intervention. (3) Pyelonephritis: - Initially managed in the ICU setting with IV Meropenem - Urine culture from [**Hospital3 417**] was positive for E. Coli, sensitive with MIC <0.12 to levofloxacin. - She was transitioned to PO Levaquin on [**2185-2-20**] and given 3-day supply in the outpatient setting for a total course of 7 days. (4) Macrocytic Anemia: Her Hct has dropped from 44 to 33.7 in the past week with no current evidence of bleeding. Her Hct was 42.9 at OSH, so lower Hct could be secondary to hemodilution. She was continued on B12 and folate supplementation. (5) Glioblastoma: Patient currently undergoing temozolomide chemotherapy and radiotherapy. Per outpatient provider, [**Name10 (NameIs) **] glioblastoma was completely resected and survival likely at least 2-3 years. She is planned for resuming radiotherapy on Monday. - She will follow up with Dr. [**First Name11 (Name Pattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) 724**] in the outpatient setting Medications on Admission: levetiracetam 500 mg PO BID oxycodone-acetaminophen 5 mg-325 mg [**11-28**] Tablet(s) PO qdaily prochlorperazine maleate 10 mg PO daily temozolomide 110 mg PO daily x45 days (from [**2185-2-7**]) cyanocobalamin 100 mcg PO daily docusate sodium 100 mg PO daily multivitamin 1 Tablet(s) PO daily thiamine HCl 100 mg PO daily Discharge Medications: 1. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. thiamine HCl 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. cyanocobalamin (vitamin B-12) 100 mcg Tablet Sig: One (1) Tablet PO DAILY (Daily). 5. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 6. levetiracetam 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. levofloxacin 750 mg Tablet Sig: One (1) Tablet PO once a day for 3 days. Disp:*3 Tablet(s)* Refills:*0* 8. Percocet 5-325 mg Tablet Sig: One (1) Tablet PO every four (4) hours as needed for pain. Disp:*30 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital1 1474**] VNA Discharge Diagnosis: Primary: Pyelonephritis, Uretero-Pelvic Junction Obstruction Secondary: Glioblastoma Multiforme Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: Dear Mrs [**Known lastname **], You were admitted to [**Hospital1 18**] for evaluation and treatment of a urinary tract infection near your kidney, a condition called pyelonephritis. You also underwent a percutaneous nephrostomy tube placement to relieve an obstruction in your ureter. You will take a medication called levofloxacin to finish your antibiotic course for pyelonephritis. You will follow up with the Interventional Radiologist tomorrow to discuss management of your percutaneous nephrostomy. You will have a CT scan as an outpatient on [**2185-2-28**] to evaluate your abdomen for a cause of the narrowing or blockage in your ureter. They will call you with a specific time to arrive. Medications: Added: Levofloxacin Changed: None Removed: None Followup Instructions: Interventional Radiology: Monday, [**2-21**] anytime between 7a and 1pm Call [**First Name8 (NamePattern2) 333**] [**Last Name (NamePattern1) 6745**] [**Telephone/Fax (1) 56404**] or pager #[**Numeric Identifier 5603**] when you go for radiation treatment tomorrow and he will come meet you Department: MRI When: MONDAY [**2185-2-28**] at 1 PM With: MRI [**Telephone/Fax (1) 327**] Building: CC CLINICAL CENTER [**Hospital 1422**] Campus: WEST Best Parking: [**Street Address(1) 592**] Garage Department: RADIOLOGY When: MONDAY [**2185-4-4**] at 11:15 AM With: RADIOLOGY MRI [**Telephone/Fax (1) 327**] Building: [**Hospital6 29**] [**Location (un) 861**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: NEUROLOGY When: MONDAY [**2185-4-4**] at 1 PM With: [**First Name11 (Name Pattern1) 640**] [**Last Name (NamePattern4) 4861**], MD [**Telephone/Fax (1) 1844**] Building: [**Hospital6 29**] [**Location (un) 858**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage ICD9 Codes: 0389
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Medical Text: Admission Date: [**2134-5-31**] Discharge Date: [**2134-6-9**] Date of Birth: [**2077-9-3**] Sex: M Service: MEDICINE Allergies: Aspirin Attending:[**First Name3 (LF) 3705**] Chief Complaint: OSH transfer for seizure Major Surgical or Invasive Procedure: intubation History of Present Illness: 56 y.o. male w/ Hep. C c/b cryoglobulinemia, ESRD on HD, s/p MVC with slight trauma to the head some weeks ago, who woke up this morning complaining of a HA after which he was found seizing in bed. According to the patient's son, he was in a car accident approximately 3 weeks ago after which he began experiencing "migraines" again. He reportedly has a history of migraines that had long resolved. He additionally had been complaining of "kaleidoscope vision" saying specifically that his vision was blurry, similar to looking through a kaleidoscope. He was also reportedly unstable on his feet, but never noted to fall. He does not have a prior history of seizures, does not consume alcohol, use illicit drugs or smoke. He had been taking Benadryl in excess because of his headaches. He ordinarily takes Benadryl to sleep. He has been chronically ill for many years, but sees doctors [**Name5 (PTitle) 83371**]. Of note, patient had been taking Alka-Seltzer for the past 3 days and has a history of a severe, but unknown allergy to aspirin. Patient was taken to [**Hospital6 302**] where additional history raised the possibility of Benadryl ingestion and ? TCA ingestion. Given a QRS of 116, he was started on bicarb drip. Additionally, because of a fever to 102.7 and a WBC of 22 in the setting of these neurological symptoms, Ceftriaxone and Vancomycin were started empirically and he was intubated to protect his airway after seizing two additional times (given Ativan) prior to being transferred to [**Hospital1 18**] for further evaluation. In the [**Hospital1 18**] ER, Acyclovir was added prior to performing an LP, which was unremarkable for infection. CT head and spine were unremarkable and neuro and toxicology were consulted. Past Medical History: Hepatitis C c/b by cryoglobulinemia ESRD on HD (last on HD one year ago, reportedly told he no longer needed it) Migraines Social History: lives in [**Location (un) 5503**] with son, remote smoking history, no alcohol or illicits. Family History: NC Physical Exam: Vitals: T: 102.6, BP: 139/81 P: 109 R:21 O2: 100% AC 500/20/.50/5 General: Sedated, intubated HEENT: NC/AT; pupils small, but equally round and reactive to light, sclera anicteric; OG with bloody secretions Neck: Supple, no LAD Lungs: CTAB CV: S1, S2 nl, no m/r/g appreciated Abdomen: Soft, non-tender, non-distended, bowel sounds present, no rebound tenderness or guarding, no organomegaly Ext: Warm, well perfused, 2+ pulses, no clubbing, cyanosis or edema Neuro: Limited due to sedation, but notable for clonus b/l and equivocal babinksi. Patient does not follow commands Skin: No rash, no jaundice Pertinent Results: [**2134-5-31**] WBC-20.4* RBC-4.14* Hgb-12.8* Hct-37.6* Plt Ct-170 [**2134-6-1**] WBC-13.4* Hct-30.4* Plt Ct-148* [**2134-6-2**] WBC-12.3* RBC-3.80* Hgb-11.8* Hct-34.6* Plt Ct-142* [**2134-6-5**] WBC-8.3 RBC-3.86* Hgb-12.1* Hct-35.1*31.3 Plt Ct-151 [**2134-6-6**] WBC-6.7 RBC-4.03* Hgb-12.4* Hct-36.4* Plt Ct-151 [**2134-6-8**] WBC-5.2 RBC-3.81* Hgb-11.7* Hct-34.8* Plt Ct-180 [**2134-6-9**] WBC-5.2 RBC-3.79* Hgb-11.6* Hct-34.2* Plt Ct-189 [**2134-5-31**] Glucose-347* UreaN-38* Creat-3.6* Na-139 K-5.0 Cl-103 HCO3-18* [**2134-6-2**] Glucose-141* UreaN-32* Creat-3.7* Na-142 K-4.0 Cl-106 HCO3-22 [**2134-6-3**] Glucose-105 UreaN-32* Creat-4.2* Na-139 K-4.1 Cl-108 HCO3-22 [**2134-6-4**] Glucose-113* UreaN-32* Creat-4.0* Na-146* K-3.8 Cl-111* HCO3-21* [**2134-6-5**] Glucose-109* UreaN-33* Creat-3.5* Na-142 K-3.4 Cl-108 HCO3-17* [**2134-6-6**] Glucose-105 UreaN-35* Creat-3.4* Na-143 K-3.4 Cl-109* HCO3-20* [**2134-6-8**] Glucose-131* UreaN-41* Creat-3.4* Na-142 K-3.8 Cl-108 HCO3-22 [**2134-6-9**] Glucose-99 UreaN-42* Creat-3.3* Na-141 K-3.9 Cl-108 [**2134-5-31**] ALT-18 AST-38 CK(CPK)-147 AlkPhos-71 TotBili-0.2 [**2134-6-1**] ALT-15 AST-36 LD(LDH)-274* CK(CPK)-284* AlkPhos-56 TotBili-0.3 [**2134-6-6**] LD(LDH)-250 CK(CPK)-151 [**2134-5-31**] CK-MB-4 cTropnT-0.03* [**2134-6-1**] CK-MB-6 cTropnT-0.05* [**2134-5-31**] Lipase-106* [**2134-6-6**] Lipase-37 [**2134-6-6**] calTIBC-309 VitB12-324 Folate-11.0 Ferritn-162 TRF-238 [**2134-6-1**] Phenyto-4.7* [**2134-6-3**] Phenyto-12.6 [**2134-6-6**] Phenyto-<0.6* [**2134-6-6**] Phenyto-1.8* [**2134-6-7**] Phenyto-1.2* [**2134-5-31**] Lactate-2.4* [**2134-6-1**] Lactate-0.8 Brief Hospital Course: Patient was admitted as a transfer to the ICU. Seizure: Seizure was of unclear etiology and patient without a known history of seizures. Differential would include brain trauma s/p MVA, acute bleed, infection, intracranial mass and toxic/metabolic derrangement. Patient underwent a lumbar puncture that was negative. Patient had head imaging that revealed as fluid collection at C2 which after serial imaging was felt to be a hematoma. The patient loaded intially started on Keppra, renally dosed. Attempt was made to switch patient to dilantin given renal clearance of Keppra, but depsite several loads, dilantin level stayed subtherapeutic. Patient was finally transitioned to keppra monotherapy. Patient was on morphine for pain control for his neck pain attributed to the C2 lesion. He was discharged then on Valium as needed and oxycontin twice daily for pain. C2 Hematoma: Secondary to fall, confirmed on MRI. Pain control as above. Toxic Ingestion: Per report, patient may have taken Benadryl or TCAs. Tox screen negative up transfer to ED. EKG with QRS of 116 initially. Patient was briefly on a bicarbonate drip. Toxicology felt it was inconclusive and that whatever ingestion may have occured the patient had recovered. Leukocytosis: With initially elevated lactate, suggestive of infection. CNS was of obvious concern for source given seizure, but LP is negative. Other culture data was negative. Patient is was initially on Ceftriaxone, Vancomycin and Acyclovir for empiric coverage intially, he was briefly off antibiotics, but when a question of the fluid collection at C2 being an abscess the patient was restarted on vancomycin and ceftazidime that were discontinued [**2134-6-7**] when the fluid collection was concluded to be hematoma on MRI ([**2134-5-27**]). Mental status. A+Ox3, but unclear about details and slow to respond and complained of poor memory. Patient reports that memory is improving, and much improved on discharge. Depression: restarted home sertraline, avoided home triazolam due to altering effect. Held amitryptiline on discharge as well. HTN: increased home amlodipine dose of 5mg to 10mg daily, and continued this on discharge. Patient initially on labetolol in unit but transitioned to home diovan on the floor. Hyperglycemia: Mild, on ISS in the hospital, by end of hospital course, no longer requiring. Respiratory Failure: Intubated in the setting of seizing to protect airway. Patient was able to be rapidly extubated. CKD Stage IV: Previously been on HD. Currently with good urine output. Patient maintained on his nephrocaps. Medications renally dosed. Hepatitis C: Unclear status of liver disease. Stable LFTS and good synthetic function during this hospitalization Elevated Troponin: EKG with non-specific changes and troponin elevated in the setting of renal failure. Patient ruled out for myocardial infarction. The patient was FULL CODE during this admission. Medications on Admission: Per PCP's office: amtriptyline 50 qhs amlodipine 5 mg qhs valsartan 80 qday nephrocaps parvocet prn triazolam 0.25 mg qhs sertraline 100 qday Discharge Medications: 1. Sertraline 100 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Valsartan 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Amlodipine 10 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*0* 4. Levetiracetam 500 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*60 Tablet(s)* Refills:*2* 5. Diazepam 5 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for muscle pain. Disp:*90 Tablet(s)* Refills:*0* 6. Tylenol Extra Strength 500 mg Tablet Sig: 1-2 Tablets PO every six (6) hours as needed for pain. 7. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed for pain. Disp:*200 Tablet(s)* Refills:*0* 8. OxyContin 15 mg Tablet Sustained Release 12 hr Sig: One (1) Tablet Sustained Release 12 hr PO twice a day. Disp:*60 Tablet Sustained Release 12 hr(s)* Refills:*0* Discharge Disposition: Home Discharge Diagnosis: Primary: Spine hematoma Seizures Secondary: Discharge Condition: stable Discharge Instructions: You were admitted to hospital after having a seizure. You had neck pain and imaging of your spine show a blood collection in your cervical spine. This blood collection should clear slowly on its own. The seizure is likely secondary to either the blood collection or trauma from the motor vehicle accident you were in several weeks ago. You should also take precautions given that you have new seizures. This would mean, that you should NOT drive, operate machinery, or bathe alone. The following were made your medication regimen: 1. Amlodipine (for blood pressure) was increased from 5mg to 10mg daily. Continue to take Diovan as well. 2. Keppra 500mg twice a day was started for seizures. 3. For pain, you should take 1gm of tylenol up to 4 times a day. 4. For muscle spasms, take [**1-8**] pills of Valium as needed, up to 3 times a day. 5. For pain you should take Oxycontin 15mg twice a day. If you still have pain, you can take percocet 2 pills up to 4 times a day. You should discuss tapering this with your primary care doctor, as your pain should decrease as the blood collection in your neck resolves 6. Do not take Triazalam and Amitriptyline. You can discuss the need for these with your Primary care doctor Please call your doctor or return to the hospital if you have fevers, chills, numbness or tingling in your fingers or legs, increased severity of neck pain or any other concerning symptoms. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) 71087**] on [**2134-6-24**] at 130Pm. ([**Telephone/Fax (1) 50234**] Dr. [**First Name (STitle) **], the neurologist, on [**2134-7-8**] at 9am. She is located [**Location (un) **], the [**Hospital Ward Name 23**] building, [**Location (un) **]. [**Telephone/Fax (1) 83372**]. Completed by:[**2134-7-3**] ICD9 Codes: 311
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Medical Text: Admission Date: [**2127-8-27**] Discharge Date: [**2127-8-29**] Date of Birth: [**2073-3-2**] Sex: M Service: Th[**Last Name (STitle) 44544**]a 54-year-old male with a known mitral valve prolapse since adolescence who developed significant regurgitation. He was taken to the Operating Room on [**2127-8-27**] where a mitral valve repair was done. The patient did well postoperatively and was transferred to the CSRU. He was fully weaned from his ventilator and extubated. He continued to improve. Physical therapy was consulted for ambulation and he did well postoperatively. The chest tube was removed. His Foley was pulled and he was kept on A-pacing due to slow return of sinus rhythm. He was transferred to the floor on postoperative day #2. He continued to improve. His chest tube was pulled. His Foley had been removed at midnight. He improved and physical therapy came to see him. They suggested for him to go home with full ambulation. His wires were removed on postoperative day #2 and on postoperative day #3, the patient was discharged home on stable condition. He was given prescriptions for Percocet 1 to 2 tablets po q4h, Zantac 150 po bid, Colace 100 po bid, KCL 20 milliequivalents po bid, Lasix 20 mg po bid, Motrin 400 po q6h prn. The patient is instructed to follow up in one to two weeks with is primary care physician and four to six weeks with Dr. [**Last Name (Prefixes) 2545**]. The patient is discharged in stable condition. [**Doctor Last Name 412**] [**Last Name (Prefixes) 413**], M.D. [**MD Number(1) 414**] Dictated By:[**First Name (STitle) **] MEDQUIST36 D: [**2127-8-29**] 10:36 T: [**2127-8-29**] 10:45 JOB#: [**Job Number 44545**] ICD9 Codes: 4240, 4019, 2720
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Medical Text: Admission Date: [**2114-5-30**] Discharge Date: [**2114-6-14**] Service: MEDICINE Allergies: Ranitidine Attending:[**First Name3 (LF) 689**] Chief Complaint: Shortness of breath Major Surgical or Invasive Procedure: None. History of Present Illness: 87 year-old female with history of hiatal hernia/GERD, AF, history of recent aspiration pneumonia presents with progressive SOB. She was recently admitted to [**Hospital1 18**] for pneumonia and treated wtih Levofloxacin for 14 days. She completed her antibiotics and presented to her PCPs office where a CXR was performed. The CXR was unchanged so she had a CT which showed multifocal infiltrates, ? aspiration versus infectious. She was told to eat smaller meals and avoid eating quickly. For the last week, she has had increased shortness of breath. Five days prior to admission she was having lots of coughing and shortness of breath. 911 was called but didn't bring her to the ED. On Sunday, she was at the [**Last Name (un) 4068**] because she swallowed a hearing aid. A CXR was performed but no further intervention was performed. Over the past week, she notes increasing fatigue and shortness of breath. she endorses a mild non-productive cough, worse at night. No fever/chills. No orthopnea, PND, or edema. In the ED, a CXR showed new multifocal infiltrates. A chest CT was subsequently obtained, which showed worsening consolidations, especially in RML with RML collapse, with ? RML abscess. She was given Ceftriaxone, Atithromycin and Flagyl. Past Medical History: 1. Hiatal hernia with gastroesophageal reflux disease 2. Paroxysmal atrial fibrillation, on Coumadin 3. Iron deficiency anemia. 4. Recurrent UTIs. 5. Hyperthyroidism attributed to Amiodarone toxicity 6. History of iatrogenic pneumothorax following line placement in 02/[**2112**]. 7. Colonic polyps 8. s/p Appendectomy. 9. Impaired visual acuity Social History: She does not smoke or drink. She walks with a cane at baseline. She lives in [**Location (un) **] with a young woman who helps with her care. Family History: Non-contributory. Physical Exam: Physical examination on admission: VS: T 98.8, Pulse 66, BP 116/76, RR 17, 95% on RA Gen: Alert, oriented, cooperative female in NAD HEENT: EOMI, anicteric, mildly dry MM Neck: Supple, -LAD, JVP not elevated Lungs: Distant lung sounds (difficult exam as in [**Doctor Last Name **] in noisy ED), no rhales appreciated Heart: RRR, nl S1S2, no murmers Abd: Soft, obese, mild distension, NT +BS Ext: 2+ edema bilaterally, ecchymoses at left calf, slight tenderness on anterior palpation of shin bilaterally Neuro: A&OX3, responding to all ?'s, moving all ext Pertinent Results: Relevant laboratory data: CBC: WBC-10.3# RBC-4.00* HGB-11.2* HCT-33.3* MCV-83 MCH-28.0 MCHC-33.7 RDW-15.0 NEUTS-81.9* LYMPHS-13.4* MONOS-3.4 EOS-0.5 BASOS-0.7 PLT COUNT-508* Chemistry: GLUCOSE-115* UREA N-12 CREAT-0.8 SODIUM-138 POTASSIUM-4.5 CHLORIDE-97 TOTAL CO2-31 ANION GAP-15 LACTATE-1.1 Coagulation: PT-34.2* PTT-31.0 INR(PT)-3.7* Cardiac enzymes: [**2114-5-30**] 01:30PM CK(CPK)-34 [**2114-5-30**] 01:30PM cTropnT-<0.01 Relevant imaging data: [**2114-5-30**] CXR: AP chest compared to [**5-1**] and [**5-17**]. Right upper lobe pneumonia is appreciably larger. Small region of pneumonia at the right base is stable. Heart size top normal. Small right pleural effusion, stable. No pneumothorax. [**2114-5-30**] CT CHEST: No evidence of pulmonary embolism. 2. Interval increase in the size of right middle lobe consolidation with further progression and increase in size of an area of low attenuation measuring 2.3 x 2.6 cm representing an abscess. There is stable appearance of the right lower lobe consolidation and slight interval decrease in the size of small nodular consolidation in the left apex. 3. Large hiatal hernia. [**2114-5-31**] Barium swallow: Large axial hiatal hernia with the gastric fundus above the diaphragm. Persistent retention of barium in the herniated fundus at the conclusion of the exam. No evidence of reflux, but poor compliance. [**2114-6-2**] ECHO: [**Name Prefix (Prefixes) **] [**Last Name (Prefixes) 6878**]. LV wall thicknesses and cavity size normal. Overall LVEF normal (LVEF>55%). RV chamber size and free wall motion are normal. AV leaflets are mildly thickened. The aortic valve is not well seen. No AS, mild (1+) AR. MV valve leaflets are mildly to moderately thickened. Mild (1+) mitral regurgitation is seen. LV inflow pattern suggests impaired relazation. TV valve leaflets are mildly thickened. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. [**2114-6-5**] CT CHEST: 1. Minimal improvement in extensive necrotizing pneumonia in the right upper lobe. Slight improvement in the left upper lobe nodular opacity. No change in the right lower lobe consolidation. 2. Increasing right pleural effusion and new left pleural effusion. 3. Stable appearance of enlarged thyroid and large hiatal hernia. [**2114-6-11**] CXR: 1. Resolving multifocal pneumonia and small bilateral pleural effusions. 2. Hiatal hernia. Brief Hospital Course: 87 year old female with a large hiatal and probable aspiration events, admitted with worsening shortness of breath, with imaging studies showing progression of her multifocal infiltrates. 1. Multifocal pneumonia and ? RML abscess: Pulmonary was consulted on admission, and she was placed on Ceftriaxone and Flagyl for coverage of probable multifocal aspiration pneumonia. Blood cultures drawn prior to initiation of antibiotics remained negative. Given concern over aspiration events, she was evaluated by speech and swallow, and a barium swallow was obtained on [**2114-5-31**] which revealed retention of contrast in the hernia without overt reflux. The study, however, was limited by poor patient compliance. On [**2114-5-31**], she was noted to be more somnolent, with increasing oxygen requirement and a temperature to 101.7. Vancomycin was added for broader coverage. A CXR obtained at that time showed some pulmonary edema, and she was treated with Lasix diuresis. She, however, remained somnolent, and an ABG obtained the following morning showed 7.34/62/65. She was transferred to the MICU for further monitoring and management. She spontaneously improved, and did not require BiPAP. Her decompensation was ultimately attributed to anxiolytic administration. She was transferred back to the floor after 1 day in the ICU. While in the ICU, an echo was obtained, which showed preserved systolic function, evidence of diastolic dysfunction, and non-significant valvular disease. Note was made of thickened MV valve leaflets, non-specific, no obvious vegetation. On the floor, she was changed to Clindamycin. A repeat CT on [**2114-6-5**] showed "minimal improvement in extensive necrotizing pneumonia in the RUL, slight improvement in the LUL opacity, no change in the RLL consolidation. Note was also made of increasing right pleural effusion and new left pleural effusion.". Given these findings, a thoracentesis was entertained, and Coumadin was held in anticipation for this. A repeat CXR on [**6-11**], however, showed decreased effusions, and a bedside ultrasound performed by IP on [**2114-6-12**] showed insufficient fluid to tap. She continued to improve, eventually without oxygen requirement. She will complete a prolonged course of Clindamycin (5 additional weeks), and will follow-up in the Pulmonary clinic with Dr. [**Last Name (STitle) **]. They will contact her with the appointment date and time. She is also scheduled for a repeat CT chest on [**7-5**] at 1130. Lenght of antibiotic therapy will ultimately be dictated by clinical/radiographic resolution. Emphasis was placed on aspiration precautions, and eating small meals. 2. Paroxysmal atrial fibrillation: As noted above, her Coumadin was held in anticipation for a possible thoracentesis. She was given 2 doses of Vitamin K to expedite reversal of Warfarin therapy. She was started on Heparin IV when INR<2. Coumadin was eventually resumed at 5 mg daily (her out-patient dose) on [**2114-6-12**], and she was placed on Lovenox (1mg/kg [**Hospital1 **]) to brige until therapeutic INR (goal INR [**3-2**]). She remains on amiodarone. Please discontinue Lovenox when INR [**3-2**]. 3. COPD: She was continued on Fluticasone and Combivent, with bronchodilator therapy via nebulizers as needed. 4. Hypertension: She was continued on Lisinopril 5 mg daily. Hydralazine was held in the hospital given good blood pressure control on the latter. If her blood pressure remains elevated, please consider addition of Hydralazine 25 mg PO QID (pre-hospital regimen). 5. Hyperthryoidism: She was continued on Methimazole 5 mg daily. 6. Code: DNR/DNI. On this admission, there was a conversation with the patient and family regarding code status. It was determined that she wanted to be DNR/DNI. Medications on Admission: Senna 8.6 mg [**Hospital1 **] Pantoprazole 40 mg daily Amiodarone 100 mg daily Hydralazine 25 mg QID Methimazole 5 mg daily Psyllium 1.7 g daily Fluticasone 110 mcg/Actuation Aerosol 2 puffs [**Hospital1 **] Warfarin 5 mg daily Lisinopril 5 mg daily Combivent 103-18 mcg/Actuation Aerosol 1 inh QID Discharge Medications: 1. Amiodarone 200 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 2. Methimazole 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Psyllium 1.7 g Wafer Sig: One (1) Wafer PO DAILY (Daily). 4. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO HS (at bedtime). 5. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 6. Warfarin 5 mg Tablet Sig: One (1) Tablet PO once a day: Please give 5 mg daily 6X/week, and 7.5 mg daily 1X/week. Please monitor INR, and discontinue Lovenox when INR between [**3-2**]. . 7. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed. 8. Trazodone 50 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed. 9. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed. 10. Fluticasone 110 mcg/Actuation Aerosol Sig: Two (2) Puff Inhalation [**Hospital1 **] (2 times a day). 11. Combivent 103-18 mcg/Actuation Aerosol Sig: One (1) inhalation Inhalation four times a day. 12. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Hold for SBP<100. 13. Enoxaparin 100 mg/mL Syringe Sig: 90 mg SC Subcutaneous [**Hospital1 **] (2 times a day): Please monitor INR, and discontinue Lovenox when INR between [**3-2**]. 14. Clindamycin HCl 150 mg Capsule Sig: Two (2) Capsule PO Q6H (every 6 hours) for 4 weeks: Please continue until patient follows-up in pulmonary clinic. . 15. Albuterol Sulfate 0.083 % Solution Sig: One (1) nebulizer Inhalation every six (6) hours as needed for shortness of breath or wheezing. Discharge Disposition: Extended Care Facility: [**Hospital1 599**] of [**Location (un) 55**] Discharge Diagnosis: Multifocal pneumonia Probable right middle lobe lung abscess Secondary diagnoses: Paroxysmal atrial fibrillation Hyperthyroidism Discharge Condition: Patient discharged to a rehab facility in stable condition. Oxygen saturation stable on room air. Discharge Instructions: Please note that we have started an antibiotic for your lung infection called Clindamycin. Please take 300 mg four times daily. Please continue to take it until you follow-up in the pulmonary clinic. You need to sleep with the head of the bed elevated to prevent further aspiration events. Please call your doctor or return to the ED if you develop worsening shortness of breath, chest pain, worsening cough, or new fever, or any symptoms of concern to you. Followup Instructions: 1. You need to follow-up with Dr. [**Last Name (STitle) **] in the pulmonary clnic. They are looking for an appointment for you in 4 weeks. Please contact his office this week, and schedule an appointment to be seen in 1 month. His office number is [**Telephone/Fax (1) 612**]. You will need a repeat CT scan prior to your appointment. Ask them to schedule that as well. 2. Please also schedule a follow-up appointment with your primary care doctor to be seen in the next 2-3 weeks to discuss your hospital admission. Completed by:[**2114-6-14**] ICD9 Codes: 5070, 5119, 496, 4019
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Medical Text: Admission Date: [**2126-11-5**] Discharge Date: [**2126-11-18**] Date of Birth: [**2103-9-21**] Sex: F Service: SURGERY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 3223**] Chief Complaint: Motor vehicle crash Major Surgical or Invasive Procedure: -Intramedullary fixation, left tibia. -Placement of external fixator, right distal tibia, angle spanning. -Open reduction and internal fixation of right pilon fracture. -Open reduction and internal fixation of distal fibula. History of Present Illness: 23yo F presents to [**Hospital1 18**] by med-flight s/p MVC on [**2126-11-5**]. Pt found at scene moving all extremities but not following commands. Intubated for altered mental status, not following commands & combative. Obvious bilateral lower leg fractures with deformity. Past Medical History: Fibromyalgia Chronic pain syndrome Chronic fatigue PTSD Depression Panic disorder Social History: H/o cocaine use in distant past, no current illicit drug use. Lives with mother. Family History: Non-contributory Physical Exam: VS - pulse 100, bp 118/p, resp 16 intubated, sat 100% HEENT - AT/NC, pupils fixed @ 4mm non-reactive Neck - cervical collar, trachea mid-line, no JVD, no mass Chest - bruising B chest, CTA bilat CV - tachy, RR Abd - bruising RUQ, soft, non-distended, nl rectal tone, guiac neg, neg FAST Pelvis - stable Ext - palpable distal pulses B Neuro - unresponsive Pertinent Results: [**2126-11-13**] 06:10AM BLOOD WBC-9.3 RBC-3.13* Hgb-8.5* Hct-26.0* MCV-83 MCH-27.0 MCHC-32.4 RDW-13.7 Plt Ct-360 [**2126-11-5**] 10:39PM BLOOD WBC-7.5 RBC-4.21 Hgb-11.9* Hct-35.9* MCV-85 MCH-28.4 MCHC-33.2 RDW-13.7 Plt Ct-232 [**2126-11-5**] 10:39PM BLOOD PT-12.9 PTT-25.7 INR(PT)-1.1 [**2126-11-5**] 10:39PM BLOOD Fibrino-302 [**2126-11-6**] 04:16AM BLOOD Glucose-111* UreaN-11 Creat-0.6 Na-140 K-3.6 Cl-106 HCO3-26 AnGap-12 [**2126-11-12**] 09:30AM BLOOD ALT-95* AST-59* AlkPhos-477* Amylase-34 TotBili-1.1 [**2126-11-6**] 02:06AM BLOOD ALT-322* AST-372* AlkPhos-204* Amylase-33 TotBili-0.5 [**2126-11-6**] 11:00AM BLOOD CK(CPK)-319* [**2126-11-12**] 09:30AM BLOOD Lipase-46 [**2126-11-6**] 02:06AM BLOOD Lipase-76* [**2126-11-10**] 04:35AM BLOOD Calcium-8.5 Phos-2.9 Mg-2.0 [**2126-11-5**] 10:39PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2126-11-6**] 02:12AM BLOOD Type-ART Temp-36.3 Rates-16/ Tidal V-500 PEEP-5 O2-60 pO2-244* pCO2-50* pH-7.35 calHCO3-29 Base XS-1 Intubat-INTUBATED Vent-IMV Brief Hospital Course: [**11-5**] - brought to [**Hospital1 18**] by med-flight intubated, diagnosed with liver laceration, bilateral tib/fib fx's. Admitted to T/SICU, orthopedics consulted. [**11-6**] - taken to OR for IM nail L tibia shaft fx, ORIF R tibia pilon fx, ORIF R fibula fx, and ex-fix placement R tibia/ankle. [**11-7**] - pt remained intubated in T/SICU, pain service consulted. [**11-8**] - pt extubated, surgical drains d/c'd, consults placed to PT/OT & psych. [**11-9**] - pt started on lovenox, regular diet [**11-10**] - transferred from T/SICU to floor, AFO splint to L leg for foot drop. [**11-11**] - begin screening for rehab [**11-12**] - repeat CT abd demonstrates stable liver injury, no acute bleeding [**11-13**] - Continuing PT/OT & pursuing placement options: acute rehab vs home with services [**11-18**] - D/C to home with VNA & home PT. Medications on Admission: Lexapro 10mg qhs Elavil 75mg qhs Klonopin 1mg [**Hospital1 **] Ambien 10mg qhs prn Methadone 100mg qd Zonagram 25mg qhs Topamax 50mg qd Zanaflex 4mg qhs Discharge Medications: 1. Clonidine HCl 0.3 mg/24 hr Patch Weekly Sig: One (1) Patch Weekly Transdermal QTHUR (every Thursday). Disp:*15 Patch Weekly(s)* Refills:*0* 2. Enoxaparin Sodium 30 mg/0.3 mL Syringe Sig: One (1) syringe Subcutaneous Q12H (every 12 hours) for 2 weeks. Disp:*28 syringe* Refills:*0* 3. Methadone HCl 10 mg Tablet Sig: Three (3) Tablet PO Q AM (). Disp:*45 Tablet(s)* Refills:*0* 4. Methadone HCl 10 mg Tablet Sig: Three (3) Tablet PO Q PM (). Disp:*45 Tablet(s)* Refills:*0* 5. Topiramate 25 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 6. Methadone HCl 40 mg Tablet, Soluble Sig: One (1) Tablet, Soluble PO Q HS (). Disp:*15 Tablet, Soluble(s)* Refills:*0* 7. Zolpidem Tartrate 5 mg Tablet Sig: 1-2 Tablets PO HS (at bedtime) as needed for insomnia. Disp:*15 Tablet(s)* Refills:*0* 8. Ferrous Sulfate 325 (65) mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 9. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for pain. Disp:*40 Tablet(s)* Refills:*0* 10. Clonazepam 0.5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). Disp:*30 Tablet(s)* Refills:*0* 11. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). Disp:*30 Capsule(s)* Refills:*0* 12. Albuterol-Ipratropium 103-18 mcg/Actuation Aerosol Sig: Six (6) Puff Inhalation Q4H (every 4 hours) as needed. Disp:*1 inhaler* Refills:*0* Discharge Disposition: Home With Service Facility: [**Location (un) 932**] Area VNA Discharge Diagnosis: Motor vehicle crash Liver laceration Bilateral tibia/fibula fractures Discharge Condition: Good, stable. Discharge Instructions: -Weight bearing as tolerated, left leg -Non-weight bearing, right leg until ex-fix removed in 8 weeks -Follow-up with both Orthopedics & Trauma in clinic -Call the clinic or return to ER for worsening pain or signs of infection. Followup Instructions: Follow-up with Dr. [**Last Name (STitle) 1005**] in [**Hospital **] Clinic in 10 days, call ([**Telephone/Fax (1) 8746**] for appointment. Follow-up in Trauma Clinic in [**1-11**] weeks, call ([**Telephone/Fax (1) 376**] for appointment. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 520**] MD, [**MD Number(3) 3226**] ICD9 Codes: 311
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Medical Text: Unit No: [**Numeric Identifier 74611**] Admission Date: [**2104-10-21**] Discharge Date: [**2104-11-6**] Date of Birth: [**2104-10-21**] Sex: F Service: NB HISTORY: Baby Girl [**Known lastname 1007**] was admitted to the newborn intensive care unit for management of prematurity. She is a 2865 gm product of a 34-3/7 weeks gestation, born to a 34- year-old, gravida 3, para 2, now 3 mother, by spontaneous vaginal delivery. Prenatal screens were blood type A- positive, antibody negative, hepatitis B surface antigen negative, RPR nonreactive, rubella immune, and group Beta Strep positive. The pregnancy was complicated by gestational diabetes requiring insulin. Also complicated by subchorionic hematomas with vaginal bleeding at 10 and 14 weeks gestation and 23 and 24 weeks gestation. She then developed prolonged premature rupture of membranes at 25 weeks gestation on about [**2104-8-19**]. She presented with leaking of fluid, mild oligohydramnios on ultrasound, and positive fetal fibronectin. She was managed expectantly with bed rest, ampicillin and erythromycin and betamethasone. Through the past 10 weeks she has not developed any fevers. The infant's biophysical profile has remained [**8-13**] and her amniotic fluid index has been [**7-17**]. The subchorionic hematomas resolved. On the morning of delivery, mom went into spontaneous labor. She was given a dose of penicillin 1-1/2 hours prior to delivery though she had been on ampicillin and gentamicin prior to the onset of labor. Fetal tachycardia to the 170s and maternal temp of 99.3 were noted during labor. Delivery occurred at 7:57 a.m. The infant emerged vigorous with a strong cry. She was resuscitated with warming, drying, stimulation and bulb suctioning and brief blow by oxygen. Apgars scores were 8 at one minute and 9 at five minutes of age. She was then transferred to the newborn intensive care unit for further management. BIRTH PARAMETERS: Weight 2865 gm (90th percentile). Length 49.5 cm (90th percentile). Head circumference 33 cm (75th percentile). PHYSICAL EXAMINATION AT TIME OF DISCHARGE: Weight 3020 grams. Length 49 cm. Head circumference 33.5 cm. At the time of discharge, a well-appearing, alert term female with stable temperature in open crib. HEENT: Anterior fontanel soft and flat, most of molding resolved, positive red reflex bilaterally, patent nares, lips/gums/palate intact. Neck: No masses noted. Cardiovascular: Heart regular rate and rhythm without any murmurs. +2 pulses in upper and lower extremities. Respiratory: Breath sounds clear and equal bilaterally and easy, comfortable respiratory pattern. Abdomen: Soft, nontender, active bowel sounds, no hepatosplenomegaly. GU: Normal female genitalia, patent anus. Spine: Straight, no dimples, hair [**Hospital1 **] noted. Extremities: Moving all extremities symmetrically with normal tone, hips stable to maneuvers and clavicles intact. Skin: Pink with no lesions. Neuro: Alert, normal tone, positive grasp and positive Moro. SUMMARY OF HOSPITAL COURSE BY SYSTEMS: Respiratory: This girl's name is [**Name (NI) **], has been in room air for the duration of her hospitalization. Respiratory rates have been in the 30s- 60s range, and she has had one apneic spell during her hospitalization on [**10-26**]. She did not require any methylxanthine for apnea of prematurity. Cardiovascular: [**Month (only) **] has had a normal blood pressure throughout her hospitalization. No fluid bolus' or pressors were required for blood pressure support. Heart regular rate and rhythm. No murmurs auscultated. Fluids, electrolytes and nutrition: Upon admission to the newborn intensive care unit a d-stick and found to be 35 at which time she received a 2 cc/kg bolus of D10W for hypoglycemia. A repeat d-stick shortly thereafter was 75. She has not had any other issues with hypoglycemia during her hospitalization. Shortly after that bolus, IV fluids of D10W were started at 80 cc/kg/day. The infant started p.o. feeds within 24 hours of age and the IV fluids were weaned off. She is currently successfully ad lib demand breast and bottle feeding. Her weight at time of discharge is 3020 grams, length 49 cm, head circumference 33.5. She is going home breastfeeding and supplementing with breast milk enriched to 24 calories per ounce with Enfamil powder. A set of electrolytes was drawn at 24 hours of age. Sodium was 139, potassium 5.1, chloride of 104, and a bicarb of 25. Gastrointestinal: Phototherapy was initiated on day of life 2 for a total bilaterally of 11.2. Phototherapy was subsequently discontinued on day of life 4 with a rebound on day of life 5 of 7.8. Followup bilis on day of life 7 and day of life 8 were 11.2 and 10.5, respectively. Hematology: [**Month (only) **]'s blood type is A-positive, Coombs' negative. She has not required any blood products during her hospitalization. Infectious disease: Upon admission to the newborn intensive care unit, a CBC with differential and blood cultures were drawn and the infant was started on ampicillin and gentamicin. That CBC had a [**Known lastname **] count of 9, hematocrit of 54.9, a platelet count of 361,000, with 7% polys and 1 band, and that blood culture was positive for Group B Strep. An LP was performed on day of life 2 which showed a total protein of 167, a glucose of 46, 4 [**Known lastname **] blood cells and [**Pager number **] red blood cells. The Group Beta Strep species was noted to be sensitive to ampicillin and the gentamicin was discontinued on day of life #3. She continued on ampicillin for a full 10 days. Her last dose of ampicillin was given on [**10-31**]. Blood culture that was drawn at 24 hours after abx initiated was negative. Despite her Group B Strep bacteremia, [**Month (only) **] remained stable and appeared clinically well throughout her NICU admission. Neurology: A head ultrasound was not indicated for this 34- 3/7 weeks infant. Sensory: A hearing screen was performed with automated auditory brainstem responses. She passed in both ears on [**10-31**]. Ophthalmology: Eye exam not indicated for this 34-3/7 weeks infant. Psychosocial: The [**Hospital1 69**] social work department has been involved with the family. The contact social worker can be reached at [**Telephone/Fax (1) **]. CONDITION ON DISCHARGE: [**Telephone/Fax (1) **] is stable in room air. Ad lib feeding without difficulty. She has completed her 10-day course of ampicillin for Group B Strep bacteremia and is clinically well. DISCHARGE DISPOSITION: To home. NAME OF PRIMARY PEDIATRICIAN: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 73591**], MD, phone number ([**Telephone/Fax (1) 68662**]. CARE RECOMMENDATIONS: Feeds at time of discharge: Ad lib breast feeding with supplements of breast milk enriched to 24 calories per ounce with Enfamil powder. Medications: Iron supplements and Tri-Vi-[**Male First Name (un) **] supplements. Iron and vitamin D supplementation. Iron supplementation is recommended for preterm and low birth weight infants until 12 months corrected age. All infants fed predominantly breast milk should received vitamin D supplementation at 200 international units (may be provided as a multivitamin preparation) daily until 12 months correct age. Car seat position screening: [**Male First Name (un) **] failed her car seat test on [**2104-10-30**]. A repeat car seat test was performed on [**2104-11-5**] for 3 hours and she passed. State newborn screening status: State newborn screen was sent on [**2104-10-24**]. No abnormal results have been reported. Immunizations received: [**Date Range **] received her first hepatitis B vaccine on [**10-27**]. No further immunizations have been given. Immunizations recommended: Synagis RSV prophylaxis should be considered from [**Month (only) **] through [**Month (only) 958**] for infants who meet any of the following 4 criteria: 1. Born at less than 32 weeks. 2. Born between 32 and 35 weeks with 2 of the following: Daycare during RSV season, a smoker in the household, neuromuscular disease, airway abnormalities, or school- aged siblings. 3. Chronic lung disease 4. Hemodynamically significant congenital heart disease. Influenza immunization is recommended annually in the fall for all infants once they reach 6 months of age. Before this age and for the first 24 months of the child's life, immunization against influenza is recommended for household contacts and out of home caregivers. This infant has not received rotavirus vaccine. The American Academy of Pediatrics recommend initial vaccination of preterm infants at or following discharge from the hospital if they are clinically stable and at least 6 weeks but fewer than 12 weeks of age. A follow-up appointment with Dr. [**Last Name (STitle) **] has been scheduled. DISCHARGE DIAGNOSES: 1. Prematurity at 34-3/7 weeks. 2. Group B Strep bacteremia. 3. Hyperbilirubinemia. 4. Infant of diabetic mother. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 48738**], MD [**MD Number(2) 55708**] Dictated By:[**Last Name (NamePattern1) **] MEDQUIST36 D: [**2104-10-31**] 18:30:05 T: [**2104-11-3**] 09:03:54 Job#: [**Job Number 74612**] ICD9 Codes: 7742
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Medical Text: Admission Date: [**2144-5-25**] Discharge Date: [**2144-6-3**] Date of Birth: [**2095-1-9**] Sex: M Service: SURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 598**] Chief Complaint: abdominal pain, fever Major Surgical or Invasive Procedure: Exploratory laparotomy, small bowel resection, end-ileostomy History of Present Illness: HISTORY OF PRESENTING ILLNESS This patient is a 49 year old male who complains of FEVER/ABD PAIN. 49M with hx of T2DM and previous hx of unexplained neutropenia who now presents with 3-4 days of fever and chills with one day of right sided abdominal pain. + nausea, - Vomiting. Pt with previous neutropenia that was possibly attributed to his glipizide use, and subsequent BMBx was unrevealing. He was hospitalized in [**Month (only) **] for neutropenia again, and this was possibly attributed to ongoing cocaine use -- "Recently, numerous case reports have related neutropenia and ANCA positivity with cocaine mixed with an anti-helminthic [**Doctor Last Name 360**] known as levamisole (a cutting [**Doctor Last Name 360**]). The patient was reluctant to divulge his recent use, but eventually admitted to ongoing cocaine use over the past year at least. A serum test for levamisole was pending at discharge." here w/ rigors, hypotensivge and abd pain- TRIGGER Timing: Gradual Quality: Dull Duration: Hours Past Medical History: Type 2 diabetes-on oral medications Chronic back pain-evidence of DJD Status post tonsillectomy Status post appendectomy Recent admission in [**Month (only) **] for chin abscess/neutropenia Microscopic hematuria with neg w/u Social History: The patient is married. Patient lives with his wife and his 12 year old son. [**Name (NI) **] currently takes care of his sister who is ill. He works as an electrical engineer and travels to NH three times weekly which is adding stress. Sister has a dog and a cat but no scratches or bites recently. Drinks 0-1 drinks a week. No tobacco history. He denied illicit drug use on admission, but later admitted to recent and ongoing cocaine use during this past year, with unclear details as to the duration of use. Family History: Sister with ALS Dad with DM CVA MI Mom with DM Physical Exam: PHYSICAL EXAMINATION HR:132 BP:86/44 Resp:26 O(2)Sat:98 Normal Constitutional: Comfortable HEENT: Normocephalic, atraumatic, Pupils equal, round and reactive to light Oropharynx within normal limits Chest: Clear to auscultation Cardiovascular: Regular Rate and Rhythm- tachy Abdominal: Soft, diffusely tender r>L no rebound. GU/Flank: No costovertebral angle tenderness Extr/Back: No cyanosis, clubbing or edema Skin: No rash Neuro: Speech fluent Psych: Normal mood Heme/[**Last Name (un) **]/[**Last Name (un) **]: No petechiae Pertinent Results: [**2144-5-31**] 05:38AM BLOOD WBC-11.2* RBC-4.35* Hgb-11.4* Hct-35.3* MCV-81* MCH-26.2* MCHC-32.3 RDW-15.6* Plt Ct-70* [**2144-5-30**] 04:59AM BLOOD WBC-9.6 RBC-4.49* Hgb-11.9* Hct-36.0* MCV-80* MCH-26.4* MCHC-33.0 RDW-15.9* Plt Ct-90* [**2144-5-29**] 05:20AM BLOOD WBC-12.5*# RBC-4.71# Hgb-12.5* Hct-38.0* MCV-81* MCH-26.6* MCHC-33.0 RDW-15.4 Plt Ct-116* [**2144-5-25**] 03:44PM BLOOD WBC-0.7* RBC-3.98* Hgb-10.7* Hct-30.6* MCV-77* MCH-27.0 MCHC-35.1* RDW-15.0 Plt Ct-190 [**2144-5-25**] 05:12AM BLOOD WBC-0.9* RBC-4.00* Hgb-11.0* Hct-31.3* MCV-78* MCH-27.5 MCHC-35.2* RDW-14.8 Plt Ct-247 [**2144-5-24**] 08:17PM BLOOD WBC-0.5*# RBC-3.86* Hgb-10.4* Hct-29.8* MCV-77* MCH-27.0 MCHC-35.1* RDW-14.4 Plt Ct-281 [**2144-5-27**] 02:03AM BLOOD Neuts-48* Bands-6* Lymphs-23 Monos-17* Eos-0 Baso-0 Atyps-0 Metas-1* Myelos-5* NRBC-1* [**2144-5-26**] 01:54AM BLOOD Neuts-11* Bands-20* Lymphs-48* Monos-10 Eos-0 Baso-0 Atyps-9* Metas-2* Myelos-0 [**2144-5-31**] 05:38AM BLOOD Plt Ct-70* [**2144-5-30**] 04:59AM BLOOD Plt Smr-LOW Plt Ct-90* [**2144-5-29**] 05:20AM BLOOD Plt Ct-116* [**2144-5-27**] 02:03AM BLOOD PT-16.3* PTT-37.3* INR(PT)-1.4* [**2144-5-26**] 01:54AM BLOOD Plt Smr-NORMAL Plt Ct-198 [**2144-6-3**] 06:15AM BLOOD Glucose-98 UreaN-17 Creat-0.9 Na-135 K-3.8 Cl-98 HCO3-31 AnGap-10 [**2144-5-31**] 05:38AM BLOOD Glucose-204* UreaN-24* Creat-0.9 Na-141 K-3.9 Cl-105 HCO3-31 AnGap-9 [**2144-5-30**] 04:59AM BLOOD Glucose-213* UreaN-29* Creat-1.0 Na-140 K-3.7 Cl-103 HCO3-32 AnGap-9 [**2144-5-24**] 08:17PM BLOOD Glucose-138* UreaN-32* Creat-1.7* Na-135 K-3.9 Cl-95* HCO3-26 AnGap-18 [**2144-5-27**] 02:03AM BLOOD ALT-69* AST-61* AlkPhos-40 TotBili-3.9* DirBili-3.5* IndBili-0.4 [**2144-5-26**] 06:15AM BLOOD DirBili-3.5* [**2144-5-26**] 06:15AM BLOOD DirBili-3.5* [**2144-5-26**] 01:54AM BLOOD ALT-73* AST-54* LD(LDH)-162 AlkPhos-31* TotBili-4.4* DirBili-3.6* IndBili-0.8 [**2144-5-24**] 08:17PM BLOOD ALT-22 AST-23 AlkPhos-46 TotBili-1.1 [**2144-5-25**] 05:12AM BLOOD CK-MB-3 cTropnT-<0.01 [**2144-6-3**] 06:15AM BLOOD Calcium-7.8* Phos-4.1 Mg-1.7 [**2144-5-31**] 05:38AM BLOOD Calcium-7.5* Phos-3.3 Mg-1.9 [**2144-5-30**] 04:59AM BLOOD Calcium-7.6* Phos-3.4 Mg-2.1 [**2144-5-27**] 02:12AM BLOOD Lactate-2.2* [**2144-5-25**] 03:20AM BLOOD Glucose-213* Lactate-2.9* Na-133* K-4.6 Cl-103 [**2144-5-26**] 03:24AM BLOOD freeCa-1.17 [**2144-5-25**] 09:05PM BLOOD freeCa-1.18 [**2144-5-24**]: x-ray of the abdomen: IMPRESSION: Nonspecific bowel gas pattern, with a few mildly dilated loops of small bowel and small scattered air-fluid levels, which could reflect gastroenteritis or ileus. Early or partial obstruction cannot be excluded and could be further evaluated on CT as clinically warranted. [**2144-5-24**]: chest x-ray: IMPRESSION: Low lung volumes, but no focal consolidation. No evidence of free air beneath the diaphragm. [**2144-5-25**]: Echo: CLINICAL IMPLICATIONS: The patient has moderate mitral regurgitation. Based on [**2139**] ACC/AHA Valvular Heart Disease Guidelines, a follow-up echocardiogram is suggested in 1 year. The left ventricular ejection fraction is <40%, a threshold for which the patient may benefit from a beta blocker and an ACE inhibitor or [**Last Name (un) **]. Based on [**2140**] AHA endocarditis prophylaxis recommendations, the echo findings indicate prophylaxis is NOT recommended. Clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. [**2144-5-25**]: cat scan of the abdomen: IMPRESSION: Findings concerning for distal ileal inflammation,perforation, and ischemia. Potential etiologies include neutropenic enterocolitis, cocaine vasculopathy, and inflammatory bowel disease. [**2144-5-28**]: Echo: Conclusions No spontaneous echo contrast or thrombus is seen in the body of the left atrium/left atrial appendage or the body of the right atrium/right atrial appendage. Normal interatrial septum by color doppler. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion. No masses or vegetations are seen on the aortic valve. No aortic regurgitation is seen. The mitral valve leaflets are structurally normal. No mass or vegetation is seen on the mitral valve. No mitral regurgitation is seen. Tricuspid valve is normal. No tricuspid regurgitation. No vegetation/mass is seen on the pulmonic valve. There is no pericardial effusion. IMPRESSION: No valvular vegetations demonstrated. Preserved biventricular systolic function. Normal cardiac valves. [**2144-5-29**]: x-ray of the abdomen: Stacked dilated loops of small bowel with distal air seen in the colon and rectum may be postoperative ileus but concerning for partial or evolving small-bowel obstruction is also considered. Followup radiographs should be considered as clinically indicated. [**2144-5-29**]: chest x-ray: IMPRESSION: Bilateral subsegmental atelectasis. Small left effusion. Minimal right pleural effusion. Increased density at the left lung base consistent with worsening atelectasis or consolidation. Brief Hospital Course: 49 year old gentleman admitted to the acute care service with abdominal pain and fever. Upon admission, he was found to be hypotensive, tachycardic and neutropenic. He was admitted to the intensive care unit where he required pressor support to maintain his blood pressure. He was made NPO, given intravenous fluids antibiotics, and had imaging studies of his abdomen which were concerning for a perforation of his ileum. Infectious disease was consulted and made recommendations regarding his managment. He was emergently taken to the operating room where he was found to have a perforated terminal ileum. He underwent an exploratory laparotomy, lysis of adhesions, distal ileum resection, ileostomy, and [**Doctor Last Name 3379**] pouch. He also had placment of a right sided abdominal drain. His operative course was stable with a 500cc blood loss. He required blood products ,crystalloid, and pressors for maintainence of his blood pressure. He was transported to the intensive care unit after his surgery for monitoring where he was hypotensive and tachycardic. He underwent a bedside Echo which showed hypokinesis. He also had blood cultures drawn which showed GPR's and recommendations were made for vancomycin, meropenum, and micafungin. His vital signs stablized, pressors weaned off, and he was successfully extubated on POD #1. His post-operative pain was managed with dilaudid PCA. His micafungin was discontinued on POD #1 and his vancomycin discontinued on POD #2, meropenum on POD #6. He was transferred to the surgical floor on POD # 2. He did continue to have episodes of tachycardia and underwent a TEE which showed no valvular vegatation and an LVEF >55%. Infectious disease continued to monitor his progress. The abdominal drain was discontinued on POD# 3. The ostomy nurse was consulted and provided care and supervison in the management of his ostomy. Because of his deconditioning, physical and occupational therapy were consulted and evaluated his physical status for discharge. He was started on clear liquids with advancement to a regular diet. His vital signs are stable and he is afebrile. His white blood cell count is 10. He has been ambulating in the [**Doctor Last Name **] with assistance. He is tolerating a regular diet and is voiding without difficulty. His ostomy was draining a large amount of watery stool, but now slightly formed stool. He has not resumed his daily home dose of insulin because of his tenuous GI status but his blood sugars have been closely monitored. He is preparing for discharge home with VNA services. He will follow-up in the acute care clinic in 2 weeks. Medications on Admission: [**Last Name (un) 1724**]: glargine 25 units QHS, Lispro, Vicodin prn, ASA 81, ferrous sulfate 325' Discharge Medications: 1. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for fever. 2. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 3. hydromorphone 2 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*25 Tablet(s)* Refills:*0* 4. insulin glargine 100 unit/mL Cartridge Sig: Twenty (20) units Subcutaneous daily: please monitor blood sugars and increase dose to pre-hospital as per blood sugars. 5. insulin lispro 100 unit/mL Cartridge Sig: 2-30 units Subcutaneous prior to meals: as per sliding scale. Discharge Disposition: Home With Service Facility: [**Hospital 119**] Homecare Discharge Diagnosis: Bowel ischemia neutropenia sepsis Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were cared for in our hospital for neutropenia and enterocolitis requiring surgery. Your illness may have been attributed to a unhealthy lifestyle. You have been advised to alter your lifestyle to prevent a recurrence. Our general surgery team performed surgery on you first with an exploratory laporatomy. Part of your small bowel was removed and an end-ileostomy was performed. You were monitored in the intensive care unit after the procedure, requiring antibiotics. Your clinical status has improved and you are now preparing for discharge home with VNA assistance. Please follow these instructions: You experience new chest pain, pressure, squeezing or tightness. *New or worsening cough, shortness of breath, or wheeze. *If you are vomiting and cannot keep down fluids or your medications. *You are getting dehydrated due to continued vomiting, diarrhea, or other reasons. Signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *You see blood or dark/black material when you vomit or have a bowel movement. *You experience burning when you urinate, have blood in your urine, or experience a discharge. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *Any change in your symptoms, or any new symptoms that concern you. Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than [**6-16**] lbs until you follow-up with your surgeon. Avoid driving or operating heavy machinery while taking pain medications. Incision Care: *Please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *Avoid swimming and baths until your follow-up appointment. *You may shower, and wash surgical incisions with a mild soap and warm water. Gently pat the area dry. *If you have staples, they will be removed at your follow-up appointment. Please notify us if you have an increase in your ostomy drainage, any change in your ostomy. Followup Instructions: Please follow-up with the acute care service in 2 weeks. You can schedule this appointment by calling # [**Telephone/Fax (1) 600**]. [**First Name8 (NamePattern2) **] [**Name8 (MD) **] MD [**MD Number(2) 601**] Completed by:[**2144-6-10**] ICD9 Codes: 0389
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Medical Text: Admission Date: [**2162-3-2**] Discharge Date: [**2162-3-12**] Service: MEDICINE Allergies: Ceftriaxone Sodium / Cefotaxime / Ace Inhibitors Attending:[**First Name3 (LF) 2297**] Chief Complaint: Renal failure Major Surgical or Invasive Procedure: central line placement respiratory mechanical ventilation IV pressors thoracentesis of pleural effusion History of Present Illness: [**Age over 90 **] year old female with exquisitely complex medical history, transferred from [**Hospital **] rehab for evaluation of renal failure and consideration for dialysis. . Of note, pateint was recently discharged from [**Hospital1 18**] in [**12-5**] after a very complicated MICU stay. She was initially admitted for respiratory distress likely from decompensated CHF and ?MRSA pneumonia. SHe was treated with vancomycin for pneumonia. She was also diurese and had afterload reduction. She also had multiple thoracentesis with transudative effusion and rapid reaccumulation. She was eventually intubated and trach on [**2161-12-30**]. Weaning has been mainly unsuccessful. . Patient was transferred to rehab on pressure support but was switched to AC becuase of intolerance. Weaning attempts were unsuccessful. She actually was admitted to ICU at [**Hospital1 **] becuase of arrhythmia. Her SVT was controlled with increasing doses of metoprolol and digoxin but she became bradycardic. Patient went into monomorphic VTs that resolved spontaneouly. Patient was given amiodarone 150mg IV 2 weeks ago. Serial CKs and troponin were negative Her course was also complicated by hemoptysis and [**Hospital1 4532**], aspirin and coumadin has been d/c'd.Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 1726**] [**Last Name (NamePattern1) 47786**] her and did not find source of bleeding. Patient was also started on imipenem for presumed ventilator associated pneumonia([**1-25**]- [**2162-2-4**]). SHe was also on Bactrim for anterobacter on her sputum. Her BUn and creatinine begin to climb around [**2-17**] t0 1.9 and 3.3 on day of admission. Renal consult suggested dialsysis. Family meeting was held with son on [**2-19**] who insisted everything to b done Past Medical History: CAD s/p bare metal stent to OM1 [**7-5**] gallstone pancreatitis cholecystitis s/p percutaneous cholecystostomy tube h/o CVA anemia CRI hemorrhoids AF junctional arrhythymias htn h/o pna s/p PEG tube placement feeds d/c [**2161-6-25**] tracheostomy s/p bilateral thoracentesis s/p hip replacement necrotic right foot CHF, hx of diastolic dysfxn R foot dry gangrene s/p AKA [**9-4**] Social History: Lives with son (healthcare proxy) in [**Hospital1 **], but has been in rehab for many months. Family History: non contributory Physical Exam: PHYSICAL EXAMINATION: Gen- frail looking elderly female lying in bed, only responsive to noxious stimuli HEENT- anicteric, flushed and swollen looking face, oral mucosa dry, neck supple, trach site looks clean CV- 2/6 SEM at apex, irregular heart sound resp- decreased breath sound right more than left abdomen- PEG site clean, no distension, unable to assess tenderness ext- 3+ pitting edema in all extremity, right AKA noted. skin- multiple bruises and also excoriation from anasarca, clean ulcer noted on left foot. Pertinent Results: Please refer to OMR records for CXR, abdominal U/S, ECG, echocardiogram, and lab results. Blood Cx with ENTEROBACTER CLOACAE Urine Cx with pseudomonas Sputum Cx with pseudomonas and proteus Brief Hospital Course: [**Age over 90 **] year old female with extensive cardiac history, AF, sick sinus syndrome, presents with acute renal failure to be considered for dialysis. . # Code Status / Overall Goals of Care: Patient was initially "Full code," confirmed with son. Over the course of her hospitalization, the patient's very grave prognosis and very limited potential quality of life (even if all acute issues were effectively treated) led to frequent discussions between the ICU team and the patient's family (son). Given the patient's deteriorating status and grave prognosis, the patient's code status was changed to DNR/I, CPR not indicated. The patient's son and ICU team decided to discontinue Levophed on [**3-12**] and the patient passed away within 1-2 hours. . # ID: The patient's clinical picture at admission very consistent with sepsis (including WBC 16 with 39% bands) and pt was started empirically on vancomycin and meropenem and given aggressive IVF resuscitation. Two out of two blood Cx bottles drawn on day of admission grew ENTEROBACTER CLOACAE, sensitive to meropenem, which pt was continued on for the remainder of her hospital stay. Patient was apparently on Flagyl 250 Q6 prophylactically at rehab facility, although C diff was negative on [**2162-2-1**]. Flagyl was not continued in the hospital. Stool studies were negative for C.diff here as well. Thoracentesis was performed and revealed a transudative process. [**Last Name (un) **] stim test was WNL. . # Acute Renal Failure: Creatinine was increased at admission but urine output was initially WNL. Pt's renal function continued to deteriorate and she became anuric. Work-up was entirely negative, including abdominal ultrasound (no hydronephrosis seen), urine eosinophils negative. Pt had history of renal artery stenosis (angiography showed high grade stenosis of the left renal artery but with normal perfusion and moderate stenosis of the right renal artery which previously had been demonstrated to be atrophic with flow studies indicative of significant stenosis too diffuse to intervene). Renal followed the patient throughout her hospitalization. The possibility of initiating dialysis was discussed at length with the patient's family (son) and the renal team and in view of the patient's grave overall prognosis and very limited potential quality of life even with dialysis, the decision was made not to pursue dialysis. . # Hypotension: was likely from sepsis. Pt required levophed for BP support despite aggressive IVF. . # CAD: Patient had a trop of 0.21, MB 22. ECG revealed Afib, nonspecific St-T changes, poor RWP(not new); likely demand ischemia. Patient was maintained on aspirin and lipitor. Cardiac enzymes - cycle cardiac enzymes - cardiology consult - bare metal stent placement in [**Month (only) **] to OM #1, doubt it is in stent thrombosis, no acute EKG a changes and completed at least 3 month of [**Month (only) 4532**] . # Diastolic heart failure; echo [**12-5**]:EF>55%, 2+MR, 1+TR. Patient was discharged on daily laisx and mitolazone; this is probably now complicated by acute renal failure - d/c afterload reduction(isordil, metoprolol and Hydralazine) until sure that BP is stable, Losartan was d/c on last admission due to ARF . # Anasarca: from admission, pt was grossly edematous with weepy skin. This was likely from low albumin state, diastolic heart failure, and complicated by acute renal failure. Pt received aggressive skin care. . # Afib with history of junctional arrythymias. EP felt that there was no indication for amiodarone during past admission, however, given one time dose of amiodarone at NH (last dose 2 weeks ago). Patient intermittently was in NSR and Afib throughout hospitalization. Anticoagulation was not initiated given recent report of hemoptysis. . # Respiratory failure: combination of pleural effusion, ?PNA. Pt was continued on ventilatory support via her trach throughout her hospitalization. . # Thrombocytopenia: stable throughout admission but lower than her plt count in [**2161-12-31**]. Could have been from low-grade DIC (high LDH, high Ddimer), although fibrinogen was high. . # Hypothyroidism - the patient was continued on her outpatient regimen of levothyroxine. . # Hemoptysis at [**Hospital1 **], apparently broch'd by Dr. [**First Name (STitle) 1726**] and was negative. Held [**Last Name (LF) 4532**], [**First Name3 (LF) **] and coumadin. . # Psych: pt had very minimal mental status throughout her hospitalization, only wincing to noxious stimuli but otherwise not interactive. . # CVA: pt had a history of a subacute right occipital infarct and was on [**First Name3 (LF) **]. . # Anemia: Work up consistent with ACD and iron deficiency . # Diabetes- on RISS and lantus . # Prophylaxis: Pt was initially on SC heparin prophylaxis but this was discontinued due to skin weeping (from anasarca). Pt was maintained on a PPI throughout her hospitalization. * # FEN: pt tolerated tubefeeds via PEG (placed [**2161-12-18**]). . # Access: a right-subclavian line was placed on [**2162-3-3**] and PICC line was removed. . # Communication: the patient's only son, [**Name (NI) **] [**Name (NI) **] [**Telephone/Fax (1) 47781**], was updated on the patient's status on a daily basis by the ICU attending and team. Medications on Admission: flagyl 250 Q6 diphenhydramine 50mg Q8 ativan 2mg Q4 lopressor 12.5mg Q12 RISS morphine Q1 prn hydralazine 40 Q6 lipitor 10 MVI synthroid 0.088 mg lansoprazole 30 isosorbide 10 Q8 ascorbic acid 250 every 12h artificial tears docusate and senna [**Last Name (LF) 4532**], [**First Name3 (LF) **] and coumadin held becuase of hemoptysis through trach Discharge Medications: (deceased) Discharge Disposition: Expired Discharge Diagnosis: sepsis, bacterial acute renal failure respiratory failure atrial fibrillation coronary artery disease, stable thrombocytopenia pleural effusion, transudative Discharge Condition: (deceased) Discharge Instructions: (deceased) Followup Instructions: (deceased) Completed by:[**2162-3-12**] ICD9 Codes: 5849, 4240, 4280, 5789, 5119, 486, 2875
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Medical Text: Admission Date: [**2105-2-18**] Discharge Date: [**2105-2-21**] Date of Birth: [**2052-9-21**] Sex: M Service: CARDIOTHORACIC Allergies: Penicillins Attending:[**First Name3 (LF) 1505**] Chief Complaint: acute shortness of breath and elevated INR s/p AVR(mechcanical)Ascending Aortic arch replacment on [**2-3**]. Major Surgical or Invasive Procedure: evacuation of pericardial effusion History of Present Illness: SOB onset about 5 days ago, increasing with any movement. Saw cardiologist yesterday had echo today with effusion. Past Medical History: Complete Heart Block(PPM) Postop DVT in LUE [**2104-3-12**] following lead extraction Hyperlipidemia s/p Dual chamber pacemaker placement in [**2087**] s/p replacement of PM generator [**2096**] s/p Lead extraction and reimplantation of PPM [**3-/2104**] Hernia repair as child s/p AVR(mechcanical)Ascending Aortic arch replacment on [**2-3**]. Social History: Lives with: Wife in [**Name2 (NI) 1727**] Occupation: Production manager on ship yard Tobacco: Quit 1.5 years ago. 40 pack year history ETOH: [**12-14**] drinks per week Family History: non-contributory Physical Exam: Physical Exam Temp 98.6 Pulse: 70 Vpaced Resp: 16 O2 sat: 96% 3LNP B/P Right: 109/70 Left: Height: Weight: General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [] Extremities: Warm [x], well-perfused [] Edema 2+ bilat Varicosities: None [x] Neuro: Grossly intact [x] Pulses: Femoral Right: 2+ Left: 2+ DP Right: Left: PT [**Name (NI) 167**]: 2+ Left: 2+ Radial Right: 2+ Left: 2+ Pertinent Results: [**2105-2-18**] 03:02PM PT-59.9* PTT-34.8 INR(PT)-6.8* [**2105-2-21**] INR 2.2 [**Hospital1 18**] ECHOCARDIOGRAPHY REPORT [**Known lastname **], [**Known firstname **] [**Hospital1 18**] [**Numeric Identifier 83779**]Portable TTE (Focused views) Done [**2105-2-18**] at 5:00:00 PM FINAL Referring Physician [**Name9 (PRE) **] Information [**Name9 (PRE) **], [**First Name3 (LF) **] R. [**Hospital1 18**], Division of Cardiothorac [**Hospital Unit Name 4081**] [**Location (un) 86**], [**Numeric Identifier 718**] Status: Inpatient DOB: [**2052-9-21**] Age (years): 52 M Hgt (in): 70 BP (mm Hg): 130/79 Wgt (lb): 277 HR (bpm): 70 BSA (m2): 2.40 m2 Indication: cath lab pericardiocentesis monitoring. ICD-9 Codes: 423.3 Test Information Date/Time: [**2105-2-18**] at 17:00 Interpret MD: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **], MD Test Type: Portable TTE (Focused views) Son[**Name (NI) 930**]: [**First Name8 (NamePattern2) 4134**] [**Last Name (NamePattern1) 4135**], RDCS Doppler: No Doppler Test Location: West Cath/EP Lab Contrast: None Tech Quality: Adequate Tape #: 2010W000-: Machine: Vivid i-3 Echocardiographic Measurements Results Measurements Normal Range Findings Limited views were done with sterile probe cover to assess fluid position during attempted pericardialcentesis. PERICARDIUM: Large pericardial effusion. RV diastolic collapse, c/w impaired fillling/tamponade physiology. Conclusions There is a large pericardial effusion. There is right ventricular diastolic collapse, consistent with impaired fillling/tamponade physiology. Electronically signed by [**Initials (NamePattern4) **] [**Last Name (NamePattern4) **] [**Last Name (NamePattern1) **], MD, Interpreting physician [**Last Name (NamePattern4) **] [**2105-2-18**] 17:47 Post-op echo [**2105-2-20**] Conclusions Overall left ventricular systolic function is normal (LVEF>55%). A bileaflet aortic valve prosthesis is present. There is a moderate sized pericardial effusion. The effusion is echo dense, consistent with blood, inflammation or other cellular elements. There are no echocardiographic signs of tamponade. No right ventricular diastolic collapse is seen. Compared with the findings of the prior study (images reviewed) of [**2105-2-18**], the pericardial effusion is smaller, now with signs of consolidation; no evidence of cardiac tamponade. Brief Hospital Course: Mr [**Known lastname **] was admitted on [**2105-2-18**] and taken to the Operating Room for evacuation of large pericardaicl effusion. See operative note for details. POst operatively he was transferred to the CVICU intubated and sedated for hemodynamic and ventilator management. He awoke neurologically intact and was extubated. He was tarnsferred from the ICU to the step down unit on POD#1. His couamdin was resumed for anticoagulation of mechanical aortic valve. His statin, betablocker and diuretic were also resumed. He was evaluated by physical therpay for strength and conditioning and was claered for discharge to home on POD#3. Medications on Admission: 1. Simvastatin 40' 2. Aspirin 81' 3. Acetaminophen 325-650/PRN 4. Hydromorphone 2-4 mg/Q4H/PRN 6. Warfarin 5QD: **dose will change daily for goal INR 2.5-3.5, 7. Potassium Chloride 20 Q12H (every 12 hours) x5 days. 8. Ranitidine HCl 150' 9. Docusate Sodium 100" 10. Metoprolol Tartrate 25" 11. Furosemide 40" Discharge Medications: 1. Simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 3. Ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO once a day. 4. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 5. Keflex 500 mg Capsule Sig: One (1) Capsule PO four times a day for 5 days. Disp:*20 Capsule(s)* Refills:*0* 6. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 7. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*75 Tablet(s)* Refills:*0* 8. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO Q12H (every 12 hours) for 10 days. Disp:*20 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* 9. Lasix 40 mg Tablet Sig: One (1) Tablet PO twice a day for 10 days. Disp:*20 Tablet(s)* Refills:*0* 10. Coumadin 2.5 mg Tablet Sig: Two (2) Tablet PO once a day: take 5mg on [**2-22**] then as directed by Dr. [**Last Name (STitle) 83780**]. Disp:*60 Tablet(s)* Refills:*2* 11. Outpatient Lab Work INR check on [**2105-2-22**] and call results to [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 4129**] NP [**Telephone/Fax (1) 170**] AFTER [**2105-2-22**] INR check and call results to Dr. [**Last Name (STitle) 80724**] [**Telephone/Fax (1) 8226**]; Fax [**Telephone/Fax (1) 83781**] Discharge Disposition: Home With Service Facility: VNA of Southern [**State 1727**] Discharge Diagnosis: Complete Heart Block(PPM) Postop DVT in LUE [**2104-3-12**] following lead extraction Hyperlipidemia s/p Dual chamber pacemaker placement in [**2087**] s/p replacement of PM generator [**2096**] s/p Lead extraction and reimplantation of PPM [**3-/2104**] Hernia repair as child Past Surgical History: [**2105-2-3**] 1. Ascending aortic replacement with 28-mm Gelweave graft under deep hypothermic circulatory arrest. 2. Aortic valve replacement, 25-mm St. [**Hospital 923**] Medical Regent mechanical valve. 3. Coronary artery bypass grafting x1 of the left internal mammary artery graft to left anterior descending. Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with percocet prn Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month until follow up with surgeon No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Followup Instructions: Recommended Follow-up: Surgeon Dr. [**Last Name (STitle) **] [**2105-3-12**] at 1pm [**Telephone/Fax (1) 170**] Please call to schedule appointments: Primary Care Dr. [**Last Name (STitle) 28272**] [**Telephone/Fax (1) 83777**] in [**12-13**] weeks Cardiologist Dr. [**Last Name (STitle) 80724**] in [**12-13**] weeks. Dr. [**Last Name (STitle) 80724**] will follow your coumadin starting monday [**2105-2-23**]. Wound check appointment - [**Hospital Ward Name 121**] 6 ([**Telephone/Fax (1) 3071**]) - your nurse will schedule Completed by:[**2105-2-21**] ICD9 Codes: 2724
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Medical Text: Admission Date: [**2118-3-17**] Discharge Date: [**2118-3-25**] Date of Birth: [**2073-4-21**] Sex: M Service: MEDICINE Allergies: Aloe / Levaquin / Tape [**12-6**]"X10YD / Penicillins / Betaseron / vancomycin Attending:[**First Name3 (LF) 2145**] Chief Complaint: hypoxia Major Surgical or Invasive Procedure: none History of Present Illness: 44 year old male with history of multiple sclerosis, baseline cognitive defects, chronic indwelling suprapubic catheter and recurrent resistant urinary tract infections presenting with UTI. He was recently hospitalized [**Date range (3) 45860**] for UTI complicated by encephalopathy (somnolent, difficult to arouse). Urine culture grew staph aureus; sensitivities were not back by time of discharge. He improved on bactrim and discharged on 14 day course. However, sensitivities after discharge returned with MRSA. . He was seen by his outpatient urologist (Dr [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 770**]).... . In the ED, initial VS: 95.1 75 151/100 16 97%. He received 1g IV vancomycin. Previously, he had had an erythematous skin reaction on the arm that vancomycin had been infusing. No history of resp distress on vancomycin. Per ED, he had no ostensible reaction while receiving the vancomycin. Per wife, he appeared more red than usual in face and upper chest. Urology was called (but did not officially consult) and agreed with admission to medicine with urology following. . Within minutes of arrival to the floor, patient began to have active seizures. Per wife, he does not have history of seizures and was conversing and at baseline mental status while in ED. He began to groan, head moving side to side, upper extremities twitching and outstretched. During the first episode, he had oxygen desaturation briefly to the mid 70s on room air for a few seconds. Blood pressure was in systolic 180s; HR in 110s. He then fell into stupor and within a few minutes again became tremulous in upper extremities. Pupils were not reactive to light. He received a total of 10mg iv ativan. Neurology was consulted who recommended 1g loading dose of iv fosphenytoin. Wife confirmed that pt is [**Name (NI) 835**]/DNR. . REVIEW OF SYSTEMS: Denies fever, chills, night sweats, headache, vision changes, rhinorrhea, congestion, sore throat, cough, shortness of breath, chest pain, abdominal pain, nausea, vomiting, diarrhea, constipation, BRBPR, melena, hematochezia, dysuria, hematuria. Past Medical History: - Multiple sclerosis diagnosed in '[**03**]. Wheel chair bound. - Neurogenic bladder s/p suprapubic catheter '[**10**] - Multiple urinary tract infections (Providencia, Pseudomonas, MRSA) - Multiple episodes Bacteremia and urosepsis - Nephrolithiasis s/p R ureteral stent placement [**11-11**], multiple lithotripsy procedure, s/p L ureteral stent exchange [**2114-12-7**]. s/p removal of L stent on [**1-6**]. Social History: - Lives with wife who is primary caretaker. - Former electrician/web designer. - Wheelchair bound. - No tobacco - No Alcohol - No illicits Family History: no history of seizures Physical Exam: Admission exam GENERAL - Alert, interactive, well-appearing in NAD HEENT - PERRLA, EOMI, sclerae anicteric, MMM, OP clear NECK - Supple, no thyromegaly, no JVD, no carotid bruits HEART - PMI non-displaced, RRR, nl S1-S2, no MRG LUNGS - CTAB, no r/rh/wh, good air movement, resp unlabored, no accessory muscle use ABDOMEN - NABS, soft/NT/ND, no masses or HSM EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses SKIN - no rashes or lesions LYMPH - no cervical, axillary, or inguinal LAD NEURO - awake, A&Ox3, CNs II-XII grossly intact, muscle strength [**4-9**] throughout, sensation grossly intact throughout, DTRs 2+ and symmetric, cerebellar exam intact, steady gait Discharge exam 98.3 111/77 84 20 97%2L GENERAL - ill-appearing caucasian male,A+O x 2 (not to time), looks improved HEENT - PERRLA, sclerae anicteric, MMd, OP clear. Face is erythematous. NECK - Supple, no JVD HEART - RRR, no MRG LUNGS - bibasilar crackles ABDOMEN - NABS, soft/NT/ND, no masses or HSM EXTREMITIES - WWP, no c/c/e, 2+ peripheral pulses SKIN - face is red, w/ well-demarcated areas, though this is improving NEURO - awake, A+ O x 2, PERRL. CNs II-XII grossly intact muscle strength decreased globally, increased muscle tone/spasticity are somewhat better since baclofen restarted Pertinent Results: Admission labs [**2118-3-17**] 09:33PM BLOOD WBC-7.6 RBC-5.12 Hgb-14.4 Hct-45.3 MCV-89 MCH-28.2 MCHC-31.9 RDW-15.4 Plt Ct-152 [**2118-3-17**] 09:33PM BLOOD Neuts-74.2* Lymphs-17.4* Monos-6.5 Eos-1.0 Baso-0.9 [**2118-3-17**] 09:33PM BLOOD Glucose-114* UreaN-12 Creat-0.9 Na-135 K-4.5 Cl-96 HCO3-32 AnGap-12 [**2118-3-18**] 05:57AM BLOOD Albumin-3.5 Calcium-9.1 Phos-4.6*# Mg-1.9 Other labs [**2118-3-19**] 03:06AM BLOOD ALT-55* AST-49* AlkPhos-87 TotBili-0.1 [**2118-3-22**] 06:00AM BLOOD ALT-37 AST-42* AlkPhos-87 TotBili-0.4 [**2118-3-19**] 03:06AM BLOOD TSH-2.9 [**2118-3-22**] 09:26PM BLOOD HEPARIN DEPENDENT ANTIBODIES- negative Discharge labs [**2118-3-25**] 06:16AM BLOOD WBC-6.1 RBC-3.93* Hgb-11.5* Hct-36.1* MCV-92 MCH-29.2 MCHC-31.8 RDW-15.9* Plt Ct-181 [**2118-3-25**] 06:16AM BLOOD Glucose-72 UreaN-15 Creat-0.8 Na-141 K-3.7 Cl-102 HCO3-28 AnGap-15 [**2118-3-25**] 06:16AM BLOOD Calcium-8.9 Phos-2.7 Mg-1.9 Studies EEG [**3-18**]: CONTINUOUS EEG RECORDING: Began at 12:05 on [**3-18**] and continued until 7:O0 the next morning. At the beginning, it showed a low voltage faster pattern in all areas with bursts of focal slowing especially in the left temporal region. There were also some runs of rhythmic 6 Hz slowing in the left temporal area and other runs of periodic slowing with sharp features, none lasting for more than 8-10 seconds or so. On video, they did not appear to have any clinical correlate. By the evening, the background was more suppressed and, while left temporal slowing was still evident, the sharp features were not. SPIKE DETECTION PROGRAMS: Showed a few of the left temporal sharp features, especially early in the record. SEIZURE DETECTION PROGRAMS: Showed no electrographic seizures. PUSHBUTTON ACTIVATIONS: There were none. SLEEP: No normal waking or sleep patterns were evident. CARDIAC MONITOR: Showed a generally regular rhythm. IMPRESSION: This telemetry captured no pushbutton activations. There was continued focal slowing in the left temporal region. Early in the record, this also included some runs of irregular sharp activity and some 6 Hz rhythmic slowing in the same area, but these episodes did not appear to show any clinical evidence of seizure on video. They were brief. No more prolonged and clear electrographic seizures were recorded. CXR [**2118-3-18**]: Portable AP chest radiograph demonstrates low lung volumes and worsening basilar atelectasis. The left PICC has been removed. There is no focal consolidation, large pleural effusion, or pneumothorax. The cardiomediastinal silhouette is partially obscured. MR head [**2118-3-19**]: FINDINGS: The study is compared with most recent enhanced MR examination of [**2-/2118**], as well as the remote study of [**2109-9-11**]. Again demonstrated is the extensive confluent T2-/FLAIR-hyperintensity throughout bihemispheric subcortical and periventricular white matter, with similar abnormality involving the posterior fossa, including the brainstem, cerebellar peduncles and cerebellar hemispheres. Allowing for the motion artifact, above, the overall appearance is unchanged. By and in-large, the extensive lesions demonstrate intrinsic T1-hypointensity, representing "black holes" of irreversible demyelination. However, there is a prominent curvilinear or "targetoid" 16 mm focus of enhancement in the right corona radiata with a possible second enhancing focus in the corresponding location on the left. The right-sided focus appears new since the [**4-/2117**] examination, though previously, there was a smaller, more nodular focus in the immediately adjacent centrum semiovale. Allowing for the marked limitation in the post-contrast imaging, no other definite enhancing focus is seen, with apparent interval resolution of the left-sided subcortical white matter, temporal lobar and cerebellar hemispheric foci. Currently, there is no pathologic leptomeningeal or dural focus of enhancement. There is no definite focus of slow diffusion to suggest an acute ischemic event, and the principal intracranial vascular flow-voids, including those of the dural venous sinuses are preserved and these structures enhance normally. In comparison to the more remote study there is no definite progression of the marked global atrophy (particularly given the patient's age) or the severe diffuse atrophy of the corpus callosum. Limited imaging of the upper cervical spinal cord, through the mid-C4 level, demonstrates no definite abnormality. IMPRESSION: The study, particularly the post-contrast MP-RAGE acquisition, is quite limited by motion artifact, with: 1. No significant change in the overall extensive demyelinating "disease burden." 2. Curvilinear rim-enhancing focus in the right corona radiata appears new since the [**2117-4-6**] study and likely represents a site of active inflammation; allowing for the limitation above, there is no definite additional enhancing focus, with apparent interval resolution of many of the foci demonstrated on that study. 3. Marked global and corpus callosal atrophy, not significantly changed since the [**9-/2109**] study. CXR [**2118-3-25**]: : A right-sided PICC terminates within the distal SVC. The aeration of the lungs has improved compared to the prior study. Cardiac silhouette is stable. No large pleural effusions are seen. There is no pneumothorax. Bones are intact. IMPRESSION: Right-sided PICC terminating within the distal SVC. Brief Hospital Course: Mr. [**Known lastname 45855**] is a 44yoM with h/o multiple sclerosis, baseline cognitive defects, chronic indwelling suprapubic catheter and recurrent resistant urinary tract infections presenting with a UTI and new onset seizures. . After initially being admitted to the floor, he developed seizures requiring 10mg IV ativan and started on fosphenytoin with a load and transferred to the MICU. He was noted to be increasingly somnelent with periods of central apenea. ABG showed acidemia with CO2 on the 70s. He was started on Bipap with improvement in his CO2. It was presumed that his central apnea was secondary to his large ativan dose which slowly improved with clearance of the ativan. He was started emperically on vanc/ctx/amp/acyclivir to cover both his UTI and for empiric coverage for meningitis given his AMS. A head MRI was done, which showed unchanged appearance of extensive demyelinated, w/ new curvilinear rim focus in corona radiatia, likely site of active inflammation, no evidence of ischemic event, unchanged marked global atrophy. Given that meningitis was less likely he was narrowed to vanc/[**Known lastname **]. He began to wake up over the day on [**3-19**] and was weaned off BiPap to a shovel mask and transferred to the floor. . On the floor, he remained stable throughout the day on [**3-20**]. However, that morning was noted to be more tachycardic and febrile to 103 in the setting of hypoxia to the 80s. He was put on a NRB and sats remained in the 80s for a while before improving to the mid- 90s. ABG on NRB was 7.48/40/72. His eyes were open but wasn't following commands and appeared obtunded on the floor. CXR on the floor showed no new infiltrate. Patient was transitioned to the MICU and briefly broadened to vanco/[**Month/Year (2) **]/flagyl for aspiration pneumonia, but quickly narrowed given rapid improvement of respiratory status. By morning patient was alert and oriented X3, communicating and breathing comfortably on 2L nasal cannula with saturation in mid to high 90s. Abx were again narrowed to [**Month/Year (2) 21347**]/Vanco for coverage of UTI. Patient was then called out to floor. . #) Seizures (new): several possible etiologies in this patient; he has severe multiple sclerosis, and though he has never had a seizure before, there is a new area of inflammation on his MRI. Infectious causes in setting of severe MS [**First Name (Titles) **] [**Last Name (Titles) 45861**] seizures, most notably his UTI. He was started on fosphenytoin IV initially, then transitioned to phenytoin PO once mental status improved. There was no sign of further seizure activity. He will f/u w/ [**First Name8 (NamePattern2) 730**] [**Last Name (NamePattern1) **] in ~2 weeks . # Altered mental status: per wife, was at baseline until the seizures. 24h EEG did not show status epilepticus. Mental status then to near baseline by discharge suggesting largely resultant from infections/medications/post-ictal state. . #) Apnea/Hypercarbia: fully resolved as his mental status improved once coming out of the MICU the 2nd time. . #) UTI: growing MRSA and pseudomonas. He will is on vancomycin/ceftazidime, and will complete a 14 day course. A PICC line was insserted and home infusion company will assist w/ antibiotics. There was a question of home aids flushing his foley, thus potentially introducing pathogens. There should be no flushing of the foley and this was addressed w/ wife and in page 1 instructions. . #) Rash w/ vancomycin: pt did develop red rash on arms and face w/ vancomycin infusion. Component of redman syndrome was suspected. Benedaryl was given w/ vancomycin and this improved his symptoms. There was no other evidence of allergic disease, and no facial swelling or airway obstruction. . #) Thrombocytopenia- Bseline ~150's, went downt to 89 this admission. No signs of active bleeding. No rashes on exam. He had been exposed to heparin in the last 30 days, so PF4 antibody was checked and was negative. His platelets responded to baseline by discharge, and likely this was all secondary to acute infection. . #) Multiple sclerosis: initially held home home baclofen given AMS, but restarted by discharge once mental status improved. . #) HTN: continued home amlodipine . # CODE: DNI/DNR (confirmed with wife) . ======================================= TRANSITIONAL ISSUES # further seizure care per Dr [**Last Name (STitle) **] in Neurology # PICC line is to be d/c'ed by home infusion company # Foley catheter should NOT be flushed, except at the direct recommendations of [**Name8 (MD) **] MD Medications on Admission: 1. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. oxybutynin chloride 5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. baclofen 10 mg Tablet Sig: Two (2) Tablet PO 5X/DAY (5 Times a Day). 4. famotidine 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 5. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. polyethylene glycol 3350 17 gram Powder in Packet Sig: One (1) Powder in Packet PO DAILY (Daily). Discharge Medications: 1. ceftazidime 2 gram Recon Soln Sig: One (1) Recon Soln Injection Q8H (every 8 hours) for 6 days. Disp:*19 Recon Soln(s)* Refills:*0* 2. vancomycin 1,000 mg Recon Soln Sig: 1250mg Intravenous twice a day for 6 days: Start on [**3-26**] AM. Give IV benadryl prior to infusion. Infuse over 2 hours. Disp:*12 doses* Refills:*0* 3. amlodipine 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. oxybutynin chloride 5 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 5. baclofen 10 mg Tablet Sig: Two (2) Tablet PO 5X/DAY (5 Times a Day). 6. famotidine 20 mg Tablet Sig: One (1) Tablet PO Q12H (every 12 hours). 7. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. polyethylene glycol 3350 17 gram Powder in Packet Sig: One (1) Powder in Packet PO DAILY (Daily). 9. phenytoin 50 mg Tablet, Chewable Sig: Three (3) Tablet, Chewable PO 3 tabs in the morning, 3 tablets at noon, and 4 tablets in the evening. Disp:*300 Tablet, Chewable(s)* Refills:*1* 10. Benadryl 25 mg Capsule Sig: One (1) Capsule PO twice a day: give 20 minutes before vancomycin infusion. Disp:*20 Capsule(s)* Refills:*0* Discharge Disposition: Home With Service Facility: [**Hospital1 1474**] [**Hospital1 269**] Discharge Diagnosis: Primary: MRSA urinary tract infection, seizure Secondary: multiple sclerosis Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Dear Mr [**Known lastname 45855**], It was a pleasure taking care of you at [**Hospital1 18**]. You were admitted for a urinary tract infection. You then developed seizures. You had a head MRI, which showed a new area of multiple sclerosis, and this plus the infection is probably why you had a seizure. You were started on antibiotics and anti-seizure medications, and got much better. The following changes have been made to your medications: ** START phenytoin (dilantin) [anti-seizure medication]. Take 150mg in the morning and at noon, and 200mg at night (3 total doses per day) ** START vancomycin [antibiotic] ** START ceftazidine [antibiotic] ** START benadryl, take 20 minutes before vancomycin infusion Followup Instructions: Name: [**Last Name (LF) **],[**First Name3 (LF) **] D. Address: [**Location (un) 45857**], [**Location (un) **],[**Numeric Identifier 45858**] Phone: [**Telephone/Fax (1) 45859**] Appointment: Friday [**2118-4-1**] 10:15am Department: NEUROLOGY When: MONDAY [**2118-4-4**] at 9:00 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 7598**], MD [**Telephone/Fax (1) 5434**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 858**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: SURGICAL SPECIALTIES When: MONDAY [**2118-4-11**] at 1:20 PM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 4653**], MD [**Telephone/Fax (1) 164**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: NEUROLOGY When: FRIDAY [**2118-5-20**] at 11:30 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 7598**], MD [**Telephone/Fax (1) 5434**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 858**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 2158**] ICD9 Codes: 5990, 2875, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7562 }
Medical Text: Admission Date: [**2103-7-25**] Discharge Date: [**2103-8-2**] Date of Birth: [**2051-2-19**] Sex: M Service: NEUROSURGERY Allergies: Penicillins / Codeine / Morphine / Amitriptyline / Neurontin / Tramadol / Percocet / Niacin / Naprosyn Attending:[**First Name3 (LF) 1271**] Chief Complaint: Head Injury scalp laceration Major Surgical or Invasive Procedure: Craniotomy for Subdural Hematoma Evacuation History of Present Illness: 52 y/o male found in the middle of a four [**Male First Name (un) **] highway with trauma to scalp. Pt brought in by ems for eval on arrival to ER to see pt for SAH/ SDH and IPH. On arrival to ER pt was combatitive and and speaking. He became obtunded prior to our team assessing him. We asked for a stat CT which showed SAH predominently on the left side with left temporal IPH 1.8 x 1.1 with SDH with associated MLS. No obvious bone fracture noted. Past Medical History: Alcoholism Left leg skin graft Social History: Unmarried has four children. Disabled after work injury. Post traumatic stress disorder treated at VA Family History: Unknown Physical Exam: BP: 169/94, HR: 86 R22 99 O2Sats on 100% NRB Gen: WD/WN HEENT: NC, abrasion with STS to right parietal region - no open lacs noted. Negative battles, negative raccoon sign, unable to visualize left TM, Right TM without hemotypanum. Pupils: 3mm trace reaction / + corneals, roving eye movements / non attentive to examiner, no eye opening to voice or noxious, no grimace. Neck: IN collar Lungs: CTA bilaterally. Cardiac: RRR. S1/S2. Abd: Soft, NT, BS+ Extrem: Warm and well-perfused. Neuro: Mental status: GCS= 3 Eye=1, Voice =none/ 1 Motor= 1 s at 5 minutes. Cranial Nerves: I: Not tested II: Pupils equally round and reactive to light, 3 trace reaction bilaterally. III, IV, VI: Extraocular movements = not able to test/ roving eye movements V, VII: unable to assess. VIII: unable to assess. IX, X: unable to assess. [**Doctor First Name 81**]: unable to assess. XII: unable to assess. Motor: Strength full power [**4-21**] throughout on arrival - now with some finger movement and toe movement on the left without w/d to noxious. Toes downgoing bilaterally Pertinent Results: [**2103-7-25**] 02:00AM PT-11.9 PTT-24.9 INR(PT)-1.0 [**2103-7-31**] 02:45AM BLOOD Plt Ct-279 [**2103-7-31**] 02:45AM BLOOD Glucose-121* UreaN-12 Creat-0.5 Na-134 K-4.2 Cl-104 HCO3-22 AnGap-12 [**2103-7-31**] 02:45AM BLOOD Albumin-3.0* Calcium-8.5 Phos-2.9 Mg-2.2 [**2103-7-25**] 02:00AM BLOOD ASA-NEG Ethanol-460* Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2103-7-31**] 03:11AM BLOOD Type-ART pO2-138* pCO2-31* pH-7.48* calTCO2-24 Base XS-1 [**2103-7-31**] 03:11AM BLOOD Lactate-1.6 [**2103-7-25**] 06:14AM BLOOD Hgb-10.0* calcHCT-30 [**2103-7-31**] 03:11AM BLOOD freeCa-1.17 Brief Hospital Course: Mr [**Known lastname 1007**] was seen by Neurosurgery and taken emergently to the OR to undergo a left sided craniotomy for evacuation of left sided subdural hematoma and partial lobectomy. Post operatively he did not respond to any painful stimuli until approx 24 hours post operatively. He would attempt to localize his right arm and infrequently his left arm with very little movemment of his lower extremeties. His immediate post op course was complicated by high fevers with only source was HFlu in his sputum. His post operative CT that showed extensive hemorrhagic contusion within the left temporal lobe, a large quantity of pneumocephalus within the left frontal region, as well was as within an apparent partially evacuated left cerebral convexity subdural hematoma. There does appear to be persistent mass effect, as well as continued rightward subfalcine herniation. An EEG showed some generalized slowing. His exam continued to show roving eye movement, occasional eye opening, localizing on right>left. On [**7-30**] a CT showed some increase mass effect causing midline shift. His family was adament that Mr [**Known lastname 1007**] would not want a Trach or PEG or 24 hour nursing care on [**8-1**] they made him CMO. He was started on a Morphine drip and passed away on [**8-2**]. Medications on Admission: None Discharge Medications: None Discharge Disposition: Expired Discharge Diagnosis: Traumatic Brain Injury Discharge Condition: Deceased Discharge Instructions: N/A Followup Instructions: N/A [**Name6 (MD) 742**] [**Name8 (MD) **] MD [**MD Number(2) 1273**] Completed by:[**2103-8-6**] ICD9 Codes: 496, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7563 }
Medical Text: Admission Date: [**2151-1-12**] Discharge Date: [**2151-1-19**] Date of Birth: [**2123-10-28**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 348**] Chief Complaint: fever, hypotension Major Surgical or Invasive Procedure: 1. Withdrawal Right tunneled line. 2. Placement and withdrawal of right subclavian line. 3. Placement and withdrawal of right femoral line. 4. Placement of left subclavian tunneled line. History of Present Illness: 27 yo M w/ESRD on HD presented to the ED [**1-12**] with fever and hypotension. He was feeling well after HD day pta, when he developed fever and rigors. These were associated with nausea, leading to vomiting every 20-30 minutes overnight. . Day of admission Mr. [**Known lastname 34030**] felt so weak that he fell to the floor multiple times on his way to the bathroom, though he never lost consciousness. His profound weakness and persistent nausea prompted his call to EMS, and he was brought by ambulance to the [**Hospital1 18**] ED. He admits to diarrhea since day pta. Per his wife, he has had no chest pain, dyspnea, abd pain, melena, or hematochezia. . In the ED, he had a temp of 103.6, BP 70/30, HR 140. He was treated with 6.5 liters NS, and SBP transiently improved to 100s, then drifted down to 80's-90's. he was treated empirically with IV vanco, ceftazidime, doxycycline, and dexamethasone. Phenylephrine gtt and norepi gtt were started for BP support. He was transfused 2 units FFP for unclear reasons. UA, CXR, and abd CT were completed and showed no localizing signs of infection. He was admitted to the MICU. . MICU course - found to have bacteremia, MSSA, treated now with nafcillin. TEE neg. for endocarditis, but needs TLC pulled and cultured once piv access established. Past Medical History: ESRD [**1-1**] reflux nephropathy s/p failed kidney transplant in [**2-2**] and again in [**8-5**] HTN UTIs s/p Tenckhoff placement s/p tunnelled line placement Social History: Pt denies any tobacco, alcohol, or IVDU. Pt currently on disability. Family History: Mother's side of the family with kidney disease (uncertain etiology). Father with DM. Physical Exam: PLEASE NOTE THAT WHAT FOLLOWS IS THE PHYSICAL EXAM AFTER THE PATIENT WAS TRANSFERRED OUT OF THE MICU ON [**2151-1-17**]. THERE ARE NO PHYSICAL EXAMS IN THE SYSTEM FOR THE ADMISSION DATE. VITALS IN THE EMERGENCY ROOM WERE 103.6, BP 70/30, HR 140. NAD 98.3 120/70 80 16 98 2L NAD RRR, [**1-5**] hsm at apex CTA, min expiratory wheeze NT, ND, BS+, no HSM, soft No edema Pertinent Results: [**2151-1-12**] 08:29PM TYPE-MIX TEMP-39.1 PO2-42* PCO2-38 PH-7.29* TOTAL CO2-19* BASE XS--7 [**2151-1-12**] 08:29PM O2 SAT-63 [**2151-1-12**] 08:21PM GLUCOSE-126* UREA N-33* CREAT-13.0*# SODIUM-137 POTASSIUM-4.6 CHLORIDE-104 TOTAL CO2-18* ANION GAP-20 [**2151-1-12**] 08:21PM CK(CPK)-413* [**2151-1-12**] 08:21PM CK-MB-7 cTropnT-0.07* [**2151-1-12**] 08:21PM CALCIUM-8.2* PHOSPHATE-2.2*# MAGNESIUM-0.9* [**2151-1-12**] 08:14PM WBC-23.2*# RBC-2.92* HGB-10.2* HCT-29.8* MCV-102* MCH-34.9* MCHC-34.3 RDW-16.3* [**2151-1-12**] 08:14PM PLT COUNT-153 [**2151-1-12**] 07:08PM LACTATE-2.4* [**2151-1-12**] 05:45PM LACTATE-2.0 [**2151-1-12**] 04:51PM LACTATE-2.1* [**2151-1-12**] 03:30PM URINE BLOOD-LG NITRITE-NEG PROTEIN-30 GLUCOSE-250 KETONE-TR BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-NEG [**2151-1-12**] 03:30PM URINE RBC->50 WBC-[**2-1**] BACTERIA-RARE YEAST-NONE EPI-0 [**2151-1-12**] 01:07PM LACTATE-4.6* [**2151-1-12**] 01:05PM GLUCOSE-107* UREA N-37* CREAT-14.6*# SODIUM-135 POTASSIUM-3.8 CHLORIDE-93* TOTAL CO2-24 ANION GAP-22* [**2151-1-12**] 01:05PM CK(CPK)-149 [**2151-1-12**] 01:05PM cTropnT-0.09* [**2151-1-12**] 01:05PM CK-MB-1 [**2151-1-12**] 01:05PM CALCIUM-10.6* PHOSPHATE-0.6*# MAGNESIUM-1.2* [**2151-1-12**] 01:05PM CORTISOL-28.7* [**2151-1-12**] 01:05PM CRP-69.6* [**2151-1-12**] 01:05PM WBC-11.6*# RBC-3.75* HGB-13.2* HCT-38.3* MCV-102* MCH-35.2* MCHC-34.5 RDW-15.6* [**2151-1-12**] 01:05PM NEUTS-73* BANDS-19* LYMPHS-6* MONOS-1* EOS-0 BASOS-0 ATYPS-0 METAS-1* MYELOS-0 [**2151-1-12**] 01:05PM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-1+ [**2151-1-12**] 01:05PM PLT COUNT-196 [**2151-1-12**] 01:05PM PT-15.6* PTT-29.1 INR(PT)-1.4* . [**2151-1-12**] 1:05 pm BLOOD CULTURE AEROBIC BOTTLE (Final [**2151-1-15**]): [**2151-1-13**] REPORTED BY PHONE TO [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 29926**] AT 7:30 AM. STAPH AUREUS COAG +. FINAL SENSITIVITIES. Staphylococcus species may develop resistance during prolonged therapy with quinolones. Therefore, isolates that are initially susceptible may become resistant within three to four days after initiation of therapy. Testing of repeat isolates may be warranted. SENSITIVITIES: MIC expressed in MCG/ML _________________________________________________________ STAPH AUREUS COAG + | CLINDAMYCIN-----------<=0.25 S ERYTHROMYCIN----------<=0.25 S GENTAMICIN------------ <=0.5 S LEVOFLOXACIN----------<=0.12 S OXACILLIN------------- 0.5 S PENICILLIN------------ 0.25 R ANAEROBIC BOTTLE (Final [**2151-1-15**]): STAPH AUREUS COAG +. SENSITIVITIES PERFORMED FROM AEROBIC BOTTLE. . [**2151-1-12**] CT-TORSO WITH CONTRAST IMPRESSION: 1. No pulmonary embolism or aortic pathology noted. 2. Minimal bibasilar atelectasis left worse than right with small bilateral pleural effusions. 3. CT findings consistent with aggressive fluid resuscitation. 4. Questionable bowel wall thickening involving the cecum, ascending colon, and proximal transverse colon. Diagnostic considerations include pseudomembranous colitis, typhlitis (if immunocompromised), further sequela of fluid resuscitation, and much less likely ischemia. 5. Internal fluid within the colon highly suggestive of diarrhea. 6. No intra-abdominal abscess. Explanted kidney transplant site unremarkable. . [**2151-1-15**] CXR AP PORTABLE. Worsening of alveolar consolidative process within right upper, right lower, and retrocardiac regions probably pneumonia or multifocal alveolar hemmorhage, edema less likely. . [**2151-1-18**] CXR PA/LAT IMPRESSION: Marked interval improvement in the diffuse opacities. In retrospect this behavior is most concordant with alveolar edema. Minimal left base atelectasis and left costophrenic angle blunting. . [**2151-1-19**] tunneled line placement. IMPRESSION: Successful placement of a 14.5 French double lumen hemodialysis catheter via the left subclavian vein, with 19 cm tip to cuff in length and tip in the right atrium. The line is ready for use. Brief Hospital Course: By Problem: 1. Sepsis: The patient was admitted to the MICU on phenylephrine and norepinephrine drips. The patient did not require intubation. Blood cultures grew MSSA. It was felt that the patient's sepsis originated from the tunneled hemodialysis catheter. Another possible source was the finding on the abdominal CT of bowel wall thickening. The dialysis catheter was removed and the tip failed to grow any bacteria. Access was obtained by the angiography service who placed a right subclavian central venous catheter. The patient was treated with naficillin, levofloxacin and vancomycin. The patient's WBC dropped, the fever resolved, the blood pressure stablized. An ECHO on [**1-16**] showed that there was a possible vegatation at the tip of the new catheter. A right femoral central venous catheter was placed and the right subclavian catheter was removed. A tip culture from the right subclavian line failed to grow bacteria. On [**1-18**] the patient went for dialysis and after 3 hours the line clotted off. It could not be cleared. On [**1-19**] the femoral line was removed and the angiography service placed a left subclavian tunneled catheter. All surveillance cultures of the blood, urine and stool, including three serial C.diffs were negative. Despite the growth of MSSA the renal service asked that the patient be kept on Vancomycin for ease of dosing at dialysis. The Nafcillin and levofloxacin were discontinued. The patient will complete 2 weeks on vancomycin. . 2. ESRD: Secondary to reflux nephropathy. The renal service helped ensure that the patient recieved hemodialysis and guided the management of the patient's electrolytes. . 3. Hypoxia: The patient had an oxygen requirement of uncertain etiology. Possible etiologies considered were DAH, PNA, and ARDS. The patient was put on levofloxacin until the CXR on the 19th showed that the parenchymal opacities had resolved. In retrospect this was likely just pulmonary edema from aggressive fluid resucitation. Medications on Admission: 1. Cinacalcet 30 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 2. Doxercalciferol 2.5 mcg Capsule Sig: One (1) Capsule PO EVERY OTHER DAY (Every Other Day). 3. Renagel 800 mg Tablet Sig: Four (4) Tablet PO three times a day: Please take with meals. . 4. Nephrocaps 1 mg Capsule Sig: One (1) Capsule PO once a day. Discharge Medications: 1. Cinacalcet 30 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 2. Doxercalciferol 2.5 mcg Capsule Sig: One (1) Capsule PO EVERY OTHER DAY (Every Other Day). 3. Vancomycin in Dextrose 1 g/200 mL Piggyback Sig: One (1) gram Intravenous QHD (each hemodialysis) for 7 days: This will be managed at dialysis. 4. Renagel 800 mg Tablet Sig: Four (4) Tablet PO three times a day: Please take with meals. . 5. Nephrocaps 1 mg Capsule Sig: One (1) Capsule PO once a day. Discharge Disposition: Home Discharge Diagnosis: Sepsis likely originating in right tunnled line. Discharge Condition: Afebrile, blood pressure stable, patient ambulating. Discharge Instructions: Please return to the hospital if you have fevers, chills, nightsweats, if you notice blood around the catheter site, or if you are just not feeling well. . Please follow up with plans for dialysis tomorrow, Wednesday [**2151-1-20**]. . Please note that you will need to recieve antibiotics at dialysis at least until [**2151-1-26**]. . Followup Instructions: Provider: [**First Name11 (Name Pattern1) 819**] [**Last Name (NamePattern4) 820**], MD Phone:[**Telephone/Fax (1) 673**] Date/Time:[**2151-1-21**] 8:20 You should present for dialysis on [**2151-1-20**]. Per our discussion your wife has your primary care [**Name (NI) 48924**] contact information and you will make a follow up appointment in the next week. Of note the number listed above for Dr. [**First Name (STitle) **] is not active. Completed by:[**2151-1-20**] ICD9 Codes: 5856, 486
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Medical Text: Admission Date: [**2125-4-10**] Discharge Date: [**2125-4-18**] Service: NSU HISTORY OF PRESENT ILLNESS: This is an 84-year-old man with a history of hypertension who woke up at 2:30 in the morning on [**4-10**] confused per his wife, not giving appropriate answers to questions. The patient went back to bed and woke up still confused. EMS was called to bring the patient to the emergency room. His wife denied any trauma. The patient's baseline is fully functional. He recently drove back to [**State 350**] from [**State 108**]. Head CT in the emergency room showed a large left frontal 7 cm bleed, likely to be amyloid related to history and age. PAST MEDICAL HISTORY: Asthma and hypertension. LABORATORY DATA: On admission sodium was 139, potassium 4.5, chloride 100, CO2 29, BUN 20, creatinine 1.2, sugar 138; hematocrit 41.5, white count 9.4, platelet count 167; INR 1.0. PHYSICAL EXAMINATION: Vital signs: Temperature 97.3, blood pressure 170/69, respirations 18, oxygen saturation 92% on room air. General: He was alert to voice stimulation. Cardiovascular: Regular, rate, and rhythm. Lungs: Clear bilaterally. Abdomen: Soft and nondistended. Neurologic: EOMs full. Visual fields full to confrontation. Pupils 2.5-1.5 bilaterally. No weakness. Symmetric motor strength. Speech was fluent. He was only alert and oriented times one. Motor exam was 2+ in his uppers and patellas and 1+ in his Achilles. Again strength was 5 out of 5 in both upper and lower extremities. HOSPITAL COURSE: The patient was brought emergently to the operating room where he underwent a left frontal craniotomy for evacuation of this hematoma. Postoperatively he was awake however intubated over night. He was moving his left upper extremity was good strength with full movement. He was able to raise his right upper extremity with a strong grip. His blood pressure was in the 116-130 range. Heart rate was 58. He was loaded with Dilantin in the emergency room and was continued on Dilantin 100 mg t.i.d. He was monitored in the intensive care unit. On his first postoperative day, his blood pressure was 116-140s. He was alert and following commands times three. He had some less movement in his right upper extremity. He was extubated on his first day. His head CT showed good evacuation of the hemorrhage. He did have some gas collection within the subdural and subgaleal compartments. On his postoperative day, he was extubated as previously mentioned, and he was found to be aphasic, and alert and oriented times two. His blood pressure was kept strictly less than 140. He was weaned from his Nipride drip and started on Lopressor and Norvasc, and he was evaluated by speech and swallow and physical therapy. On his second postoperative day, he was found to be aphasic with problems with naming objects but alert and attentive following commands. Pupils were equal and reactive. EOMs were full. He had a bed side swallow evaluation which at that time felt for him to be too lethargic to complete the exam appropriate, and he appeared to be aspirating thin liquids. He was started on a diet of nectar-thick liquids and soft solids. On his third postoperative day, he appeared much improved; however, he was having some periods of agitation for which neurology was consulted. They were consulted to rule out the possibility of having seizures, which they felt he did not have seizures but that his change in mental status was probably secondary to the intracerebral bleed and increased edema. They recommended possibly starting him on Decadron to minimize the inflammation. During his hospitalization, he was found to have some periods of respiratory difficulties. He had had a chest x-ray which noted to have a hazy opacity in the left mid and lower lung zones which resolved over the following three days serially and treating with albuterol inhalers. Most likely it was found to be pleural fluid and atelectasis. On [**2125-4-16**], he was transferred to the neurology step-down unit. He appeared much more awake and following simple commands. Speech was nonfluent; however, he was able to name [**12-17**] objects. He had no drift. His wound was clean, dry, and intact. He appeared much more appropriate. He was transferred to the step-down unit for blood pressure monitoring to keep strictly in the 140 range. He had a repeat head CT which showed a stable appearance of the left frontal intraparenchymal hemorrhage and left frontal infarct. There were no new areas of hemorrhage identified within the brain. On [**4-17**] fiberoptic endoscopic evaluation of his swallowing was done that showed a functional oral pharyngeal swallowing ability of pureed food and nectar-thick liquids. They recommended continuing a diet of pureed foods and nectar- thick, that he should take two swallows per bit or sip and alternate between one bite and one sip to clear residue from his throat. He should only eat when fully seated upright. A video swallow could be performed at rehabilitation to see is his diet can be advanced. He remained neurologically improved on [**4-18**], which is his discharge date. He is awake, alert, and oriented times three. He had a slight droop and left-sided weakness. His lungs were clear on discharge. He had no further respiratory difficulties; however, we do recommend to have a chest x-ray in the next week at rehabilitation to follow-up for clearance of his pleural fluid and atelectasis. Also they had found an oval-shaped opacity adjacent to the left hemidiaphragm which they felt was due to nipple shadow but also recommended following up to rule out a pulmonary nodule. He should continue on his Dilantin until he follows up with Dr. [**First Name (STitle) **] and have a weekly Dilantin level checked, and he needs aggressive and physical and occupational therapy. His Foley remains in and may be discontinued at the rehabilitation facility's guidance. DISCHARGE INSTRUCTIONS: Keep incision clean and dry until staples are removed. They may be removed at the rehabilitation facility on [**2125-4-20**]. He is to watch incision for redness, drainage, bleeding, swelling, or any fever greater than 101. He is to call Dr.[**Name (NI) 14510**] office. He should continue with aggressive physical therapy and occupational therapy. FOLLOW UP: With Dr. [**First Name (STitle) **] on [**5-11**] at 10:15 at the [**Hospital Ward Name **] radiology for head CT and follow-up with Dr. [**First Name (STitle) **] at 11 o'clock. Again he should have a chest x-ray at the rehabilitation facility to follow-up on the resolution of his atelectasis and questionable opacity that was seen on previous chest x-ray. DISCHARGE MEDICATIONS: Tylenol as needed, heparin 5000 units t.i.d., Norvasc 5 mg half tablet daily, artificial tear p.r.n., Protonix 40 mg daily, Dilantin 50 mg 2 tab p.o. t.i.d., hydralazine 25 mg 1 tab p.o. t.i.d. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 8632**] Dictated By:[**Last Name (NamePattern1) 12790**] MEDQUIST36 D: [**2125-4-18**] 11:03:49 T: [**2125-4-18**] 12:14:26 Job#: [**Job Number 99645**] ICD9 Codes: 431, 4019
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Medical Text: Admission Date: [**2181-7-22**] Discharge Date: [**2181-7-30**] Date of Birth: [**2102-3-14**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 759**] Chief Complaint: Respiratory distress Major Surgical or Invasive Procedure: None. History of Present Illness: 79 y/o M w/HTN, CHB s/p PPM, end-stage dementia, who was admitted on [**2181-7-22**] after he presented from his nursing home ([**Hospital3 537**]) in respiratory distress. Per notes, he was found to have O2 sats in the 70s, and he was sent here. . In the ED, he had temp of 101.4, HR of 60 (paced), BP of 150/90, RR of 45-50, sats of 70s on RA -> 90% on NRB. He was given Lasix 100mg IV x1, and placed on BiPAP, along with a nitro gtt to lower his BP. He was given Levaquin 500mg IV x1, Vanco 1g IV x1, and Flagyl 500mg IV x1 for aspiration PNA vs NH-associated PNA. His RR decreased down to the 20s and his BiPAP was discontinued and switched back to a NRB. He was evaluated by cards for a troponin of 0.08 who felt it was likely demand ischemia, no indication for heparin. He had a bedside ultrasound, which was negative for pericardial effusion. Per ED request, His nitro gtt was d/c'ed prior to arrival to the floor. . On the floor, he was felt by the medicine team to have more of an aspiration pneumonia and they did not feel he was in florid CHF. He was kept on vanco/levo/flagyl. Per NH staff, he gets an aspiration pna "every now and then". He was supposed to have a speech and swallow today, but when they arrived to evaluate him, he was clearly aspirating his oral secretions and they deferred. He was made NPO. He was found to have a LUE DVT and was begun on a heparin gtt. He was transfused 2U PRBCs for hypoxia and Hct 23. His O2 was weaned (from NRB to 2.5L earlier tonight). . On night of HD #1, respiratory was called to see him for inability to clear secretions. He was audibly gurgling when they arrived. They eventually got him to cough up some secretions, at which point he respiratory arrested for approximately 3 minutes (was bagged throughout). [**Name8 (MD) **] RN he was blue. He then began breathing spontaenously with a RR in the mid 20s, pulse 110s-130s, bp 150s. He then grew very agitated and was grimacing, so he received morphine 8 mg IV. His wife and son were notified, and they confirmed that he was DNR/DNI on [**2181-7-23**]. He was transferred to the ICU for frequent suctioning. . Patient remained stable in the medicine ICU for two days with normotensive BP, though he had frequent desats due to mucus plugging and airway congestion. Per DNR/DNI status, he did not get endotracheal suctioning, only what he could bring up on his own after turnovers. He was transferred out of the ICU to the medicine service on [**7-26**] after family meeting with palliative care. It was decided that he would complete 10 day antibiotic course, currently day 5, after which he will be on comfort measures only. He will be discharged to [**Hospital3 537**] on [**7-27**]. Please note family discussion under dispo plans. Past Medical History: Frequent aspiration pnas (per wife, 6-7 times recently) HTN Cardiomyopathy Complete heart block s/p pacer Dementia RA Social History: No smoking, occasional alcohol, no drug use. Family History: non-contributory Physical Exam: VS: T: 101.6 RR 24 BP:154/80 HR: 90 RR:28 O2sat: 90% 3L GEN: Elderly male, awake&alert, not following commands HEENT: MMM RESP: coarse rhonchi throughout CV: Regular, nml s1,s2. No murmurs. ABD: Not distended. No HSM appreciated. +BS. EXT: 2+ edema to mid-shins bilat. ext cool. LUE also with 1-2+ edema Pertinent Results: [**2181-7-21**] 08:50PM BLOOD WBC-25.7* RBC-3.09* Hgb-10.1* Hct-30.1* MCV-97 MCH-32.6* MCHC-33.5 RDW-16.4* Plt Ct-352 [**2181-7-24**] 01:39AM BLOOD WBC-12.8* RBC-3.77*# Hgb-11.8*# Hct-34.7*# MCV-92 MCH-31.2 MCHC-33.9 RDW-17.1* Plt Ct-201 [**2181-7-21**] 08:50PM BLOOD Neuts-86.2* Lymphs-11.4* Monos-1.7* Eos-0.6 Baso-0.1 [**2181-7-24**] 01:39AM BLOOD PT-16.6* PTT-141.4* INR(PT)-1.5* [**2181-7-23**] 01:20PM BLOOD PT-20.6* PTT-150.0* INR(PT)-2.0* [**2181-7-22**] 07:00PM BLOOD Ret Aut-2.9 [**2181-7-24**] 01:39AM BLOOD Glucose-197* UreaN-19 Creat-0.8 Na-145 K-3.4 Cl-108 HCO3-25 AnGap-15 [**2181-7-21**] 08:50PM BLOOD Glucose-287* UreaN-16 Creat-1.0 Na-146* K-4.7 Cl-107 HCO3-26 AnGap-18 [**2181-7-22**] 07:00PM BLOOD LD(LDH)-260* TotBili-0.8 [**2181-7-22**] 05:27AM BLOOD LD(LDH)-319* [**2181-7-21**] 08:50PM BLOOD CK-MB-NotDone cTropnT-0.08* [**2181-7-24**] 01:39AM BLOOD Calcium-8.5 Phos-3.7 Mg-2.1 [**2181-7-21**] 08:50PM BLOOD Albumin-3.9 Calcium-8.4 Phos-6.3* Mg-2.4 [**2181-7-22**] 07:00PM BLOOD Hapto-99 [**2181-7-21**] 08:50PM BLOOD Valproa-18* [**2181-7-23**] 08:20AM BLOOD Lactate-1.9 [**2181-7-21**] 11:04PM BLOOD Lactate-4.0* WBC RBC Hgb Hct MCV MCH MCHC RDW Plt Ct [**2181-7-28**] 06:25AM 8.3 3.57* 11.2* 33.3* 93 31.4 33.7 15.9* 120* Glucose UreaN Creat Na K Cl HCO3 AnGap [**2181-7-29**] 06:30AM 111* 13 0.7 144 3.71 108 25 15 . Imaging Studies: . CHEST (PORTABLE AP) [**2181-7-21**] 8:56 PM FINDINGS: Bibasilar costophrenic angles are blunted by small bilateral pleural effusions. The left diaphragmatic border is obscured by retrocardiac opacity, atelectasis versus pneumonia. The heart and mediastinal contours are stable. The pulmonary vasculature is engorged, and the septal lines indicate a small degree of pulmonary edema. . IMPRESSION: 1. Mild pulmonary edema and bilateral pleural effusions. 2. Retrocardiac opacity is atelectasis versus pneumonia. . ECG Study Date of [**2181-7-21**] 10:59:50 PM Normal sinus rhythm AV nodal wenckebach block Low voltage Anterolateral ST-T wave changes, consider ischemia/myocardial infarction No previous tracing available for comparison . UNILAT UP EXT VEINS US LEFT [**2181-7-22**] 12:35 PM LEFT UPPER EXTREMITY ULTRASOUND: No prior studies for comparison. [**Doctor Last Name **]-scale and color Doppler son[**Name (NI) 867**] was performed of the left upper extremity including the internal jugular, subclavian, axillary, brachial, basilic veins. There is occlusive thrombus extending through one of the axillary veins, as well as throughout the course of the basilic vein. These veins are non- compressible and demonstrate no demonstrable flow. The jugular vein is patent with normal compressibility and waveforms. The subclavian vein is difficult to evaluate on this study but is patent were visualized. There may be a collateral vein that parallels the subclavian vein which contains clot.The brachial veins are patent with normal compressibility, flow, and waveforms. The cephalic vein compresses normally. The axillary and subclavian veins on the contralateral right side demonstrate normal flow, waveforms, and compressibility. . IMPRESSION: DVT involving the left axillary vein, basilic veins, and possibly a small collateral paralleling the subclavian vein. Findings discussed with the ordering physician, [**Last Name (NamePattern4) **]. [**First Name (STitle) **] [**Name (STitle) **] immediately after the study. . CHEST (PA & LAT) [**2181-7-22**] 1:19 PM IMPRESSION: PA and lateral chest compared to [**7-21**]. Bibasilar consolidation and small bilateral pleural effusions have increased since [**7-21**], consistent with pneumonia. Heart size is normal. Upper lungs show vascular engorgement, but are otherwise clear. Transvenous right atrial and right ventricular pacer leads are unchanged in their standard placements. A large curvilinear calcification over the left ventricle is probably an aneurysm. Brief Hospital Course: 79 y/o M with PMHx of HTN, CM, s/p pacer, dementia, who presented from NH today with resp distress. . # Resp Failure: Most likely etiology was aspiration pna, given numerous episodes of this in past, and witnessed aspiration of oral secretions while on floor. Likely had mucus plug on floor causing prolonged hypoxic event. Pt unable to clear secretions and protect airway [**1-18**] dementia. Pt had not improved despite broad spectrum antibiotics. ICU team had lengthy discussion with wife and son, and they did not wish to pursue further aggressive measures. They do not wish to continue oro-tracheal suctioning pt given its obvious discomfort. They understood he was likely going to continue aspirating, and they do not wish for him to be sustained on mechanical ventilation or tube feeds. Patient received morphine IV/elixer PRN for discomfort after transfer to medicine floor from CCU. He was treated for aspiration pneumonia with Vanco/Levaquin/Flagyl to complete 10 day course, though there was no source of infection from blood or urine cultures. Scopolamine patch was placed to aid clear secretions. He received anti-pyretics for febrile episodes. . # Septic shock Likely from aspiration pneumonia. No other clear source identified. Pt with a lactate of 4.0 in the ED, received 1L NS (limited by pulmonary edema). Currently, pt hemodynamically stable. BP currently stable. Blood/urine cx after admission were negative. Patient's urine culture on [**7-27**] was positive for yeast. Blood pressure was stable with SBP in 120s-130s through most of hospital stay, but declined to SBP 80-90s two days prior to death. . # HTN Held antihypertensives given hypotensive on arrival, although likely due to morphine. He was administered IVF on admission for resucitation efforts and also once he was made NPO by family during his CCU course. . # CHB s/p pacer Pt with paced rhythm in the 50s. . # Dementia Unclear patient's baseline, here nonverbal and not responding to verbal stimuli. On Zyprexa at baseline at NH. Per family, they feel he sometimes recognizes them and interacts with them but mental status waxes and wanes. Speech and swallow study determined pt. to be aspiration risk with oral secretions as well as PO nutrition. He was made NPO to prevent further aspirations and CCU team discussed plan with family. . # DISPO: Below is discussion summary between palliative care and family regarding patient care plan: Signed by [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], RNC on [**2181-7-26**] Affiliation: [**Hospital1 18**] Met with Mrs. [**Known lastname 69686**], daughter and son, Dr. [**Last Name (STitle) **], [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 805**], Sw to discuss plan of care for [**Known firstname **]. Family understands [**Known firstname **] has a progressive dementia with frequent episodes of asp. pneumonia. The last one was 2 wks ago. They do not want him to recieve a PEG, they do not want further hospitalizations. they like the care he receives at the [**Last Name (un) **] Home [**Hospital1 1501**], he has been there for just over a year. We discussed possible outcomes- clearly no matter what care he receives he is in his dying phase, they understand that but are uncomfortable with stopping all his meds and fluids right now. We agreed we would continue IV abx and gentle IVF for a total 10 day course. At the end of that period he would have either improved and be able to take in some fluids and nurtrition- we discussed it would never be enough to maintain life but would offer pleasure/memories. If he deteriorates during the 10 day course the decision to stop treatment sooner should be discussed. Once this treatment course is finished, family agrees he should not be hospitalized, or treated except for comfort when he re-infects. . We discussed he may die tomorrow or in a few days, weeks or months if he improves with antibiotics. His wife has made funeral plans already. She is prepared for his death and wants him to die peacefully. She is not interested in hospice care as she feels hospice hastens death. We discussed this in detail- she may be open to hearing from the individual hospice program but he will not be eligible for hospice until after abx are finished. Patient was made DNR/DNI by family during hospital course in CCU. After being transferred to medicine service on [**2181-7-26**], plan was for him to be cared at the [**Hospital3 537**] as he approached end-of-life and family would consider hospice services. Patient at that time was in midst of completing antibiotic course with 4 days remaining. In order to be transferred to [**Hospital3 537**] with vancomycin, patient would need a PICC line, instead of a peripheral IV. However, family did not wish for him to have a PICC line but desired for him to complete the full course of antibiotics. This would thus be done in the hospital and they agreed that on Monday, [**7-30**] he could be transferred to [**Hospital3 537**]. . Over the course of the weekend, however, patient continued to have desaturations in the 60s-70s and remained on 3-4L oxygen. His BP had continued to decline with SBP in 80s. Per nursing reports, patient was having respiratory distress and was made comfortable with morphine drip and ativan. On morning of Monday [**2181-7-30**], patient remained in respiratory failure and oxygen saturations were staying in 60-70% range. Family was notified of patient's deteriorating clinical condition. Morphine IV was titrated up until patient appeared comfortable and not tachypneic and ativan was also administered. Patient was in peaceful state and he died at 10:23am on [**2181-7-30**]. Family members were arrived to see the patient. Death report was filed and submitted to Admitting Office. Cause of death was respiratory failure secondary to aspiration pneumonia. [**Name (NI) **] wife [**Name (NI) 53564**] [**Name (NI) 69686**] declined autopsy. Medical examiner evaluation was not indicated. Medications on Admission: Prednisone 7.5 Duonebs Lasix 20mg 3x/week Prilosec 20 ASA 325 Plaquenil 400 Lisinopril 5 Zyprexa 5mg q1400 Depakaote 250 Exelon 3 [**Hospital1 **] Discharge Medications: 1. Acetaminophen 650 mg Suppository Sig: One (1) Suppository Rectal Q6H (every 6 hours) as needed for fever. 2. Morphine Concentrate 20 mg/mL Solution Sig: [**12-18**] PO Q3H (every 3 hours) as needed for respiratory distress. 3. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day. Discharge Disposition: Extended Care Facility: [**Hospital3 537**]- [**Location (un) 538**] Discharge Diagnosis: Primary diagnosis: Respiratory distress secondary to pneumonia/mucus plugging Hypotension secondary to sepsis . Secondary diagnoses: Frequent aspiration pnas (per wife, 6-7 times recently) HTN Cardiomyopathy Complete heart block s/p pacer Dementia RA Discharge Condition: Deceased. Discharge Instructions: None. Followup Instructions: None. ICD9 Codes: 0389, 2760, 5070, 4254, 4019
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7566 }
Medical Text: Admission Date: [**2180-11-18**] Discharge Date: [**2180-12-8**] Date of Birth: [**2115-8-12**] Sex: M Service: MEDICINE Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 7055**] Chief Complaint: Cardiogenic shock s/p STEMI and VF arrest Major Surgical or Invasive Procedure: Pulmonary Intubation Intracardiac Defibrillator implantation Cardiac catheterization with placement of three bare metal stents PICC line placement History of Present Illness: Mr. [**Known lastname 27063**] is 65 year-old man who does not regularly seek medical care a history of myocardial infarction and pulseless arrest five days prior to admission who was transferred to [**Hospital1 18**] early this AM for urgent CABG. Mr. [**Known lastname 27063**] was in his usual state of health until [**Known lastname 766**], [**11-13**]. On [**11-13**], after pt had been complaining of 3d chest pain, he had witnessed cardiac arrest. His female companion, a retired nurse, initiated CPR and performed until arrival of EMS 8-10min later. Found to be in agonal respirations, monitor showed VF, and pt was shocked twice --> en route to hospital, noted asystole --> epi and atropine --> A-fib --> amiodarone bolus --> ER, where intubated (sats 84%), in cardiogenic shock with SBPs in 90s, then in VF again, shocked once --> EKG revealed STEMI --> took to cath lab, where stented BMSx3 to LAD. Once opened LAD, went into VFib, shocked 360J x1 and given amiodarone bolus 450mg. Went to CCU with intra-aortic balloon pump, and began cooling protocol. CXR at that time showed multifocal lobar PNA (presumed aspiration PNA), and was started on Ceftriaxone and Unasyn. . On [**11-15**], pt was noted to have Torsades vs polymorphic VT, given K and Mg, and shocked with 200J. He was extubated [**11-17**]. Following extubation his family reports that his mental status gradually improved to baseline on Thursday evening. Early this AM, c/o 10/10 chest pain. EKG with ST elevatations in V1-4 --> heparin, plavix, morphine, SL nitro x3, taken to cath lab, where BMS placed to proximal LAD. Then dissected mid LAD, which required stenting of the dissected area. It was presumed that the culprit lesions were the proximal and mid LAD in-stent thromboses. . Neurology was consulted after admission given concern for anoxic brain injury. They had been following, and daughter expressed concern re: some difficulties with time perception (he thought that hours were passing when only minutes had passed) on morning of transfer. RNs also noted him to be less conversant, mumbling and unable to focus on their questions. . Note, pt also had episode of bloody secretions from OG tube at OSH . Transferred to CCU for management of cardiogenic shock. Past Medical History: PAST MEDICAL HISTORY: 1. CARDIAC RISK FACTORS: CAD, Smoker 2. CARDIAC HISTORY: -CABG: None -PERCUTANEOUS CORONARY INTERVENTIONS: **[**2180-11-13**], Cardiac Catheterization: LM: 50%, heavily calcified LAD, 100% proximal thrombotic occlusion, calcified LCX with 90% stenosis, 100% RCA occlusion, 55% LVEF, LV pressures 85/2, LVEDP 18 --> BMSx2 to ostium of LAD, BMSx1 to proximal LAD **[**2180-11-18**], Cardiac Catheterization: BMS placed to proximal LAD. Then dissected mid LAD, which required stenting of the dissected area. -PACING/ICD: None 3. OTHER PAST MEDICAL HISTORY: -At 3-4y of age, had severe pertussis with high fevers. Lapsed into a coma lasting weeks. Did not speak for three years but gradually resumed full childhood levels of activity. -Lifelong focal learning impairment presumed to be from the above-described encephalopathy. -? aortic aneurysm -PVD Social History: SOCIAL HISTORY: Son is [**Name2 (NI) 87760**] surrogate decision maker, but pt's siblings have been supportive and assist with decision making. One sister is [**Name8 (MD) **] RN and helps interpret medical information for pt's children. Children report pt lives alone at baseline, currently on disability. Pt was divorced when children were young, pt had minimal contact with them when they were growing up. Son sees pt once per month or so and takes pt shopping. [**Last Name (un) **] rarely sees pt. Son relayed hx of pt having anoxic brain injury as a child. Pt has residual cognitive impairment, notably impaired judgment. Children report pt has had a hard life. They report pt has a significant other, who is [**Name8 (MD) **] RN. Children express concern pt has always been avoidant of seeing doctors and taking [**Name5 (PTitle) 4982**], and fear he will not comply with treatment. Sister relayed life-long hx of familytrying to meet pt's care needs. She herself has made extensive attempts at arranging home care and psychiatric services, but pt never keeps appts, and often is not home to allow services in. Per family t has hx of 1 psych admission for SI in the past. Pt has extensive hx of impulsive behavior and poor judgement. Family relayed that they promised pt's mother they would look after him. SW advised family to allow professionals at rehab to help determine and plan for pt's long term care needs. Family History: per OSH records, strong family hx CAD, but details unknown Physical Exam: On Admission: GENERAL: Intubated, sedated. Withdrawing to pain HEENT: NCAT. Sclera anicteric. PERRL. Conjunctiva were pink NECK: Supple with JVP to ears. CARDIAC: PMI located in 5th intercostal space, midclavicular line. RR, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: Mostly clear without crackles, wheezes or rhonchi except R lateral lung with decreased BS. ABDOMEN: Soft, NTND. No HSM. EXTREMITIES: Cool to touch. L 1st and 2nd toes blue, and 2nd toe with area of ulcer at tip of toe ~3/4 cm. SKIN: see above. PULSES: Carotid L 2+, R 1+; Radial L R ; Femoral L R ; DP L R On discharge: 97.3 (97.8 Max) 93/51 (90s/50s)- 60 (60s) 96% on 0.5L GENERAL: sitting up in bed eating, alert, NAD. HEENT: NCAT. Sclera anicteric. PERRL. Conjunctiva pink, poor dentition CARDIAC: RRR, normal S1, split S2. [**1-29**] holosystolic murmur loudest at LLSB. No thrills, lifts. LUNGS: transmitted upper airway sounds bilaterally, Equal air entry BL. CHEST: L sided ICD in place. No erythema. ABDOMEN: Soft, ND. nontender. No HSM. EXTREMITIES: FROM. No edema. Warm, no cyanosis of toes, stable ulcer over L 2nd phalanx Neurologic: Alert and answering questions appropriately. Responding to simple commands, moving all extremities. Oriented x3. Pertinent Results: Admission Labs: [**2180-11-18**] 06:20AM PT-12.5 PTT-31.5 INR(PT)-1.0 [**2180-11-18**] 06:20AM WBC-13.9* RBC-3.91* HGB-12.1* HCT-35.9* MCV-92 MCH-31.0 MCHC-33.7 RDW-14.5 [**2180-11-18**] 06:20AM CALCIUM-8.2* PHOSPHATE-4.6* MAGNESIUM-2.1 [**2180-11-18**] 06:20AM CK-MB-GREATER TH cTropnT-20.83* [**2180-11-18**] 06:20AM GLUCOSE-152* UREA N-15 CREAT-0.7 SODIUM-137 POTASSIUM-4.2 CHLORIDE-105 TOTAL CO2-21* ANION GAP-15 [**2180-11-18**] 06:30AM O2 SAT-86 [**2180-11-18**] 06:30AM GLUCOSE-141* LACTATE-2.5* K+-4.0 [**2180-11-18**] 06:30AM TYPE-ART TEMP-36.1 PO2-50* PCO2-34* PH-7.38 TOTAL CO2-21 BASE XS--3 [**2180-11-18**] 09:27AM URINE RBC->1000* WBC-59* BACTERIA-NONE YEAST-NONE EPI-0 [**2180-11-18**] 09:27AM URINE BLOOD-LG NITRITE-NEG PROTEIN-30 GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-SM [**2180-11-18**] 09:27AM URINE COLOR-Red APPEAR-Hazy SP [**Last Name (un) 155**]-1.041* [**2180-11-18**] 11:23AM freeCa-1.15 [**2180-11-18**] 11:23AM LACTATE-3.0* K+-4.6 [**2180-11-18**] 11:23AM TYPE-ART PO2-58* PCO2-36 PH-7.40 TOTAL CO2-23 BASE XS--1 [**2180-11-18**] 03:05PM PT-14.0* PTT-35.5* INR(PT)-1.2* [**2180-11-18**] 03:05PM PLT SMR-NORMAL PLT COUNT-192 [**2180-11-18**] 03:05PM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-NORMAL [**2180-11-18**] 03:05PM NEUTS-86* BANDS-0 LYMPHS-7* MONOS-7 EOS-0 BASOS-0 ATYPS-0 METAS-0 MYELOS-0 [**2180-11-18**] 03:05PM WBC-12.0* RBC-3.91* HGB-12.3* HCT-35.8* MCV-92 MCH-31.4 MCHC-34.3 RDW-14.4 [**2180-11-18**] 03:05PM %HbA1c-5.9 eAG-123 [**2180-11-18**] 03:05PM ALBUMIN-3.2* CALCIUM-8.7 PHOSPHATE-5.3* MAGNESIUM-2.7* [**2180-11-18**] 03:05PM CK-MB-423* MB INDX-5.1 cTropnT-20.85* [**2180-11-18**] 03:05PM LIPASE-13 [**2180-11-18**] 03:05PM ALT(SGPT)-720* AST(SGOT)-1152* LD(LDH)-2750* CK(CPK)-8221* ALK PHOS-80 AMYLASE-27 TOT BILI-0.8 [**2180-11-18**] 03:05PM GLUCOSE-144* UREA N-22* CREAT-0.9 SODIUM-139 POTASSIUM-4.9 CHLORIDE-107 TOTAL CO2-21* ANION GAP-16 [**2180-11-18**] 06:00PM O2 SAT-96 [**2180-11-18**] 06:00PM LACTATE-2.0 [**2180-11-18**] 06:00PM TYPE-ART TEMP-37.6 RATES-16/ TIDAL VOL-500 PEEP-5 O2-50 PO2-97 PCO2-39 PH-7.41 TOTAL CO2-26 BASE XS-0 -ASSIST/CON INTUBATED-INTUBATED . Labs on Discharge: [**2180-12-8**] 06:45AM BLOOD WBC-9.8 RBC-3.40* Hgb-10.2* Hct-31.3* MCV-92 MCH-30.1 MCHC-32.6 RDW-16.8* Plt Ct-220 [**2180-12-8**] 06:45AM BLOOD PT-34.4* PTT-35.6* INR(PT)-3.5* [**2180-12-8**] 06:45AM BLOOD Glucose-90 UreaN-24* Creat-0.8 Na-139 K-4.0 Cl-104 HCO3-28 AnGap-11 [**2180-12-8**] 06:45AM BLOOD Calcium-8.1* Phos-4.0 Mg-2.2 ECHO [**11-18**]: The left atrium is normal in size. The right atrial pressure is indeterminate. Left ventricular wall thicknesses and cavity size are normal. There is severe regional left ventricular systolic dysfunction with akinesis of the anterior and anterolateral walls, dyskinesis of the anteroseptal wall, and hypokinesis of the mid inferoseptum and inferolateral walls. Overall left ventricular systolic function is severely depressed (LVEF= 20-25 %). The estimated cardiac index is depressed (<2.0L/min/m2). The right ventricular free wall is hypertrophied. Right ventricular chamber size is normal. with moderate global free wall hypokinesis. The aortic valve leaflets are mildly thickened (?#). There is no aortic valve stenosis. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. The tricuspid valve leaflets are mildly thickened. There is at least mild pulmonary artery systolic hypertension. There is a trivial/physiologic pericardial effusion. CT FINDINGS [**11-18**]: There is no evidence of intracranial hemorrhage, edema, mass effect, or large acute territorial infarction. There are diffuse periventricular, subcortical and semiovale hypodensities, slightly more focal left superior periventricular (series 2, image 22); all representing a sequela of chronic small vessel disease. The ventricles are minimally dilated, nonspecific. Incidental note is made of basal ganglia calcifications as well as calcifications of the left greater than right internal carotid arteries. Mild mucosal thickening of the maxillary sinuses bilaterally as well as the ethmoid air cell and the sphenoid sinus. Mastoid air cells are clear and well aerated. No suspicious lytic or sclerotic bony lesions. IMPRESSION: 1. No acute intracranial process. 2. Minimal, nonspecific dilatation of the ventricles. CXR [**11-18**]: Portable AP chest radiograph was reviewed with no prior studies available for comparison. Heart size is mildly enlarged. Mediastinum is unremarkable. Widespread alveolar opacities in the perihilar, upper lung, and lower lobe areas are most likely consistent with pulmonary edema giving patient's history. They are accompanied by minimal amount of pleural effusion. Otherwise, the differential diagnosis would include ARDS or extensive infections. Pulmonary contusions are less likely. . [**2180-11-23**]: Cardiac Catheterization: COMMENTS: 1. Limited selective coronary angiography showed two vessel coronary artery disease. The LMCA had 60% origin stenosis. The LAD had 50-60 origin calcified stenosis prior to previous stents. Prior LAD stents were patent. The LCx had 80-90% origin stenosis as well as a 70% mid LCx stenosis. The RCA was known to be totally occluded and fills via left to right collaterals and was not engaged. 2. Resting hemodyamics revealed elevated right and left sided filling pressure with RVEDP of 14 mmHg and mean PCWP of 25 mmHg. There was moderate pulmonary hypertension with pasp of 54/23 mmHg. There was borderline cardiac index of 2.4 L/min/m2 on dopamine. There was normal blood pressure of 106/67 mmHg, however in the setting of moderate dopamine. 3. Successful placment of IABP. 4. Successful placement of temporary pacemaker via right femoral vein. 5. Successful PTCA and stenting of mid LCx with a 3.0x18mm Vision bare metal stent and origin of LM into Lcx with a 3.0x23mm Vision bare metal stent. The LM stent segment was postdilated to 4.0mm. 6. Successful PTCA only rescue of LAD with 3.0x15mm NC balloon with 40% residual stenosis. . [**11-27**] ECHO: The left atrium is normal in size. Left ventricular wall thicknesses are normal. There is severe regional left ventricular systolic dysfunction with akinesis of the mid inferior and inferolateral wall, mid to distal anterior wall and anterior septum and all apical segments. No masses or thrombi are seen in the left ventricle. Right ventricular chamber size and free wall motion are normal. The diameters of aorta at the sinus, ascending and arch levels are normal. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. Mild to moderate ([**12-25**]+) mitral regurgitation is seen. There is a small pericardial effusion. The effusion appears circumferential. There are no echocardiographic signs of tamponade. IMPRESSION: Severe regional LV systolic dysfunction consistent with mutli-vessel coronary artery disease. Mild to moderate mitral regurgitation. . [**12-4**]: CXR FINDINGS: As compared to the previous radiograph, there is a massive increase in density of the pre-existing relatively extensive bilateral apical opacities. Given the co-existing increase in size of the cardiac silhouette, increasing pulmonary edema must be suspected. On the right, a small pleural effusion could have newly occurred. . ECG [**12-5**]: Sinus rhythm. Left atrial abnormality. Right bundle-branch block. Right axis deviation. Q waves with ST segment elevations in leads V1-V5 raise concern for evolving myocardial infarction with possible involvement of the conduction system. Clinical correlation is suggested. . Brief Hospital Course: A 65M with PVD, static encephalopathy [**1-25**] childhood pertussis, lost to medical care who presented to OSH in VF/asystolic arrest on [**11-13**] and s/p BMx3 to LAD on [**11-14**] c/b another VF arrest. Placed on cooling protocol and treated for pneumonia; shocked for torsades on [**11-15**], extubated on [**11-17**]. Had STEMI on [**11-18**] with LAD in-stent restenosis; placement of BMS c/b mid-LAD dissection; EF 20-25%. [**Hospital1 **] course since [**11-18**] c/b CHF (EF 20-25%, [**12-25**]+ MR) with difficulty weaning off pressors, ischemic right foot (improved on A/C), PEA arrest on [**11-22**], NSTEMI on [**11-23**] with LCx dz s/p POBA & BMSx2, VT/VF arrest on [**11-28**] on amio and s/p ICD on [**11-29**]. . # s/p STEMI x2, Vfib arrest, and cooling protocol, transferred to [**Hospital1 18**] for CABG. It was eventually determined that he is not a candidate for CABG. He was continued on ASA, Plavix, Atorvastatin 40 mg. While in the unit, on [**11-22**] he had a PEA arrest and was successfully resuscitated. EKG showed NSTEMI and he was taken to the cath lab which demonstrated LCx disease and he had 2 bare-metal stents placed. On [**11-28**] he had a VT/VF arrest and was cardioverted and loaded with amiodarone. On [**11-29**] he had an ICD device implanted and actively diuresed. He is on aspirin and Prasugrel and should remain on these medicines unless Dr. [**Last Name (STitle) 31888**] (out patient cardiologist) says that it is OK to stop them. Any discharge plan will need to include strict adherance to Prasugrel regimen. He was started on coumadin [**1-25**] low EF, INR 3.4 at time of discharge and warfarin held. Will need INR checked on Saturday [**12-9**] and restart Warfarin at low dose because of interaction with amiodarone and vancomycin, suggest 1-2 mg daily. He was discharged on Amiodarone 400mg [**Hospital1 **] and will need to decrease dose to Amiodarone 400mg daily x 3 weeks, final day [**2180-12-29**] then change to Amiodarone to 200mg daily. . # Acute systolic Congestive Heart Failure: On recent ECHO, overall left ventricular systolic function is severely depressed (LVEF= 20-25 %). He was initially on dopamine for pressure support, weaned off of dopamine and diuresed when he presented with what was likely flash edema secondary to a panic attack. His weight at discharge is 59.6 (131 pounds) kg and he is euvolemic on 80 mg of Lasix daily. Lasix was decreased to 40 mg daily today and additional 40 mg can be given in pm if weight starts to increase. ACEi therapy has been held secondary to borderline BP. Lisinopril at 2.5 mg should be started when BP allows. . # Anoxic brain injury: suspected given amount of time with poor circulation. CT without acute inschemia, however, this does not rule out anoxic brain injury. As per family he was back to his baseline following extubation the second time. This baseline seems to be quite limited and has impaired his judgement and ability to care for himself in the past per family. He will need social service evaluation. . # Multilobar PNA concerning for aspiration PNA; unclear circumstances of re-intubation prior to arrival at [**Hospital1 18**], however, likely in setting of cardiogenic shock to preserve airway. He developed fever, leukocytosis, with productive cough and infiltrates on CXR and was treated with Cefepime/Vancomycin for health care assoicated pneumonia. Antibiotics now finished and stable on RA. . # Clostridium Difficile: Patient developed diarrhea and leukocytosis and was found to be c. diff positive. He was started on Metronidazole 500mg TID and chagned to vancomycin 250mg PO Q6H after ID consult. He will need a 2 week course of this medication. His stool is now formed and WBC trending down. . # H/o bloody secretions from OGT at OSH before admission. He was started on Pantoprazole 40 mg IV Q24H and then was transitioned to a PO regimen. Hct has been stable with no further evidence of GI bleed. . # Elevated LFTs, likely related to ischemic injury. These trended downwards. Admit to OSH: Pt had c/o 3 days of CP but refused to be evaluated. . # Peripheral Vascular Disease: After cardiac cath, left #1-#3 toes became acutely cyanotic likely related to pressors vs embolic phenomenon vs Intra aortic balloon pump-related. IABP was discontinued and he was started on heparin gtt with bridge to warfarin. Perfusion improved after pressors d/c and IABP d/c. Peripheral pulses palpable but faint at the time of discharge. He will need to continue warfarin with goal INR 2.0-2.5 for 3 months as above. He will need follow up with ankle brachial index measurement. [**Hospital1 **] on Admission: None Discharge [**Hospital1 **]: 1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. multivitamin Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. folic acid 1 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. nitroglycerin 0.4 mg Tablet, Sublingual Sig: [**12-26**] Tablet, Sublinguals Sublingual PRN (as needed) as needed for chest pain. 5. prasugrel 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours). 7. isosorbide mononitrate 30 mg Tablet Sustained Release 24 hr Sig: 0.5 Tablet Sustained Release 24 hr PO DAILY (Daily). 8. olanzapine 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 9. amiodarone 200 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily) for 3 weeks: Start [**2180-12-9**]. 10. amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Start: [**2180-12-30**] after 400 mg daily is finished . 11. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 12. metoprolol tartrate 25 mg Tablet Sig: 0.5 Tablet PO BID (2 times a day). 13. vancomycin 250 mg Capsule Sig: One (1) Capsule PO Q6H (every 6 hours): Day #1 [**12-4**], needs total of 2 weeks course. 14. acetaminophen 500 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day) as needed for pain. 15. oxycodone 5 mg Tablet Sig: 0.5-1 Tablet PO Q6H (every 6 hours) as needed for pain. 16. furosemide 40 mg Tablet Sig: One (1) Tablet PO once a day: Please give additional 40 mg in afternoon if weight is trending up. Discharge Disposition: Extended Care Facility: [**Hospital 4542**] Rehabilitation and Nursing of [**Location (un) 38**] Discharge Diagnosis: ST Elevation Myocardial Infarction Ventricular Fibrillation Arrest C difficile colitis Multilobar Pneumonia Acute systolic Congestive Heart Failure Cardiogenic shock Discharge Condition: Mental Status: Confused - sometimes. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: You had a cardiac arrest and a heart attack and needed shocks and CPR to start your heart again. Three bare metal stents were placed in your heart arteries. You underwent a cooling protocol to protect your brain after the heart attack. During your hospital stay, you developed a pneumonia from the cardiac arrest, and a bowel infection with a bacteria called c difficile. Your heart function is very weak and an internal defibrillator was placed so that it will shock your heart muscle if you ever have a cardiac arrest again. No lifting your left arm over your head for at least 6 weeks, you may shower and wash your hair. No lifting more than 10 pounds with your left arm for 6 weeks. You will need to stay on Plavix every day until Dr. [**Last Name (STitle) 31888**] tells you it is OK to stop. No not miss [**First Name (Titles) 691**] [**Last Name (Titles) 4319**]. Weigh yourself every morning, call Ddr. [**Last Name (un) 31888**] if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. . Medication changes: (no prescriptions taken at home) 1. Start a multivitamin and folic acid to help your nutrition 2. Start Amiodarone and Metoprolol to control your heart rhythm 3. Start Atorvastatin to lower your cholesterol 4. Start Aspirin and Prasugrel to keep the stents open. Do not stop taking these medicines unless Dr. [**Last Name (STitle) 31888**] says that it is OK. 5. Start furosemide to keep fluid from accumulating 6. Start Imdur to prevent chest pain, take nitroglycerin if you have chest pain. Dr. [**Last Name (STitle) 31888**] should know about any chest pain. 7. Start Olanzapine to help you stay calm at night 8. Start pantoprazole to prevent bleeding 9. Start Vancomycin to treat the diarrhea 10. Start tylenol and oxycodone to help with any pain. Followup Instructions: Name: [**Last Name (LF) 31888**], [**First Name7 (NamePattern1) **] [**Initial (NamePattern1) **] [**Last Name (NamePattern4) **] Location: HEART CENTER OF [**Hospital1 **] Address: [**Location (un) **],2ND FL, [**Location (un) **],[**Numeric Identifier 7398**] Phone: [**Telephone/Fax (1) 6256**] Appointment: [**Last Name (LF) 766**], [**12-26**], 11AM . ICD9 Codes: 4275, 5070, 486, 4271, 4280, 2768
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7567 }
Medical Text: Admission Date: [**2203-10-26**] Discharge Date: [**2203-10-31**] Date of Birth: [**2133-2-23**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 165**] Chief Complaint: exertional chest pain Major Surgical or Invasive Procedure: [**2203-10-26**] 1. Re-do sternotomy. 2. Re-do coronary artery bypass graft x2: Saphenous vein graft to left anterior descending artery and saphenous vein graft to obtuse marginal. 3. Endoscopic harvesting of the long saphenous vein. History of Present Illness: 70M was diagnosed with rectal cancer in [**2202-12-30**]. He received chemotherapy and radiation in [**Month (only) 404**]-[**2203-3-31**] and underwent an open proctosigmoidectomy with diverting loop ileostomy [**2203-6-29**]. A cardiac catheterization was done at [**Hospital1 18**] on [**2203-6-24**] prior to his surgery. This was notable for a patent SVG to RCA, occluded SVG to OM, and LIMA, and severe proximal LAD and LCX disease. PCI was deferred at that time due to urgency of his surgery and the need to be off ASA and Plavix prior to surgery. He will be having ileostomy reversal sometime in the near future. Since surgery, he has started to experience chest pain with exertion, e.g. walking or taking out garbage. He had a stress test in [**Month (only) **] at Dr.[**Name (NI) 31668**] office that was notable for EKG changes. On cardiac catheterization, he was found to have total occlusion in LIMA and heavily calcified LAD. He is now being referred to cardiac surgery for redo-CABG. Past Medical History: Diabetes type II Hyperlipidemia CAD s/p MI/CABG [**2193**] Carotid disease Rectal cancer s/p resection and cyber knife radiation (finished [**8-15**]) C spine injury [**3-3**] fall at work [**2198**] s/p repair [**Doctor Last Name **] [**Location (un) 2452**] exposure Past Surgical History: right carotid endarterectomy [**2196**] proctosigmoidectomy, diverting loop ileostomy [**2203-6-29**] cholecystectomy placement of left portacath Past Cardiac Procedures: Surgery: CABG (LIMA to LAD, SVG to OM, and SVG to PDA) Date: [**2193-4-17**] with Dr. [**Last Name (STitle) 2230**] Social History: Lives with: wife Contact: [**Name (NI) **] (Wife) Phone #[**Telephone/Fax (1) 37867**], cell # [**Telephone/Fax (1) 37868**] Occupation: Retired air force and postal service Cigarettes: Smoked no [] yes [x]Hx: quit [**2180**] Other Tobacco use: denies ETOH: < 1 drink/week [x] [**3-8**] drinks/week [] >8 drinks/week [] Illicit drug use: denies Family History: Mother died from heart disease at age 67 Physical Exam: Pulse: 94 Resp: 16 O2 sat: 98/RA B/P Right: Left: 130/76 Height: 5'8" Weight: 183 lbs General: Skin: Dry [x] intact [x] HEENT: PERRLA [] EOMI [x] Neck: Supple [x] Full ROM [] Chest: Lungs clear bilaterally [x], well healed midline sternotomy incision Heart: RRR [x] Irregular [] Murmur [] grade ______ Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds+ [+], well healed midline incision, ileostomy pink w/ gas + stool in bag Extremities: Warm [x], well-perfused [x] Edema [] _____, LLE with well healed SVG harvest site Varicosities: None [x] Neuro: Grossly intact [] Pulses: Femoral Right: Left: DP Right: 2+ Left: 2+ PT [**Name (NI) 167**]: 1+ Left: 1+ Radial Right: 2+ Left: 2+ Carotid Bruit Right: none Left: none Pertinent Results: Conclusions PRE-CPB: No spontaneous echo contrast is seen in the left atrial appendage. A tiny patent foramen ovale is present. A left-to-right shunt across the interatrial septum is seen at rest. Overall left ventricular systolic function is mildly depressed (LVEF= 40 - 45 %). with mild global free wall hypokinesis. The ascending aorta is mildly dilated. There are simple atheroma in the descending thoracic aorta. The aortic valve leaflets (3) are mildly thickened and hypo-motile. There is mild aortic valve stenosis (valve area 1.2-1.9cm2). No aortic regurgitation is seen. The mitral valve leaflets are moderately thickened. Physiologic mitral regurgitation is seen (within normal limits). There is no pericardial effusion. Intra-op the patient's RV was cut by the sternotomy saw, causing early move onto fem-fem bypass. Then several episodes of Vfib occurred, and air was found in the LV cavity. Post-CPB: The patient is in SR, on an infusion of epinephrine. Biventricular systolic fxn is worse, with EF now 30 - 35%. Inferior wall and inferior septum are hypokinetic. MR remains trace. No AI. Aorta intact. Discussed with Dr [**First Name (STitle) **] in the OR. . [**2203-10-31**] 08:05AM BLOOD Hct-27.2* [**2203-10-30**] 06:05AM BLOOD WBC-8.0 RBC-2.90* Hgb-8.0* Hct-24.2* MCV-84 MCH-27.4 MCHC-32.9 RDW-16.3* Plt Ct-227# [**2203-10-29**] 06:00AM BLOOD WBC-8.2 RBC-2.83* Hgb-8.0* Hct-23.7* MCV-84 MCH-28.2 MCHC-33.7 RDW-16.1* Plt Ct-149* [**2203-10-31**] 08:05AM BLOOD UreaN-21* Creat-1.0 Na-141 K-4.7 Cl-103 [**2203-10-30**] 06:05AM BLOOD Glucose-139* UreaN-17 Creat-0.8 Na-140 K-4.2 Cl-103 HCO3-28 AnGap-13 [**2203-10-29**] 06:00AM BLOOD Glucose-108* UreaN-17 Creat-0.8 Na-140 K-4.1 Cl-105 HCO3-26 AnGap-13 [**2203-10-28**] 03:55AM BLOOD Glucose-164* UreaN-13 Creat-1.0 Na-138 K-4.0 Cl-103 HCO3-29 AnGap-10 Brief Hospital Course: The patient was brought to the Operating Room on [**2203-10-26**] where the patient underwent redo sternotomy, CABG x 2 with Dr. [**First Name (STitle) **]. Overall the patient tolerated the procedure well and post-operatively was transferred to the CVICU in stable condition for recovery and invasive monitoring. He remained intubated overnight and on Nitro for hypertension. This was weaned and POD 1 found the patient extubated, alert and oriented and breathing comfortably. The patient was neurologically intact and hemodynamically stable, weaned from inotropic and vasopressor support. Beta blocker was initiated and the patient was gently diuresed toward the preoperative weight. The patient was transferred to the telemetry floor for further recovery. Chest tubes and pacing wires were discontinued without complication. The patient was evaluated by the physical therapy service for assistance with strength and mobility. By the time of discharge on POD 5 the patient was ambulating freely, the [**First Name (STitle) **] was healing and pain was controlled with oral analgesics. The patient was discharged home with VNA in good condition with appropriate follow up instructions. Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from webOMR. 1. Gabapentin 400 mg PO TID 2. Clopidogrel 75 mg PO DAILY 3. GlipiZIDE 10 mg PO BID 4. Lisinopril 40 mg PO DAILY 5. MetFORMIN (Glucophage) 1500 mg PO DAILY 6. Metoprolol Succinate XL 50 mg PO DAILY 7. Oxycodone-Acetaminophen (5mg-325mg) [**1-31**] TAB PO Q4H:PRN pain 8. Rosuvastatin Calcium 10 mg PO DAILY 9. Tamsulosin 0.4 mg PO HS 10. Aspirin 81 mg PO DAILY 11. Ferrous Sulfate 325 mg PO DAILY Discharge Medications: 1. Aspirin 81 mg PO DAILY 2. Clopidogrel 75 mg PO DAILY 3. Ferrous Sulfate 325 mg PO DAILY 4. Gabapentin 400 mg PO TID 5. GlipiZIDE 10 mg PO BID 6. MetFORMIN (Glucophage) 1500 mg PO DAILY 7. Oxycodone-Acetaminophen (5mg-325mg) [**1-31**] TAB PO Q4H:PRN pain 8. Rosuvastatin Calcium 10 mg PO DAILY 9. Tamsulosin 0.4 mg PO HS 10. Metoprolol Tartrate 75 mg PO TID Hold for HR < 55 or SBP < 90 and call medical provider. [**Last Name (NamePattern4) 9641**] *metoprolol tartrate 50 mg 1.5 tablet(s) by mouth three times a day Disp #*150 Tablet Refills:*0 11. Furosemide 20 mg PO DAILY Duration: 7 Days RX *furosemide 20 mg 1 tablet(s) by mouth daily Disp #*7 Tablet Refills:*0 12. Potassium Chloride 20 mEq PO DAILY Duration: 7 Days RX *potassium chloride [Klor-Con] 20 mEq 1 packet by mouth daily Disp #*7 Packet Refills:*0 Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: Diabetes type II Hyperlipidemia CAD s/p MI/CABG [**2193**] Carotid disease Rectal cancer s/p resection and cyber knife radiation (finished [**8-15**]) C spine injury [**3-3**] fall at work [**2198**] s/p repair [**Doctor Last Name **] [**Location (un) 2452**] exposure Past Surgical History: right carotid endarterectomy [**2196**] proctosigmoidectomy, diverting loop ileostomy [**2203-6-29**] cholecystectomy placement of left portacath Past Cardiac Procedures: Surgery: CABG (LIMA to LAD, SVG to OM, and SVG to PDA) Date: [**2193-4-17**] with Dr. [**Last Name (STitle) 2230**] Discharge Condition: Alert and oriented x3 nonfocal Ambulating, gait steady Sternal pain managed with oral analgesics Sternal Incision - healing well, no erythema or drainage no edema Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming, and look at your incisions Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: The cardiac surgery office will call you with the following appointments: [**Telephone/Fax (1) 409**] Check at Cardiac Surgery Office [**Telephone/Fax (1) 170**] Surgeon Dr. [**First Name (STitle) **] [**Telephone/Fax (1) 170**] Cardiologist/PCP: [**Last Name (NamePattern4) **]. [**Last Name (STitle) **] [**Telephone/Fax (1) 16827**] **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] Completed by:[**2203-10-31**] ICD9 Codes: 2724, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7568 }
Medical Text: Admission Date: [**2104-4-2**] Discharge Date: [**2104-4-11**] Date of Birth: [**2068-11-21**] Sex: F Service: MEDICINE Allergies: Penicillins Attending:[**First Name3 (LF) 949**] Chief Complaint: jaundice, BRBPR Major Surgical or Invasive Procedure: Endoscopy x 2 with variceal banding History of Present Illness: 35F with long history of etOH abuse (last drink 10 PTA), s/p gastric bypass, 4 days BRBPR, and new jaundice. She also reports abdominal bloating but denies pain, F/C/NS or melena prior to admission. She intially presented to [**Hospital **] hospital where she was found to have a HCT 21 and TBili 17. NG lavage was negative. She recieved 2U pRBCs, 6U FFP, and levofloxacin for a preseumed UTI. She was transfered to [**Hospital1 18**] for further management. . In the ED her VS were T99.0 P101 BP99/53 R18 95% on RA. She was comfortable but jaundiced on exam with a distended, nontender abdomen. Exam was notable for appreciable fluid in abdomen and mild to moderate ascites by bedside US. Her intitial HCT here was 23 so she received an additional 2U pRBCs. She was initially admitted to the MICU for management of her acute alcoholic hepatitis and presumed GIB. . In the MICU she started on IV PPI, octreotide, and ciprofloxacin for UTI. She was seen by the hepatology team who did an EGD which revealed 3 cords of grade I and 1 [**Last Name (un) 4782**] II varices and a colonscopy which revealed melena and medium grade 2 external hemorrhoids. An ECHO was performed for low voltage EKG and peripheral edema to rule out pericardial effusion and dilated cardiomyopathy, which was negative. A CT abdomen was performed which showed an 18cm distended gall bladder for which surgery was consulted. . Past Medical History: Alcohol abuse Gastric bypass in [**2100**] Chronic neck pain Suicide attempt with flexeril overdose in [**2103**] Social History: [**2-1**] PPD for the past year. Drank about 3L wine per day for past year. Vodka often. Last drink 10 days PTA. Denies other substance abuse. Family History: CAD in father and grandfather, breast cancer in grandmother Physical Exam: GEN: NAD, jaundiced, talkative VS: T:98.6 BP:98/64 P:98 RR:18 O2Sat 97% RA HEENT: Clear OP, MMM, icteric sclera, no JVD, no LAD CV: RR, NL rate. NL S1, S2. No murmurs, rubs or gallops LUNGS: CTA on R, bronchial breath sounds at L base ABD: Collateral veins present. BS+. Distended with shifting dullness. Tender epigastrium, no rebound, liver palpable 4cm below the costal margin in the mid-axillary line and spleen palpable 1-2cm belowe the costal margin in the anterior axillary line EXT: 1+ edema SKIN: jaudniced, dry NEURO: A&Ox3. Appropriate. CN 2-12 grossly intact. Preserved sensation throughout. 5/5 strength throughout. [**2-1**]+ reflexes, equal BL. Normal coordination. Gait assessment deferred PSYCH: Listens and responds to questions appropriately, pleasant Pertinent Results: Admission labs: [**2104-4-2**] 09:30PM BLOOD WBC-14.5* RBC-2.32* Hgb-8.3* Hct-23.0* MCV-100* MCH-35.8* MCHC-35.9* RDW-22.2* Plt Ct-248 [**2104-4-2**] 09:30PM BLOOD PT-21.3* PTT-41.8* INR(PT)-2.0* [**2104-4-2**] 09:30PM BLOOD Glucose-79 UreaN-21* Creat-0.6 Na-125* K-3.5 Cl-87* HCO3-25 AnGap-17 [**2104-4-2**] 09:30PM BLOOD ALT-67* AST-240* AlkPhos-159* TotBili-14.4* DirBili-9.6* IndBili-4.8 [**2104-4-2**] 09:30PM BLOOD Albumin-2.3* Calcium-7.4* Phos-3.1 Mg-2.4 . Discharge labs: [**2104-4-11**] 10:35AM BLOOD WBC-16.9* RBC-2.88* Hgb-9.9* Hct-28.7* MCV-100* MCH-34.3* MCHC-34.4 RDW-19.8* Plt Ct-266 [**2104-4-11**] 10:35AM BLOOD PT-19.9* PTT-49.0* INR(PT)-1.9* [**2104-4-11**] 10:35AM BLOOD Glucose-76 UreaN-14 Creat-1.0 Na-133 K-3.2* Cl-105 HCO3-19* AnGap-12 [**2104-4-11**] 10:35AM BLOOD ALT-43* AST-123* LD(LDH)-151 AlkPhos-113 TotBili-13.7* [**2104-4-11**] 10:35AM BLOOD Calcium-7.6* Phos-2.3* Mg-2.1 . Serologies: [**2104-4-2**] 09:30PM BLOOD HBsAg-NEGATIVE HBsAb-POSITIVE HBcAb-NEGATIVE [**2104-4-2**] 09:30PM BLOOD HCV Ab-NEGATIVE [**2104-4-3**] 04:03AM BLOOD AMA-NEGATIVE Smooth-NEGATIVE [**2104-4-3**] 04:03AM BLOOD [**Doctor First Name **]-NEGATIVE [**2104-4-3**] 04:03AM BLOOD AFP-4.1 [**2104-4-3**] 04:03AM BLOOD IgG-1397 IgA-723* IgM-154 . Urine studies: [**2104-4-2**] 10:00PM URINE Blood-TR Nitrite-NEG Protein-TR Glucose-NEG Ketone-15 Bilirub-LG Urobiln-12* pH-6.5 Leuks-NEG [**2104-4-2**] 10:00PM URINE RBC-0-2 WBC-[**7-9**]* Bacteri-FEW Yeast-NONE Epi-[**4-3**] TransE-[**4-3**] RenalEp-0-2 . Tox screen: [**2104-4-2**] 10:00PM URINE bnzodzp-NEG barbitr-NEG opiates-NEG cocaine-NEG amphetm-NEG mthdone-NEG . DUPLEX DOP ABD/PEL LIMITED Study Date of [**2104-4-2**] 9:35 PM FINDINGS: The liver is diffusely echogenic consistent with fatty infiltration. While no focal hepatic lesion is identified, evaluation is limited by difficult son[**Name (NI) 493**] penetration. There is no intrahepatic biliary ductal dilatation. While portal venous flow is intermittently identified in the left portal and extrahepatic main portal vein, reliable color flow is not acheived in the intrahepatic or right portal venous system. The common bile duct measures 5 mm. The gallbladder is significantly distended with sludge, but there are no gallstones, pericholecystic fluid or wall thickening, and the onographic [**Doctor Last Name **] sign is negative. Small ascites is present. The spleen appears normal though the pancreas is not well seen. There is no right hydronephrosis. IMPRESSION: 1. Diffusely echogenic liver may be consistent with fatty infiltration. However, other forms of liver disease and more advanced liver disease (i.e., significant hepatic fibrosis/cirrhosis) cannot be excluded. 2. Reliable intra-hepatic portal venous color flow is difficult to achieve and thrombosis cannot be completely excluded. CT is recommended for further evaluation. 3. Distended gallbladder with sludge, but no evidence for cholecystitis. 4. Small ascites. . CT ABDOMEN W/CONTRAST Study Date of [**2104-4-3**] 4:10 PM CT ABDOMEN: Small effusions are associated with relaxation atelectasis. There is no consolidation or nodule in the lung bases. Heart size is normal. There is no pericardial effusion. Diffusely enlarged fatty liver has patchy enhancement in all phases. The SMV, splenic and portal veins are patent. There are gastric and splenic varices. The celiac and superior mesenteric arteries are patent. Replaced right hepatic artery arises from the SMA. The pancreas and adrenals are unremarkable. The gallbladder is markedly distended, measuring 18 (CC) x 6 (AP) x 7 (ML) cm. The spleen remains mildly enlarged, measuring 12.7 cm. Post-gastric bypass changes are noted. The imaged intra- abdominal loops of large and small bowel are unremarkable without evidence of pneumatosis, free air or obstruction. There is no mesenteric or retroperitoneal lymphadenopathy. Moderate ascites tracks along the paracolic gutters into the pelvis. Diffuse subcutaneous stranding represents anasarca. Bone windows demonstrate no evidence of lesion that is suspicious for metastasis or infection. IMPRESSION: 1. No evidence of SMV, splenic or portal thrombosis. 2. Diffuse anasarca and moderate ascites. 3. Enlarged fatty liver with heterogeneous perfusion reflects cirrhosis. 4. Markedly enlarged gallbladder without evidence of gallstones or cholecystitis. 5. Moderate bilateral pleural effusions. 6. Gastric and splenic varices. . MRCP (MR ABD W&W/OC) Study Date of [**2104-4-5**] 6:11 PM FINDINGS: The gallbladder is significantly distended and there are some folds seen within. There is small amount of sludge within the gallbladder and the wall is not appreciably thickened. The cystic duct does not appear dilated. The common bile duct is normal in caliber without evidence of stones. There is no intrahepatic biliary ductal dilatation. No pancreatic ductal dilatation. The liver is enlarged measuring 26 cm in length. The liver is significantly fatty showing signal dropout on the out-of-phase images. There is a small amount of ascites. There are also minimal bilateral pleural effusions and subcutaneous edema and fluid is also seen in the left pararenal space. There is atelectasis of the bilateral lung bases. Sutures are seen in the stomach, probably from prior gastric bypass surgery. No focal masses are seen in the liver on the post-contrast images. There is mild narrowing of the proximal celiac artery with acute angulation which could be due to stenosis (this can be a normal variant in assymptomatic patients). There are two right renal arteries incidentally noted. There is no bulky adenopathy. Multiplanar 2D and 3D reformations delineated the dynamic series with multiple perspectives. IMPRESSION: 1. Hepatomegaly with fatty liver. 2. Distended gallbladder with minimal sludge. No evidence of biliary ductal dilatation. . CHEST (PA & LAT) Study Date of [**2104-4-4**] 2:26 PM Since yesterday, lung volumes are still low. Small-to-moderate pleural effusion is new. Small left pleural effusion increased. Bibasilar opacities increased, likely atelectasis. Left retrocardiac opacity increased, could be atelectasis or pneumonia. There is no other overall change. Brief Hospital Course: 35F with history of gastric bypass and etOH abuse who was transfered to [**Hospital1 18**] with acute etOH hepatitis, dilated gall bladder, evidence of cirrhosis, and GIB with an initial HCT of 21. Endoscopy showed varices and portal gastropathy but no active bleeding. Tbili rose to >20 and then declined. INR peaked at 2.0 and began to fall prior to discharge. HCT stabilized. Pt was incidentally noted to have an enlarged gall bladder but MRCP was WNL. Her physical exam and CXR were concerining for pneumonia, which was treated with antibiotics against CAP and aspiration PNA. She was discharged to her parents' home with close follow up. . #. Alcoholic hepatitis: New onset jaundice for 2 weeks prior to admission. Max AST/ALT of 250/67 with max Tbili 21.3. Had GI bleed from portal gastropathy. Evidence of collaterals on CT concerning for chronic underlying cirrhosis. Viral hepatitis negative as were serologies for autoimmune hepatitis. This was likely all related to alcohol abuse. Management of varices as below. Started on spironlactone 50mg PO daily for LE edema as well as midodrine for orthostatic hypotension. . #. Possible PNA: Pt with rising WBC and bilat bronchial breath sounds of exam as well as worsening infiltrates on CXR concerning for PNA. Unclear if this is a communitiy acquired PNA or [**3-3**] aspiration from endoscopy. Treated with levofloxacin 750 mg PO Q24H for community aquired PNA from [**2104-4-6**] to [**2104-4-11**] for a 5 day course and clindamycin 300 mg PO Q6H hepatically dosed for anaerobic coverage for possible aspiration from [**2104-4-6**] to [**2104-4-11**] for a 5 day course. . #. GI bleed: likey secondary to portal hypertensive gastropathy seen on EGD. She recieved initial 4U pRBCS and additional units PRN later in the admission. She was treated with an IV PPI and octreotide. Her HCT has stabilized around 27. Had variceal banding at repeat EGD on [**2104-4-7**]. Discontinued Nadolol as s/p banding and had been hypotensive. Switch to Pantoprazole 40 mg PO daily and discharged on this medication at this dose. . #. Hypotension / orthostatic hypotension: Recurrent this admisison likely due to hypovolemia and hypoalbuminemia. DCed nadolol. Started midodrine 10mg PO TID with good effect. Discharged on this medication. . #. Dilated gall bladder: mildly painful, 18cm on CT scan, does not appear infected, but like obstructed, no gall stones but + sludging. [**Month (only) 116**] be a normal variant from gastric bypass. MRCP read showed hepatomegaly with fatty liver, a distended gallbladder with minimal sludge, and no evidence of biliary ductal dilatation. . #. UTI: Levaquin given at OSH. Repeat UCx no growth (final). Repeat UA with 6-10 WBC. Initially on Ciprofloxacin HCl 500 mg PO Q12H, but then treated with levofloxacin for PNA as above which would cover common UTI pathogens. . #. Alcohol abuse: Reportedly last drink was >2 weeks ago. SW Consulted with patient. Will continue to have close follow up on this issue. Medications on Admission: Multivitamin Vitamin A Vitamin D Vitamin K Iron Discharge Medications: 1. Spironolactone 50 mg Tablet Sig: One (1) Tablet PO once a day: for swollen legs. Disp:*30 Tablet(s)* Refills:*5* 2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours): for bleeding in your stomach. Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*5* 3. Midodrine 5 mg Tablet Sig: One (1) Tablet PO TID (3 times a day): for low blood pressure. Disp:*90 Tablet(s)* Refills:*5* Discharge Disposition: Home With Service Facility: [**Company 1519**] Discharge Diagnosis: Primary: Alcoholic hepatitis, GI bleeding . Secondary: Cirrhosis, alcohol abuse Discharge Condition: Stable vital signs, tolerating POs Discharge Instructions: It was a pleasure taking care of you at [**Hospital1 827**]. . You were admitted for alcoholic hepatitis. This is injury to your liver from drinking alcohol. You had bleeding in your GI tract from this. We did an endoscopy and placed bands on varices or dilated veins in your esophagus. You improved and are being discharged home with physical therapy and close follow up. . Please take your medications as ordered. . Do no drink alcohol. Alcoholic hepatitis is a potentially fatal condition. . Please attend your follow up appointments. . Please call your doctor or come to the emergency room if you experience confusion, bleeding, excessive bruising, fevers, chest pain, shortness of breath, decrease in urine output, passing out, or other concerning symptoms. Followup Instructions: [**2104-4-21**] 11:10a [**Last Name (LF) 1383**],[**First Name3 (LF) 1382**] (LIVER CENTER) LM [**Hospital Unit Name **], [**Location (un) **] LIVER CENTER (SB) [**Telephone/Fax (1) 2422**] Completed by:[**2104-4-14**] ICD9 Codes: 486, 2761, 2762, 5990, 5070, 3051
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7569 }
Medical Text: Admission Date: [**2144-9-6**] Discharge Date: [**2144-9-15**] Date of Birth: [**2070-1-23**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 759**] Chief Complaint: Altered mental status and CT scan at outside hospital with colonic abcess, right renal artery embolus Major Surgical or Invasive Procedure: [**2144-9-7**] PICC line placed RUE History of Present Illness: 74 y/o F with a h/o HTN, RA, hypercholesterolemia who presents from OSH for further w/u of R renal artery embolus and sigmoid diverticulosis with intramural abscess, and slurred speech. Pt. is delirious and is unable to relay a history; history is obtained from her daughter and EMS reports. . Per report she fell at home 3 days PTA. She does not remember the fall. She says that her friend found her beside the bed yesterday morning and called EMS. She reports L lower back pain since the fall. She reports that she has felt "generally down and punk" for several days, and that her speech has been "heavy, thick and boozy" for about 2 weeks. She denies numbness anywhere, has noticed generalized weakness but no focal weakness, denies dysphagia, word finding difficulties, bowel or bladder incontinence. She denies fevers, chills, N/V, abd pain, or dysuria at home. . Per EMS records they were called to pt's house on [**9-5**] at 18:00. Pt. was complaining of lower back pain and LUQ abd pain. Family reported to them that pt. fell 3 days ago, that she has been increasingly confused over the past few days, that her speech has been "slightly slurred," and that she has had generalized weakness for several days. . Pt. was brought to an OSH, where head CT showed age-related atrophy but no infarcts. CT abd performed and showed R renal artery embolus and diverticulosis with chronic-appearing intramural abscess. CEs negative x 1, WBC Ct 18. Pt. received Clindamycin, transferred here for further w/u. . In the ED she underwent evaluation by the neurology, vascular surgery, and general surgery teams. CXR showed a hilar mass. Vascular surgery recommended medical management of renal embolus due to new finding of hilar [**Hospital3 **] surgery recommended antibiotics and NPO status to manage diverticular abscess. She received 1 mg of ativan in the ED, mucomyst, ASA, and levo/flagyl. . ROS (per family): Pt is s/p fall 6 mos ago and experienced a vertebral fracture. Denies fever or chills. 10 pound weight loss over past 6 months. Denied headache, cough, chest pain. Denied nausea, vomiting, diarrhea, or abdominal pain. No dysuria. No rash. Past Medical History: HTN Hypercholesterolemia Rheumatoid arthritis Vertebral fracture Multiple falls per pt., etiology unclear spont pneumothorax - [**2097**] Social History: lives alone in [**Location (un) 4047**] with home health asst several times a week. Tobacco: 1.5 PPD since age 16. No EtOH, no illicits. Family History: emphysema - mother glomerulonephritis - son Physical Exam: Vitals: T: 97.8 ax P: 86 BP: 120/60 RR: 18 SaO2: 95% on 2L O2 General: Awake, alert, NAD. HEENT: NC/AT, PERRL, EOMI, sclera anicteric. MMM, OP without lesions Neck: supple, no JVD or carotid bruits appreciated Pulm: Lungs CTA bilaterally without R/R/W Cardiac: RRR, nl. S1S2, no M/R/G appreciated Abdomen: soft, NT/ND, + BS, no masses or organomegaly noted. Ext: No clubbing cyanosis or edema. Skin: no rashes or lesions noted. Neurologic: -mental status: Alert & Oriented x [**2-10**] (occaisionally correctly identifies this as a hospital). -cranial nerves: intact except unable to protrude tongue. -motor: reduced bulk. Able to hold limbs against gravity but would not resist. So [**4-12**] throughout. Possibly confounded by effort. -sensory: No deficits to light touch detected. -cerebellar: dysarthric. -DTRs: 2+ biceps, triceps. Pertinent Results: CBC: [**2144-9-6**] 02:00AM WBC-15.1* RBC-4.35 HGB-10.9* HCT-32.3* MCV-74* MCH-25.0* MCHC-33.7 RDW-16.3* [**2144-9-6**] 02:00AM PLT COUNT-364 [**2144-9-6**] 02:00AM NEUTS-87.9* LYMPHS-9.5* MONOS-2.0 EOS-0.5 BASOS-0.1 . Chemistries: [**2144-9-6**] 02:00AM GLUCOSE-112* UREA N-10 CREAT-0.8 SODIUM-142 POTASSIUM-3.0* CHLORIDE-103 TOTAL CO2-29 ANION GAP-13 [**2144-9-6**] 02:00AM ALT(SGPT)-25 AST(SGOT)-21 ALK PHOS-107 AMYLASE-17 [**2144-9-6**] 02:00AM LD(LDH)-767* [**2144-9-6**] 02:00AM ALBUMIN-2.4* CALCIUM-11.1* PHOSPHATE-2.2* MAGNESIUM-2.4 [**2144-9-6**] 02:00AM TSH-2.3 [**2144-9-6**] 09:00PM PTH-13* [**2144-9-6**] 09:00PM calTIBC-203* FERRITIN-252* TRF-156* . Serum Tox: [**2144-9-6**] 02:00AM ASA-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG . Coags: [**2144-9-6**] 04:25AM PT-13.9* PTT-20.7* INR(PT)-1.2* . Urine studies: [**2144-9-6**] 04:40AM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.021 [**2144-9-6**] 04:40AM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-7.0 LEUK-NEG . CXR [**9-6**]: Right hilar mass, with associated airspace opacity within the right upper lobe. These findings are concerning for malignancy within the right hilum, and secondary post-obstructive pneumonia or consolidation. Further evaluation with a CT scan is recommended. . CT Pelvic [**9-6**]: 1. Tubular filling defect measuring 1.2 cm in proximal right renal artery with hypoperfusion of right kidney, most likely representing right renal artery emboli. Persistent non-perfusion areas seen in the right kidney on delayed images. 2. Inflammatory changes in sigmoid colon with fat stranding, and 1.3 cm fluid collection versus small abscess. 3. Compression fracture of lower thoracic vertebra. 4. Right hilar mass noted on chest x-ray was not imaged on this abdominal CTA. . Renal US [**9-6**]: 1. No hydronephrosis. 2. The renal vein was difficult to assess. 3. The resistive indices are slightly less within the right kidney compared to the left. Further evaluation with a CTA study is recommended. . CAROTID U/S [**9-8**]: No plaque or wall thickening of either carotid artery. Diffuse low velocity seen b/l suggesting low cardiac output. . CHEST CT [**9-7**]: 1. A very large heterogeneous right hilar mass measuring 7 cm with multiple areas of central necrosis extending to the level of the thyroid with associated mediastinal adenopathy. The mass extends into the SVC as well as the right mainstem bronchus with a short segment demonstrating 50% occlusion. 2. Lack of perfusion of right kidney secondary to previously identified thrombus. 3. Multiple hypodensities in the liver, the largest representing a simple cyst, the smallest too small to characterize, but may also represent cysts. 4. Compression deformity of T9 of indeterminate age. . Echo [**9-8**]: The left atrium is normal in size. No atrial septal defect or patent foramen ovale is seen by 2D, color Doppler or saline contrast with maneuvers. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve appears structurally normal with trivial mitral regurgitation. There a moderate-sized (1.2 cm-thick) echogenic anterior space which most likely represents an epicardial fat pad, though a loculated, organized anterior pericardial effusion cannot be excluded. . L-spine film [**9-10**]: 1. Chronic-appearing L1 vertebral body compression fracture. 2. Likely small fusiform abdominal aortic aneurysm which was seen on the prior CTA abdomen of [**2144-9-6**]. . FNA, Right supraclavicular lymph node [**9-10**]: POSITIVE FOR MALIGNANT CELLS consistent with non-small cell carcinoma. . CT Head with Contrast [**9-12**]: Single focus of low density within the white matter of the right frontal lobe likely representing chronic microvascular infarct. No evidence of enhancing lesions to suggest metastatic disease. . CXR [**9-14**]: 1. Worsening right upper lobe post-obstructive pneumonia secondary to right hilar mass. Increased right lung volume loss. 2. Bilateral pleural effusions . RUQ US [**9-14**]: No evidence of acute cholecystitis. Brief Hospital Course: Ms. [**Known lastname 19961**] is a 74 year old female with a history of HTN, RA, hypercholesterolemia, who presents from OSH for work up of R renal artery embolus and sigmoid diverticulosis with intramural abscess, delirum and slurred speech, now with hypercalcemia and likely nephrogenic DI. Hospital course outlined by problem below: . 1. Right hilar mass - This was concerning for malignancy given history of tobacco and appearance on imaging. The CT scan found a 7cm mass in the right lung which invades into the SVC and right mainstem bronchus. Intervential pulmonology was consulted for possible stenting of right mainstem bronchus. They did not feel it was necessary at the time. Thoracic surgery was consulted for a fine needle aspiration of the supraclavicular node for diagnosis and to see if she was a surgical candidate. The FNA preliminarily showed malignant cells consistent with non-small cell carcinoma. Hematology/oncology and radiation oncology were consulted and treatment options were discussed the with the patient and the family. Outpatient appointments were established. A bone scan was to be performed to look for bony mets on day of discharge, but this was discontinued secondary to a change in the patient's treatment goals (see below). On the last night of admission, the patient had an acute increased need for oxygen therapy (she was on room air prior). A chest x-ray showed pulmonary effusions and a RUL infiltrate suggestive of post-obstructive pneumonia vs lobe collapse. The patient remains afebrile but her WBC was elevated to 20K on discharge from 16K and 18K a fews days prior. She was already receiving levofloxacin and metronidazole for the diverticular abscess, and she was given furosemide to help with the pleural effusions. In a family discussion with the medical team, the patient and her daughter decided that no further aggressive treatment was wanted. Hospice consult was placed per Ms. [**Known lastname 19961**]' request. Extensive conversations had been held with the patient and the daughter throughout her stay regarding her code status and wishes towards treatment and this decision is consistent with those prior conversations. . 2. Hypercalcemia - The patient presented with delirium and slurred speech. She was found to have hypercalcemia and hypernatremia which was thought to be a paraneoplastic syndrome. Her PTHrp was found to be elevated at 8.6. Her hypercalcemia was causatively linked to nephrogenic diabetes insipidus. Renal consult was placed and she was agressively treated with IVF, furosemide, calcitonin, and pamidronate to decrease her calcium levels. She spent one night in the ICU mostly for nursing issues regarding her frequent lab checks and electrolyte monitoring. Once they were within normal limits, her sodium levels dropped to normal range and she was no longer delirious. . 3. Hypernatremia - secondary to nephrogenic diabetes insipidus. See above. . 4. Diverticulitis with localized abscess - surgery consult was obtained and they recommened conservative treatment given her comorbidities. She was placed on levofloxacin and metronidazole. She was initially NPO, but as her delirium resolved, surgery recommended normal diet. She was cleared by a speech and swallow evaluation and placed on soft foods and thin liquids along with Boost supplementation per nutrition recommendations. . 5. Right renal emboli - Normal renal function on admission but large renal artery emboli noted. At first this was thought to be likely due to cholesterol emboli per the renal team given h/o hypercholesterolemia and did not require anticoagulation. At discharge it was unclear whether this thrombus is secondary to cholesterol emboli or to her hypercoagulable state secondary to malignancy. Her renal function is still within normal limits. . 6. Leukocytosis - The patient's WBC was stable around 16K on levofloxacin and metronidazole for her diverticular abscess. A few days prior to admission, her WBC rose to 18K, but she remained afebrile. Work up showed no urinary tract infection (patient had foley cath in place for close monitoring of ins/outs for DI treatment) and a RUQ ultrasound showed no cholecystitis (patient had RUQ pain on exam on the day prior to discharge. The chest x-ray the night prior to admission showed possible post-obstructive pneumonia which may account for her increased WBC. She was discharged on oral antibiotics. . 7. Anemia - iron studies are consistent with anemia of chronic disease. Her Hct remained stable throughout admission. No transfusion was required. . 8. Rheumatoid arthritis - The patient was not taking medications at admission and treatment was defered. She was given acetaminophen for pain. During admission, the patient complained of lower back pain and a lumbar spine x-ray showed only an old compression fracture of L1. No new fractures. A bone scan was to be performed to look for bony mets on day of discharge, but this was discontinued secondary to a change in the patient's treatment goals. . *FEN: eating soft foods and thin liquids with boost after cleared by speech and swallow. *Comm: daughter [**Name (NI) **] [**Name (NI) **] [**Telephone/Fax (1) 69496**] cell [**Telephone/Fax (1) 69497**] home *Code Status: DNR/DNI per HCP (daughter) and per patient Medications on Admission: (not taking any of these medications) atenolol prednisone folic acid fosamax methotraxate Discharge Medications: 1. Metoprolol Tartrate 25 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 2. Lorazepam 1 mg Tablet Sig: One (1) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 3. Levofloxacin 250 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours). 4. Metronidazole 500 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 5. Nicotine 14 mg/24 hr Patch 24HR Sig: One (1) Patch 24HR Transdermal DAILY (Daily) for 6 weeks. 6. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation Q2-3H (every 2-3 hours). 7. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q4-6H (every 4 to 6 hours) as needed for fever or pain. 8. Morphine 10 mg/5 mL Solution Sig: One (1) PO Q4-6H (every 4 to 6 hours) as needed for dyspnea/pain. Discharge Disposition: Extended Care Discharge Diagnosis: Primary diagnosis: Lung cancer- cytology consistent with NSCLC Hypercalcemia causing nephrogenic diabetes insipidus Right renal artery embolus Intramural sigmoid abscess . Secondary diagnosis: Anemia Rheumatoid arthritis Discharge Condition: stable, on 5L oxygen via nasal canual Discharge Instructions: You have been diagnosed with lung cancer and are being discharged to a hospice facility to make you comfortable. . You have been prescribed antibiotics for a pneumonia. You have also been given morphine and lorazepam to help with the back pain and shortness of breath. Followup Instructions: none Completed by:[**2144-9-15**] ICD9 Codes: 2760, 2859
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Medical Text: Admission Date: Discharge Date: [**2150-4-2**] Date of Birth: [**2089-9-10**] Sex: M Service: CSU ADMISSION DIAGNOSES: 1. Hypotension. 2. Status post AVR/MVR/MAZE. 3. Atrial fibrillation. 4. History of rheumatic heart disease. DISCHARGE DIAGNOSES: 1. Pericardial effusion, status post pericardial window. 2. Rheumatic heart disease, status post aortic valve replacement (21 [**First Name8 (NamePattern2) 1495**] [**Male First Name (un) 923**]) mitral valve replacement (29 [**First Name8 (NamePattern2) 1495**] [**Male First Name (un) 923**]). 3. Status post MAZE procedure. 4. Atrial fibrillation. 5. Pleural effusion. ADMISSION HISTORY AND PHYSICAL: Mr. [**Known lastname **] is a 60 year-old gentleman with a history of rheumatic heart disease, who underwent an AVR, MVR, MAZE procedure on [**2150-3-12**] without significant complication in his postoperative course. He was discharged to home in good condition. He presented to his primary care physician on [**2150-3-23**] with some fatigue and light headedness. He was found to be hypotensive at the time and in rapid atrial fibrillation. He was, therefore, admitted to the Emergency Department for management of this. He was cardioverted in the Emergency Department. It was felt that his rapid atrial fibrillation was the cause of his hypotension. He was subsequently admitted to the medical service for further management. On his initial examination, his temperature was 98.3; pulse was in the 1-teens to 130's. His blood pressure was 88/53 and he was saturating 96 percent on room air. He followed commands. He had a significant amount of jugulovenous distention and his heart sounds were distant. His breath sounds were decreased in the lower lobes. His abdomen was otherwise soft and his extremities had no edema. His initial white blood cell count was 20.1 with a hematocrit of 28. His INR was markedly elevated at 6.0 and his BUN and creatinine were 34 and 1.6. The patient's initial chest x-ray showed low lung volumes, ill-defined bibasilar opacities, which were thought to represent consolidation and presence of cardiomegaly. HOSPITAL COURSE: The patient was admitted as noted to the medical service for further work-up. Given his clinical scenario, it was felt prudent to obtain an echocardiogram to rule out tamponade or pericardial effusion, responsible for his hypotension and his acute renal insufficiency. He did undergo this echocardiogram which revealed presence of significant pericardial effusion, although there was no evidence of pericardial tamponade. The effusions seemed loculated and it was felt that interventional attempts at drainage would be unsuccessful. Therefore, he was transferred to the cardiac surgery service and taken to the operating room on [**2150-3-24**] at which time he had a pericardial window created and evacuation of his pericardial effusion. Notably preoperatively, the patient had markedly elevated transaminases with an ALT of 1139 and an AST of 1415 with a normal total bilirubin and normal alkaline phosphatase, amylase and lipase. A right upper quadrant ultrasound was obtained on our service and didn't show any evidence of biliary tract obstructions. It was felt that this may have been secondary to cardiogenic etiology and congestion. The liver function tests subsequently normalized without any intervention after his pericardial window. Postoperatively, the patient did quite well. We initially held his Coumadin until his INR drifted back down towards 2.5. He had multiple episodes of atrial fibrillation postoperatively which required starting Amiodarone. By the time he was ready for discharge, though, his rate was controlled with a blood pressure in the 100/60's and rate of 80 to 90 and atrial fibrillation. To note, the patient developed an increase in oxygen requirement towards the latter part of his hospitalization and chest x-ray showed accumulation of a large right pleural effusion. A pig-tail drain was placed in this effusion and approximately 2.2 liters of old blood and serous fluid were drained. The pigtail catheter remained in place for two days and was subsequently removed without reaccumulation of the fluid. By hospital day number 11, as the patient had been afebrile and otherwise hemodynamically normal with rate controlled atrial fibrillation and lungs clear to auscultation on examination, it was felt that he could be discharged to home in stable condition. By the time of his discharge, his liver function tests had normalized and his white blood cell count had normalized to 8.8. To note, his hematocrit was 36.4 and his INR was 3.0. His renal function had normalized to its baseline with BUN and creatinine of 22 and 0.9. His transaminase, as noted, had normalized and his chest x-ray showed the presence of no significant effusion and he only had small apical pneumothoraces which had been stable. To note, he was treated empirically with Vancomycin and levofloxacin throughout his hospitalization for the question of infection of his pericardial effusion, given that his white blood cell count was elevated. This was discontinued prior to his discharge as none of his culture data showed any growth. He was discharged to home on [**2150-4-2**] on the following medications: 1. Colace 100 mg p.o. twice a day when taking narcotics. 2. One multi-vitamin a day. 3. Percocet prn. 4. Aspirin 81 mg daily. 5. Protonix 40 mg p.o. once daily. 6. Amiodarone 400 mg p.o. once daily for seven days and then 200 mg once per day. 7. Lasix 40 m once per day for 10 days and then 20 mg once a day. 8. Coumadin as directed for a goal INR of 3 to 3.5. 9. Lopressor 12.5 mg p.o. twice a day. 10. Potassium chloride 20 meq p.o. once daily when taking Lasix. FOLLOW UP: He was to follow up in Dr.[**Name (NI) 57924**] clinic on the following day for INR check. She manages Coumadin and INR levels. She is to follow up with Dr. [**Last Name (STitle) 7047**] and Dr. [**Last Name (STitle) 70**]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 5662**], [**MD Number(1) 5663**] Dictated By:[**Doctor Last Name 3763**] MEDQUIST36 D: [**2150-4-2**] 17:17:19 T: [**2150-4-2**] 18:02:03 Job#: [**Job Number 57925**] ICD9 Codes: 5849, 5119, 2859
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Medical Text: Admission Date: [**2107-5-26**] Discharge Date: [**2107-6-9**] Date of Birth: [**2029-5-6**] Sex: F Service: SURGERY Allergies: Cortisone / Percocet / Prednisone / Advair Diskus Attending:[**First Name3 (LF) 3376**] Chief Complaint: Abdominal pain Major Surgical or Invasive Procedure: [**2107-5-26**]: Exploratory laparotomy with ileocolectomy History of Present Illness: 78F s/p laparoscopic converted to open right hemicolectomy for Stage 1 (T1N0) right colon cancer on [**2106-10-29**], now being transferred from OSH with diffuse abdominal pain and guarding on exam. She started with diffuse abdominal pain at 9am yesterday and went to [**Hospital3 4485**] at 9pm. She had some nausea and bilious emesis x5, but had been passing flatus and bowel movements. A non-contrast CT was performed and she was sent here as her abdominal exam was concerning. In ED with A.fib w/RVR, hypertension up to 200/100. Past Medical History: CAD s/p PCI (last '[**02**]), pAFib, CHF, HTN, hyperchol, interstitial lung disease, GIB, GERD, CRI (baseline Cr 1.3-1.8), NIDDM, hypothyroid, TIA, parkinson's, low back pain Past Surgical History: Diverting transverse loop colostomy after colonic perforation from colonoscopy,, colostomy reversal, ventral hernia repair with mesh, Laparoscopic converted to open right hemicolectomy [**2106-11-15**]. Social History: Patient is retired, lives at home with husband. Former [**Name2 (NI) 1818**]. Denies alcohol or other drugs. Family History: NC Physical Exam: On admission: Vitals: T 101.1 HR 160 BP 120/90 RR 20 SO2 96% GEN: A&O, NAD HEENT: No scleral icterus, mucus membranes moist CV: RRR, No M/G/R PULM: Clear to auscultation b/l, No W/R/R ABD: Firm, nondistended, severely tender diffusely, mild rebound tenderness and voluntary guarding. DRE: normal tone, no gross or occult blood Ext: 1+ LE edema b/l, LE warm and well perfused On Discharge: Pertinent Results: ADMISSION LABS -------------- [**2107-5-26**] 12:30AM BLOOD WBC-29.3*# RBC-4.63# Hgb-13.3# Hct-42.3# MCV-91 MCH-28.8 MCHC-31.5 RDW-15.8* Plt Ct-263# [**2107-5-26**] 12:30AM BLOOD PT-30.3* PTT-23.7 INR(PT)-3.0* [**2107-5-26**] 12:30AM BLOOD Glucose-182* UreaN-40* Creat-1.6* Na-143 K-6.0* Cl-107 HCO3-19* AnGap-23* [**2107-5-26**]: TEE No intracardiac thrombus. Mild mitral regurgitation. [**2107-5-26**]: CT abd/pelvis: - Diffuse bowel wall dilatation, with lack of mural enhancement in the distal ileum, concerning for bowel ischemia or necrosis. There is an occlusion of an ileal branch of the superior mesenteric artery suggesting an embolic cause for bowel ischemia upstream of affected areas. - Extensive atherosclerotic disease of the aorta and iliac arteries. [**2107-5-30**]: MRI Head - Acute infarction in the left middle cerebral artery distribution involving the left parietal lobe. - Small old infarct in the right cerebellum. - No evidence of susceptibility artifact to suggest intracranial hemorrhage. [**2107-6-3**]: KUB - ileus [**2107-6-4**]: KUB - There has been no significant change. There remains air and stool seen throughout the colon and some mildly prominent loops of small bowel. Left side down decubitus radiograph, shows no free intra-abdominal gas present. Surgical skin staples are seen projecting over the midline. [**2107-6-4**]: CT HEAD: - Evolving left parietal infarct. No evidence of hemorrhagic transformation. - Global atrophy and chronic small vessel change. - Small old right cerebellar infarct. [**2107-6-8**] 05:10AM BLOOD WBC-7.8 RBC-3.43* Hgb-10.1* Hct-31.3* MCV-91 MCH-29.6 MCHC-32.4 RDW-15.6* Plt Ct-454* [**2107-6-7**] 05:22AM BLOOD WBC-7.6 RBC-3.28* Hgb-9.5* Hct-30.5* MCV-93 MCH-29.1 MCHC-31.3 RDW-15.8* Plt Ct-438 [**2107-6-6**] 05:00AM BLOOD WBC-7.8 RBC-3.15* Hgb-9.3* Hct-29.0* MCV-92 MCH-29.4 MCHC-32.0 RDW-15.9* Plt Ct-361 [**2107-6-5**] 05:37PM BLOOD WBC-8.8 RBC-3.24* Hgb-9.2* Hct-29.2* MCV-90 MCH-28.4 MCHC-31.5 RDW-16.3* Plt Ct-313 [**2107-6-5**] 09:24AM BLOOD WBC-8.0 RBC-3.16* Hgb-9.3* Hct-28.5* MCV-90 MCH-29.3 MCHC-32.5 RDW-16.2* Plt Ct-310 [**2107-6-5**] 01:42AM BLOOD WBC-7.3 RBC-3.02* Hgb-9.2* Hct-26.5* MCV-88 MCH-30.6 MCHC-34.9 RDW-15.9* Plt Ct-268 [**2107-6-4**] 12:11AM BLOOD WBC-7.1 RBC-3.61* Hgb-10.6* Hct-32.7* MCV-91 MCH-29.5 MCHC-32.5 RDW-16.3* Plt Ct-307 [**2107-6-3**] 05:12AM BLOOD WBC-5.3 RBC-3.42* Hgb-10.0* Hct-31.5* MCV-92 MCH-29.3 MCHC-31.8 RDW-15.9* Plt Ct-245 [**2107-6-2**] 05:25AM BLOOD WBC-4.1 RBC-3.44* Hgb-10.1* Hct-31.5* MCV-92 MCH-29.4 MCHC-32.1 RDW-15.8* Plt Ct-200 [**2107-6-1**] 05:20AM BLOOD WBC-3.0* RBC-3.64* Hgb-10.9* Hct-32.8* MCV-90 MCH-29.8 MCHC-33.1 RDW-15.8* Plt Ct-157 [**2107-5-31**] 05:10AM BLOOD WBC-4.0# RBC-3.83* Hgb-11.4* Hct-34.1* MCV-89 MCH-29.8 MCHC-33.5 RDW-15.9* Plt Ct-132* [**2107-5-26**] 12:30AM BLOOD Neuts-93* Bands-0 Lymphs-2* Monos-5 Eos-0 Baso-0 Atyps-0 Metas-0 Myelos-0 [**2107-5-26**] 12:30AM BLOOD Hypochr-NORMAL Anisocy-NORMAL Poiklo-1+ Macrocy-NORMAL Microcy-NORMAL Polychr-NORMAL Ovalocy-1+ Tear Dr[**Last Name (STitle) 833**] [**Name (STitle) 4486**] [**2107-6-9**] 11:10AM BLOOD PT-24.3* PTT-26.1 INR(PT)-2.3* [**2107-6-8**] 05:10AM BLOOD Plt Ct-454* [**2107-6-8**] 05:10AM BLOOD PT-25.3* PTT-28.1 INR(PT)-2.4* [**2107-6-7**] 05:22AM BLOOD Plt Ct-438 [**2107-6-7**] 05:22AM BLOOD PT-39.7* PTT-29.9 INR(PT)-4.1* [**2107-6-6**] 05:00AM BLOOD Plt Ct-361 [**2107-6-6**] 05:00AM BLOOD PT-39.0* PTT-29.5 INR(PT)-4.0* [**2107-6-5**] 05:37PM BLOOD Plt Ct-313 [**2107-6-5**] 09:24AM BLOOD Plt Ct-310 [**2107-6-5**] 01:42AM BLOOD Plt Ct-268 [**2107-6-5**] 01:42AM BLOOD PT-39.8* PTT-28.6 INR(PT)-4.1* [**2107-6-4**] 12:11AM BLOOD Plt Ct-307 [**2107-6-4**] 12:11AM BLOOD PT-38.6* PTT-26.7 INR(PT)-3.9* [**2107-6-3**] 05:12AM BLOOD PT-38.4* PTT-27.4 INR(PT)-3.9* [**2107-6-2**] 11:20AM BLOOD PT-34.5* PTT-68.9* INR(PT)-3.5* [**2107-6-1**] 12:58PM BLOOD PT-17.7* PTT-45.5* INR(PT)-1.6* [**2107-6-1**] 05:20AM BLOOD Plt Ct-157 [**2107-6-1**] 05:20AM BLOOD PT-16.7* PTT-44.1* INR(PT)-1.5* [**2107-5-31**] 05:10AM BLOOD PT-16.1* PTT-26.0 INR(PT)-1.4* [**2107-5-30**] 03:20PM BLOOD PT-17.6* PTT-25.5 INR(PT)-1.6* [**2107-5-28**] 03:10AM BLOOD PT-16.8* PTT-28.7 INR(PT)-1.5* [**2107-5-27**] 12:26PM BLOOD Plt Ct-120* [**2107-5-27**] 12:26PM BLOOD PT-23.0* PTT-32.7 INR(PT)-2.1* [**2107-5-27**] 03:29AM BLOOD PT-31.2* PTT-35.1* INR(PT)-3.1* [**2107-5-26**] 07:22AM BLOOD PT-19.8* PTT-29.8 INR(PT)-1.8* [**2107-5-26**] 12:30AM BLOOD PT-30.3* PTT-23.7 INR(PT)-3.0* [**2107-6-9**] 11:10AM BLOOD Glucose-90 UreaN-13 Creat-1.3* Na-146* K-3.6 Cl-111* HCO3-23 AnGap-16 [**2107-6-8**] 05:10AM BLOOD Glucose-90 UreaN-13 Creat-1.2* Na-141 K-3.1* Cl-112* HCO3-21* AnGap-11 [**2107-6-7**] 05:22AM BLOOD Glucose-93 UreaN-16 Creat-1.3* Na-141 K-3.8 Cl-108 HCO3-21* AnGap-16 [**2107-6-6**] 05:00AM BLOOD Glucose-91 UreaN-15 Creat-1.3* Na-142 K-4.1 Cl-111* HCO3-21* AnGap-14 [**2107-6-5**] 05:37PM BLOOD Glucose-110* UreaN-15 Creat-1.3* Na-140 K-4.2 Cl-111* HCO3-20* AnGap-13 [**2107-6-5**] 07:23AM BLOOD Creat-1.3* Na-140 K-4.2 Cl-113* [**2107-6-5**] 01:42AM BLOOD Glucose-125* UreaN-17 Creat-1.4* Na-139 K-4.0 Cl-110* HCO3-21* AnGap-12 [**2107-6-4**] 12:11AM BLOOD Glucose-136* UreaN-16 Creat-1.1 Na-141 K-3.4 Cl-110* HCO3-22 AnGap-12 [**2107-6-3**] 05:12AM BLOOD Glucose-94 UreaN-17 Creat-1.2* Na-143 K-3.4 Cl-111* HCO3-21* AnGap-14 [**2107-6-2**] 05:25AM BLOOD Glucose-109* UreaN-23* Creat-1.3* Na-143 K-3.3 Cl-111* HCO3-21* AnGap-14 [**2107-6-1**] 12:44PM BLOOD Glucose-118* UreaN-29* Creat-1.4* Na-142 K-3.4 Cl-108 HCO3-23 AnGap-14 [**2107-6-1**] 05:20AM BLOOD Glucose-102* UreaN-30* Creat-1.4* Na-142 K-3.3 Cl-107 HCO3-23 AnGap-15 [**2107-5-31**] 05:10AM BLOOD Glucose-120* UreaN-36* Creat-1.4* Na-143 K-3.6 Cl-107 HCO3-24 AnGap-16 [**2107-5-29**] 07:55PM BLOOD Glucose-121* UreaN-36* Creat-1.4* Na-140 K-3.5 Cl-105 HCO3-20* AnGap-19 [**2107-5-29**] 01:35AM BLOOD Glucose-97 UreaN-39* Creat-1.8* Na-142 K-3.8 Cl-110* HCO3-21* AnGap-15 [**2107-5-28**] 03:10AM BLOOD Glucose-90 UreaN-36* Creat-1.7* Na-141 K-4.6 Cl-108 HCO3-22 AnGap-16 [**2107-6-6**] 05:00AM BLOOD ALT-9 AST-13 LD(LDH)-178 AlkPhos-40 TotBili-0.3 [**2107-5-26**] 12:30AM BLOOD ALT-14 AST-42* AlkPhos-41 TotBili-0.3 [**2107-6-7**] 05:50PM BLOOD CK-MB-5 cTropnT-0.04* [**2107-5-29**] 01:35AM BLOOD CK-MB-2 cTropnT-0.05* [**2107-6-9**] 11:10AM BLOOD Calcium-8.4 Phos-3.9 Mg-1.8 [**2107-6-8**] 05:10AM BLOOD Calcium-8.0* Phos-3.5 Mg-1.9 [**2107-6-7**] 05:22AM BLOOD Calcium-8.0* Phos-4.0 Mg-1.9 [**2107-6-6**] 05:00AM BLOOD Calcium-7.8* Phos-4.2 Mg-2.0 [**2107-6-5**] 05:37PM BLOOD Calcium-7.9* Phos-3.7 Mg-2.0 [**2107-6-4**] 12:11AM BLOOD Calcium-8.2* Phos-3.3 Mg-2.0 [**2107-6-3**] 05:12AM BLOOD Calcium-7.8* Phos-2.9 Mg-2.3 [**2107-6-2**] 05:25AM BLOOD Calcium-8.0* Phos-2.5* Mg-1.9 [**2107-6-1**] 12:44PM BLOOD Calcium-8.1* Phos-3.1 Mg-2.0 [**2107-5-31**] 05:10AM BLOOD Calcium-7.9* Phos-3.9 Mg-2.1 Cholest-97 [**2107-5-30**] 05:35AM BLOOD Calcium-8.3* Phos-4.2 Mg-2.1 [**2107-5-29**] 01:35AM BLOOD Calcium-8.2* Phos-3.7# Mg-2.3 [**2107-5-28**] 03:10AM BLOOD Calcium-8.7 Phos-5.5* Mg-2.1 [**2107-5-27**] 12:26PM BLOOD Calcium-7.9* Phos-4.5 Mg-2.0 [**2107-6-2**] 05:25AM BLOOD Triglyc-193* [**2107-5-31**] 05:10AM BLOOD Triglyc-212* HDL-16 CHOL/HD-6.1 LDLcalc-39 [**2107-5-31**] 05:10AM BLOOD Vanco-19.5 [**2107-5-28**] 06:00AM BLOOD Vanco-13.7 [**2107-6-6**] 05:00AM BLOOD Digoxin-0.9 [**2107-5-28**] 03:10AM BLOOD Digoxin-0.7* Brief Hospital Course: Ms. [**Known lastname **] was taken emergently to the OR for exploratory laparatomy on [**2107-5-26**]. She was transferred to the SICU in fair condition postoperatively, intubated and sedated. Her hospital course is discussed below by system: Neuro: Patient's pain was controlled with PCA and transitioned to IV and po pain medications when appropriate. During her ICU stay, she was noted to have word finding difficult and sundowning. Family felt that patient was confused but otherwise at baseline and her neurologic exam was nonfocal. As her overall condition improved and sundowning resolved, her word finding difficulty became more apparent and an MRI of her head was performed on [**2107-5-30**] with acute infarction in the left middle cerebral artery distribution involving the left parietal lobe noted. She was started on a heparin drip and her afib was controlled as below. Over the following 48 hours, her speech improved and a speech and swallow evaluation was performed prior to starting po intake. Patient improved daily until [**2107-6-3**] when she developed hypertension into the 200s with associated worsening speech. A CT head was performed which showed no hemorrhagic conversion and evolving stroke. She was continued on coumadin once therapeutic on heparin, and her dose of this was titrated to an appropriate level. She had been initially supratherapeutic with a maximum INR during her admission of 4.1, following which her coumadin was held. This was restarted on 0.5mg of Warfarin at discharge with a plan to follow her INR at rehab. CV: Patient was in Afib RVR upon admission. IV metoprolol was used for rate control. TEE showed no evidence of intracardiac thrombus to explain her synchronous embolization to her small bowel and brain. Patient required multiple IV antihypertensives (metop, labetalol, hydralazine) for BP control. On [**2107-6-3**], patient's hypertensive episode prompted a transfer to ICU where she was controlled with a labetalol drip to maintain systolic blood pressure <140. Patient was eventually transitioned to PO metoprolol and IV metoprolol PRN and transferred back to the general surgery service. Following transfer she was started on lisinopril and her blood pressure remained stable and appropriate and continued on an increased dose of Lopressor. Her blood pressure was improved and appropriate. Resp: Patient showed evidence of moderate pulmonary edema and was diuresed with IV lasix. She was given nebulizer treatments and encourage to use her IS. Her O2 was weaned. Abd: Patient's abdomen was distended with a prolonged ileus postoperatively. Initial attempts at diet advanced with speech and swallow recommendations were met with abdominal distension and pain. On [**2107-6-3**], patient complained of severe abdominal pain with nausea. KUB showed an ileus. NG tube was placed with 500 cc of bile drained and improvement in pain. NG tube was removed while patient in ICU and abominal distension was improved. Her diet was advanced to a regular diet and calorie counts were followed. She was given supplementation with ensure and was instructed to continue this on discharge. Wound: The midline surgical incision was closed with staples post-operatively. The inicsion line was intact without signs of infection. These staples were removed on discharge and replaced with steri-strips. The patient was to wear an abdominal binder when out of bed. Renal: Patient's mild renal insufficiency was unchanged throughout admission. Heme: Patient received one unit of FFP prior to ex lap on [**5-27**], one unit of PRBC on [**2107-5-29**] and one unit of PRBC on [**2107-6-3**] for low Hct. Her INR rose from 1.4 to 3.5 with one dose of coumadin once therapeutic on heparin. Her INR peaked at 4.1 and then trended down. She was kept therapeutic on her coumadin thereafter with a low dose. Patient was also kept on Heparin SC with venodynes for DVT prophylaxis. ID: The patient was ruled out for C. Diff suring this admission. Consulting teams: During this admission the patient was followed closely by neurology, geriatric medicine, speech and swallow, phyiscal therapy, and social work. Medications on Admission: Coumadin 2', ASA 81', toprol XL 75', digoxin 0.125qod, lipitor 40', omeprazole 20', glipizide 2.5', fentanyl patch 50, topamax 25', sinemet 25/100''', seroquel 25'am-50'pm-100'hs, remeron 30'hs, divalproex 250am/500pm, ativan 0.5'''prn, ambien 10'prn, MVI, colace 100", CaCarb 1000''', Fe 65', fish oil, ?lasix 20', toprol 75', mirtazapine 30', Omeprazole 20', Discharge Medications: 1. bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed for constipation. 2. furosemide 20 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 3. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 4. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 5. digoxin 125 mcg Tablet Sig: One (1) Tablet PO EVERY OTHER DAY (Every Other Day). 6. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 7. glipizide 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 8. topiramate 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 9. carbidopa-levodopa 25-100 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 10. quetiapine 25 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)). 11. quetiapine 50 mg Tablet Sig: One (1) Tablet PO QPM (once a day (in the evening)). 12. quetiapine 100 mg Tablet Sig: One (1) Tablet PO QHS (once a day (at bedtime)). 13. mirtazapine 30 mg Tablet Sig: One (1) Tablet PO HS (at bedtime). 14. divalproex 250 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO QAM (once a day (in the morning)). 15. divalproex 500 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO QPM (once a day (in the evening)). 16. lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO Q8H (every 8 hours) as needed for anxiety. 17. multivitamin,tx-minerals Tablet Sig: One (1) Tablet PO DAILY (Daily). 18. lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 19. metoprolol tartrate 25 mg Tablet Sig: 2.5 Tablets PO BID (2 times a day). Disp:*150 Tablet(s)* Refills:*2* 20. acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 21. warfarin 1 mg Tablet Sig: [**1-30**] Tablet PO QHS (once a day (at bedtime)) for 1 doses: Please give at 1600 on [**2107-6-9**] and recheck INR on [**2107-6-10**]. Goal INR 2.0-3.0, pt have been difficult to manage, very sensitive to warfarin. Discharge Disposition: Home With Service Facility: [**Hospital6 **] in [**Location (un) **] Discharge Diagnosis: Mesenteric Ischemia Ileal Resection CVA Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - requires assistance or aid (walker or cane). Discharge Instructions: You were admitted to the hospital after a an open colectomy for surgical management of your mesenteric ischemia. It is thought that this mesenteric ischemia was caused by a blood clot in the membranes attatched to your intestine caused by your heart condition atrial fibrillation. During this time, it is thought that you also suffered from a stroke related to a blood clot which traveled to your brain. It is very important that you continue your coumadin therapy which ahs been difficult to manage, however, will be managed by the [**Hospital 4487**] hospital providers. You have recovered from this surgery well and you are now ready to be discharged to rehabilitation. From the stoke, you have difficulty saying words and it is our hope as well as the hope of the neurology team that this will improve over time with the help of occpational therapy and speech therapy. Please continue to hope and work for improvement in your symptoms. Please participate in physical therapy to regain your strength. You have tolerated a regular diet, passing gas and your pain is controlled with pain medications by mouth. Please monitor your bowel function closely. You have had a bowel movement. After anesthesia it is not uncommon for patient??????s to have some decrease in bowel function but your should not have prolonged constipation. Some loose stool and passing of small amounts of dark, old appearing blood are explected however, if you notice that you are passing bright red blood with bowel movments or having loose stool without improvement please call the office or go to the emergency room if the symptoms are severe. If you are taking narcotic pain medications there is a risk that you will have some constipation. Please take an over the counter stool softener such as Colace, and if the symptoms does not improve call the office. If you have any of the following symptoms please call the office for advice or go to the emergency room if severe: increasing abdominal distension, increasing abdominal pain, nausea, vomiting, inability to tolerate food or liquids, prolonges loose stool, or constipation. You have a long vertical incision on your abdomen the staples have been removed prior to your discharged and steri-strips have been applied. This incision can be left open to air or covered with a dry sterile gauze dressing if the incision becomes irritated from clothing. Please monitor the incision for signs and symptoms of infection including: increasing redness at the incision, opening of the incision, increased pain at the incision line, draining of white/green/yellow/foul smelling drainage, or if you develop a fever. Please call the office if you develop these symptoms or go to the emergency room if the symptoms are severe. You may shower, let the warm water run over the incision line and pat the area dry with a towel, do not rub. Please wear an abdominal binder provided to you at all times while out of bed. No heavy lifting for at least 6 weeks after surgery unless instructed otherwise by Dr. [**Last Name (STitle) 1120**] or Dr. [**Last Name (STitle) **]. You may gradually increase your activity as tolerated but clear heavy excersise after follow up. You may take Tylenol as recommended for pain. Please do not take more than 4000mg of Tylenol daily. Do not drink alcohol while taking narcotic pain medication or Tylenol. You will take 0.5mg coumadin today [**2107-6-9**]. Your INR today [**2107-6-9**] is 2.3. The rehab facility will need to check daily INRs until your INR is stable and therapeutic, with a goal INR of 2.0-3.0. Thank you for allowing us to participate in your care! Our hope is that you will have a quick return to your life and usual activities. Good luck! Followup Instructions: Please plan to follow up in Dr. [**Last Name (STitle) 4488**] clinic in approximately 2 weeks. Call ([**Telephone/Fax (1) 3378**] to make an appointment. Completed by:[**2107-6-9**] ICD9 Codes: 2762, 2930, 2720, 5859, 2449, 4280
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Medical Text: Admission Date: [**2120-1-4**] Discharge Date: [**2120-1-9**] Date of Birth: [**2056-5-26**] Sex: M Service: HISTORY OF PRESENT ILLNESS: The patient is a 63-year-old man with a history of atrial fibrillation, prior ischemic strokes, most recently in the right MCA, who was discharged on [**2119-12-30**] with a recent right MCA ischemic infarction. He was left with a left hemiparesis which had improved remarkably by the time of discharge. He had been doing well at rehabilitation until the day prior to admission when he developed a right frontal headache which had gotten progressively worse over 24 hours. He also had chest pain which was sharp and intermittent without radiation. The patient was unable to provide any history besides this. There was no report of his left-sided weakness becoming worse again. A noncontrast head CT at the [**Hospital1 188**] Emergency Department showed an intraparenchymal bleed into the old MCA ischemic infarction. PAST MEDICAL HISTORY: 1. Right MCA stroke in 01/[**2119**]. 2. Atrial fibrillation on Coumadin. 3. Stroke in [**2117**]. MEDICATIONS ON ADMISSION: Lopressor 50 mg p.o. b.i.d.; Coumadin 3 mg p.o. q.h.s.; Zantac 150 mg p.o. b.i.d.; trazodone 50 mg p.o. q.h.s.; Percocet 1-2 tablets p.o. q. 4-6 hours p.r.n.; Colace 100 mg p.o. b.i.d. p.r.n. ALLERGIES: The patient has no known drug allergies. SOCIAL HISTORY: The patient quit smoking 30 years ago. He is a retired woodcutter and has a sixth grade level of education. He is illiterate and he lives with his wife. PHYSICAL EXAMINATION: Examination on admission showed vital signs with a temperature of 98.6, blood pressure 174/100, heart rate 95, respiratory rate 18, oxygen saturation 96% on room air. In general he was well-developed, well-nourished. He did not appear to be in any distress. Head and neck were normocephalic, atraumatic. Neck was supple. Mucous membranes were moist. There were no bruits. Cardiovascular examination showed an irregular rhythm with normal rate. Pulmonary examination showed his lungs to be clear bilaterally. His abdomen was soft and nontender. He had positive bowel sounds. There was no distention. Extremities were warm. There was mild edema at the ankles. Neurologically his mental status was awake, alert and oriented to name, place, year and situation. Language and comprehension were intact. Cranial nerves: Pupils reacted normally to light. Visual fields showed a left hemianopsia. The funduscopic examination was normal. Extraocular movements were full without nystagmus. Facial movement showed a left facial droop. Palate elevation was symmetric. His tongue protruded in the midline. Sensation was intact to touch, temperature and pinprick. There was no evidence of neglect. Motor examination showed normal tone and bulk. The left arm was flaccid. He had mild to moderate left leg weakness in an upper motor neuron pattern. Reflexes were diminished in his left arm. Plantar reflexes were extensor. Sensory examination showed sensation to be intact to pinprick. Gross touch was decreased in the left arm. Coordination showed finger-to-nose and alternating movements intact on the right arm. LABORATORY STUDIES: On admission his white count was 10, hematocrit 37, platelet count 340, PT 23, INR 3.6, sodium 143, potassium 3.9, chloride 101, bicarbonate 25, BUN 28, creatinine 1, glucose 101, CK 69, troponin 0.1. EKG showed atrial fibrillation. Head CT showed an intraparenchymal bleed into the old ischemic infarct in the right MCA distribution. There was minimal shift. HOSPITAL COURSE: The patient was admitted to the neurology service initially to the intensive care unit and he was later transferred to the floor. His Coumadin was discontinued and he was given three doses of subcutaneous vitamin K. The patient had several CT scans while in the hospital. The scan taken on [**1-8**] demonstrated an increase in the size of his bleed compared to [**1-7**]. However he had no clinical correlation for this finding. The patient was started on an aggressive bowel regimen and pain relievers to prevent rise in his intracranial pressure. His systemic blood pressure was controlled with a combination of Lopressor, hydralazine and Norvasc. The patient complained of a right-sided headache until [**1-8**]. By [**1-9**] his headache was resolved. The patient will be discharged to rehabilitation on [**2120-1-9**]. DISCHARGE DIAGNOSES: 1. Right MCA territory hemorrhage on top of an old ischemic infarct. 2. Prior strokes. 3. Atrial fibrillation. 4. Hypertension. DISCHARGE MEDICATIONS: 1. Colace 100 mg p.o. b.i.d. 2. Protonix 40 mg p.o. q.d. 3. Hydralazine 10 mg p.o. q. 6 hours. 4. Tylenol 650 mg p.o. q. 4-6 hours p.r.n. 5. Morphine sulfate 2 mg p.o. q. 3-4 hours p.r.n. 6. Lactulose 30 mL p.o. t.i.d. 7. Dulcolax 10 mg p.o. p.r. q.d. p.r.n. 8. Lopressor 100 mg p.o. t.i.d. 9. Norvasc 5 mg p.o. q.d. His blood pressure should be kept under 140 systolic. 10. Aspirin should be restarted two weeks after discharge, on approximately [**2120-1-24**], with consideration being given to Coumadin in about two months. CONDITION ON DISCHARGE: The patient is being discharged in improved condition. He will require further rehabilitation for his left-sided weakness. FOLLOW UP: The patient will follow up with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] as an outpatient. [**Name6 (MD) 11982**] [**Last Name (NamePattern4) 11983**], M.D. [**MD Number(1) 11984**] Dictated By:[**Last Name (NamePattern1) 5476**] MEDQUIST36 D: [**2120-1-9**] 10:38 T: [**2120-1-9**] 10:49 JOB#: [**Job Number **] ICD9 Codes: 431, 4240, 4019, 412
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Medical Text: Admission Date: [**2169-9-5**] Discharge Date: [**2169-9-6**] Date of Birth: [**2120-8-10**] Sex: F Service: NEUROSURGERY Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 5084**] Chief Complaint: IPH and IVH. Major Surgical or Invasive Procedure: none History of Present Illness: Ms. [**Known firstname 3968**] is a 49 y/o female who was found down and unresponsive this morning. Her husband states that he found her around 8 a.m. and that he last spoke with her at 1 a.m. at which time she was "normal." She was transferred via EMS to [**Hospital **] Hospital and underwent a head CT which showed a intraparenchymal and intraventricular hemorrhage. A chest x-ray showed bilateral infiltrations, likely aspiration from being obtunded. She was intubated and transferred to [**Hospital1 18**] via [**Location (un) **]. She received Mannitol 60mg IV in flight. Her SBP dropped into the 50s and she received 3 liters of IV fluids as well as Levophed and Neo-Synephrine yet continued with systolic blood pressures in the 50-60s upon arrival to [**Hospital1 18**]. She received Dilantin 1gram IV x1. She underwent a repeat CT of the head and a CTA which revealed a left frontal intraparenchymal and intraventricular hemorrhage. CTA showed a right ophthalmic aneurysm but no aneurysm in the region of the bleed. She received Mannitol 50mg IV x1 in the emergency department. Past Medical History: Hyperlipidemia; Lymphoma 20 years ago. Social History: Resides with husband and three children. Family History: non contributory Physical Exam: On admission [**2169-9-5**]: PHYSICAL EXAM: BP: 97/50 on Levophed and Neo Gen: Lying on bed; intubated. Does not open eyes spontaneously or on command. HEENT: Pupils: Right 5mm and fixed; left pupil 3mm and fixed. EOMs unable to assess. Positive gag and cough. Negative Corneals Bilat. Extrem: Warm and well-perfused. Neuro: Mental status: Intubated; unresponsive. Motor: Extensor posturing x 4 extremities. Normal bulk and tone bilaterally. No abnormal movements, tremors. Formal motor examination and pronator drift could not be assessed. Pertinent Results: CTA NECK W&W/OC & RECONS Study Date of [**2169-9-5**] 11:08 AM CTA HEAD W&W/O C & RECONS Study Date of [**2169-9-5**] 11:08 AM IMPRESSION: 1. Large flame-shaped left paramedian frontal hemorrhage extending into the corpus callosum bilaterally, with associated anterior interhemispheric fissure and bifrontal sulcal subarachnoid blood. 2. Intraventricular extension of hemorrhage, with blood filling the third ventricle, partially filling the fourth ventricle, and expanding the body and atrium of the right lateral ventricle. The temporal [**Doctor Last Name 534**] of the right lateral ventricle is dilated, presumably due to obstruction. 3. Diffuse cerebral edema. Left subfalcine herniation. Significant rightward shift of midline structures. Crowding of the cerebellar tonsilsin the foramen magnum. 4. Though an aneurysm of the anterior communicating artery is suspected based on the pattern of intracranial hemorrhage, no such aneurysm is seen. Please note that a small aneurysm may be compressed by the hemorrhage. There is a fenestration of the right aspect of the anterior communicating artery, and 2-mm fusiform dilatation of the proximal A2 segment of the right anterior cerebral artery. Consider conventional angiography. 5. 3 x 2-mm aneurysm of the supraclinoid right internal carotid artery near the ophthalmic artery origin. 6. 4 x 2.5-mm aneurysm of the paraclinoid left internal carotid artery. 7. Fenestration of the proximal basilar artery. 8. Atherosclerosis at the origins of the cervical internal carotid arteries with mild, less than 40% stenoses. 9. 2-cm right thyroid nodule. Recommend further assessment by [**Name (NI) 13416**], if not previously performed elsewhere. 10. Large dependent opacities in the imaged upper lungs with partial air bronchograms. Recommend correlation with chest radiography. 11. Air in the venous structures of the upper chest and neck, mostly on the right, which is most likely related to line placement or a line placement attempt. Please correlate clinically. CHEST PORT. LINE PLACEMENT Study Date of [**2169-9-5**] 3:51 PM Diffuse pulmonary edema, likely neurogenic rather than cardiogenic. Right subclavian central line in appropriate position with the tip in lower SVC. Bibasilar hazy opacities, left greater than right, suggestive of possible pleural effusion and/or aspiration. Brief Hospital Course: Ms. [**Known firstname 3968**] is a 49 year old female who was found down and unresponsive this morning. Her husband states that he found her around 8 a.m. and that he last spoke with her at 1 a.m. at which time she was "normal." She was transferred via EMS to [**Hospital **] Hospital and underwent a head CT which showed a intraparenchymal and intraventricular hemorrhage. A chest x-ray showed bilateral infiltrations, likely aspiration from being obtunded. She was intubated and transferred to [**Hospital1 18**] via [**Location (un) **]. She received Mannitol 60mg IV in flight. Her SBP dropped into the 50s and she received 3 liters of IV fluids as well as Levophed and Neo-Synephrine yet continued with systolic blood pressures in the 50-60s upon arrival to [**Hospital1 18**]. The patient was evaluated by Neurosurgery. She received Dilantin 1gram IV x1. She underwent a repeat CT of the head and a CTA which revealed a left frontal intraparenchymal and intraventricular hemorrhage. CTA showed a right ophthalmic aneurysm but no aneurysm in the region of the bleed. She received Mannitol 50mg IV x1 in the emergency department. On exam the patients Pupils were fixed and dilated. She was Intubated and exhibiting extensor posturing. A family meeting was held in the Emergency Room Department, and given the severity of the bleed and the very poor neurological exam it was explained that the patient had a very grave diagnosis and that surgery would not benefit the patient at this time. The patient was transferred to the intensive care unit and another meeting was held with the family and the intensive care physicians and it was determined that given the patient's grave prognosis the patient will be DNR/DNI status. The patient was on 4 agents for hypotension on [**9-6**] and her neurologic exam did not improve. She transitioned to CMO status this day after discussion with the husband and she expired with family at the bedside. Medications on Admission: Lipitor, dose unknown. Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: intraparenchymal hemorrhage interventricular hemorrhage Hypotension Pneumonia cerebral edema Discharge Condition: expired Discharge Instructions: none Followup Instructions: expired Completed by:[**2169-9-6**] ICD9 Codes: 431, 5070, 2724, 4589
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Medical Text: Admission Date: [**2154-5-31**] Discharge Date: [**2154-6-6**] Date of Birth: [**2081-6-6**] Sex: M Service: SURGERY Allergies: Morphine / Haldol Attending:[**First Name3 (LF) 4691**] Chief Complaint: Residual colostomy from diverticular perforation Giant abdominal Hernia residual from dehiscence with open abdomen. Major Surgical or Invasive Procedure: [**2154-5-31**] [**Doctor Last Name **] reversal History of Present Illness: This is a 72-year-old man who presented three months ago with perforated diverticulitis and severe peritonitis. He had a Hartmann's procedure for this. He developed an open abdomen 2' to abdominal sepsis. This was eventually closed with full thickness skin flaps. After discharge he also developed a retracted colostomy with stenosis of the skin aperture. Therefore, he is now taken for a colostomy take-dow. This is much earlier than would be normally be planned due to the expectation of a 'hostile abdomen'. Past Medical History: PMH: HTN, CAD s/p CABG, BPH, Diverticulosis s/p sigmoid resection, AFib (on coumadin), DVT PSH: Hartmann's ([**1-/2154**]) c/b dehiscence, Wound Closure 3/[**2153**]. AAA repair [**2146**], CABG [**2127**] Social History: Lives with family, works part time as an Optometrist. No tobacco use. Family History: Non-contributory Physical Exam: (at discharge) NAD/AAO, pleasant gentleman in afib, regular rate CTA b/l soft, nondistended abdomen, with midline incision, no erythema, no drainage no peripheral edema Brief Hospital Course: The patient was admitted to the surgical service to a floor bed after his surgery. He was initially kept NPO and his diet was slowly advanced as tolerated once he was passing flatus. He remained afebrile with a normal WBC and his wound had no signs of infection. His pain was initially controlled with a pca and this was converted to oral medications once he was taking oral intake. At time of discharge he was ambulating without difficulty, tolerating a regular diet, and passing flatus. Medications on Admission: 1. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for indigestion. 2. warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. 3. tamsulosin 0.4 mg Capsule, Ext Release 24 hr Sig: One (1) Capsule, Ext Release 24 hr PO BID (2 times a day). 4. zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for sleep. 5. atenolol 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Discharge Medications: 1. calcium carbonate 200 mg calcium (500 mg) Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day) as needed for indigestion. 2. warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. 3. tamsulosin 0.4 mg Capsule, Ext Release 24 hr Sig: One (1) Capsule, Ext Release 24 hr PO BID (2 times a day). 4. zolpidem 5 mg Tablet Sig: One (1) Tablet PO HS (at bedtime) as needed for sleep. 5. atenolol 25 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 6. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) as needed for constipation: Take as needed for constipation while taking pain medication. Disp:*30 Capsule(s)* Refills:*0* 7. simvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 8. hydrocodone-acetaminophen 5-500 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*30 Tablet(s)* Refills:*0* Discharge Disposition: Home With Service Facility: All Care VNA of Greater [**Location (un) **] Discharge Diagnosis: Reversal of [**Doctor Last Name 3379**] pouch Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: You were admitted to the hospital for reversal of your colostomy. Please call your doctor or nurse practitioner or return to the Emergency Department for any of the following: *You experience new chest pain, pressure, squeezing or tightness. *New or worsening cough, shortness of breath, or wheeze. *If you are vomiting and cannot keep down fluids or your medications. *You are getting dehydrated due to continued vomiting, diarrhea, or other reasons. Signs of dehydration include dry mouth, rapid heartbeat, or feeling dizzy or faint when standing. *You see blood or dark/black material when you vomit or have a bowel movement. *You experience burning when you urinate, have blood in your urine, or experience a discharge. *Your pain is not improving within 8-12 hours or is not gone within 24 hours. Call or return immediately if your pain is getting worse or changes location or moving to your chest or back. *You have shaking chills, or fever greater than 101.5 degrees Fahrenheit or 38 degrees Celsius. *Any change in your symptoms, or any new symptoms that concern you. Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than [**4-30**] lbs until you follow-up with your surgeon. Avoid driving or operating heavy machinery while taking pain medications. Incision Care: *Please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *Avoid swimming and baths until your follow-up appointment. *You may shower, and wash surgical incisions with a mild soap and warm water. Gently pat the area dry. *If you have staples, they will be removed at your follow-up appointment. Followup Instructions: Please follow up with the Acute Care Service next week for removal of your staples. You can schedule this appointment by calling # [**Telephone/Fax (1) 600**] Please follow-up with your PCP as usual for monitoring of your INR (coumadin level). ICD9 Codes: 4019, 412
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Medical Text: Admission Date: [**2181-4-15**] Discharge Date: [**2181-4-15**] Service: MEDICINE Allergies: Nsaids / Sulfa (Sulfonamide Antibiotics) / Zosyn Attending:[**First Name3 (LF) 5608**] Chief Complaint: sepsis Major Surgical or Invasive Procedure: central line a-line bronchoscopy History of Present Illness: This is a Mr [**Name13 (STitle) 21658**] is an 85 year old man, recently discharged from the intensive care unit, with history of prior DVT (now s/p IVC filter), intracranial bleeding, HTN, CKD on HD, right lower extremity dry gangrene who presents with hypotension, aspiration, fever. Patient transfered from [**Hospital1 **] after being found aspirating from TF. Became hypoxic to 80%, was suctioned with vomintous removed, placed on 100% NRB with improvement of sats. Per ED call in, T 101.8, BP 120/70 at [**Hospital1 **] which is actually thought to be elevated from baseline of 80/50. Per [**Hospital1 **], he is oriented x 2 at baseline with some AMS but was more lethargic after the event. . Of note, he has had two complicated admissions this year. His first admission, he had DVT, SHD [**1-15**] heparin gtt, sezures, embolic stroke, poor mental status, inability to swallow, low BP's, tachycardia, demand ischemia and PAD with distal ischemia. He was then discharged to [**Hospital1 **]. He was readmitted a month later on [**2180-2-29**] for ? PNA, with cough and SOB, initially tx'ed with Vanc and Zosyn. He was also found to have a VRE UTI and was treated with 14 days of Linezolid, finished [**2181-3-26**]. He also developed a rash and eosinophilia which may have been due to Zosyn. He was also in the CCU for hypotension, tachycardia, was breifly on vasopression and amiodarone drip. Amiodarone was eventually discontinued. . In the ED: The patient arrived in distress, tachpnic. Vitals on arrival: temp 99, HR 115, BP 60/40 97% NRB. BP's ranged from SBP's 60's -100's. Hr 130's, then [**Month (only) **] to 100's. When his BP's dropped, he was started on fluids, levophed and had a right femoral line placed; BP now 116/64. The patient was also intubated for tachpnea and airway protection with copious vomitous noted in his airways. He was started on fentanyl and Versed for sedation. He was also noted to have loose stool in the rectum. The patient was started on Zosyn/Vanc/Flagyl. Vitals on transfer: HR 98, BP 116/74, on CMV FIO2 100% Past Medical History: HTN thoracic and abdominal aortic aneurysm h/o transitional cell bladder cancer CKD h/o lumbar laminectomy tertiary hyperparathyroidism BPH DVT in the past, s/p IVC filter placement bilateral cataracts s/p removal glaucoma s/p L TKR ?[**Name (NI) **] unclear per records PVD ? Fem/[**Doctor Last Name **] bipass Social History: Formerly worked in family business, now retired. Was living independently until [**12/2180**] hospitalization. More recently lived in [**Hospital1 **]. Family History: Non-contributory. Physical Exam: General: intubated, sedated HEENT: + cataracts, dry MMM, no lesions noted in OP Neck: supple, no JVD Chest: left IJ, right subclavian HD line Pulmonary: Lungs with diffuse rhonchi Cardiac: RRR, nl. S1S2, no M/R/G noted Abdomen: soft, NT/ND, normoactive bowel sounds, subcutaneous hematoma in RLQ Extremities: 4+ edema, right foot with dry gangrene in toes as well as a 5 cm patch gangrene on shins Skin: no rashes or lesions noted. Neurologic: intubated and sedated Pertinent Results: CXR: 1. Bibasilar opacification, with bilateral pleural effusion, which could suggest bibasilar atelectasis, volume overload; however, consolidation cannot be excluded. 2. ETT, NG and left IJ, and right central venous line in appropriate placement. 3. Right PICC line with tip terminating in the mid subclavian vein. . KUB: Nonspecific bowel gas pattern with no evidence of obstruction, bowel wall thickening, pneumatosis or free air. . Micro: results returned after pt expired - Blood: 3/4 bottles GNR - BAL: GRAM STAIN (Final [**2181-4-15**]): 1+ (<1 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. 3+ (5-10 per 1000X FIELD): GRAM NEGATIVE ROD(S). 1+ (<1 per 1000X FIELD): GRAM POSITIVE ROD(S). RESPIRATORY CULTURE (Final [**2181-4-17**]): OROPHARYNGEAL FLORA ABSENT. Due to mixed bacterial types ( >= 3 colony types) an abbreviated workup will be performed appropriate to the isolates recovered from this site. GRAM NEGATIVE ROD #1. 10,000-100,000 ORGANISMS/ML.. GRAM NEGATIVE ROD #2. 10,000-100,000 ORGANISMS/ML.. GRAM NEGATIVE ROD #3. 10,000-100,000 ORGANISMS/ML.. GRAM NEGATIVE ROD #4. 10,000-100,000 ORGANISMS/ML.. . Labs: CBC [**2181-4-15**] 09:55AM BLOOD WBC-37.5*# RBC-2.76* Hgb-8.2* Hct-27.3* MCV-99* MCH-29.6 MCHC-29.9*# RDW-21.0* Plt Ct-315# [**2181-4-15**] 01:29PM BLOOD WBC-4.2# RBC-2.76* Hgb-8.8* Hct-28.7* MCV-104* MCH-31.7 MCHC-30.6* RDW-22.0* Plt Ct-272 [**2181-4-15**] 03:23PM BLOOD WBC-8.4# RBC-2.57* Hgb-7.9* Hct-26.0* MCV-101* MCH-30.6 MCHC-30.3* RDW-21.0* Plt Ct-206 . Coags [**2181-4-15**] 09:55AM BLOOD PT-14.9* PTT-33.5 INR(PT)-1.3* [**2181-4-15**] 01:33PM BLOOD PT-14.4* PTT-42.2* INR(PT)-1.3* [**2181-4-15**] 03:23PM BLOOD Fibrino-320# . Chem 10 [**2181-4-15**] 09:55AM BLOOD Glucose-113* UreaN-65* Creat-2.5* Na-136 K-4.5 Cl-95* HCO3-26 AnGap-20 [**2181-4-15**] 01:29PM BLOOD Glucose-115* UreaN-64* Creat-2.4* Na-137 K-4.2 Cl-98 HCO3-24 AnGap-19 [**2181-4-15**] 01:29PM BLOOD Calcium-8.5 Phos-2.9 Mg-1.9 [**2181-4-15**] 03:23PM BLOOD Calcium-7.4* Phos-2.9 . ABG [**2181-4-15**] 01:54PM BLOOD Type-ART pO2-70* pCO2-79* pH-7.04* calTCO2-23 Base XS--11 [**2181-4-15**] 02:40PM BLOOD Type-ART Temp-37.6 Rates-30/ Tidal V-380 PEEP-10 FiO2-100 pO2-65* pCO2-68* pH-7.09* calTCO2-22 Base XS--10 AADO2-599 REQ O2-95 Intubat-INTUBATED Vent-CONTROLLED [**2181-4-15**] 05:03PM BLOOD Type-ART pO2-44* pCO2-51* pH-7.26* calTCO2-24 Base XS--4 MISC: [**2181-4-15**] 09:55AM BLOOD ALT-15 AST-28 CK(CPK)-77 AlkPhos-110 TotBili-0.2 [**2181-4-15**] 09:55AM BLOOD CK-MB-NotDone proBNP-[**Numeric Identifier 19213**]* [**2181-4-15**] 09:55AM BLOOD cTropnT-0.57* [**2181-4-15**] 10:00AM BLOOD Lactate-2.8* [**2181-4-15**] 01:46PM BLOOD Lactate-4.0* [**2181-4-15**] 03:29PM BLOOD Lactate-4.8* [**2181-4-15**] 05:03PM BLOOD Lactate-5.7* [**2181-4-15**] 01:46PM BLOOD O2 Sat-68 [**2181-4-15**] 03:29PM BLOOD O2 Sat-80 [**2181-4-15**] 03:29PM BLOOD freeCa-1.06* Brief Hospital Course: The patient was admitted with aspiration pneumonia, sepsis and respiratory failure. He was admitted on a ventilator and on levophed. Initially, his BP was 90's/40's - not markedly off his baseline. However, soon after admission to the ICU, his blood pressures dropped precipitously to 60's/ 40's. Lactate started rising. pH fell to low 7.0's. An a-line was placed. Bicarbonate drip started. Vassopressin and then subsequently phenylephrine were added to levophed. The patient was also given benadryl and famotidine given the question of anaphlyaxis in the setting of possible Zosyn allergy. However, the patient was not bronchospastic and did not have hives. He was intially given Vancomycin and Cefepime. Vanc changed to Linezolid as prior VRE. PO Vanc added empirically for possible C.diff as pt was having diarrhea and has been on abx recently. . An emergent bronchoscopy was performed, BAl obtained and secretions suctioned out. The patient's abdomen was noted to slightly firm but not rigid. A KUB showed mildly dilated transverse colon. Given the concern for C.diff, rising lactate, ? dilated colon, surgery was consulted for evaluation of megacolon. However, prior to the arrival of surgical consult, the patient's condition deteriorated. The patient required maximum doses of three pressors. Was receiving frequent IVF bolusus. Albumin was given in an attempt to salvage his blood pressure. Sedation was withheld to maximize pt's BP. In addition, PEEP was decreased. However, with [**Month (only) **] PEEP the patient's oxygenation deteriorated despite FiO2 100%. . The patient's son was at the patient's bedside the entire time. The son indicated that the patient should be DNR, no defibrillation or CPR. It was also decided with the patient's family that surgery was not indicated as the source of sepsis was most likely pulmonary and as surgery would most likely be fatal. Per family request, the chaplain came to the patient's bedside to perform last rites. Ultimately, the family chose to withdraw care, stop pressors and give morphine for dyspnea. The patient passed away quickly at 9:12pm. After the patient passed away, sputum cx's returne with GNR's and blood cx's returned with 3/4 bottles GNR's, making GNR sepsis from PNA the final diagnosis. Medications on Admission: Home Medications: Latanoprost 0.005 % Drops [**Month (only) **]: One (1) Drop Ophthalmic HS Levetiracetam 500 mg [**Hospital1 **] Aspirin 325 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). Timolol Maleate 0.5 % Drops [**Hospital1 **]: One (1) Drop Ophthalmic [**Hospital1 **] Simvastatin 80 mg DAILY Folic Acid 1 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). Omeprazole 20mg daily Xenaderm Ointment q 12hrs to gangrene Heparin (Porcine) 5,000 TID Oxycodone 5 mg/5 mL Solution [**Hospital1 **]: Five (5) mg PO Q4H Acetaminophen 325 mg Tablet [**Hospital1 **]: 1-2 Tablets PO every eight hrs Calcium 500 mg Tablet TID Folic Acid 1 mg Tablet [**Hospital1 **]: One (1) Tablet PO once a day. Fentanyl 75 mcg/hr Patch 72 hr One (1) patch Transdermal every seventy-two (72) hours. Bacitracin ointment Citalopram 10mg daily Collagenase q 12hr sto sacral sound Darbepoetine alfa 200mg q Wednesday Midodrine 15mg prior to HD Sodium bicarbonate 10cc with omperazole Discharge Disposition: Expired Discharge Diagnosis: sepsis Discharge Condition: expired ICD9 Codes: 2762, 4589, 5859, 0389
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Medical Text: Admission Date: [**2115-7-4**] Discharge Date: [**2115-7-19**] Date of Birth: [**2052-12-23**] Sex: M Service: MEDICINE Allergies: Ciprofloxacin Attending:[**First Name3 (LF) 1363**] Chief Complaint: R-sided chest pain, SOB Major Surgical or Invasive Procedure: Left-sided thoracentesis History of Present Illness: 62M with T3, N0, M0 (stage IIb) recurrent esophageal adenocarcinoma s/p neoadjuvant chemoradiation [**2114-1-4**], then esophagectomy 5/[**2113**]. He had a positive margin on the surgical resection and has undergone palliative chemo with epirubicin/oxaliplatin/5FU x 5cycles starting 5/[**2113**]. Started palliative taxotere [**2115-1-24**] - C5D1 [**2115-5-30**], C6D1 held today. Pt admitted from clinic for R-sided chest pain and SOB. Pt with h/o of bilateral pleural effusions s/p L thoracentesis [**5-29**], cytology neg. Pt on lasix after thoracentesis and did better for a period of time, but worsening the past couple of weeks. Pt sent for CTA chest today: neg for PE, showed reaccumulation of large bilateral pleural effusions. Pt reports R-sided chest pain x2-2.5wks. Reports pain constant, [**4-11**] at baseline and increases with movement and deep inspiration. Pain [**9-11**] with [**Month/Year (2) **]. Pt reports chest pain located over R anterior chest with radiation around to the back. Pt also with dry [**Month/Year (2) **] for same time period. Pt reports SOB at rest, worse with exertion. Pt also reports PND, orthopnea. No LE edema or pain. No fevers/chills, n/v, abdominal pain. Eating poorly but enough to maintain weight. Pt reports seen in clinic [**6-27**] and given robitussin but no improvement in [**Last Name (LF) **], [**First Name3 (LF) **] no longer taking it. Pt also recently treated for thrush with nystatin swish and swallow, but no longer taking. On arrival to the floor, pt reports continued R-sided chest pain and SOB. Past Medical History: ONCOLOGIC HISTORY: Mr. [**Known lastname 26973**] presented with a sensation of food getting stuck in his chest in the fall of [**2112**]. Barium swallow demonstrated a stricture in the distal esophagus. ECG demonstrated circumferential narrowing and thickening at the GE junction (40 cm), and extended proximally to 35 cm. Biopsies were performed and pathology demonstrated adenocarcinoma, mucin-producing with few signet ring cells, moderately differentiated. He underwent PET/CT scan [**2113-12-31**], which showed FDG uptake in the GE junction but no evidence of regional or distant metastases. He was referred for EUS staging, performed on [**2114-1-5**], which demonstrated a mass at the distal esophagus/GEJ consistent with known adenocarcinoma, maximum depth 1 cm, with extension beyond the muscularis propria. There were no concerning lymph nodes identified. By EUS, the tumor was staged as T3N0Mx, Stage IIB esophageal adenocarcinoma. . He began concurrent chemoradiation with cisplatin/5-FU on [**2114-1-23**]. He had a J-tube placed prior to treatment. His last radiation treatment was on [**2114-3-1**], total dose 5040 cGy. His last cycle of chemotherapy (C2D1) was [**2114-2-19**]. He underwent [**Month/Day/Year 12351**]-[**Doctor Last Name **] esophagectomy [**2114-4-25**] which demonstrated residual disease, including a positive proximal margin. Surveillance endoscopy demonstrated friable and nodular distal esophagus and biopsy demonstrated adenocarcinoma. . [**2114-9-3**] C1D1 Epirubicin, Oxaliplatin, 5-fluorouracil (5-FU given by continuous infusion pump Mon-Fri x96 hours given his difficulty swallowing pills) [**2114-9-24**] C2D1 Epirubicin, Oxaliplatin, 5-fluorouracil . PAST MEDICAL HISTORY: -Myocardial infarction in [**2101**] treated with plain old balloon angioplasty to one vessel and a stent in another vessel. -Open gall bladder surgery -Kidney stones -Osteoarthritis: mainly neck and right knee -Low back injury -GERD Social History: Married to his wife of 40 years. two children, & two grandchildren. He works in software and customer teaching for an electronic access device maker. Smoked half a pack to pack a day for approximately 30 years, but quit in [**2101**] with his heart attack. He does not drink alcohol regularly. Family History: Parents both died of heart attack. He has a sister who has had breast cancer twice and a brother with diabetes. Physical Exam: Admission PE: Vitals - T: 98.3 BP: 114/68 HR: 98 RR: 18 sat: 100% RA GENERAL: sitting up in bed, pleasant, in NAD HEENT: AT/NC, PERRLA, anicteric sclera, pink conjunctiva, patent nares, MMM, a few small white plaques on R side inside mouth, nontender supple neck, no cervical/supraclavicular/axillary LAD CARDIAC: RRR, S1/S2, no murmers, gallops, or rubs LUNG: speaking in short sentences, tachypneic, inspiratory rales on R > L, decent air movement bilaterally CHEST: anterior chest tender to palpation around ribs [**2-3**] on the right ABDOMEN: nondistended, decreased BS, nontender EXTREMITIES: no LE edema or tenderness NEURO: 5/5 strength in UE and LE bilaterally, sensation to light touch intact SKIN: warm and well perfused, no excoriations or lesions, no rashes Discharge PE: VS: Tc-98, HR 110-120s, BP 98-110s/60-70s, RR 20-22, 94-100% RA I/O: 770(PO) + 737(IV)/1575 + 525 from L pleurex GENERAL: Chronically ill appearing gentleman, pleasant, in no acute distress HEENT: thrush resolved, dry MM CHEST: inpsiratory rales at L base but improved BS on L compared to prior, coarse inspiratory rales on the R throughout, decent air movement, pigtail on L capped CARDIAC: Tachycardic, regular rhythm, no MRG ABDOMEN: +BS, soft, non-tender, non-distended EXTREMITIES: 1+ LE edema with support stockings on; edema of L arm slightly increased with clear demarcation just proximal to the elbow Pertinent Results: Admission Labs: [**2115-7-4**] 08:50AM UREA N-16 CREAT-0.6 SODIUM-138 POTASSIUM-3.9 CHLORIDE-102 TOTAL CO2-29 ANION GAP-11 [**2115-7-4**] 08:50AM ALT(SGPT)-7 AST(SGOT)-19 ALK PHOS-77 TOT BILI-0.7 [**2115-7-4**] 08:50AM CALCIUM-8.4 PHOSPHATE-2.1* MAGNESIUM-1.8 [**2115-7-4**] 08:50AM WBC-13.5* RBC-4.10* HGB-11.3* HCT-35.3* MCV-86 MCH-27.6 MCHC-32.0 RDW-16.4* [**2115-7-4**] 08:50AM PLT COUNT-347 [**2115-7-4**] 08:50AM GRAN CT-[**Numeric Identifier 26974**]* MICRO Pleural [**Numeric Identifier 26975**]: [**2115-7-4**] 6:13 pm PLEURAL [**Month/Day/Year **] **FINAL REPORT [**2115-7-10**]** GRAM STAIN (Final [**2115-7-4**]): 2+ (1-5 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. [**Month/Day/Year **] CULTURE (Final [**2115-7-7**]): NO GROWTH. [**2115-7-5**] 11:35 am PLEURAL [**Month/Day/Year **] **FINAL REPORT [**2115-7-10**]** GRAM STAIN (Final [**2115-7-5**]): 4+ (>10 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. [**Month/Day/Year **] CULTURE (Final [**2115-7-10**]): LACTOBACILLUS SPECIES. RARE GROWTH. STREPTOCOCCUS ANGINOSUS (MILLERI) GROUP. RARE GROWTH. IDENTIFICATION PERFORMED ON CULTURE # 352-0143D [**2115-7-6**]. ANAEROBIC CULTURE (Final [**2115-7-10**]): NO ANAEROBES ISOLATED. [**2115-7-6**] 4:00 am BLOOD CULTURE No growth x2 [**2115-7-6**] 2:52 pm PLEURAL [**Year (2 digits) **] GRAM STAIN (Final [**2115-7-6**]): Reported to and read back by [**First Name8 (NamePattern2) 26976**] [**Last Name (NamePattern1) **] @ 7PM [**2115-7-6**] . 4+ (>10 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. 3+ (5-10 per 1000X FIELD): GRAM POSITIVE COCCI. IN PAIRS, CHAINS, AND CLUSTERS. 2+ (1-5 per 1000X FIELD): GRAM NEGATIVE ROD(S). 1+ (<1 per 1000X FIELD): GRAM POSITIVE ROD(S). [**Month/Day/Year **] CULTURE (Preliminary): LACTOBACILLUS SPECIES. MODERATE GROWTH. STREPTOCOCCUS ANGINOSUS (MILLERI) GROUP. MODERATE GROWTH. Susceptibility testing requested by [**First Name9 (NamePattern2) **] [**Doctor Last Name **] #[**Numeric Identifier 26977**] [**2115-7-12**]. ANAEROBIC CULTURE (Final [**2115-7-10**]): NO ANAEROBES ISOLATED. [**2115-7-8**] 1:35 pm PLEURAL [**Month/Day/Year **] **FINAL REPORT [**2115-7-13**]** GRAM STAIN (Final [**2115-7-9**]): 3+ (5-10 per 1000X FIELD): POLYMORPHONUCLEAR LEUKOCYTES. NO MICROORGANISMS SEEN. [**Month/Day/Year **] CULTURE (Final [**2115-7-13**]): LACTOBACILLUS SPECIES. RARE GROWTH. ANAEROBIC CULTURE (Final [**2115-7-13**]): NO ANAEROBES ISOLATED. IMAGING: TTE [**2115-7-19**]: Moderate circumferential pericardial effusion. No clear-cut evidence of tamponade physiology. However, the presence of tachycardia and relatively small chamber sizes along with hyperdynamic left ventricular systolic function is suggestive of poor diastolic filling. Compared with the prior study (images reviewed) of [**2115-7-9**] and [**2115-7-8**], the findings are similar. CT Chest [**2115-7-18**]: Moderate layering nonhemorrhagic left pleural effusion is larger today than on [**7-11**]. Left pleural catheter enters laterally, traverses the major fissure and ends superiorly alongside the spine at the level of the fourth posterior interspace. No left pneumothorax: Moderate-to-large right pleural effusion is larger, particularly in the right lower and anterolateral hemithorax where [**Month (only) **] now replaces previous air component. Fissural and paramediastinal components of the moderate-to-large right pleural effusion have also increased. More extensive ground-glass opacification in the upper aspect of the right lower lobe which is still consolidated at the base could be edema associated with pleural [**Month (only) **] interfering with lymphatic milking due to pleural restriction that prevents ventilatory change in lobar volume, however, could also be progression of pneumonia even though cavitation present previously has not worsened. The residual esophagus or upper neoesophagus is still distended above the alimentary stent, which though unchanged in position, roughly from the level of the T5-T9 is still largely occluded with semisolid material. Large pericardial effusion, also nonhemorrhagic, is larger. The superior vena cava above the pericardial reflection is larger than the intrapericardial segment, and the right atrium and ventricle are both smaller today than on [**7-11**], warranting evaluation for possible early cardiac tamponade. Mild atelectasis in the lingula and left lower lobe are probably due to ventilatory compromise by the larger left pleural effusion. Left-sided central venous line ends at the superior cavoatrial junction. Atherosclerotic coronary calcification is heavy in the left main, anterior descending and circumflex vessels. Discharge Labs: [**2115-7-19**] 06:12AM BLOOD WBC-7.6 RBC-3.58* Hgb-9.5* Hct-29.5* MCV-82 MCH-26.6* MCHC-32.3 RDW-18.2* Plt Ct-328 [**2115-7-19**] 06:12AM BLOOD Glucose-112* UreaN-7 Creat-0.4* Na-137 K-3.5 Cl-101 HCO3-34* AnGap-6* [**2115-7-19**] 06:12AM BLOOD Calcium-7.8* Phos-2.3* Mg-1.7 Brief Hospital Course: 62M with T3, N0, M0 (stage IIb) recurrent esophageal adenocarcinoma s/p neoadjuvant chemoradiation [**2114-1-4**], then esophagectomy [**4-/2114**] admitted from clinic with R-sided CP and SOB. CTA showing reaccumulation of large bilateral pleural effusions. . Active diagnoses: #Bilateral pleural effusions, R-sided empyema: CT on admission showed large bilateral pleural effusions, with the right one being loculated, which had reaccumulated from prior drainage 6/[**2114**]. Pigtail placed on L [**2115-7-4**] by IP with pleural [**Month/Day/Year **] exudative, cytology neg, no growth from culture. Pt had R pigtail placed [**2115-7-5**] by IP with pleural [**Month/Day/Year **] exudative, cytology neg, culture with rare growth of lactobacillus and STREPTOCOCCUS ANGINOSUS. Pt transferred to [**Hospital Unit Name 153**] for hypotension (SBP to 80s) and tachycardia [**2115-7-5**]. Pt started on Vanc and ceftriaxone initially. Because of the potential for sepsis, Ceftriaxone was broadened to Cefepime. Bl cultures from [**2115-7-6**] negative x2. A repeat gram stain of the right pleural [**Month/Day/Year **] was sent, which showed polymicrobial results. Flagyl was added. This repeat pleural [**Month/Day/Year **] culture from R on [**2115-7-6**] with moderate growth of lactobacillus and STREPTOCOCCUS ANGINOSUS. Chest tube placed on R [**2115-7-8**] with pleural [**Month/Day/Year **] culture without growth. Given the concern for an esophageal-pleural fistula, a CT thorax with PO contrast was done on [**7-7**] which was inconclusive, so an esophagram was performed on [**7-9**] that did not show evidence of esopahgeal leak. R sided pleural effusion loculations and bacterial growth concerning for empyema. In pt with h/o bilateral effusions with reaccumulation, seems that pt likely infected preexisting effusions. Bacteria are consistent from oral flora per ID. This suggests microaspiration caused infection and organization of R pleural effusion. Cytology has been repeatedly negative. R sided effusion/empyema concerning for abscess or necrotizing pneumonia per CT chest [**2115-7-11**]. Initial etiology of pt's pleural effusions still unclear since cytology consistently negative but known to reaccumulate. L effusion exudative but does not appear infected on pleural [**Month/Day/Year **] culture. Bl cx neg. The patient was seen by Thoracic Surgery as well as Interventional Pulmonology. The tubes continued to [**Month/Day/Year 19843**] serosanguinous [**Month/Day/Year **] with intermittent instillations of alteplase and dronase. Thoracic surgery felt intervention would not be beneficial given his overall clinical picture. ID was consulted and pt was switched to meropenem monotherapy [**2115-7-11**] with plan for 4wk IV ABX course (starting [**2115-7-8**]). Pt to be discharged on IV ertapenem q24h with plan to follow-up with ID and complete at minimum of 4wk course ([**2115-8-5**]). On [**2115-7-14**], L pigtail exchanged for pleurex. [**2115-7-15**] smaller R pigtail removed by IP. On [**7-17**], pt accidentally pulled remaining R chest tube. Pt had CT chest to evaluate if repeat pigtail needed to be placed. IP reported no need for placing another chest tube on the R. They want to follow-up with repeat chest CT and then appt in clinic to evaluate if reaccumulation occurs to require a chest tube. Pt with small PTX after L tube exchanged. Persisted for many days. L tube capped with plan for intermittent drainage M, W, F up to 1L each time. Again, thoracic surgery was contact[**Name (NI) **] regarding possibility of intervention based on CT chest [**7-17**]. They reported they did not feel he would benefit from decortication based on mainly parenchymal abnormalities on imaging. . #Pericardial effusion: The patient had a TTE that noted an approximately 1cm effusion located posteriorly but had no echocardiographic signs of tamponade. His pulsus paradoxus remained approximately 6-8 mmHg during his ICU stay. Cardiology recommended following the effusion with a repeat echo in 2 weeks (~[**2115-7-23**]). Pt found to have slight increase in pericardial effusion on chest CT [**7-17**], so TTE completed [**7-18**]. Showed moderate effusion without clear tamponade physiology. Talked to cardiology about poor diastolic filling on repeat TTE from [**7-18**] and they said that without clear tamponade physiology they did not want to do a pericardiocentesis. Patient will follow-up with cardiology on [**8-1**] as an outpatient. . #Hypotension: The patient occasionally became hypotensive with systolics in the high 80s. His hypotension responded well to boluses of NS. His antihypertensive medications were held. His SBPs came up to 100-120 range. BP meds continue to be held on discharge. . #Tachycardia: Pt remained tachycardic throughout hospital stay. HR in 100-110s mostly with occasional elevation to 120s. . #Thrush: pt put on fluconazole on admission because of inability to tolerate nystatin secondary to severe worsening of GERD. Thrush resolved during hospital stay. . #Edema: from IVF, pt was positive during admission resulting in LE edema. Pt also developed asymmetric edema of L arm distal to the elbow. Pt had duplex U/S on [**7-14**] which was neg for DVT. L arm edema worsened, so pt had repeat duplex U/S on [**7-18**]. ACE wraps started on L arm to mobilize [**Month/Year (2) **]. . Chronic diagnoses: # Recurrent esophageal adenocarcinoma: s/p C5D1 [**2115-5-30**], cycle 6 held [**7-4**]. Continued pain mgmt, nausea mgmt, home ativan. # CAD s/p MI: Continued home [**Month/Day (2) **], atenolol held for low BPs. # GERD: continued home PPI Transitional issues: # Pt to f/u with ID in [**Hospital 4898**] clinic, IP with plan for repeat chest CT prior to appt, cards for pericardial effusion f/u # Pt will also f/u with OP oncologist, Dr. [**Last Name (STitle) 3274**] # Pt will require weekly lab draws: CBC with diff, Chem7, AST, ALT; please fax results to ([**Telephone/Fax (1) 4591**]. All questions regarding outpatient parenteral antibiotics should be directed to the Infectious Disease R.N.s at ([**Telephone/Fax (1) 21403**] or to the on-call ID fellow when the clinic is closed. # Full Code Medications on Admission: Preadmission medications listed are correct and complete. Information was obtained from PatientwebOMR. 1. Aspirin 325 mg PO DAILY 2. Atenolol 25 mg PO DAILY 3. Fentanyl Patch 25 mcg/hr TP Q72H 4. Lansoprazole Oral Disintegrating Tab 30 mg PO BID 5. FIRST-Mouthwash BLM *NF* (lidocaine-diphenhyd-[**Doctor Last Name **]-mag-[**Doctor Last Name **]) 200-25-400-40 mg/30 mL Mucous Membrane TID 6. Lorazepam 0.5 mg PO Q4H:PRN nausea, insomnia 7. Ondansetron 8 mg PO Q12H:PRN nausea 8. Naproxen 500 mg PO Q12H:PRN pain Discharge Medications: 1. Fentanyl Patch 25 mcg/hr TP Q72H 2. Lansoprazole Oral Disintegrating Tab 30 mg PO BID 3. Lorazepam 0.5 mg PO Q4H:PRN nausea, insomnia 4. Naproxen 500 mg PO Q12H:PRN pain 5. Aspirin 325 mg PO DAILY 6. FIRST-Mouthwash BLM *NF* (lidocaine-diphenhyd-[**Doctor Last Name **]-mag-[**Doctor Last Name **]) 200-25-400-40 mg/30 mL Mucous Membrane TID 7. Ondansetron 8 mg PO Q12H:PRN nausea 8. ertapenem *NF* 1 gram Intravenous daily end date earliest [**2115-8-5**] - or longer per ID recommendation 9. Docusate Sodium 100 mg PO BID 10. OxycoDONE (Immediate Release) 5 mg PO Q4H:PRN pain hold for sedation, RR <12 11. Senna 1 TAB PO BID:PRN constipation 12. HYDROmorphone (Dilaudid) 1-2 mg IV QMWF PRN for pain from chest tube drainage Discharge Disposition: Extended Care Facility: [**Hospital1 700**] TCU - [**Location (un) 701**] Discharge Diagnosis: Primary diagnosis: Bilateral Pleural effusions Right empyema Secondary diagnosis: Recurrent esophageal cancer Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Dear Mr. [**Known lastname 26973**], It was a pleasure taking care of you at [**Hospital3 **]. You came into the hospital because of right-sided chest pain and shortness of breath. Your pleural effusions were found to be increased on the CT scan of your chest. We had the lung doctors [**Name5 (PTitle) 19843**] the [**Name5 (PTitle) **] from your left lung and leave in a [**Name5 (PTitle) 19843**]. They then drained the right lung as well and left a [**Name5 (PTitle) 19843**] in place. A repeat CT scan on [**7-11**] showed that the infection in your lung had not gotten better. You had a third drainage tube placed in your right lung. Your two right lung drains were removed. The chest tube in your left chest will remain in place and will be drained every M, W, F up to 1L each time. Your home medications were not changed. Please see the attached list for new medications added to your regimen. Please follow-up at the appointments listed below. Followup Instructions: Department: CARDIAC SERVICES When: THURSDAY [**2115-8-1**] at 9:00 AM With: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], MD [**Telephone/Fax (1) 62**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: HEMATOLOGY/ONCOLOGY When: TUESDAY [**2115-8-6**] at 10:00 AM With: [**First Name8 (NamePattern2) 251**] [**Name8 (MD) **], MD [**0-0-**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: INFECTIOUS DISEASE When: FRIDAY [**2115-8-9**] at 10:00 AM With: [**First Name11 (Name Pattern1) 3049**] [**Last Name (NamePattern4) 14666**], MD [**Telephone/Fax (1) 457**] Building: LM [**Hospital Ward Name **] Bldg ([**Last Name (NamePattern1) **]) [**Hospital 1422**] Campus: WEST Best Parking: [**Hospital Ward Name **] Garage Department: SURGICAL SPECIALTIES When: FRIDAY [**2115-8-16**] at 9:45 AM With: [**First Name8 (NamePattern2) 161**] [**Name6 (MD) 162**] [**Name8 (MD) 163**], MD [**Telephone/Fax (1) 921**] Building: [**Hospital6 29**] [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Department: HEMATOLOGY/ONCOLOGY/Interventional Pulmonology When: THURSDAY [**2115-8-22**] at 10:30 AM With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 6543**], MD [**0-0-**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) 24**] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage **You will get a repeat chest CT on this same day [**2115-8-22**] [**Name6 (MD) **] [**Name8 (MD) **] MD, [**MD Number(3) 1368**] Completed by:[**2115-7-19**] ICD9 Codes: 5119, 412, 4589
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Medical Text: Admission Date: [**2182-10-30**] Discharge Date: [**2182-11-26**] Date of Birth: [**2122-3-3**] Sex: M Service: MEDICINE Allergies: Penicillins / Actos / Percocet / Cephalosporins Attending:[**First Name3 (LF) 1145**] Chief Complaint: Epigastric pain and shortness of breath Major Surgical or Invasive Procedure: Intubated IABP RIJ History of Present Illness: Mr. [**Known lastname **] is a 60 y.o male with a history of nonischemic cardiomyopathy with an ejection fraction of 20% and ICD who presented to [**Hospital6 **] with epigastric chest pain and shortness of breath. At [**Hospital1 487**], he was found to have a left bundle branch block that was not known to be old and as such was taken to the cath lab. The LBBB was later noted to be old, however during cath he was noted to have a total occlusion to the OM2 as well as 2 tight lesions in the RCA. Of note, the patient had been found to have inferior septal ischemia on a stress test during outpatient workup. In the cath lab, the patient subsequently developed acute shortness of breath, at which point he was given 100mg of lasix and started on a nitroglycerin drip. His symptoms did not improve, at which point he was intubated and an intra-aortic balloon pump was placed through right femoral access. He also received angiomax and 300mg of clopidogrel. A swan was placed which showed elevated pulmonary artery pressures and wedge pressures between 37-44. Laboratory exam at [**Hospital1 487**] was significant for Na 129, K 4.1, BUN 53, Cr 1.3, hemoglobin 16.6 and platelets of 135. Her PT was 19.4 and INR was 1.8. Dig level of 0.8, and cardiac enzymes significant for CK of 135, MB of 7 and Troponin of 0.08 which was negative in their reference range. . Review of systems could not be obtained due to intubation. Past Medical History: CARDIAC HISTORY: Positive for non-ischemic cardiomyopathy with ejection fraction 16%. -PACING/ICD: VVI AICD implated on [**2180-4-26**] 3. OTHER PAST MEDICAL HISTORY: Diabetes type II on insulin Hypercholesterolemia Peripheral neuropahty Hypertriglyceride CHF Afib Dilated non-ischemic cardiomyopathy Multinodule goitor likely due to amiodarone Past surgical history: Appy Chole Epigastric hernia repair Tonsillectomy AICD/pacemaker implanted [**2180-4-8**] . Social History: -Tobacco history: Former smoker -ETOH: no etoh Is not married. Family History: Father died with rectal cancer Mother has [**Name2 (NI) **] of colon ca, rheumatic valvular dz Physical Exam: PHYSICAL EXAMINATION on Admission: VS: T=97.5 BP= 87/38 HR=89 RR=16 O2 sat=100% on 500/18/5/40 GENERAL: Intubated, sedated. HEENT: NCAT. Sclera anicteric. PERRL, Conjunctiva were pink, no pallor or cyanosis of the oral mucosa. CARDIAC: Fast, irregular, normal S1, S2. No m/r/g. No thrills, lifts. No S3 or S4. LUNGS: Diffusely rhonchorous with crackles throughout. ABDOMEN: Soft, NTND. No HSM or tenderness. EXTREMITIES: Trace lower extremity edema. Right femoral sheath introducer sheeth and swan in place. SKIN: No stasis dermatitis, ulcers, scars, or xanthomas. PULSES: Radial, DP 2+ bilaterally. . Pertinent Results: Admission Labs: [**2182-10-30**] 11:04PM BLOOD WBC-12.7* RBC-4.68 Hgb-15.5 Hct-44.1 MCV-94 MCH-33.1* MCHC-35.1* RDW-17.0* Plt Ct-157 [**2182-10-30**] 11:04PM BLOOD Neuts-83.9* Lymphs-10.4* Monos-4.5 Eos-0.6 Baso-0.6 [**2182-10-30**] 11:53PM BLOOD PT-33.4* PTT-150* INR(PT)-3.4* [**2182-10-30**] 11:04PM BLOOD Plt Ct-157 [**2182-10-30**] 11:04PM BLOOD Glucose-243* UreaN-54* Creat-1.6* Na-133 K-4.4 Cl-96 HCO3-29 AnGap-12 [**2182-10-30**] 11:04PM BLOOD ALT-22 AST-31 LD(LDH)-313* CK(CPK)-126 AlkPhos-89 TotBili-0.3 [**2182-10-30**] 11:04PM BLOOD CK-MB-10 MB Indx-7.9* cTropnT-0.17* [**2182-10-30**] 11:04PM BLOOD Calcium-7.9* Phos-5.3* Mg-1.9 [**2182-10-30**] 11:04PM BLOOD TSH-3.9 . STUDIES: CHEST (PORTABLE AP) Study Date of [**2182-10-30**] Large right upper lobe opacity is consistent with a right upper lobe collapse. The NG tube tip is in the distal right mainstem bronchus. The aortic balloon pump tip is 2.4 cm from the aortic arch. ET tube tip is 2.3 cm above the carina. Swan-Ganz catheter from inferior approach is in the main right pulmonary artery. Left transvenous pacemaker lead terminates in the standard position in the right ventricle. There is moderate-to-severe cardiomegaly. Left perihilar and left upper lobe opacities could be atelectasis or infection. There is gastric distention. There is mild shifting of the cardiomediastinum towards the right side. . Portable TTE (Complete) Done [**2182-10-31**] Conclusions The left atrium is mildly dilated. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses are normal. The left ventricular cavity is severely dilated. There is severe global left ventricular hypokinesis (LVEF = 15 %). Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). There is no ventricular septal defect. Right ventricular chamber size is normal. with normal free wall contractility. The aortic valve leaflets are mildly thickened (?#). There is mild aortic valve stenosis (valve area 1.5 cm2). The aortic stenosis is likely the "low flow/low gradient" type. No aortic regurgitation is seen. The mitral valve leaflets are mildly thickened. There is no mitral valve prolapse. The left ventricular inflow pattern suggests a restrictive filling abnormality, with elevated left atrial pressure. The tricuspid valve leaflets are mildly thickened. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. . CT Ab/Pelvis [**2182-11-13**] 1. Findings suggestive of mild-to-moderate pulmonary edema. More focal small nodular opacities within the lungs as described above may represent focal regions of underlying pneumonitis/pneumonia, possibly aspiration related in this patient with distal trachea secretions. Small right simple pleural effusion. Follow up CT chest in [**4-13**] months recommended to confirm nodular opacity resolution. 2. No definite source of infection noted within the abdomen/pelvis. No biliary ductal dilatation. 3. Moderate sized right piriformis collection, probably intramuscular hematoma, particularly in the setting of anticoagulation (infected collection cannot be excluded). 4. Dense atherosclerotic calcifications involving the aorta and coronary tree. Cardiac enlargement dilatation of both the left ventricle and left atrium. . CARDIAC CATH [**2182-11-21**] 1.Selective coronary angiography in this right dominant system demonstrated two vessel coronary artery disease. The LMCA was free of angiographically-apparent disease. The LAD was heavily calcified with mild luminal irregularities. The LCx had a short total occlusion in the mid CX into the OM2 which filled via collaterals from the OM1 and LAD. The RCA had severe diffuse calcific diesease with calcific 70-80% stenoiss in the proximal vessel, distal 50% stenosis adn 99% calcific stenosis at the RPDA/RPL bifurcation. 2.Resting hemodynamics revealed normal right and left sided filling presures with RVEDP 13 mmHg and PCWP 12 mHg. The cardiac index was preserved at 2.6 l/min/m2. There was mild systolic hypotension SBP 87 mmHg. 3. Left ventriculography was deferred. 4. Successful PCI of RCA lesions with rotablation and DES via R radial approach and balloon pump support 5. Unsuccessful PCI of the OM. 6. Secondary prevention of CAD 7. Plavix 75mg daily for 12 months 8. Monitor for signs of left leg ischemia 9. Follow creatinine and HCT FINAL DIAGNOSIS: 1. Two vessel coronary artery disease. 2. Successful PCI to RCA with rotablation and IABP support. 3. Unsuccessful PCI of the OM. 4. Successful removal of IABP. . DISCHARGE LABS: Na 134, K 4.8, BUN 35, Creat 1.2, WBC 3.7, HCT 27, HGB 8.9, plt 116, INR 1.6 . ECHO [**11-25**]: The left atrium is moderately dilated. Left ventricular wall thicknesses are normal. The left ventricular cavity is severely dilated. There is severe global left ventricular hypokinesis with near akinesis of the inferior septum, inferior, and inferolateral wall. The anterior wall and anterior septum contracts best, but are hypokinetic. Global systolic function is severely depressed. (LVEF = 20 %). No masses or thrombi are seen in the left ventricle. Tissue Doppler imaging suggests an increased left ventricular filling pressure (PCWP>18mmHg). Right ventricular chamber size is normal. with mild global free wall hypokinesis. The aortic root is mildly dilated at the sinus level. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. There is mild aortic valve stenosis (valve area 1.2-1.9cm2). Trace aortic regurgitation is seen. The mitral valve leaflets are structurally normal. There is no mitral valve prolapse. Mild (1+) mitral regurgitation is seen. There is mild pulmonary artery systolic hypertension. There is no pericardial effusion. Compared with the prior study (images unavailable for review) of [**2182-10-31**], left ventricular systolic function is similar. Mild mitral regurgitation is now seen. . Micro data: (unless noted positive, result is negative) [**2182-11-13**] STOOL CLOSTRIDIUM DIFFICILE TOXIN A & B TEST-FINAL INPATIENT [**2182-11-12**] Blood (Toxo) TOXOPLASMA IgG ANTIBODY-FINAL; TOXOPLASMA IgM ANTIBODY-FINAL INPATIENT [**2182-11-12**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-12**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-11**] URINE URINE CULTURE-FINAL INPATIENT [**2182-11-11**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-11**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-10**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-10**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-9**] CATHETER TIP-IV WOUND CULTURE-FINAL INPATIENT [**2182-11-9**] CATHETER TIP-IV WOUND CULTURE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE, STAPHYLOCOCCUS, COAGULASE NEGATIVE} INPATIENT [**2182-11-9**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL INPATIENT [**2182-11-8**] BLOOD CULTURE ( MYCO/F LYTIC BOTTLE) BLOOD/FUNGAL CULTURE-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE}; BLOOD/AFB CULTURE-FINAL; Myco-F Bottle Gram Stain-FINAL INPATIENT [**2182-11-8**] URINE URINE CULTURE-FINAL INPATIENT [**2182-11-8**] BLOOD CULTURE Blood Culture, Routine-FINAL {STAPHYLOCOCCUS, COAGULASE NEGATIVE}; Aerobic Bottle Gram Stain-FINAL INPATIENT [**2182-11-7**] Blood (Toxo) TOXOPLASMA IgG ANTIBODY-FINAL; TOXOPLASMA IgM ANTIBODY-FINAL INPATIENT [**2182-11-7**] Immunology (CMV) CMV Viral Load-FINAL INPATIENT [**2182-11-7**] Blood (EBV) [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS VCA-IgG AB-FINAL; [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS EBNA IgG AB-FINAL; [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS VCA-IgM AB-FINAL INPATIENT [**2182-11-7**] SEROLOGY/BLOOD VARICELLA-ZOSTER IgG SEROLOGY-FINAL INPATIENT [**2182-11-7**] Blood (EBV) [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS VCA-IgG AB-FINAL; [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS EBNA IgG AB-FINAL; [**Doctor Last Name **]-[**Doctor Last Name **] VIRUS VCA-IgM AB-FINAL INPATIENT [**2182-11-7**] Blood (CMV AB) CMV IgG ANTIBODY-FINAL; CMV IgM ANTIBODY-FINAL INPATIENT [**2182-11-6**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL INPATIENT [**2182-11-6**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-6**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-6**] URINE URINE CULTURE-FINAL INPATIENT [**2182-11-5**] URINE URINE CULTURE-FINAL INPATIENT [**2182-11-3**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-3**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-3**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL INPATIENT [**2182-11-3**] URINE Legionella Urinary Antigen -FINAL INPATIENT [**2182-11-1**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-1**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-11-1**] URINE URINE CULTURE-FINAL INPATIENT [**2182-10-31**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL INPATIENT [**2182-10-31**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-10-31**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-10-31**] URINE URINE CULTURE-FINAL INPATIENT [**2182-10-31**] SPUTUM GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL INPATIENT [**2182-10-31**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-10-31**] BLOOD CULTURE Blood Culture, Routine-FINAL INPATIENT [**2182-10-31**] URINE URINE CULTURE-FINAL INPATIENT [**2182-10-30**] MRSA SCREEN MRSA SCREEN-FINAL INPATIENT Brief Hospital Course: 60 year old man who presented to an outside hospital emergency room with epigastric pain and shortness of breath, who was subsequently taken to the cath lab after being found to have a LBBB which was later demonstrated to be old. The patient subsequently became dyspneic in the cath lab, was intubated, became hypotensive, and an IABP was placed with phenylephrine started. He was subsequently transferred to the [**Hospital1 18**] CCU for further care. . # Shock and Dyspnea: The patient initially had elevated biventricular elevated filling pressures, increased cardiac output and low SVR. He was therefore thought to have distributive shock with potential sepsis. Our initial chest x-ray after new OG tube placement showed a collapsed right upper lobe of his lung which later resolved after replacement of the OG tube. He was pan-cultured and started on broad spectrum antibiotics including Vancomycin and Zosyn, later switched to Vancomycin, Cefepime, and Ciprofloxacin. His pressors remained marginal, and he required levophed to maintain MAPs >65. Due to persistently adequate cardiac output readings from his Swan, his intra-aortic balloon pump and Swan were removed. Repeat chest x-rays showed pulmonary edema and acute exacerbation of his systolic congestive heart failure. Extubation was attempted on [**2182-11-1**], but afterwards his oxygenation decreased acutely most likely secondary to flash pulmonary edema. He failed a trial of BiPAP and became acutely agitated, requiring emergent re-intubation. He was subsequently aggressively diuresed with IV boluses of furosemide in addition to a furosemide drip with metolazone. After the initial diuresis, he was transitioned to Torsemide PO and developed hyponatremia. The Torsemide dose was adjusted to 10 mg and he appears to be at his dry weight today of 200 pounds. He is ambulating on RA with O2 sats in high 90's, no peripheral edema and clear lung sounds. Given his very low EF, he should be started in spironolactone and digoxin as his BP allows. Please weight daily and adjust diuretics to maintain weight at 200 pounds. He is being considered for a heart transplant and transplant workup was started during this hospital stay. He will follow up with Dr. [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) 437**] and [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **], NP here for continued workup and evaluation. . # Coronary artery disease: The patient had evidence of a reperfusion defect on recent SPECT stress test and evidence of tight lesions in RCA from his cardiac catheterization at the outside hospital. His troponins were mildly elevated which could have represented demand ischemia and/or congestive heart failure, but less likely acute coronary syndrome. His ECG showed a LBBB that remained unchanged throughout his CCU stay. He was medically managed with 48 hours of a heparin drip, full dose aspirin, atorvastatin 40mg daily, loaded with 300mg plavix and then given plavix 75mg daily. He underwent catheterization prior to discharge with stenting of an RCA lesion (see cath report.) Note that in the setting of a heparin gtt, the patient developed a piriformis hematoma; his HCT remained stable. . # Atrial fibrillation and Ventricular Tachycardia: The patient was persistently in atrial fibrillation and had several episodes of ventricular tachycardia prompting firing of his ICD. His beta blocker was held secondary to his hypotension requiring pressors. He was seen by our electrophysiology team and received a AV nodal ablation following by a BiV pacer upgrade. He has been restarted on his betablocker at a lower dose and amiodarone was loaded. He has had no further VT within the last 4-5 days and he is [**Age over 90 **]% AV paced on telemetry. . # Acute renal failure: This was most likely secondary to poor forward flow in the setting of an acute on chronic systolic CHF exacerbation. His lisinopril was held, medications were renally dosed and his renal function improved with diuresis. ACEi was restarted before discharge at lower dose. . # Diabetes mellitus type 2: The patient was maintained on glargine and an ISS without complications. Metformin was d/c'ed because of his CHF. His glargine may need to be uptitrated as his appetite improves. Please continue to do fingerstickes before meals with Humalog insulin coverage per sliding scale. . #Transaminitis: LFTs trending down. Thought to be secondary to poor forward flow with CHF exacerbation. Statin has been restarted. . # Anemia: Hct has slowly trended down during hospital stay. He has no evidence of acute bleeding at present and piriformis hematoma development did not seem to drop his hct precipitously. It is thought that anemia a combination or phlebotomy, ARF and critical illness. His hct should be monitored and iron studies sent if hct/hgb continues to drop. Stools should be Guiaiced. . # Hyponatremia: now resolved. Thought secondary to overdiuresis. Torsemide dose has been adjusted and should be titrated to maintain dry weight of 200 pounds. . # Social: Patient lives alone with an elderly aunt and uncle as [**Name2 (NI) **] supports.He was functionally independent before admission and goal is to return to this. Medications on Admission: Home medications Aspirin 81mg daily lipitor 40mg daily lisinopril 40mg qd lopressor 150mg [**Hospital1 **] digoxin 0.375mg MWF, 0.25mg TTSS furosemide 160mg [**Hospital1 **] metolazone 2.5 qweek Gemfibrozil 600mg [**Hospital1 **] metformin 1000mg [**Hospital1 **] lantus 48 units qd multivitamin coumadin 5mg TWFSS, 7.5mg MT Discharge Medications: 1. aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 2. atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 3. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*0* 4. metoprolol succinate 25 mg Tablet Sustained Release 24 hr Sig: 0.5 Tablet Sustained Release 24 hr PO DAILY (Daily). Disp:*30 Tablet Sustained Release 24 hr(s)* Refills:*0* 5. clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily): Do not skip doses or stop taking unless Dr. [**Last Name (STitle) **] says it is OK. Disp:*30 Tablet(s)* Refills:*11* 6. senna 8.6 mg Capsule Sig: One (1) Capsule PO twice a day as needed for constipation. 7. trazodone 50 mg Tablet Sig: 0.5 Tablet PO HS (at bedtime) as needed for Insomnia. 8. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. amiodarone 200 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 10. torsemide 5 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily): Hold for SBP < 70. 11. insulin glargine 100 unit/mL Solution Sig: Ten (10) units Subcutaneous at bedtime. 12. insulin lispro 100 unit/mL Solution Sig: per sliding scale units Subcutaneous three times a day: before meals. 13. warfarin 5 mg Tablet Sig: One (1) Tablet PO 4X per week (Sun, Tues, Wed, Fri): Please check INR on Thursday [**11-28**]. 14. warfarin 2.5 mg Tablet Sig: Three (3) Tablet PO 3X/week (Mon, Thurs, Sat). 15. gemfibrozil 600 mg Tablet Sig: One (1) Tablet PO twice a day. 16. multivitamin Tablet Sig: One (1) Tablet PO once a day. 17. Outpatient Lab Work [**Last Name (un) 6267**] check IR, PT, CBC and Chem 7 on [**2182-11-28**] Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: Atrial fibrillation s/p AV node ablation Acute on chronic systolic congestive heart failure Anemia Hypothyroidism Ventricular Tachycardia Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Ambulatory - Independent. Discharge Instructions: It was a pleasure to take care of you in the hospital. You were admitted for heart failure and required a lengthy stay in the ICU. During your time in the ICU you were intubated and had pneumonia. Also, three important procedures were performed. First, you had an AV nodal ablation which allowed your heart to beat more slowly. Second, you had a revision to your pacer to help your heart work better. Finally, you had a catheterization of your heart during which stents were placed to open blocked vessels. You should make the following changes to your medications: CHANGE THE FOLLOWING DOSES: - Change aspirin 81 mg daily to aspirin 325 mg daily - Change Lisinopril 40 mg daily to Lisinopril 5 mg daily - Change Metoprolol 150 mg [**Hospital1 **] to Toprol XL 12.5 mg daily - Change Furosemide to torsemide 10 mg daily STOP THE FOLLOWING MEDICATIONS: - Digoxin, Metolozone, metformin, spironolactone START THE FOLLOWING NEW MEDICATIONS: - Plavix to keep the stents open. You will need to take this medicine every day for at least one year with a 325 mg aspirin. Do not stop taking these medicines unless Dr. [**First Name (STitle) 437**] tells you it is OK. - Start Amiodarone to control your heart rhythm - Start Trazadone to help you sleep - start senna as needed if you get constipated. - Ranitidine to protect your stomach from the Plavix and aspirin. Weigh yourself every morning, call Dr. [**First Name (STitle) 437**] if weight goes up more than 3 lbs in 1 day or 5 pounds in 3 days. Please go to all of the recommended followup appointments that are listed below. Followup Instructions: Department: CARDIAC SERVICES When: MONDAY [**2182-12-16**] at 9:00 AM With: DR. [**First Name8 (NamePattern2) **] [**Doctor Last Name **] [**Telephone/Fax (1) 62**] Building: SC [**Hospital Ward Name 23**] Clinical Ctr [**Location (un) **] Campus: EAST Best Parking: [**Hospital Ward Name 23**] Garage Please call Dr. [**Last Name (STitle) **] and Dr. [**Last Name (STitle) 63252**] when you get out of rehab to schedule appts. Completed by:[**2182-11-27**] ICD9 Codes: 0389, 486, 5845, 4271, 2760, 4254, 2761, 7907, 4280, 2720
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7578 }
Medical Text: Admission Date: [**2119-1-9**] Discharge Date: [**2119-1-14**] Date of Birth: [**2087-4-22**] Sex: M Service: CARDIOTHORACIC Allergies: No Known Allergies / Adverse Drug Reactions Attending:[**First Name3 (LF) 1406**] Chief Complaint: Type A dissection Major Surgical or Invasive Procedure: [**2119-1-9**] Replacement of Ascending aorta with 28mm Gelweave graft History of Present Illness: This 31 year old male awoke on [**1-9**] with substernal chest pain radiating to his back and then legs with shortness of breath. A CTA elsewhere revealed a Type A dissection, extending to the renal, without visualization of the right kidney. He was Life Flighted here after diversion from [**Hospital1 2025**]. Past Medical History: Remote stroke after rodding, no residual Left deep vein thrombophlebitis Chronic low back pain Obstructive sleep apnea Sinusitis- completed course antibiotics/prednisone s/p Lumbar laminectomies s/p femoral rodding h/o tympanic membrane surgeries Social History: 15pk year history (active smoker) heavy ETOH until 2years ago disabled from back pain Family History: noncontributory Physical Exam: admission: Pulse: 88 Resp: O2 sat: B/P Right: 116/60 Left: Height: Weight: 95 kg General: Skin: Dry [x] intact [x] HEENT: PERRLA [x] EOMI [x] Neck: Supple [x] Full ROM [x] Chest: Lungs clear bilaterally [x] Heart: RRR [x] Irregular [] Murmur Abdomen: Soft [x] non-distended [x] non-tender [x] bowel sounds + [x] Extremities: Warm [x], well-perfused [x] Edema Varicosities: None [] Neuro: Grossly intact Pulses: Femoral Right: 2+ Left: 2+ DP Right: 2+ Left: dop PT [**Name (NI) 167**]: dop Left: dop Radial Right: 2+ Left: 2+ Carotid Bruit Right: no Left: Pertinent Results: [**2119-1-9**] Echo: PRE-CPB:1. The left atrium is normal in size. No atrial septal defect is seen by 2D or color Doppler. 2. Left ventricular wall thicknesses are normal. The left ventricular cavity is mildly dilated. Overall left ventricular systolic function is mildly depressed (LVEF= 50 %). 3. Right ventricular chamber size and free wall motion are normal. 4. The aortic root is mildly dilated at the sinus level. The ascending aorta is mildly dilated. The descending thoracic aorta is mildly dilated. A mobile density is seen in the ascending aorta consistent with an intimal flap/aortic dissection. The aortic wall is thickened consistent with an intramural hematoma, which extends into the descending aorta. 5. There are three aortic valve leaflets. There is no aortic valve stenosis. Mild to moderate ([**1-8**]+) aortic regurgitation is seen. Mild (1+) mitral regurgitation is seen. 6. There is a small left pleural effusion. 7. There is a trivial/physiologic pericardial effusion. Dr. [**Last Name (STitle) **] was notified in person of the results. POST-CPB: On infusion of phenylephrine. A pacing for slow sinus. Repaired ascending aorta with synthetic material seen. No residual dissection flap seen. Preserved biventricular systolic function. No AI seen. MR remains 1+. The descending aortic contour is unchanged post decannulation. I certify that I was present for this procedure in compliance with HCFA regulations. [**2119-1-10**] Kidney U/S: 1. No normal arterial venous waveforms noted within the right kidney with an abnormal-appearing pulsatile flow only seen within the right renal hilum likely representing collateral flow from lumbar vessels. 2. More normal-appearing arterial and venous waveforms within the left kidney. Although, this also appears slightly hypoperfused as demonstrated by the lack of significant vascularity extending out into the cortex on the color images. [**2119-1-13**] CXR: The heart size is stable. Post-sternotomy wires are unremarkable. The aortic contour is still enlarged which might be related to recent surgery and the presence of known dissection. There is no pneumothorax. There is small amount of left pleural effusion but overall the aeration at the lung bases has improved in the interim. [**2119-1-9**] 07:20PM BLOOD WBC-13.4* RBC-3.79* Hgb-11.0* Hct-33.1* MCV-88 MCH-29.0 MCHC-33.2 RDW-12.9 Plt Ct-297 [**2119-1-11**] 01:51AM BLOOD WBC-25.1*# RBC-3.44* Hgb-10.3* Hct-29.8* MCV-87 MCH-30.1 MCHC-34.7 RDW-13.4 Plt Ct-238 [**2119-1-14**] 05:50AM BLOOD WBC-14.4* RBC-3.21* Hgb-9.4* Hct-28.3* MCV-88 MCH-29.4 MCHC-33.4 RDW-14.2 Plt Ct-316 [**2119-1-9**] 07:20PM BLOOD PT-16.3* PTT-27.4 INR(PT)-1.4* [**2119-1-11**] 01:51AM BLOOD PT-17.7* PTT-28.8 INR(PT)-1.6* [**2119-1-9**] 07:20PM BLOOD UreaN-15 Creat-1.5* [**2119-1-10**] 04:56AM BLOOD Glucose-112* UreaN-15 Creat-1.5* Na-137 K-4.6 Cl-108 HCO3-23 AnGap-11 [**2119-1-14**] 05:50AM BLOOD Glucose-94 UreaN-20 Creat-1.5* Na-134 K-4.0 Cl-100 HCO3-26 AnGap-12 Brief Hospital Course: Following admission he was taken in stable condition emergently to the Operating Room where the ascending aorta was replace. Please see operative report for surgical details. He tolerated the procedure well and weaned from bypass on Neo-Synephrine and Propofol and transferred to the CVICU for invasive monitoring in stable condition. He remained stable, weaned from sedation, awoke neurologically intact and extubated with 24 hours. During surgery, the aorta appeared abnormal and aortitis was considered. Biopsy was sent from the Operating Room. Rheumatology and Infectious Disease were consulted for assistance in elucidation of this. Blood cultures were sent. He was transferred to the floor on post-op day #2 to begin increasing his activity level. He was gently diuresed toward his preop weight. His pathology report suggested a differential diagnosis that included Ehlers-Danlos Type IV. As such he was referred to see the genetic counselling service at [**Hospital1 11900**] of [**Location (un) 86**] as an outpatient. As mentioned earlier Infectious disease was consulted to evaluate for an infectious cause of his dissection or aortitis but it was felt that there was not evidence for either. He continued to make good progress and by post-operative day five he was ready for discharge to home with VNA services, appropriate medications and follow-up appointments. Medications on Admission: Naprosyn PRN Amoxicillin 500 mg PO TID-just completed 10 day course for sinusitis Cipro 500 mg PO BID for 14 days-just completed 14 day course Prednisone taper just completed 5 days ago for sinusitis Discharge Medications: 1. docusate sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day) for 1 months. Disp:*60 Capsule(s)* Refills:*0* 2. aspirin 81 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*1* 3. oxycodone-acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. Disp:*50 Tablet(s)* Refills:*0* 4. ranitidine HCl 150 mg Tablet Sig: One (1) Tablet PO DAILY (Daily) for 2 weeks. Disp:*14 Tablet(s)* Refills:*0* 5. metoprolol tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Disp:*90 Tablet(s)* Refills:*2* 6. Lasix 20 mg Tablet Sig: One (1) Tablet PO once a day for 3 days. Disp:*3 Tablet(s)* Refills:*0* 7. potassium chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig: One (1) Tab Sust.Rel. Particle/Crystal PO once a day for 3 days. Disp:*3 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0* Discharge Disposition: Home With Service Facility: VNA of Southeastern Mass. Discharge Diagnosis: Type A Aortic dissection s/p Replacement of ascending aorta Postop UTI Past medical history: Remote stroke Chronic low back pain Obstructive sleep apnea s/p Lumbar laminectomies s/p femoral rodding h/o tympanic membrane surgeries Discharge Condition: Alert and oriented x3, nonfocal Ambulating with steady gait Incisional pain managed with oral analgesics Incisions: Sternal - healing well, no erythema or drainage Edema: trace Discharge Instructions: Please shower daily including washing incisions gently with mild soap, no baths or swimming until cleared by surgeon. Look at your incisions daily for redness or drainage Please NO lotions, cream, powder, or ointments to incisions Each morning you should weigh yourself and then in the evening take your temperature, these should be written down on the chart No driving for approximately one month and while taking narcotics, will be discussed at follow up appointment with surgeon when you will be able to drive No lifting more than 10 pounds for 10 weeks Please call with any questions or concerns [**Telephone/Fax (1) 170**] Females: Please wear bra to reduce pulling on incision, avoid rubbing on lower edge **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Followup Instructions: You are scheduled for the following appointments: Surgeon: Dr. [**Last Name (STitle) **] ([**Telephone/Fax (1) 170**]) on Wednesday [**2-1**] at 1:00 ([**Hospital Ward Name **] 2A) *** Cardiologist: Please ask Dr. [**Last Name (STitle) **] for a referral to a cardiologist and make appt for 4 weeks Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] office from genetic testing at [**Hospital1 11900**] of [**Location (un) 86**] will be calling you on Monday to arrange an appointment. His office phone is ([**Telephone/Fax (1) 77621**]. Please call to schedule appointments with your Primary Care Dr.[**Last Name (STitle) **] in [**4-11**] weeks **Please call cardiac surgery office with any questions or concerns [**Telephone/Fax (1) 170**]. Answering service will contact on call person during off hours** Completed by:[**2119-1-14**] ICD9 Codes: 5990
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7579 }
Medical Text: Admission Date: [**2131-2-10**] Discharge Date: [**2131-2-17**] Date of Birth: [**2085-9-12**] Sex: M Service: NEUROLOGY Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**Last Name (NamePattern1) 1838**] Chief Complaint: Progression of stroke Major Surgical or Invasive Procedure: CTA MRI/MRA ECHO History of Present Illness: HPI: The pt is a 45 year-old left-handed man with a long tobacco history and a recent stroke who presented to the ED today with complaints of new L facial tingling. He states that about 3-4 weeks ago, he was in his USOH driving home on a snow mobile when he developed abrupt onset dizziness (spinning) and severe nausea and vomiting. He tried to drive and had to look down on the ground to decrease the sensation of spinning. He did not have diplopia or weakness and was able to drive himself slowly home but required help to get up to the house as he was "weak all over". He then spent the next few days in bed, as he thought he had a "stomach bug". His symptoms persisted however, so he went to see his PCP who told him he had an ear infection and vertigo. He was treated with meclizine and antibiotics. His symptoms gradually improved over the next few days, however 7 days ago, he woke at 3am with severe room spinning, double vision and slurred speech. His wife also noted that his R eye was "turned out". Mr. [**Known lastname **] states the diplopia is intermittent and is unable to characterize the diplopia further (unsure if it is vertical or horizontal or for near vs far). He again waited for a couple of days, but by Monday his symptoms were persistent and he had developed severe tinnitus in the L ear. He therefore went to his PCP who sent him to [**Hospital **] [**Hospital3 **]. There he was admitted and was told he had a stroke. He states that he had an MRI and what seems to be at TEE ("camera down the throat to look at the heart"). Per the family report, they were unable to identify a source of stroke and started him on ASA 325 and Simvastatin. He was discharged home 3 days ago, despite persistent difficulty with his gait and slurring of his speech. Yesterday evening, he developed abrupt onset tingling over the L side of his mouth around 8:30 pm. He decided to go to bed, but then woke with L sided tingling over his arm as well. He and his wife therefore decided to come here for further care. He has had persistent slurred speech and intermittent diplopia since last Saturday as well as falling to the L side when walking. He denies dysphagia or hearing difficulties now. ROS: per HPI. The pt denied recent fever or chills. No night sweats or recent weight loss or gain. Denied cough, shortness of breath. Denied chest pain or tightness, palpitations. Denied nausea, vomiting, diarrhea, constipation or abdominal pain. No recent change in bowel or bladder habits. No dysuria. Denied arthralgias or myalgias. Denied rash. Past Medical History: - as above - R steel plate in leg Social History: -beer 6-8 per day (max 12 per day, denies hx of DT's or withdrawal) -tobacco [**12-29**] ppd -drug: denies -works as a mechanic -lives w/ wife Family History: mother: HTN, DM -father: no medical problems -aunt: stroke in her 50's Physical Exam: NIH SS: 2 1a. Level of Consciousness: 0 1b. LOC questions: 0 1c. LOC commands: 0 2. Best gaze: 0 3. Visual: 0 4. Facial palsy: 1 5a. Motor arm, left: 0 5b. Motor arm, right: 0 6a. Motor leg, left: 0 6b. Motor leg, right: 0 7. Limb ataxia: 0 8. Sensory: 0 9. Best language: 0 10. Dysarthria: 1 11. Extinction and inattention: 0 Vitals: 97.6 72 148/66 16 100% RA General: Awake, cooperative, NAD. HEENT: NC/AT, no scleral icterus noted, MMM, no lesions noted in oropharynx Neck: Supple, no carotid bruits appreciated. No nuchal rigidity Pulmonary: Lungs CTA bilaterally without R/R/W Cardiac: RRR, nl. S1S2, no M/R/G noted Abdomen: soft, NT/ND, normoactive bowel sounds, no masses or organomegaly noted. Extremities: No edema or rashes Neurologic: -Mental Status: Alert, oriented x 3. Able to relate history without difficulty. Attentive. Language is fluent with intact repetition and comprehension but significant dysarthria. Normal prosody. There were no paraphasic errors. Pt. was able to name both high and low frequency objects. Able to read without difficulty. Able to follow both midline and appendicular commands. There was no evidence of apraxia or neglect. CN I: not tested II,III: VFF to confrontation, pupils 3mm->2mm bilaterally, fundi normal but narrow vessels III,IV,V: EOMI, slight R exotropia (no clear skew). mild bilateral ptosis. No nystagmus V: sensation intact V1-V3 to LT (despite persistent feeling of L face tingling); + corneals & nasal tickle bilaterally VII: slight R facial droop, symm forehead wrinkling VIII: hears finger rub bilaterally IX,X: palate elevates symmetrically, uvula midline; + gag [**Doctor First Name 81**]: SCM/trapezeii [**5-1**] bilaterally XII: tongue protrudes midline, able to move tongue symmetrically L/R Motor: Normal bulk and tone; slight asterixis; no myoclonus. No pronator drift. Delt [**Hospital1 **] Tri WE FE Grip IO C5 C6 C7 C6 C7 C8/T1 T1 L 5 5 5 5 5 5 5 R 5 5 5 5 5 5 5 IP Quad Hamst DF [**Last Name (un) 938**] PF L2 L3 L4-S1 L4 L5 S1/S2 L 5 5 5 5 5 5 R 5 5 5 5 5 5 Reflex: No clonus [**Hospital1 **] Tri Bra Pat An Plantar C5 C7 C6 L4 S1 CST L 1--------------- Flexor R 1--------------- Flexor -Sensory: No deficits to light touch, pinprick. No extinction to DSS. -Coordination: No intention tremor, mild dysmetria bilaterally with FNF. Overshoots w/ mirror testing bilaterally -Gait: deferred given concern for acute stroke Pertinent Results: [**2131-2-15**] 06:20AM BLOOD WBC-10.3 RBC-4.39* Hgb-13.3* Hct-39.2* MCV-89 MCH-30.2 MCHC-33.9 RDW-12.8 Plt Ct-200 [**2131-2-14**] 06:00AM BLOOD WBC-10.0 RBC-4.45* Hgb-13.6* Hct-40.2 MCV-90 MCH-30.6 MCHC-33.8 RDW-12.8 Plt Ct-187 [**2131-2-13**] 03:45AM BLOOD WBC-9.7 RBC-4.50* Hgb-13.8* Hct-40.1 MCV-89 MCH-30.8 MCHC-34.5 RDW-12.9 Plt Ct-218 [**2131-2-12**] 06:18AM BLOOD WBC-10.7 RBC-4.43* Hgb-13.6* Hct-39.1* MCV-88 MCH-30.6 MCHC-34.7 RDW-13.0 Plt Ct-188 [**2131-2-11**] 03:16AM BLOOD WBC-10.1 RBC-4.68 Hgb-14.4 Hct-41.7 MCV-89 MCH-30.7 MCHC-34.5 RDW-12.9 Plt Ct-203 [**2131-2-10**] 09:42PM BLOOD WBC-13.3* RBC-4.92 Hgb-15.1 Hct-44.0 MCV-89 MCH-30.6 MCHC-34.2 RDW-12.8 Plt Ct-200 [**2131-2-10**] 12:20PM BLOOD Neuts-71.6* Lymphs-20.0 Monos-4.8 Eos-3.2 Baso-0.4 [**2131-2-15**] 10:30AM BLOOD PTT-50.1* [**2131-2-15**] 06:20AM BLOOD Plt Ct-200 [**2131-2-15**] 03:08AM BLOOD PTT-46.3* [**2131-2-14**] 05:05PM BLOOD PTT-48.2* [**2131-2-12**] 06:18AM BLOOD Plt Ct-188 [**2131-2-12**] 06:18AM BLOOD PT-12.5 PTT-72.4* INR(PT)-1.1 [**2131-2-10**] 09:42PM BLOOD PT-12.8 PTT-33.0 INR(PT)-1.1 [**2131-2-10**] 08:00PM BLOOD PTT-25.1 [**2131-2-10**] 12:20PM BLOOD Plt Ct-185 [**2131-2-10**] 08:00PM BLOOD ACA IgG-PND ACA IgM-PND [**2131-2-10**] 08:00PM BLOOD AT III-94 ProtCFn-123 ProtSFn-100 [**2131-2-10**] 08:00PM BLOOD Lupus-NEG [**2131-2-15**] 06:20AM BLOOD Glucose-102 UreaN-11 Creat-0.8 Na-142 K-4.2 Cl-111* HCO3-23 AnGap-12 [**2131-2-13**] 03:45AM BLOOD Glucose-108* UreaN-16 Creat-0.8 Na-141 K-3.5 Cl-106 HCO3-28 AnGap-11 [**2131-2-11**] 01:42AM BLOOD Glucose-100 UreaN-12 Creat-0.7 Na-146* K-5.5* Cl-115* HCO3-20* AnGap-17 [**2131-2-10**] 12:20PM BLOOD Glucose-90 UreaN-15 Creat-0.9 Na-142 K-4.3 Cl-106 HCO3-24 AnGap-16 [**2131-2-10**] 08:00PM BLOOD ALT-28 AST-23 LD(LDH)-171 CK(CPK)-49 AlkPhos-63 TotBili-0.5 [**2131-2-12**] 06:18AM BLOOD CK-MB-NotDone cTropnT-<0.01 [**2131-2-15**] 06:20AM BLOOD Calcium-8.7 Phos-3.9 Mg-2.1 [**2131-2-10**] 09:42PM BLOOD Calcium-9.4 Phos-2.7 Mg-1.9 [**2131-2-10**] 08:00PM BLOOD %HbA1c-5.4 [**2131-2-10**] 08:00PM BLOOD Homocys-9.7 [**2131-2-12**] 10:27AM BLOOD Osmolal-280 [**2131-2-10**] 08:00PM BLOOD TSH-4.1 [**2131-2-12**] 10:27AM BLOOD CRP-4.1 [**2131-2-10**] 12:20PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-NEG Barbitr-NEG Tricycl-NEG [**2-10**] CT: 1. Multiple cerebellar hypodensities, bilaterally. In the absence of prior studies, exact age is difficult to determine. However, the left inferior cerebellar hypodensity could be chronic in nature. Right-sided hypodensiies are concerning for acute ischemia. MRI is recommended for further evaluation. 2. No intracranial hemorrhage. [**2-10**] CTA brain: IMPRESSION: 1. No abnormalities are detected on CTA of the neck. 2. CTA of the head demonstrates suspicion for subtle filling defect from thrombus in the distal basilar artery. 3. Posterior fossa infarcts are again identified. MRI can help for further assessment if clinically indicated. [**2131-2-10**] MRI brain: IMPRESSION: 1. Acute infarctions in the lateral aspect of the right cerebellar hemisphere and in the right midbrain. While the basilar artery is not evaluated on this study, the pattern of infarction is congruent with basilar artery disease. 2. Encephalomalacia and gliosis in the inferior left cerebellar hemisphere may be related to chronic infarction. [**2-11**] MRI: IMPRESSION: 1. New acute infarction involving the superior left cerebellar hemisphere, left superior vermis, and left midbrain compared to one day earlier. 2. Acute infarctions are again seen in the lateral aspect of the right cerebellar hemisphere and the right midbrain. 3. While the basilar artery is not well evaluated on this study, the pattern of infarctions is concordant with the previously suspected basilar artery disease. [**2-11**] CTA: 1. Unchanged appearance of bilateral cerebellar and midbrain infarctions. 2. Persistent non-occlusive central filling defect in the proximal V3 segment of the left vertebral artery. 3. Persistent filling defect in the right aspect of the basilar tip. Persistent nonvisualization of the right superior cerebellar artery and of the proximal P1 segment of the right posterior cerebral artery. These findings are concerning for thromboembolic occlusion. [**2-13**] CT head: Grossly unchanged appearance of bilateral cerebellar and midbrain infarcts. It is unclear if the fourth ventricle is minimally smaller. Recommend short- interval follow-up. CT Torso: 1. Unusual appearance of the duodenal bulb, most likely represents passing of a bolus of solid food mixed with contrast. 2. L5 compression deformity, with roughly 25% loss of vertebral body height and grade 1 retrolisthesis of L5 on S1. Without prior comparison imaging, acuity of this finding is uncertain. Brief Hospital Course: Pt was admitted to the stroke service for further work-up and management of his stroke. Admission to the floor included frequent neuro-checks, cardiac telemetry, frequent glucose checks. The night of admission he had a change in his exam significant for worsening dizziness, face weakness and decreased extraocular movements. CTA of the brain showed an occlusion in the right P1 segment of the PCA. This occlusion was seen on brain imaging studies from [**Hospital6 204**] from [**2132-2-5**] and [**2131-2-6**]. He also had a filling defect in the right side of the distal basilar artery. Discussion with Dr. [**First Name (STitle) **], of interventional neuro-radiology, was made about possible neuroradiology intervention. He was deemed inappropriate for mechanical intervention or intra-arterial tpa. Hypercoagulable panel was sent. He was transfered to the ICU and started on heparin gtt. During the morning of [**2-11**], he was alert but not oriented to place or month. He knew the year. He was able to say phrases and follow bilateral commands. He had mild to moderate dysarthria. Patient had impaired vertical upgaze. His right eye could not fully abduct to the right. When he looked to the left, the left eye would skew downwards. The right eye could not look inferiorly. The right pupil was reactive from 5 to 3mm. The left pupil was reactive from 4 to 3mm. He had mild bilateral ptosis. Decreased sensation to light touch and pinprick of V1 to V3. There was a right lower facial droop. Decreased gag on the right. He was full strength in all four extremities. He had a marked ataxia of left fnf (greater than ataxia of right fnf).Intact sensation of all four extremities. MRI of the brain on [**2131-2-11**] showed new left superior cerebellar and left midbrain infarcts. CTA neck on [**2-11**] showed again a filling defect of the right side of the distal basilar artery. There was a small filling defect of the right V3 segment of the left vertebral artery. He was probably having artery to artery emboli from the left vertebral artery to the basilar artery and its tributaries. Another possibility is that the left V3 thrombus originally came from the heart or aorta. That night he became more somnolent and had a stat CT which showed slight swelling of the cerebellum. He was started on mannitol and had improvement in his exam. He was weaned off the manitol without significant change in exam. He was eventually transfered to Stepdown. He continued to improve clinically while on the floor. His BP was allowed to autoregulate. TTE did not show a cardioembolic source. He did not have further cardiac imaging due to report of negative TEE at OSH within 1-2 weeks. He was then started on coumadin with goal INR of 2.0 to 3.0. His discharge exam is significant for decreased upgaze bilaterally, left worse than right, though he has full upward movements with Bells phenomenon. He has slurred speech and a slight left facial droop. He has full strenght but clumsiness with the left arm and leg. He also has truncal ataxia. He will follow-up with the stroke clinic as an outpt and should continue coumadin for at least three months. Will obtain a CTA brain and neck as an outpatient in three months. Medications on Admission: - ASA 325mg PO QD - Simvastatin 10mg PO QD Discharge Medications: 1. Simvastatin 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 3. Warfarin 5 mg Tablet Sig: One (1) Tablet PO Once Daily at 4 PM. 4. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO QID (4 times a day). 5. Pantoprazole 40 mg IV Q24H 6. Heparin (Porcine) in D5W 25,000 unit/250 mL Parenteral Solution Sig: Nine Hundred (900) units/hr Intravenous ASDIR (AS DIRECTED). Discharge Disposition: Extended Care Facility: [**Hospital3 **] Discharge Diagnosis: Cerebellar and brainstem infarcts Cerebellar and brainstem infarcts Discharge Condition: Improved Discharge Instructions: You were admitted with because of new strokes. These new strokes were caused by a blood clot in the ateries inthe back of your head. You will need to remain on a blood thinner until furhter instructed. You will need to routinely have the coumadin checked as an outpt. Followup Instructions: Provider: [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 640**] [**Last Name (NamePattern4) 3445**], MD Phone:[**Telephone/Fax (1) 44**] Date/Time:[**2131-4-20**] 3:00 ICD9 Codes: 3051
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Medical Text: Admission Date: [**2148-12-13**] Discharge Date: [**2148-12-18**] Date of Birth: [**2096-9-27**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2901**] Chief Complaint: s/p VT arrest Major Surgical or Invasive Procedure: Cardiac catheterization s/p MiniVision LAD stent Intubation R arterial line placement History of Present Illness: Mr. [**Known lastname 29887**] is a 52 yo male with significant PMH significant for HTN, smoking, who collapsed and hit his head at work this afternoon. The fall was witnessed by his collegue. There is no report of chest pain, SOB, or any other symptoms prior to his fall. He was found to be breathing when he was found down. He was given 5 minutes of CPR with no respirations. Paramedics arrived, he was found to be in VF (no strips available)and was shocked. He remained in a ventricular rhythm with a rate of 20, and then converted spontaneously to sinus rhythm. Patient had agonal respirations at the time of the arrest. He was brought to [**Hospital1 **] [**Location (un) 620**] where he was found to have posturing. The patient was given Ativan, Versed, and Nitro and a CT of the head was done which suggested subdural hematoma vs. meningioma. EKG showed ST elevations in 1, aVL, V2-V6. The patient did not receive ASA, heparin, or integrilin for concern for a possible intracranial bleed. He was transferred to [**Hospital1 18**] for cardiac catheterization and closer monitoring. In the cath lab he was found to have occluded LAD after D1 & S1 and 1 subbranch with long subtotal occlusion with collateral filling of distal vessel. MiniVision stent was placed into D2. Hemodynamic parameters as follows: CO 6.5, CI 3.3 and PCWP 23. Past Medical History: Hypertension Social History: The pt is a CEO/CPA in [**Location (un) 620**]. He is an 80 pack year smoker, no alcohol. Married, has 1 son. [**Name (NI) **] illicit drugs. Family History: Possible CAD Physical Exam: vitals T 98.8 BP 137/89 AR 88 RR 20 02 sat 100% vent settings: AC FIO2 0.5 TV 650 RR 20 PEEP 5 Gen: Pt sedated; not responsive to sternal rub or pain HEENT:PERRLA, ETT in place Lungs:Course breath sounds Heart:Distant heart sounds Abdomen: soft, NT/ND, +BS Extremities: no edema, 2+ DP/PT pulses Neuro:Does not respond to pain stimuli Pertinent Results: Laboratory Results: [**2148-12-13**] 08:01PM HGB-12.5* calcHCT-38 O2 SAT-98 [**2148-12-13**] 08:01PM GLUCOSE-105 LACTATE-0.8 K+-3.4* [**2148-12-13**] 08:01PM TYPE-ART TIDAL VOL-880 O2-100 PO2-371* PCO2-49* PH-7.26* TOTAL CO2-23 BASE XS--5 AADO2-305 REQ O2-56 INTUBATED-INTUBATED [**2148-12-13**] 09:08PM O2 SAT-99 [**2148-12-13**] 09:08PM TYPE-ART TIDAL VOL-700 O2-100 PO2-437* PCO2-37 PH-7.35 TOTAL CO2-21 BASE XS--4 AADO2-251 REQ O2-48 INTUBATED-INTUBATED [**2148-12-13**] 10:34PM PT-13.1 PTT-36.7* INR(PT)-1.1 [**2148-12-13**] 10:34PM PLT COUNT-330 [**2148-12-13**] 10:34PM CALCIUM-7.9* PHOSPHATE-2.3* MAGNESIUM-1.7 [**2148-12-13**] 10:34PM CK-MB-35* MB INDX-9.0* cTropnT-0.73* [**2148-12-13**] 10:34PM GLUCOSE-146* UREA N-20 CREAT-1.0 SODIUM-140 POTASSIUM-4.7 CHLORIDE-110* TOTAL CO2-22 ANION GAP-13 [**2148-12-15**] 04:06PM CK 1048* [**2148-12-15**] 05:45AM CK 1011*1 [**2148-12-15**] 04:06PM CKMB 15* MBI 1.4 [**2148-12-15**] 05:45AM CKMB 17* MBI 1.7 . EKG: nl sinus rhythm, ST elevations in 1, aVL, V2-V6, reciprocal ST depressions in III, aVF, t wave inversions laterally, LAFB . Relevant Imaging: 1)Cardiac Catheterization ([**2148-12-13**]): 1. Selective coronary angiography in this right dominant system revealed severe two vessel coronary artery disease. The LMCA had diffuse mild disease. The LAD was totally occluded after D1 and S1. The distal LAD was a small diffusely disease vessel that filled via right to left collaterals. The first diagonal was severely diffusely disease. The second diagonal was a large vessel with a large subbranch with a long subtotal occlusion; this vessel filled distally via collaterals. The LCx had a 30% proximal and a 50% mid occlusion. 2. Left ventriculography was deferred. 3. Hemodynamics revealed elevated left and right sided filling presures. The LVEDP was 23 mmHg. The RVEDP was 16 mmHg. There was pulmonary artery hypertension. Pulmonary artery pressure wa 41/21 mmHg with a mean of 30 mmHg. Cardiac index was perserved at 3.25 l/min/m2. 2)C,T,L-spine CT ([**2148-12-14**]): no evidence of fracture or malalignment. 3)CT head ([**2148-12-15**]): There is a 5-mm hyperdensity along the right frontal falx of uncertain etiology. There is no evidence of hemorrhage, mass effect, shift of normally midline structures, hydrocephalus, or infarction. The density values of the brain parenchyma are within normal limits and the [**Doctor Last Name 352**]-white matter differentiation is preserved. The ventricles and sulci are normal in size. The surrounding osseous and soft tissue structures are unremarkable. The imaged portions of the paranasal sinuses are well-aerated. 4)MRI/MRA Head ([**2148-12-16**]): Study is limited due to patient motion artifact. However, the major vessels of the circle of [**Location (un) 431**] appear patent. There do not appear to be any large areas of intracranial atherosclerotic disease. The right vertebral artery is dominant. There appears to be a fetal origin to the right posterior cerebral artery. Brief Hospital Course: Mr. [**Known lastname 29887**] is a 52 yo male with HTN who is now s/p anterolateral STEMI and VF arrest s/p LAD stent, and s/p intubation. He was extubated following cardiac catheterization. He remained stable thereafter, but did have some residual short term memory deficits. 1)STEMI: The patient had evidence of an anterolateral STEMI and subsequent Vfib arrest. He was taken to the cath lab where he was found to have occluded LAD after D1 & S1 and 1 subbranch with long subtotal occlusion with collateral filling of distal vessel. A MiniVision stent was placed into the mid-LAD. The patient was maintained on ASA 325 mg, Lipitor 80mg, Plavix 75mg daily X 1 month, Lisinopril 10 mg QD, and Metoprolol titrated to 50mg TID. The patient was made a follow up appointment with Dr. [**Last Name (STitle) **], cardiologist. 2)Pump: The patient had an ECHO 2 days after PCI and VF arrest which showed an EF~ 30% with an akinetic apex. Although the PCWP 23 on cardiac cath, the patient was diuresed during his hospitalization and was euvolemic on exam by time of discharge. Given the akinetic apex found on echo and increased risk of clot formation, the patient was started on a heparin drip as a bridge to coumadin. Upon discharge the patient's INR was 1.4. He was discharged on Lovenox SQ and Coumadin. He was told to have his INR checked on Friday and have the results faxed to Dr.[**Name (NI) 5907**] office. 3)Rhythm: The patient is s/p vfib arrest secondary to an anterolateral STEMI. He stayed in normal sinus rhythm throughout his hospitalization. His Metoprolol was titrated up to 50mg TID. 4)Fall: The patient is s/p posterior head trauma prior to the VF arrest. Head CT head showed a 5-mm hyperdense focus along anterior falx. Differential included meningioma vs. bleed. This focus was thought to be stable after the patient was therapuetic on heparin. Neurosurgery was involved throughout and recommended follow-up in [**5-1**] weeks with an outpatient CT and appointment with Dr. [**Last Name (STitle) **]. CT of the C- T- and L-spine ruled out fracture. 5)Short term memory: The patient's STM deficit was thought to be secondary to anoxic brain injury from poor perfusion during the Vfib arrest. It was stable to slightly improved by the time of discharge. Both neurology and psychiatry were consulted. They recommended follow up in the [**Hospital 29888**] clinic for further testing. A follow up appointment was made with Dr. [**Last Name (STitle) **] for this purpose. 6)Leukocytosis: The patient's leukocytosis was attributed to the recent STEMI. The patient was clinically asymptomatic and over the course of the hospitalization. UA and CXR were negative for UTI and PNA respectively. The leukocytosis slowly improved and was WNL by discharge. Medications on Admission: None Discharge Medications: 1. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). Disp:*30 Tablet, Delayed Release (E.C.)(s)* Refills:*2* 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 3. Atorvastatin 80 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 4. Metoprolol Tartrate 50 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). Disp:*90 Tablet(s)* Refills:*2* 5. Warfarin 2.5 mg Tablet Sig: Three (3) Tablet PO HS (at bedtime). Disp:*90 Tablet(s)* Refills:*2* 6. Lisinopril 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). Disp:*30 Tablet(s)* Refills:*2* 7. Lovenox 80 mg/0.8 mL Syringe Sig: One (1) injection Subcutaneous twice a day for 3 days. Disp:*6 injections* Refills:*0* 8. Outpatient Lab Work Please check PT, PTT, INR please call in results to Dr. [**Last Name (STitle) **] ([**Telephone/Fax (1) 5909**] fax ([**Telephone/Fax (1) 29889**]. Discharge Disposition: Home With Service Facility: Visiting Nurse [**First Name (Titles) **] [**Last Name (Titles) 269**] [**Location (un) 270**] Discharge Diagnosis: Primary diagnosis: ST elevation MI with stent placement V-fib arrest New systolic dysfunction (EF 30%) with apical akinesis Meningioma . Secondary diagnosis: Hypertension Discharge Condition: Safe for discharge home. Discharge Instructions: 1. Please continue to take your Lovenox as instructed for three additional days. . 2. Please have your coumadin level (INR) checked on Friday and the results sent to Dr.[**Name (NI) 5907**] office phone([**Telephone/Fax (1) 5909**]. . 3. Please take all medications as prescribed. Most importantly, you must take your aspirin and plavix every day. Please do not miss [**First Name (Titles) 691**] [**Last Name (Titles) 4319**]. Failure to take these medications can result in stent closure which could be life threatening. . 4. If you develop any chest pain, shortness of breath, lightheadedness or dizziness, or any other concerning symptoms, please contact your doctor or report to the nearest ER. Followup Instructions: 1. Please contact Dr.[**Name2 (NI) 5907**] office (cardiologist) to follow up Phone:[**Telephone/Fax (1) 5003**] Date/Time:[**2149-1-14**] 3:20. Please have your coumadin level checked this Friday at his office. . 2. Please contact Dr. [**First Name (STitle) **] [**Name8 (MD) **], MD, PHD[**MD Number(3) 708**]:[**Telephone/Fax (1) 1690**] Date/Time:[**2149-1-8**] 1:00 [**Hospital 29890**] Clinic. . 3. Please follow up with Dr. [**Last Name (STitle) **] from Neurosurgery in [**5-1**] weeks with a head CT. Please call [**Telephone/Fax (1) 2731**] to make these arrangements after discharge. . 4. Previously scheduled appointments: Provider: [**Initials (NamePattern4) **] [**Last Name (NamePattern4) 5004**] [**Last Name (NamePattern1) **], M.D. Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2148-12-31**] 12:00 [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) 2908**] MD, [**MD Number(3) 2909**] ICD9 Codes: 4275, 4271, 4019
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Medical Text: Admission Date: [**2178-6-28**] Discharge Date: [**2178-7-5**] Date of Birth: [**2122-5-24**] Sex: F Service: NEUROSURGERY Allergies: Nitrofurantoin Sodium / Ergotamine Attending:[**First Name3 (LF) 1835**] Chief Complaint: Transfer from OSH with large intracranial hemorrhage Major Surgical or Invasive Procedure: Craniotomy for evacuation of intraparenchymal hemorrhage History of Present Illness: This is a 56 year old female that was at pilates class this afternoon at 1230 pm when she reportedly experienced the worst headache of life and became unresponsive. The patient was noted by observers to be posturing but was breathiung spontaneously. EMS arivved at the scence and note a right blown pupil on on route the the emergency department Past Medical History: xx Social History: Married and lives with husband Family History: NC Physical Exam: GCS 4t E:1 V:1 Motor:2 Gen: INTERBATED UNRESPONSIVE Neuro: intubated, no eye opening, R pupil 6mm fixed, L 3mm, extending bilat UEs, min movement bilat LEs CT:massive right temporal IPH Pertinent Results: CT HEAD [**6-27**] There is a very large right temporoparietal acute hemorrhage, causing prominent compression of the right lateral ventricle, and nearly 7 mm leftward subfalcine herniation. There is a mild degree of edema surrounding this very large hemorrhage. There is also accompanying uncal and hippocampal herniation on the right side. There is moderate dilatation of the right temporal [**Doctor Last Name 534**] tip, likely due to entrapment. The surrounding osseous and extracranial soft tissues do not reveal additional abnormalities. CT angiography of the head reveals displacement of the right middle cerebral artery branches, consequence of the large right temporoparietal lobe hemorrhage. CT HEAD [**6-28**] 1. Status post evacuation of a large right hemispheric intraparenchymal hematoma via a right craniotomy, with expected post-surgical changes and mild residual subarachnoid blood. 2. Slightly increased intraventricular blood. 3. Improved leftward subfalcine herniation. 4. Improved mild uncal herniation. 5. Unchanged mild effacement of the quadrigeminal cistern. CT HEAD [**6-29**] Slight decrease in left subfalcine herniation and pneumocephalus; other findings MRI Head [**6-29**] 1. Acute infarcts involving the left paramedian pons, right thalamus and subthalamic nuclei of the midbrain, and at the margins of the resection bed in the right temporoparietal lobe, as described. 2. Similar degree and appearance of blood products in the resection margin, as well as in the ventricles, compared to several hours earlier in the day, allowing for difference in imaging modality. 3. No abnormal vascular flow void or enhancing vessel to suggest residual AVM, but evaluation for enhancing abnormality is limited due to intrinsically T1-hyperintense blood products Brief Hospital Course: Pt was admitted to the neurosurgery service and underwent an elective craniotomy for evacuation of left temporal ICH. SHe tolerated this procedure well with no complications. Post operatively she was transferred to the ICU for further care. She remained intubated and on post op exam she did improve. She had no eye opening but moved her LE's to noxious and moved both upper extremities with left greater than right. Her pupils remained asymetric but reacted to light. Her post op head ct showed good evacuation of ICH. On [**6-29**] her dilantin was reloaded for a level of 6.5. She also underwent angiography and an MRI. The angio revealed no vascular abnormality but the MRI revealed thalamic and pons infarcts. On [**6-30**] her neurological exam was slightly improved but still poor. She was started on tube feeds via an NG Tube.An MRI was obtained to help with prognosis and this showed left sided acute strokes. A family meeting was held and the family decided to make her CMO. Pt was extubated and past away on [**2178-7-5**]. Medications on Admission: None Discharge Medications: None Discharge Disposition: Expired Discharge Diagnosis: Intracranial hemorrhage Discharge Condition: Expired Discharge Instructions: Followup Instructions: xx Completed by:[**2178-7-5**] ICD9 Codes: 9971
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Medical Text: Admission Date: [**2179-1-20**] Discharge Date: [**2179-2-5**] Date of Birth: [**2144-5-28**] Sex: F Service: NEUROLOGY Allergies: Shellfish Derived / Pineapple / Apple / Wheat Starch / Soy / Potato Starch / Rice / Milk Attending:[**First Name3 (LF) 2518**] Chief Complaint: Right sided weakness/confusion Major Surgical or Invasive Procedure: Intra-arterial-tissue plasminogen activator. MERCI - mechanical intra-arterial clot retrieval. Embolization of a right pulmonary arterial venous fistula. History of Present Illness: HPI: 34yo right-handed woman with PMH significant for migraines and depression presents as a transfer from an outside hospital with right hemiparesis and aphasia. She was in her USOH this morning, lying in bed after awakening as her children did not need to go to school, when she had acute change at 7:25am witnessed by her husband. She had a blank look, moved around in the bed, not responding to him, and tried to get up but could only move her left side. She became nonverbal. EMS was called and she was brought to Caritas [**Hospital6 5016**] in [**Location (un) 7661**]. At the OSH, VS were T 96.5, HR 82, BP 103/64, RR 20, SaO2 100%. She was noted to be lethargic and witnessed to have convulsive activity of her right leg. She was aphasic and would not follow commands. She had a right hemiparesis. She had a head CT showing a hyperdense left MCA. Neurology at [**Hospital1 18**] was called; IV tPA was suggested, but the family preferred to wait for transfer and evaluation as she was just outside of the 3 hour window at that time (3.5hrs). Prior to transfer, she was given ativan 1mg, ASA 325mg, and she was put on a heparin gtt (at 1055). She was transferred to [**Hospital1 18**] at 1125. On arrival to [**Hospital1 18**], CODE STROKE was called. Neurology was at bedside prior to the CODE STROKE page at 1229pm. Heparin was stopped as soon as it was found to have been started, which was at 1235. Bloodwork was drawn, she was examined by the stroke fellow (see below), and sent to the CT scanner. ROS: No recent head or neck trauma, no chiropracty or professional massage, occ massage by husband, no martial arts. ?Mild dysarthria the day prior to presentation noted by patient's mother, patient said she was tired, and husband did not notice any change in speech prior to the am events as above. No recent fevers, chills, +diaphoresis last two nights, not previously. +10lbs weight loss with diet over last several months. H/o miscarriage x 1, no other clotting (see below). Told mother-in-law she had fallen down stairs several weeks ago, but did not seem like there was any significant injury (mentioned in passing when mother-in-law said she tripped up the stairs, pt said she fell down the stairs, not mentioned to husband). Past Medical History: migraines depression food allergies - hives to most foods, but she eats them anyway, breathing difficulties with pineapples and tabouli (new over the last several months) miscarriage x 1, no known reason, s/p 3 c-sections (first child SVD, second c-section for failure to progress, third and fourth children repeat c-sections) occasional kidneystones frequent UTIs Social History: married, 4 children, husband [**Name (NI) **] [**Telephone/Fax (1) 77824**], no tobacco, rare EtOH, no drug use Family History: kidneystones; no strokes, miscarriages, clotting problems Physical Exam: T 99.3, HR 106, BP 116/71, RR 23, SaO2 97%/RA, BG 91 Gen: Lying in bed and looking to left HEENT: NC/AT, moist oral mucosa Neck: No tenderness to palpation, normal ROM, supple, no carotid or vertebral bruit Back: No point tenderness or erythema CV: RRR, Nl S1 and S2, no murmurs/gallops/rubs Lung: Clear to auscultation bilaterally aBd: +BS soft, nontender ext: no edema NIHSS 1a. LOC: 1, arousable to gentle stim 1b. LOC q's: 1, mute 1c. LOC commands: 1, squeezes hand, does not close eyes 2. gaze: 1, left gaze preference 3. visual field: 2, no blink to threat from right 4. facial palsy: 3, R facial palsy 5a. RUE motor: 4 5b. LUE motor: 0 6a. RLE motor: 2, lifts, cannot sustain 6b. LLE motor: 0 7. ataxia: 0, hemiplegic 8. sensory: 0 9. language: 2, follows some 1 step commands 10. dysarthria: 2, mute 11. neglect: x unable to test NIHSS total: 19 Mental status: Mute but alert, cooperative with exam. Could not check orientation. Attentive with exam. Speech: some intact comprehension, no repetition, no speech heard. Cranial Nerves: Pupils equally round and reactive to light, 4 to 2 mm bilaterally. Visual fields are full to confrontation from left but not from right, could not check formal visual fields, eyes looking to left side, does not cross midline, no nystagmus. Sensation decreased to LT on right. Facial movement decreased on right side. Hearing intact to finger rub bilaterally. Palate elevation symmetrical. Sternocleidomastoid and trapezius not checked. Tongue midline, movements intact Motor: Normal bulk bilaterally. Tone decreased in right upper and lower. No observed myoclonus or tremor, could not check full formal muscle strength. [**Doctor First Name **] Tri [**Hospital1 **] WF WE FE FF IP H Q DF PF TE TF L 4 4 4 4 4 4 4 4 4 4 4 4 4 4 R 0 0 0 0 0 0 0 3 3 3 3 3 3 3 Sensation: Intact to light touch throughout trunk and extremities. Reflexes: +2 on right, +2 on left side, Toes downgoing on right and left, Coordination: unable to check Gait: could not check Romberg: not checked, Pertinent Results: [**2179-1-20**] 10:41PM PT-12.2 PTT-27.6 INR(PT)-1.0 [**2179-1-20**] 08:09PM TYPE-ART PO2-165* PCO2-36 PH-7.36 TOTAL CO2-21 BASE XS--4 [**2179-1-20**] 07:48PM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.006 [**2179-1-20**] 07:48PM URINE BLOOD-SM NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-6.5 LEUK-NEG [**2179-1-20**] 07:47PM GLUCOSE-117* UREA N-7 CREAT-0.6 SODIUM-146* POTASSIUM-4.1 CHLORIDE-116* TOTAL CO2-21* ANION GAP-13 [**2179-1-20**] 07:47PM CK(CPK)-272* [**2179-1-20**] 07:47PM CK-MB-10 MB INDX-3.7 cTropnT-0.22* [**2179-1-20**] 07:47PM CALCIUM-8.7 PHOSPHATE-3.7 MAGNESIUM-2.3 [**2179-1-20**] 05:10PM WBC-13.0* RBC-4.36 HGB-12.5 HCT-37.5 MCV-86 MCH-28.6 MCHC-33.3 RDW-13.1 [**2179-1-20**] 03:18PM %HbA1c-5.5 [**2179-1-20**] 12:13PM GLUCOSE-107* UREA N-14 CREAT-0.7 SODIUM-142 POTASSIUM-3.5 CHLORIDE-110* TOTAL CO2-21* ANION GAP-15 [**2179-1-20**] 12:13PM CHOLEST-157 [**2179-1-20**] 12:13PM TRIGLYCER-67 HDL CHOL-46 CHOL/HDL-3.4 LDL(CALC)-98 [**2179-1-20**] 12:13PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2179-1-20**] 12:13PM WBC-11.9* RBC-4.75 HGB-13.7 HCT-40.3 MCV-85 MCH-28.9 MCHC-34.1 RDW-12.9 [**2179-1-20**] 12:13PM NEUTS-92.6* BANDS-0 LYMPHS-5.2* MONOS-1.6* EOS-0.4 BASOS-0.1 [**2179-1-20**] 12:13PM PT-12.9 PTT-34.5 INR(PT)-1.1 [**1-20**]: CT/CTA/CTP: Dense left MCA sign, increased mean transit time within a large area of the left MCA territory with corresponding decreased blood flow, but normal blood volume. CTA shows complete occlusion of the left MCA. The patient had already been taken to the interventional suite by the time of dictation. [**1-20**]: repeat CTH: New hemorrhage in the left basal ganglia and frontal [**Doctor Last Name 534**] of the left lateral ventricle, with some residual contrast posteriorly. [**1-20**]: repeat CTH: Increase in the extent of the parenchymal hemorrhage centered primarily within the area of the left basal ganglia, with new rightward shift of the septum pellucidum, and intraventricular extension as described above. [**1-21**]: CT/CTA: Extensive blood within the putamen and caudate nucleus on the left, with persistent intraventricular blood. Midline shift is similar to prior study. CTA shows the left MCA is still open. Studies: [**1-21**]: echo: The left atrium is normal in size. An atrial septal defect (most likely secundum) is present (positive bubble study at rest). The estimated right atrial pressure is 10-20mmHg. Left ventricular wall thickness, cavity size and regional/global systolic function are normal (LVEF 60%) There is no ventricular septal defect. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve leaflets are structurally normal. Mild to moderate ([**12-9**]+) mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is no pericardial effusion. There is an anterior space which most likely represents a fat pad. [**1-21**]: LENIs: FINDINGS: No DVT was demonstrated in either leg. [**1-21**]: EEG: IMPRESSION: This is an abnormal portable EEG due to the marked voltage asymmetry between the hemispheres with decreased voltages noted broadly over the left side consistent with either a structural or destructive process affecting the left hemisphere or material interposed between the left cortex and skull. In addition, the background was disorganized, poorly modulated, consisting of a fast alpha or slow beta frequency rhythm admixed with frequent and, at times, prolonged bursts of moderate amplitude mixed theta and delta frequency slowing. This latter constellation of findings is consistent with a mild to moderate encephalopathy suggesting dysfunction of bilateral subcortical or deep midline structures. Medications, metabolic disturbances, and infection are among the common causes of encephalopathy but there are others. There were no areas of prominent focal slowing although encephalopathic patterns can sometimes obscure focal findings. There were no epileptiform features. No electrographic seizure activity was noted. CT of the torso with and without contrast: [**2179-1-27**] IMPRESSION: 1. Large pulmonary arteriovenous malformation in the right middle lobe, corresponding to chest radiograph abnormality. This likely explains the embolic source related to patient's recent cerebrovascular infarct. The presence of pulmonary AVM raises the possibility of Osler-[**Doctor Last Name 11586**]-Rendu syndrome. 2. Two additional tiny right lower lobe nodules, nonspecific but possibly suggestive of additional small pulmonary AVM. 3. 1.4-cm segment VI hepatic lesion with features most consistent with hemangioma. 4. Tiny cortical hypodensities in the kidneys bilaterally could represent cysts or other hypodense lesions too small to characterize, although the possibility of scarring from prior renal cortical infarcts cannot be excluded. Brief Hospital Course: The patient was initially found to have significant clot in distal ICA and MCA on the left side. She was brought emergently to the angiography suite where an angiogram was performed. IA TPA was given and MERCI clot retrieval was performed. Flow through the ICA and MCA on the left was restored at the end of the procedure. Post procedure CT's showed hemorrhagic conversion in the basal ganglia with intraventricular extension. Clinically, in the ICU, she was aphasic, not following commands. She was awake, alert, but did not attend, and did not track. She had a left gaze preference, but with equally reactive pupils, + corneals, + OCR, + gag. She had spontaneous movements of the L side. She continued to be hemiparetic on the right side even after transf from the ICU. A hypercoagulable workup was commenced given the patient's youth and significant clot burden. Factor V leiden, prothrombin gene mutation, homcysteine, protein S, and anticardiolipin IgG and IgM were all normal or negative. Protein C level was 68 (low normal is 70). This was not felt to be significant. She was started on an aspirin. A CT scan obtained inorder to assess for infectious or metastatic disease (the former to explain a fever, and the latter to assess for hypercoagulability) was obtained. This revealed an unexpected finding - a large AVM in the right lung. This was deemed by radiology to be the likely source of the embolus that caused her stroke. Pulmonary was called and suggested that we see if interventional radiology would embolize the lesion. IR agreed, assessed the patient and agreed to the procedure, which they perfromed on [**2179-2-3**]. A 1cm coil was placed with good hemodynamic effects. CV: echo revealed was initally read as demonstrating an ASD, but was subsequently hypothesized to be demonstrating flow throught the pulmonary AVm. LENIs were negative. She was started on a statin. ID: she was diagnosed with UTI and was treated with ceftriaxone. she continued to spike fevers and cultures sent which were negative. A CXR was without obvious consolidation. A CT torso was ordered which did not reveal any metastatic or infectious disease (it did show the AVM as above). An LP revealed a possible meningitis with 42 WBC, 281 RBC, 47 protein and 44 glucose. This was hypothesized to represent a partially treated meningitis. The patient was started on ceftriaxone and vancomycin which should be continued for a total of a two week course. Endo: The patient exhibited dilute urine loss immediately post procedure. With increasing Na and dilute urine she was suspected of having diabetes insipidus. DDAVP given with good response suggesting Central DI. The patient was ultimately able to be weened off of the DDAVP and sodiums normalized. Physical therapy felt that the patient would benefit from a rehab admission. The patient will be discharged with follow up with Dr. [**First Name (STitle) **]. Medications on Admission: xyzal 5mg daily - started recently for food allergies effexor XR 75mg daily Discharge Medications: 1. Artificial Tear with Lanolin 0.1-0.1 % Ointment Sig: One (1) Appl Ophthalmic PRN (as needed). 2. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) dose Injection TID (3 times a day). 3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Atorvastatin 10 mg Tablet Sig: Three (3) Tablet PO DAILY (Daily). 5. Ranitidine HCl 15 mg/mL Syrup Sig: One [**Age over 90 1230**]y (150) mg PO BID (2 times a day). 6. Acetaminophen 325 mg Tablet Sig: 1-2 Tablets PO Q6H (every 6 hours) as needed. 7. Camphor-Menthol 0.5-0.5 % Lotion Sig: One (1) Appl Topical QID (4 times a day) as needed. 8. Fexofenadine 60 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 9. Bisacodyl 5 mg Tablet, Delayed Release (E.C.) Sig: Two (2) Tablet, Delayed Release (E.C.) PO DAILY (Daily) as needed. 10. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 11. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 12. Metoclopramide 5 mg/mL Solution Sig: Ten (10) mg Injection Q6H (every 6 hours). 13. Ceftriaxone-Dextrose (Iso-osm) 2 gram/50 mL Piggyback Sig: Two (2) grams Intravenous Q12H (every 12 hours) for 6 days: this is to complete a 2 week course that started on [**2179-1-28**]. 14. Vancomycin in Dextrose 1 gram/200 mL Piggyback Sig: One (1) gram Intravenous Q 12H (Every 12 Hours): this is to complete a 2 week course that started on [**2179-1-28**]. Discharge Disposition: Extended Care Facility: [**Hospital3 7665**] Discharge Diagnosis: Left MCA infarct. Right pulmonary AVM - suspicious for Hereditary Hemorrhagic Telangiectasia - Osler-[**Doctor Last Name 15716**]-Rendu. Discharge Condition: Vtal signs stable. The patient has right sided weakness of the arm greater than leg. She has right sided facial droop. She has a non-fluent aphasia. Discharge Instructions: Please take your medications as prescribed. Please follow up with your appointments as documented below. Please return to the hospital if you should have any concerning symptoms. These include, but are not limited to, worsening limb weakness, slurred speech or numbness. Followup Instructions: Please make an appointment to see your primary care physician in the next two weeks to discuss the details of this admission. Provider: [**First Name8 (NamePattern2) **] [**Name11 (NameIs) 162**], MD Phone:[**Telephone/Fax (1) 44**] Date/Time:[**2179-3-12**] 8:30 [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 2533**] ICD9 Codes: 431, 5990
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Medical Text: Admission Date: [**2134-3-14**] Discharge Date: [**2134-3-24**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 6029**] Chief Complaint: resp distress Major Surgical or Invasive Procedure: None History of Present Illness: HPI: Pt is a [**Age over 90 **] F who was admitted on [**2134-3-14**] from [**Hospital1 10151**] Center with cough, wheezes, tachypnea, and fever. She was found to be influenza-A positive. Her hospital course was also complicated by atrial fibrillation with rapid ventricular response. She required two separate transfers to the [**Hospital Unit Name 153**] due to respiratory distress and hypercarbic respiratory failure. Patient is DNR/DNI, but she required frequent CPAP therapy and was not able to be weaned off completely. A family meeting was held on [**2134-3-19**] and the decision was made to change the goals of care to comfort. Past Medical History: 1. history of UTI's 2. 2nd degree HB s/p PPM 3. s/p TIA 4. HTN 5. RA 6. hypothyroid 7. varicose veins b/l LE insufficency 8. uterine prolapse with pessary 9. s/p R cataract surgery [**38**].kyposcoliosis with severe osteoporosis and T8 compression fracture 11.diabetes mellitus type 2 Social History: Lives with daughter [**Name (NI) **] and her husband who themselves are in their 70's and 80's, respectively. Has required acute rehab at Heb reb in the past after hospital discharge. Grandson is an immunologist. Family History: NC Physical Exam: vitals: Temp 97.9 BP 111/72 HR 105 RR 30 Pulse Ox 97% on 15L mask GEN: lethergic, Opens eyes spontaneously, paradoxical breathing, accessory muscle use HEENT: PERRL, anicteric, dry MM NECK: JVD difficult to assess, no LAD CHEST: irreg, irreg, tachy LUNGS: coarse BS b/l, + accessory muscle use, no wheeze ABDOMEN:soft, nt, nd, hypoactive BS EXT: 1+ pitting edema, extremities warm Brief Hospital Course: This is a [**Age over 90 **] y/o female with influenza, rapid afib requiring BIPAP therapy now with comfort as main goal of care. Her respiratory distress was multifactorial including influenza, COPD, possible secondary bacterial pneumonia. Unable to wean off BiPAP for any extended period of time. Family meeting on [**2134-3-19**] decided to make the patient DNR/DNI no BiPAP, no blood draws, no finger sticks. No morphine drip, but morphine prn. The patient was made as comfortable as possible with ativan, morphine, nebs, and steroids prn. She passed away at 6 am on [**2134-3-24**] from hypoxic respiratory failure. Medications on Admission: Meds on Xfer: Heparin 5000 UNIT SC TID Hydrochlorothiazide 25 mg PO DAILY Insulin SC Sliding Scale Ipratropium Bromide Neb 1 NEB IH Q6H Levofloxacin 250 mg PO Q48H Aspirin 81 mg PO DAILY Levothyroxine Sodium 50 mcg IV DAILY Clopidogrel Bisulfate 75 mg PO DAILY Methylprednisolone Na Succ 60 mg IV Q24H Diltiazem 30 mg PO QID Pantoprazole 40 mg PO Q24H Diltiazem 10 mg IV TID:PRN tachycardia GlyBURIDE 1.25 mg PO DAILY Guaifenesin [**5-19**] ml PO Q6H Xopenex *NF* 0.31 mg/3 mL Inhalation [**Hospital1 **] Discharge Medications: None Discharge Disposition: Expired Discharge Diagnosis: Respiratory distress, influenza Discharge Condition: Expired Discharge Instructions: None Followup Instructions: None [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 6035**] Completed by:[**2134-3-24**] ICD9 Codes: 5849, 2767, 2449
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Medical Text: Admission Date: [**2184-10-10**] Discharge Date: [**2184-10-16**] Date of Birth: [**2134-3-31**] Sex: M Service: MED Allergies: Penicillins / Nsaids / Ciprofloxacin Attending:[**First Name3 (LF) 1190**] Chief Complaint: Rash Major Surgical or Invasive Procedure: None. History of Present Illness: 50 yo male with PMH significant for EtOH abuse as well as several psychological diagnoses, presents to ER for evaluation of rash on his chest and legs/groin 1 week after starting ciproflox for R hand cellulitis. Rash is pruritic. No associated fever, no respiratory compromise. In ER noted to be quite tremulous. Stated last drink was within 24h, has a history of "getting shaky" if EtOH withdrawal. No known seizure history. Given total of 16mg ativan in the ER as well as a total of 100mg valium. Also given atenolol, clonidine (on this at baseline), thiamine/folate, B12, magnesium (Mg 0.8), calcium (ionized Ca 0.77). Treated for allergic rxn with SQ epi, atarax, zantac and 60mg prednisone. No respiratory compromise. He was initially admitted to [**Hospital Unit Name 153**] for DTs, observation. On arrival to [**Hospital Unit Name 153**], the patient was diaphoretic and tremulous, oriented x 3, cooperative with history and physical exam. Given 10mg valium x 2 and then 20mg. Labs rechecked--iCa up to 0.99, repeated 3amps Ca gluconate. Past Medical History: 1. Extensive history of substance abuse with EtOH and benzo use. He drinks regularly and has intermittent binges of several days with very heavy consumption. These are typically in response to feeling sad or happy. Has been at several hospitals including [**Doctor First Name 1191**] for inpt detox from benzo's including Valium and Serax. Denies other recreational drugs. 2. Atrial fibrillation. He was admitted in [**2171**] for AF with rapid response, and converted spontaneously to NSR with only rate control. It was felt to be holiday heart. TSH was normal, and echo showed mild MR [**First Name (Titles) **] [**Last Name (Titles) 1192**] AI. 3. L pectoralis muscle strain after a URI. 4. Low back pain, seen at [**First Name4 (NamePattern1) 1193**] [**Last Name (NamePattern1) 1194**] Clinic 5. Hypertension 6. Migraines 7. AI - longstanding murmur consistent with AI, documented by echo [**2171**] 8. bipolar 9. OCD 10. PTSD 11. R hand cellulitis s/p trauma, cipro course [**Date range (1) 1195**] Social History: Married, in the past stated that he lived with wife, now living in group home per MICU. No children. Currently unemployed. No tobacco. Family History: Brother with heart murmur. Father died of melanoma; mother has chronic bronchitis (tobacco user). Physical Exam: General: awake and alert, cooperative Vital Signs: 98.2, HR 68, BP 126-141/43-60, SaO2 99-100% on RA HEENT: NC/AT, perrl, sclerae anicteric, o/p with MMM, no thrush neck supple, FROM, no LAD Pulmonary: scattered crackles at the L base, otherwise clear CV: rrr, nl s1 and s2 Abdomen: distended, obese, soft, palpable liver edge. no rebound or guarding. no caput Extremities: trace to 1+ edema in bilaterally LE's. ecchymosis LUE(s/p phlebotomy there 1 week ago in ER) Neuro: awake, alert, oriented x 3. moves all extremities. Pertinent Results: [**2184-10-10**] 12:20AM BLOOD WBC-8.0 RBC-3.84* Hgb-13.7* Hct-38.9* MCV-102* MCH-35.6* MCHC-35.1* RDW-14.2 Plt Ct-227 [**2184-10-16**] 06:53AM BLOOD WBC-6.1 RBC-3.34* Hgb-11.4* Hct-35.1* MCV-105* MCH-34.0* MCHC-32.4 RDW-14.4 Plt Ct-264 [**2184-10-10**] 12:20AM BLOOD Neuts-45.0* Lymphs-47.7* Monos-5.0 Eos-1.5 Baso-0.8 [**2184-10-10**] 11:00AM BLOOD Neuts-81.9* Lymphs-14.3* Monos-2.7 Eos-0.8 Baso-0.3 [**2184-10-10**] 12:20AM BLOOD Glucose-122* UreaN-8 Creat-0.5 Na-137 K-3.9 Cl-93* HCO3-21* AnGap-27* [**2184-10-16**] 06:53AM BLOOD Glucose-91 UreaN-12 Creat-0.7 Na-136 K-5.0 Cl-98 HCO3-29 AnGap-14 [**2184-10-10**] 11:00AM BLOOD ALT-105* AST-403* AlkPhos-305* TotBili-0.8 [**2184-10-13**] 04:31AM BLOOD ALT-78* AST-215* AlkPhos-247* TotBili-1.2 [**2184-10-10**] 02:11PM BLOOD Phos-4.1 Mg-1.2* [**2184-10-16**] 06:53AM BLOOD Calcium-9.1 Phos-4.5 Mg-1.4* [**2184-10-10**] 08:30AM BLOOD Calcium-6.1* Phos-4.6* Mg-0.8* [**2184-10-10**] 11:00AM BLOOD VitB12-334 Folate-5.0 [**2184-10-10**] 02:11PM BLOOD ASA-NEG Ethanol-NEG Acetmnp-NEG Bnzodzp-POS Barbitr-NEG Tricycl-NEG AEROBIC BOTTLE (Final [**2184-10-16**]): NO GROWTH. ANAEROBIC BOTTLE (Final [**2184-10-16**]): NO GROWTH. URINE CULTURE (Final [**2184-10-12**]): NO GROWTH. AEROBIC BOTTLE (Final [**2184-10-17**]): NO GROWTH. ANAEROBIC BOTTLE (Final [**2184-10-17**]): NO GROWTH. RAPID PLASMA REAGIN TEST (Final [**2184-10-13**]): NONREACTIVE. [**10-10**] CXR: There is no focal consolidation, and the lateral costophrenic foci are sharply delineated. Pulmonary vascular markings are normal. The heart size is at the upper limits of normal, and the mediastinum is otherwise unremarkable. [**10-10**] EKG: Baseline artifact. Sinus rhythm. Prolonged QTc interval. Prominent precordial QRS voltage - consider left ventricular hypertrophy. Prominent lateral T waves of uncertain significance - could be within normal limits or early repolarization pattern. Clinical correlation is suggested. Since the previous tracing of [**2173-11-9**], QTc interval is longer and early repolarization pattern less prominent. [**10-12**] SKIN L BACK: Skin left back (A): Perivascular lymphocytic infiltrate with eosinophils consistent with dermal hypersensitivity reaction. Note: No intraepidermal neutrophils are seen on multiple levels. The results of a PAS stain will be reported in an addendum. Brief Hospital Course: 1) EtOH withdrawal: EtOH neg on tox screen. Pt states he has baseline tremor ("shaky jakey" he calls himself), but it's not clear whether the hx of tremor might be due to episodes of Etoh withdrawl. Valium given per CIWA scale. His beta blocker and clonidine were continued. Thiamine, folate, B12, and MVI were supplemented. Urine and blood cultures were negative. He exhibited sx of insomnia, tremulousness, anxiety, gastrointestinal upset, headache, diaphoresis, disorientation, tachycardia, hypertension, and agitation during this hospitalization. He was still mildly disoriented when he signed out AMA on the last day of hospitalization. 2) Drug rash - Treated in the ER with SQ epinephrine, steroids, atarax, and zantac. Biopsy was consisted with drug rash, likely secondary to ciprofloxacin. He should be recorded as having an allergy to ciprofloxacin. His rash resolved. 3) FEN - He had low Ca, Mg, P04 on admission, which were repleted. 4) Gap acidosis: He had a gap acidosis on admission that resolved - likely alcoholic ketoacidosis +/- starvation. 5) Hematuria - The patient's foley was removed on [**10-15**], and he subsequently complained of hematuria. A UA was ordered, however the patient signed out AMA shortly thereafter, before the UA could be obtained. The patient was transfered to the floors on [**10-15**], and subsequently signed out against medical advice. Medications on Admission: atenolol 100mg clonidine 2 tabs [**Hospital1 **] (? dose) effexor 50mg paxil 50mg Discharge Medications: Signed out AMA Discharge Disposition: Home Facility: Signed out against medical advice. Discharge Diagnosis: Signed out against medical advice. Discharge Condition: Stable. Discharge Instructions: Signed out against medical advice. Followup Instructions: Signed out against medical advice. Usual PCP is [**Last Name (NamePattern4) **]. [**Last Name (STitle) **]. ICD9 Codes: 4019
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Medical Text: Admission Date: [**2194-12-11**] Discharge Date: [**2194-12-23**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 4052**] Chief Complaint: Elevated Cr, SOB Major Surgical or Invasive Procedure: None History of Present Illness: [**Age over 90 **] yo male with h/o Parkinsons, HTN, and worsening renal failure who presents with w/ K>6, Cr 4 from NH. a few days ago at [**Hospital 100**] Rehab, he spiked a fever to 102. No night sweats or recent weight loss or gain. Denies headache, rhinorrhea or congestion. Positive cough productive of white phlegm. Patient also reports that he has had DOE and shortness of breath for the last 6 weeks. He does not know whether this has changed recently. Denies chest pain or tightness, palpitations. Denies nausea, vomiting but developed diarrhea today. Patient states that he has had constipation on and off and he was given something at his rehab today to get his bowels moving. Then this afternoon he devloped loose stools. The patient also c/o abdominal distention which is not new. The patient also complains of chronic low back pain radiating to the groin which is similar to the pain he had on last admission when a compression fx was discovered. The patient also states that he has had decreased PO intake over the last week. He states that he has not felt hungry and "everything tastes wrong" . The patient was recently admitted with worsening low back pain. CT and plain films revealed a compression fracture. MRI spine showed no evidence of epidural abscess, cord compression, osteo. But may have acute compression of vertebrae causing pain. Pain control was with tylenol standing, morphine prn, calcitonin nasal spray. Patient with significant SOB and new oxygen requirement that was thought [**2-20**] CHF exacerbation. CXR showed atelectasis vs. PNA and evidence of CHF. The team held Amiodarone in this patient as Amiodarone toxicity was thought to possibly be contributing to his shortness of breath and hypoxia. He was also treated for pneumonia given possible infiltrate in gentleman with no clear source for fever, he was afebrile after day one of admission. Echo during hospital stayed showed decreased EF to 30% - 35% from 40% in [**Month (only) 404**]. He was significantly volume overloaded on initial exam, with edema, crackles and evidence of pulm edema and diuresed throughout the admission. . In the ED today, EKG showed old AV delay, old LBBB, no TW peaking. CBC/chem revealed an AG of 16, elevated WBC. CEs showed an elevated troponin but this is in the setting of ARF. MB was flat. Guaiac test of stool was positive in setting of loose stools. CXR/KUB -> bowel loops herniating to thorax but no obstruction. Past Medical History: 1. Parkinson's 2. Hypertension 3. Atrial fibrillation 4. CAD s/p MI [**2192**], recent cath in [**1-24**] showed right dominancy circulation with 3VD, s/p stenting of mid LAD at that time 5. Ulcers 6. Asthma 7. Chronic renal insufficiency, baseline Cr 2.5-2.8 8. Diverticulosis 9. L groin hernia 10. h/o GIB (10y ago) Social History: Retired salesman. Widower. Lives independently in senior housing. Nonsmoker. Only socially drinks ETOH. No IVDU. No children. Family History: Mother- died at 86 of MI. Father- heavy [**Name2 (NI) 1818**] and drinker. Died at 75y (? cause) Brother- died of complications from [**Name (NI) 5895**] Physical Exam: Vitals: T 96.9 P 76 BP 110/70 97% 2L General: Elderly man resting in bed, appears in mild respiratory distress, NAD HEENT: NC/AT, PERRL, EOMI, sclera anicteric. MM dry, OP without lesions Neck: supple, no JVD or carotid bruits appreciated Pulm: Decreased air movement, diffuse wheezes Cardiac: RRR, nl S1/S2, II/VI SEM at RUSB Abdomen: distended, soft, typanic, hyperactive bowel sounds, in ED good rectal tone, guiac negative. Ext: 1+ bilateral pitting edema to knees, 1+ DP pulses Lymphatics: No cervical, supraclavicular, axillary, or inguinal LAD. Skin: no rashes or lesions noted. Neurologic: AAO x3, CN II-XII intact, muscle strength 5/5 in all 4 extremities. Pertinent Results: Labs on admission: [**2194-12-11**] 12:55PM BLOOD WBC-12.6*# RBC-3.71* Hgb-11.7* Hct-34.1* MCV-92 MCH-31.5 MCHC-34.3 RDW-14.6 Plt Ct-368 [**2194-12-11**] 12:55PM BLOOD Neuts-90.5* Bands-0 Lymphs-4.1* Monos-4.7 Eos-0.5 Baso-0.1 [**2194-12-11**] 12:55PM BLOOD PT-12.5 PTT-22.6 INR(PT)-1.1 [**2194-12-11**] 12:55PM BLOOD Glucose-123* UreaN-104* Creat-5.1*# Na-128* K-6.4* Cl-90* HCO3-22 AnGap-22* [**2194-12-11**] 12:55PM BLOOD CK(CPK)-675* [**2194-12-11**] 09:30PM BLOOD CK(CPK)-536* [**2194-12-12**] 06:10AM BLOOD CK(CPK)-389* [**2194-12-11**] 12:55PM BLOOD cTropnT-0.37* [**2194-12-11**] 09:30PM BLOOD CK-MB-8 cTropnT-0.34* [**2194-12-12**] 06:10AM BLOOD CK-MB-6 cTropnT-0.35* [**2194-12-11**] 12:55PM BLOOD Calcium-8.5 Phos-6.4*# Mg-4.3* . CXR [**12-11**]: Portable upright chest radiograph reviewed. Again seen is a complex hiatal hernia containing stomach and bowel loops. Evaluation of the heart size is thus limited. The lungs are grossly clear though limited secondary to large hernia. The right costophrenic angle is sharp. The left costophrenic angle is obscured by mediastinal contour secondary to hernia. The pulmonary vessels are within normal limits. . EKG: NSR rate 83, 1st degree AV block, LAD, LBBB . Renal U/S [**12-11**]: The right kidney measures 8.6 cm. The left kidney measures 8.4 cm. Again seen are two right renal cysts. There is no evidence of hydronephrosis, stones, or mass. The distended bladder is unremarkable. . CT head [**12-11**]: There is no evidence of intracranial hemorrhage, mass effect, hydrocephalus, shift of normally midline structures, or major vascular territorial infarction. Hypodensities in the periventricular and deep cerebral white matter consistent with chronic microvascular infarction. [**Doctor Last Name **]-white differentiation is preserved. Prominence of the ventricles and sulci is consistent with brain atrophy. There are bilateral basal ganglia calcifications. Extensive carotid calcifications are also identified. Surrounding osseous and soft tissue structures are unremarkable. . Urine Cytology- [**2194-12-22**] **atypical urothelial cells. . VIDEO OROPHARYNGEAL SWALLOW [**2194-12-22**] 11:15 AM The study was performed in conjunction with the speech pathologist. Various consistencies of barium were administered to the patient under video fluoroscopy. Aspiration was demonstrated with consecutive straw sips of thin liquids. The patient had a spontaneous, ineffective cough. After the first sip of thin liquids, a small amount of penetration was also noted which was stripped out by the patient. Please see the speech pathologist's report in CareWeb for more details and treatment recommendations. Brief Hospital Course: Mr. [**Known lastname 1395**] is a pleasant and witty [**Age over 90 **] year old gentleman with h/o Parkinsons, HTN, and worsening renal failure who presented with a potassium of >6, Cr 4 from his nursing home. On admission he developing worsening dyspnea requiring MICU transfer and around the clock nebulizer treatments. He was never intubated and only required 2L oxygen for mild hypoxia, and was transferred to the general medical floor for management. It was thought severe reflux and his very large paraesophageal hernia were primarily related to his episode of dyspnea. The patient sustained an NSTEMI and revealed worsening LV systolic function to 25% EF. Coronary revascularization was not recommended given the patient's episode of GI bleeding with heparinization and baseline poor functional status. His medical therapies were maximized from cardiac, renal and pulmonary perspectives. #. Shortness of breath: No evidence of CHF or PNA on CXR. Patient's lung exam + for wheezes. Does no appear overloaded on pulmonary exam, however his significant lower extremity edema was likely secondary to decreased oncotic pressures due to nutritional depletion/low albumin. Given IV steroids and nebulizers initially q30min but nebs were spaced to q2hours then q4hours prn. Unfortunately patient had to relapsing episodes of dyspnea requiring increased frequency in nebulizers. On his 2nd relapse, LENI's were performed to rule out DVT's. A CTA was not performed due to the patient's poor creatinine clearance. He was started empirically on a heparin drip to PEs but it had to be stopped because of rectal bleeding. Serial CXR did not reveal a CHF picture. Pulmonary consultation was obtained and it was thought his wheezing was secondary to his large paraesophageal hernia in combination with severe reflux symptoms. He was placed on [**Hospital1 **] pantoprazole, and slowly tapered down on prednisone to 30mg daily. He should continue his slow prednisone taper at the MACU. . #. Acute on Chronic renal failure: Pt with worsening renal function over the last year. Baseline Creat is 2.3-2.6 and recent discharge Cr was 2.7. On admission Creat was 5.1 in setting of probable dehydration. He likely has prerenal ARF from poor forward flow from CHF, and also decreased PO intake. No evidence of obstruction or hydronephrosis u/s done in ED. Urine lytes c/w prerenal etiology with FeNa <1%. Patient received gentle fluids overnight and Cr decreased to 4.4. UOP was steady following normalization of cardiac function. We held ACE-I in the setting of his renal failure. We did not diurese the patient in this setting either, but maximized his heart function medically and allowed him to autodiurese likely post-ATN. His BUN/Cr function was steadily improving at time of discharge. Renal was consulted and recommended the above measures. Urine cytology was ordered and revealed atypical urothelial cells. This finding is of indeterminant significance given his multiple medical problems and high variability among urine cytology specimens. This should be followed up on as an outpatient by Dr. [**Last Name (STitle) 1266**] to repeat the study or decide with pt and family to pursue further work-up. . #. Guaiac positive stool and loose stools: Pt recently completed a course of Levaquin for PNA on admission. Possible C. Diff in setting of Abx. Pt started on heparin for presumed PE but had to be stopped because of bright red blood per rectum. Pt's hematocrit remained stable. He was having intermittent guaiac positive stools throughout the admission, but did not significantly drop his hematocrit. . #. Back/Groin Pain: Pt with recent CT and plain films which revealed compression fracture. Recent MRI spine showed no evidence of epidural abscess, cord compression, osteo. But may have acute compression of vertebrae causing pain. His pain was well-controlled with tylenol standing, morphine prn, calcitonin nasal spray. We had PT see the patient daily to work on mobility. . . #. Congestive heart failure: Echo [**12-2**] showed decreased EF to 30% - 35% from 40% in [**Month (only) 404**]. Repeat echo on admission revealed an EF of 25-30%. This worsening is likely related to an NSTEMI. Cardiology was consulted and recommended maximizing medical therapy. Revascularization is not a good approach given the pt's intolerance of heparin, and would not do well with the plavix, argatroban loading required for repeat PCI. We salt restricted his diet. And allowed him to autodiurese. Aggressive diuresis was not pursued given pulmonary function that was not supportive of CHF. His lower extremity edema can be treated with compression stockings/ACE bandages. . # CAD: Pt has known 3VD, cath [**1-24**] with stent of LAD. No ECG changes but pt has a LBBB. Tn elevated to 0.37 on admission and peaked at 2.54 in the setting of his renal failure. His CK-MB fraction trended down and normalized several days prior to admission. He did not have any anginal symptoms. Pt was seen by cardiology who recommended maximizing medical management given poor risk/benefit of further PCI. We maximized statin to 80mg per day, titrated his metoprolol to 37.5mg [**Hospital1 **], and continued aspirin and plavix. We held ACE-I due to renal insufficiency. . #. Abdominal distension: Noted on prior admission, pt with significant abdominal distension, minimal discomfort with palpation. no evidence of fluid. KUB showed many loops of gas filled bowel but no evidence of bowel obstruction. Suspicion for C. diff infection was considered given leucocytosis, but c. diff studies while in hospital were negative. . #. Parkinson's disease: We continued ropinarole. . #. FEN: Cardiac diet. We obtained a video swallow evaluation that cleared the patient for regular diet with only restriction of avoiding straws for beverages given that they repeatedly caused him to aspirate. . #. Prophylaxis: PPI, SC heparin, holding bowel regimen . #. Code: DNR/DNI as discussed with HCP. . #. Dispo: Pending clinical improvement Medications on Admission: 1. Morphine 2 mg/mL Syringe Sig: 0.5 mg Injection Q4H (every 4 hours) as needed for pain. 2. Metoclopramide 10 mg Tablet Sig: One (1) Tablet PO TID (3 times a day). 3. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 4. Fluticasone-Salmeterol 100-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 5. Prilosec 20 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO once a day. 6. Aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO DAILY (Daily). 7. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 8. Ropinirole 1 mg Tablet Sig: Eight (8) Tablet PO TID (3 times a day). 9. Acetaminophen 325 mg Tablet Sig: Two (2) Tablet PO Q6H (every 6 hours) as needed for pain control. 10. Levofloxacin 250 mg Tablet Sig: One (1) Tablet PO Q48H (every 48 hours) for 4 days. 11. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 12. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 13. Psyllium Packet Sig: One (1) Packet PO BID (2 times a day) as needed for constipation. 14. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day) as needed for bloating. 15. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 16. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation Q4H (every 4 hours) as needed for wheezing/sob. 17. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical Q12H ON, Q12H OFF (). 18. Calcitonin (Salmon) 200 unit/Actuation Aerosol, Spray Sig: One (1) Nasal DAILY (Daily). 19. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 20. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TIDAC (3 times a day (before meals)). 21. Furosemide 40 mg Tablet Sig: One (1) Tablet PO QAM (once a day (in the morning)). 22. Furosemide 20 mg Tablet Sig: One (1) Tablet PO QPM (once a day (in the evening)). 23. Lisinopril 5 mg Tablet Sig: 0.5 Tablet PO DAILY (Daily). 24. Metoprolol Succinate 25 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO DAILY (Daily). Discharge Medications: 1. Calcitonin (Salmon) 200 unit/Actuation Aerosol, Spray Sig: One (1) Nasal DAILY (Daily). 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Calcium Carbonate 500 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 4. Fluticasone-Salmeterol 100-50 mcg/Dose Disk with Device Sig: One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day). 5. Cholecalciferol (Vitamin D3) 400 unit Tablet Sig: Two (2) Tablet PO DAILY (Daily). 6. Hexavitamin Tablet Sig: One (1) Cap PO DAILY (Daily). 7. Ropinirole 1 mg Tablet Sig: Eight (8) Tablet PO tid (). 8. Lidocaine 5 %(700 mg/patch) Adhesive Patch, Medicated Sig: One (1) Adhesive Patch, Medicated Topical DAILY (Daily). 9. Albuterol Sulfate 0.083 % Solution Sig: [**1-20**] Inhalation every 4-6 hours as needed for shortness of breath. 10. Simethicone 80 mg Tablet, Chewable Sig: One (1) Tablet, Chewable PO TID (3 times a day). 11. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2 times a day). 12. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a day) as needed. 13. Bisacodyl 10 mg Suppository Sig: One (1) Suppository Rectal HS (at bedtime). 14. Aspirin 325 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO DAILY (Daily). 15. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 16. Heparin (Porcine) 5,000 unit/mL Solution Sig: One (1) Injection TID (3 times a day). 17. Ipratropium Bromide 0.02 % Solution Sig: One (1) Inhalation Q6H (every 6 hours). 18. Risperidone 0.5 mg Tablet, Rapid Dissolve Sig: One (1) Tablet, Rapid Dissolve PO BID, MR X1 [**Hospital1 **] (). 19. Albuterol Sulfate 0.083 % Solution Sig: One (1) Inhalation Q4H (every 4 hours). 20. Tiotropium Bromide 18 mcg Capsule, w/Inhalation Device Sig: One (1) Cap Inhalation DAILY (Daily). 21. Montelukast 10 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 22. Prednisone 10 mg Tablet Sig: Three (3) Tablet PO DAILY 23. Simvastatin 40 mg Tablet Sig: Two (2) Tablet PO QHS (once a day (at bedtime)). 24. Metoprolol Tartrate 25 mg Tablet Sig: 1.5 Tablets PO BID (2 times a day). Discharge Disposition: Extended Care Facility: [**Hospital6 459**] for the Aged - MACU Discharge Diagnosis: Primary: Heart Failure Secondary: Paraesophageal hernia gastroesophageal reflux renal insufficiency Parkinson's disease Discharge Condition: fair Discharge Instructions: You were admitted for kidney failure and shortness of breath. You were treated with steroids and breathing treatments to improve your breathing. Your kidney faily was likely related to worsening function of your heart because of another heart attack. You were seen by doctors [**Name5 (PTitle) 65386**] in your heart, lungs, and kidneys who recommended changes to medications to help with each of these organ systems. Ultimately your heart function is the underlying problem for many of your symptoms and we are currently giving you the best therapy possible given your complex medical condition. . Please call Dr. [**Last Name (STitle) 65387**] or 911 if you experience any chest pain, shortness of breath not responsive to nebulizer treatments, high fevers or diarrhea, Followup Instructions: You will be seen regularly by Dr. [**Last Name (STitle) 1266**] at [**Hospital 100**] Rehab. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 4055**] ICD9 Codes: 5849, 2767, 4280, 5789, 5859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7586 }
Medical Text: Admission Date: [**2127-2-14**] Discharge Date: [**2127-2-28**] Service: SURGERY Allergies: Tetracycline Attending:[**First Name3 (LF) 7760**] Chief Complaint: Transfer from [**Last Name (un) 4068**] to [**Hospital1 18**] SICU Major Surgical or Invasive Procedure: s/p I&D ([**2-13**]) s/p Debridement ([**2-14**]) History of Present Illness: Mr. [**Known lastname 31251**] is a 86 yo male transferred from [**Hospital1 **]-[**Last Name (un) 4068**]. He developed right foot pain the Sunday prior to admission and was seen by his Podiatrist, who diagnosed him with gout. He was given colchicine and prednisone. Mr. [**Known lastname 31251**] then developed more pain and warmth to his right foot later in the week and presented to the [**Hospital1 **]-[**Last Name (un) 4068**] ED. At this hospital he underwent an I&D ([**2-13**]) of a right foot infection and subsequently underwent re-exploration ([**2-14**]) for developing necrotizing fascitis. He was transferred to [**Hospital1 18**] for further care. Past Medical History: PMH: Prostate Ca, Glaucoma PSH: RIH repair, s/p TURP, s/p thyroid excision Social History: EtOH Physical Exam: 98.9, 93, 137/78, 16, 98% GEN: NAD HEENT: EOMI, anicteric, OP pink NECK: no masses, supple CV: RRR, no m/r RESP: clear GI: soft/NT/ND EXT: R foot with erythema/swelling; muscle and tendons exposed, with necrotic edges, some fibrinous exudate NEURO: AxOx3 Pertinent Results: MRI RLE [**2-17**] "1. 7 cm linear fluid collection running between the anterior and lateral muscle compartments, extending from a large area of soft tissue loss seen in the distal lateral foreleg to roughly the mid tibia/fibula, 18 cm distal to the knee joint line. The collection is largest at its most proximal extent, measuring 1.4 x 0.7 cm in the transverse dimension. 2. Non-specific myositis involving multiple muscle groups in the foreleg, most severe in the anterior, lateral, and posterior deep compartments. 3. Tendinosis of the posterior tibialis and peroneus brevis tendons. No tendon tear. 4. No evidence of abnormal bone marrow signal intensity or intraosseous abscess." RLE Angio [**2-17**] "1. Mild but multifocal atherosclerotic disease involving the infrarenal aorta and iliac arteries, with no significant pressure gradient associated. 2. Significant segmental stenosis (approx. 5-6 cm long) in the mid right superficial femoral artery. 3. High bifurcation of the popliteal artery at the knee level. 4. In the proximal calf, severe stenosis or occlusion of the two terminal branches arising from this popliteal bifurcation (likely the anterior tibial and the peroneal arteries). Two significant focal stenoses of the distal right anterior tibial artery. Right posterior tibial artery completely occluded. 5. Patent medial and lateral plantar arteries, filled through collaterals arising mostly from the peroneal artery. Dorsalis pedis artery not seen." Brief Hospital Course: Mr. [**Known lastname 31251**] was admitted to the TSICU. He was placed on Penicillin G, Clindamycin. for empiric coverage of his wound, with Group A strep growth from the [**Hospital1 **]-[**Last Name (un) 4068**] cultures. He was transferred to the floor on HD#2. He continued to undergo [**Hospital1 **] dressing changes. Plastic surgery was asked to evaluate the patient. Per their recommendations, silvadine was applied to the tendons to prevent dessication. Vascular surgery was also asked to evaluate the patient's right lower extremity blood flow. An angiogram on HD#4 showed severe tibial disease and moderate SFA disease, no DP artery was seen. The vascular team recommended a femoral-peroneal bypass for revascularization and performed this operation on HD #5. He tolerated the procedure well, please see Dr.[**Name (NI) 1392**] Operative Note for detail. On POD#1, Mr. [**Known lastname 31251**] received 2 units of pRBCs for post-op anemia (Hct 25). Mr. [**Known lastname 31251**] continued to be followed by Infectious Disease, whose recommendations were to complete a [**12-26**] week course of Penicillin G and Clindamycin after the foot was completely debrided and the skin flaps completed. His wound continued to heal well and by POD #6 a VAC dressing was placed. He received a PICC on POD#7 for his long-term antibiotic therapy. At the time of discharge, Mr. [**Known lastname 31251**] had good pain control, was tolerating a regular diet, had a well-healing wound treated with a VAC dressing, and was to continue his IV PCN G and Clindamycin. He was discharged to a rehab facility in fair condition. Medications on Admission: Timolol .5% Discharge Disposition: Extended Care Facility: [**Hospital 11851**] Healthcare - [**Location (un) 620**] Discharge Diagnosis: Right lower extremity necrosing fascitis history of prostate cancer s/p TURP glaucoma Discharge Condition: Fair Discharge Instructions: If you have any fevers/chills, nausea/vomiting, chest pain, foot pain, please seek medical attention. Followup Instructions: Please follow up with Dr. [**Last Name (STitle) 6633**] in one week, call [**Telephone/Fax (1) 2998**] for an appointment. Follow up with Dr. [**Last Name (STitle) 1391**] in 2 weeks, call [**Telephone/Fax (1) 1393**] for an appointment. ICD9 Codes: 2851
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7587 }
Medical Text: Admission Date: [**2150-2-19**] Discharge Date: [**2150-4-15**] Date of Birth: [**2089-5-20**] Sex: M Service: SURGERY Allergies: Desipramine Hcl Attending:[**First Name3 (LF) 148**] Chief Complaint: Pancreatic cancer Major Surgical or Invasive Procedure: Whipple procedure with J tube placement, Exploratory laparotomy for wound dehisence. s/p closure with rentention sutures [**2-25**], s/p Trach [**3-9**], s/p open drainage of splenic abscess [**3-26**] History of Present Illness: This 60-year-old man has COPD and coronary artery disease as well as bipolar depression and he originally presented with two weeks of nausea, diarrhea, dark colored urine and jaundice. He has been suffering from upper respiratory symptoms for the last three weeks and saw his pulmonologist who started on antibiotics for the steroid taper. He reported diarrhea at this time and he actually had C. diff colitis identified. He reports no change in appetite, recent weight loss or other particular symptoms. He underwent an ERCP/stent placement on [**1-27**] which showed a distal CBD stricture and atypical cells. CTA abdomen showed a 3.6 cm head of pancreas mass. He had a Whipple and J-tube on [**2150-2-19**] Past Medical History: COPD (Chronic Bronchitis, Emphysema), CAD, OSA (thumbs, right shoulder and neck), Melanoma, Bipolar/manic depression, sleep apnea, Hx C.diff PSH: Cardiac Stent x4 ([**2145**]), Melanoma excision (abdomen) [**2140**] Social History: Lives alone in [**Location (un) 5289**]. Quit tobacco [**2145**]. No EtOH. Works part-time in sales. Family History: Mother with breast CA Physical Exam: Gen: Looks a bit disheveled, but is awake and oriented x3 and fully conversant. HEENT: No evidence of scleral icterus at this point. Chest: clear to auscultation. CV: Cardiac exam shows a regular rate and rhythm. Abd: soft, nontender, and nondistended with positive bowel sounds and is quite protuberant and rotund. Ext: show no cyanosis, clubbing, or edema. Pertinent Results: On admission: [**2150-2-19**] 10:44PM BLOOD WBC-25.0*# RBC-4.04* Hgb-12.1* Hct-36.0* MCV-89 MCH-30.1 MCHC-33.7 RDW-15.5 Plt Ct-195 [**2150-2-19**] 10:44PM BLOOD PT-15.0* PTT-43.8* INR(PT)-1.3* [**2150-2-19**] 10:44PM BLOOD Glucose-186* UreaN-14 Creat-1.0 Na-140 K-5.0 Cl-107 HCO3-22 AnGap-16 [**2150-2-19**] 10:44PM BLOOD ALT-1015* AST-818* AlkPhos-96 Amylase-24 TotBili-2.1* [**2150-2-19**] 10:44PM BLOOD Lipase-15 [**2150-2-19**] 10:44PM BLOOD Calcium-8.8 Phos-5.6*# Mg-1.7 [**2150-2-19**] 12:18PM BLOOD Type-ART pO2-93 pCO2-49* pH-7.28* calTCO2-24 Base XS--3 Intubat-INTUBATED . CXR [**2150-2-20**] IMPRESSION: AP chest compared to [**2-19**]: Lung volumes remain quite low. Mild pulmonary edema is new, accompanied by increased caliber to mediastinal and hilar vessels. Small left pleural effusion is presumed. Tip of the Swan-Ganz catheter projects over the right descending pulmonary artery. ET tube tip ends at the thoracic inlet, partially withdrawn since the prior study. Nasogastric tube passes below the diaphragm and out of view. Small left pleural effusion is presumed. No pneumothorax. . Duplex Doppler Abd/Pelvis [**2150-2-20**] HISTORY: 60-year-old male status post Whipple's procedure. IMPRESSION: Replaced common hepatic artery posterior to the portal vein was not visualized; however, normal arterial waveforms were obtained in the right and left hepatic arteries. . CXR [**2150-2-20**] REASON FOR EXAM: Increased O2 requirement. FINDINGS: There are low lung volumes. Increased diffuse density of the left hemithorax is most likely due to layering pleural effusion. Cardiac silhouette is accentuated by the low lung volumes, appears to be mildly enlarged. There is engorgement of the mediastinal and pulmonary vasculature with no overt pulmonary edema. Right lower lobe atelectasis is new. NG tube tip is out of view, below the diaphragm. IMPRESSION: Increased left pleural effusion with increased adjacent atelectasis. [**2150-4-14**] 05:05AM BLOOD WBC-23.9* RBC-3.93* Hgb-11.1* Hct-34.6* MCV-88 MCH-28.3 MCHC-32.2 RDW-17.5* Plt Ct-988* [**2150-4-13**] 05:10AM BLOOD WBC-19.5* RBC-3.81* Hgb-10.8* Hct-33.7* MCV-88 MCH-28.3 MCHC-32.0 RDW-17.5* Plt Ct-940* [**2150-4-13**] 05:10AM BLOOD calTIBC-186* Ferritn-561* TRF-143* [**2150-4-6**] 02:49PM BLOOD calTIBC-120* Ferritn-610* TRF-92* [**2150-4-6**] 02:49PM BLOOD Triglyc-140 [**2150-3-25**] 02:21AM BLOOD Lithium-0.8 . CHEST (PA & LAT) [**2150-4-12**] 10:18 PM IMPRESSION: Persistent but slightly improved retrocardiac opacity which may be secondary to aspiration, pneumonia, or atelectasis. Left pleural effusion is unchanged. Subsegmental right lower lobe atelectasis. . VIDEO OROPHARYNGEAL SWALLOW [**2150-4-7**] 1:23 PM IMPRESSION: Penetration and intermittent aspiration with thin and nectar consistency barium. . CHEST (PORTABLE AP) [**2150-4-5**] 4:47 AM FINDINGS: The left chest tube is unchanged. There continued to be bilateral pleural effusions moderate in size that layer posteriorly, given positioning it is unclear but these are likely increased compared to prior. There is pulmonary vascular re-distribution, perihilar haze consistent with fluid overload. There is obscuration of both hemidiaphragms due to the effusions and an underlying infiltrate cannot be excluded. . ECHO Conclusions The left atrium is elongated. No atrial septal defect is seen by 2D or color Doppler. Left ventricular wall thicknesses and cavity size are normal. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. The ascending aorta is mildly dilated. The aortic valve leaflets (3) are mildly thickened but aortic stenosis is not present. No masses or vegetations are seen on the aortic valve. No aortic regurgitation is seen. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. No mass or vegetation is seen on the mitral valve. The pulmonary artery systolic pressure could not be determined. There is no pericardial effusion. . CT ABDOMEN W/CONTRAST [**2150-3-31**] 11:16 AM IMPRESSION: 1. Overall, no significant change. Infarcted spleen and subsequent hematoma is unchanged in size, with indwelling large-bore catheter. Heterogeneity within the hepatic parenchyma, left lobe, likely due to retractor injury, no definite evidence for infection at this time. 2. Loculated left pleural effusion with near-complete collapse of the left lower lobe. Small right effusion and atelectasis. . CT PERITINEAL DRAIN EXCLUDING APPENDICEAL [**2150-3-21**] 2:39 PM IMPRESSION: Successful CT-guided percutaneous drainage of splenic collection. . CT PELVIS W/CONTRAST [**2150-3-10**] 3:33 PM IMPRESSION: 1. Splenic vein thrombosis with extensive splenic infarction. Interval development of gas within the infarcted splenic parenchyma concerning for infection. 2. Multiple poorly defined hypoenhancing areas in the left hepatic lobe that may be related to retractor injury. However, superimposed infection cannot be excluded. 3. Small left pleural effusion and near complete collapse of the left lower lobe. 4. Emphysema. 5. No definite evidence of enterocutaneous fistula. However, please note that the small bowel was not well opacified with oral contrast at the time of the examination which limits the sensitivity of this exam. . Brief Hospital Course: Patient was admitted after a Pylorus-preserving Whipple w/ J-tube placement and placement of gold fiducial seeds for CyberKnife therapy (please see full operative note for details). Because of the pt's baseline cardiopulmonary issues, he remained intubated and was transferred directly to the ICU. Neuro: He was awake and alert after extubation and was successfully transitioned to a PCA for pain control. . Cardiac: He initially had a Swan-Ganz catheter, which was removed with stable cardiac function. He was maintained on ASA. . Pulmonary: Pt was extubated on POD 2 and eventually transitioned to O2 by nasal canula. However, he was electively re-intubated on [**2-25**] after his wound dehiscence and emergent return to OR. He required ventilatory support post-op was he had a percutaneous tracheostomy placed on [**2150-3-9**]. . FEN: Pt was on a lasix drip initially for diuresis and was eventually transitioned to intermittent doses. He responded well to the treatment. Trophic J tube feeds were started on POD#4 and were slowly advanced towards goal. He tolerated them well. They were held briefly during his evisceration but was eventually restarted and advanced to goal. Nutrition was following for tube feed recommendations. He was evaluated by Speech and Swallow and he was cleared for ground solids and nectar thick liquids. . GI: Immediately post-op, he had elevated LFTs but ultrasound of the hepatic vasculature was negative for pathology. He developed a wound infection that required re-opening of his wound. With the infection and his concurrent steroids, he eviscerated through his wound after a violent cough. He was brought back to the OR emergently on [**2-25**] and his wound was irrigated/debrided and primary closed with retention sutures. He required large amounts of PEEP up to 15 to maintain his oxygenation. He continued to be hypotensive requiring vasopressors for several post-operative days. His cortisol stim test showed a marginal response (34 to 41) and steroids were not restarted. An ECHO was obtained which showed intact LV function with no thrombi. On [**3-7**] he developed an low-output colocutaneous fistula through his abdominal wound. It's output was bilious and did not appear to have any tube feeds or methylene blue when placed via the NGT. A vacuum dressing was applied after initially using wet to dry dressings. His wound continued to improved and he will need continued wound care. . ID: He spike fevers intermittently and cultures were positive for: enterococcus faecium on [**2-21**] in blood x2 bottles, sputum culture for sparse yeast [**2-21**]; Sputum cultures from [**2-26**], [**3-2**], [**3-4**] revealed enterobacter cloacae and he was treated with appropriate ABX. On [**3-4**] (POD 13 and 7) he developed a fever to 102 and leukocytosis to 34K. CT showed Infarction of the spleen with thrombosis identified within the splenic vein and colitis. He was treated non-operatively with bowel rest for the colitis and an Aspirin for the splenic vein thrombus. . Heme: Pt had consistently decreasing platelet count while on heparin. All heparin products were d/c'd and he was maintained on pneumoboots for prophylaxis throughout his ICU stay. CT abd [**3-4**] showed infarction of the spleen with thrombosis. CT abd [**2150-3-10**] showed splenic abscess, which was drained on [**2150-3-12**] via IR. Approximately 800cc blood/foul-smelling fluid was drained and a drain was left in place. . Endo: Pt was adrenally deficient on POD#1 and started on a steroid taper, which was appropriately weaned and then stopped after he eviscerated from his incision. His blood sugars continued to be elevated and [**Last Name (un) **] Diabetes was seeing him and adjusting his sliding scales. . Psych: Lamictal and lithium were restarted on POD#4 through the J tube. Psych continued to see him and he was discharged with Diazepam PRN. Medications on Admission: ASA, Plavix 75', Toprol 25', Lipitor 80', atacand 4', prilosec', lamictal 200', lithium 900', valium 5-10mg'' prn, advair 500/50'', celebrex 200', colace prn Discharge Medications: 1. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). 2. Calcium Carbonate 500 mg Tablet, Chewable [**Last Name (STitle) **]: One (1) Tablet, Chewable PO QID (4 times a day) as needed. 3. Aspirin 325 mg Tablet [**Last Name (STitle) **]: One (1) Tablet PO DAILY (Daily). 4. Acetaminophen 325 mg Tablet [**Last Name (STitle) **]: 1-2 Tablets PO Q6H (every 6 hours) as needed. 5. Ascorbic Acid 90 mg/mL Drops [**Last Name (STitle) **]: Five Hundred Four (504) mg PO DAILY (Daily). 6. Ferrous Sulfate 300 mg/5 mL Liquid [**Last Name (STitle) **]: One (1) PO DAILY (Daily). 7. Albuterol Sulfate 2.5 mg/3 mL Solution for Nebulization [**Last Name (STitle) **]: One (1) Inhalation Q6H (every 6 hours) as needed for wheeze. 8. Therapeutic Multivitamin Liquid [**Last Name (STitle) **]: One (1) Cap PO DAILY (Daily). 9. Papain-Urea 830,000-10 unit/g-% Ointment [**Last Name (STitle) **]: One (1) Appl Topical [**Hospital1 **] (2 times a day). 10. Heparin (Porcine) 5,000 unit/mL Solution [**Hospital1 **]: One (1) Injection TID (3 times a day). 11. Metoprolol Tartrate 25 mg Tablet [**Hospital1 **]: Three (3) Tablet PO TID (3 times a day). 12. Albuterol 90 mcg/Actuation Aerosol [**Hospital1 **]: Six (6) Puff Inhalation Q6H (every 6 hours) as needed. 13. Thiamine HCl 100 mg Tablet [**Hospital1 **]: One (1) Tablet PO DAILY (Daily). 14. Ipratropium-Albuterol 18-103 mcg/Actuation Aerosol [**Hospital1 **]: [**4-12**] Puffs Inhalation Q4H (every 4 hours). 15. Fluticasone 110 mcg/Actuation Aerosol [**Month/Day (3) **]: Four (4) Puff Inhalation [**Hospital1 **] (2 times a day). 16. Amylase-Lipase-Protease 33,200-10,000- 37,500 unit Capsule, Delayed Release(E.C.) [**Hospital1 **]: [**4-12**] Caps PO QIDWMHS (4 times a day (with meals and at bedtime)). 17. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution [**Month/Day (3) **]: 5-10 MLs PO Q6H (every 6 hours) as needed. 18. Cholestyramine-Sucrose 4 gram Packet [**Month/Day (3) **]: One (1) Packet PO QID (4 times a day). 19. Insulin NPH Human Recomb 100 unit/mL Suspension [**Month/Day (3) **]: Twenty Five (25) Units Subcutaneous twice a day. 20. Lithium Carbonate 300 mg Capsule [**Month/Day (3) **]: Three (3) Capsule PO QHS (once a day (at bedtime)). 21. Lamotrigine 100 mg Tablet [**Month/Day (3) **]: Two (2) Tablet PO QHS (once a day (at bedtime)). 22. Miconazole Nitrate 2 % Powder [**Month/Day (3) **]: One (1) Appl Topical TID (3 times a day) as needed. 23. Clopidogrel 75 mg Tablet [**Month/Day (3) **]: One (1) Tablet PO DAILY (Daily). 24. Zolpidem 5 mg Tablet [**Month/Day (3) **]: One (1) Tablet PO HS (at bedtime) as needed. 25. Vancomycin 250 mg Capsule [**Month/Day (3) **]: Two (2) Capsule PO Q6H (every 6 hours) for 1 weeks. 26. Metronidazole 500 mg Tablet [**Month/Day (3) **]: One (1) Tablet PO TID (3 times a day) for 1 weeks. 27. Diazepam 5 mg Tablet [**Month/Day (3) **]: One (1) Tablet PO TID (3 times a day) as needed. Discharge Disposition: Extended Care Facility: [**Hospital3 105**] Northeast - [**Location (un) 1110**] Discharge Diagnosis: Whipple, J-tube [**2-19**] wound dehiscence s/p closure with rentention sutures [**2-25**], s/p Trach [**3-9**], s/p open drainage of splenic abscess [**3-26**] Adrenal Insufficiency, enterococcal bacteremia, MRSE line sepsis, wound infection, splenic vein thrombosis, splenic infarct respiratory failure, enterocutaneous fistula Discharge Condition: Good Tolerating tubefeedings Wound Healing Discharge Instructions: Please call your doctor or return to the ER for any of the following: * You experience new chest pain, pressure, squeezing or tightness. * New or worsening cough or wheezing. * If you are vomiting and cannot keep in fluids or your medications. * You are getting dehydrated due to continued vomiting, diarrhea or other reasons. * Signs of dehydration include dry mouth, rapid heartbeat or feeling dizzy or faint when standing. * You see blood or dark/black material when you vomit or have a bowel movement. * Your skin, or the whites of your eyes become yellow. * Your pain is not improving within 8-12 hours or not gone within 24 hours. Call or return immediately if your pain is getting worse or is changing location or moving to your chest or back. * You have shaking chills, or a fever greater than 101.5 (F) degrees or 38(C) degrees. * Any serious change in your symptoms, or any new symptoms that concern you. . * Please resume all regular home medications and take any new meds as ordered. * Do not drive or operate heavy machinery while taking any narcotic pain medication. You may have constipation when taking narcotic pain medications (oxycodone, percocet, vicodin, hydrocodone, dilaudid, etc.); you should continue drinking fluids, you may take stool softeners, and should eat foods that are high in fiber. * Continue to increase activity daily * No heavy lifting (>[**10-21**] lbs) for 6 weeks. * Monitor your incision for signs of infection * Keep your incision clean and dry. Followup Instructions: Please follow-up with Dr. [**Last Name (STitle) **] on [**5-15**] at 10:30am. Call [**Telephone/Fax (1) 1231**] with questions or concerns. Completed by:[**2150-4-15**] ICD9 Codes: 5119, 5180, 496, 2859
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7588 }
Medical Text: Admission Date: [**2139-5-25**] Discharge Date: [**2139-6-1**] Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2880**] Chief Complaint: Transfer for possible placement of BiV pacer Major Surgical or Invasive Procedure: [**Hospital1 **]-ventricular pacer placement History of Present Illness: Patient is a 84 year old man with ischemic cardiomyopathy (EF in the 30's, 2+ TR, 2+MR [**First Name (Titles) **] [**Last Name (Titles) **] on [**2138-10-22**])admitted [**2139-5-19**] to [**Hospital3 3583**] with complaints of several weeks of generalized fatigue. He was r/o for MI and was found to have a UTI for which he was given ceftriaxone 1g IV yesterday ([**2139-5-24**]). His creatinine was 1.7 on admission but has since improved to 1.2. He was also found to be hyperglycemic with positive ketones secondary to self dicontinuation of glyburide. During his hospital stay he developed a right lower extremity DVT and is now on heparin drip 900u/hour. During this admission he also had a head CT which showed moderate atrophy. The reason for this was not clarified as he was not reported to have any mental status changes. They also did an abdominal u/s as his LFT's were elevated which showed hepatic steatosis. Upon admit to [**Hospital3 **] he was also found to have new onset RAF to the 110's. While on telemetry he had a 13 beat run of NSVT. They were trying to manage his rate but last Friday he did have some pauses up to 3 seconds, therefore his digoxin (level 1.2 on [**2139-5-19**] admission) and verapamil were held. He has not had any pauses in 3 days. He was transferred for possible placement of BiV pacer. Past Medical History: 1. Ischemic cardiomyopathy, EF 30% 2. CAD s/p CABGx3 2. New onset AF 3. hypertension 4. hyperlipidemia 5. DM 6. Prostate cancer- dx mid-[**2123**]'s with urinary retention 7. CRI 8. glaucoma 9. right total hip replacement 10. LBBB Social History: Rarely uses alcohol, former smoker quit 55 years ago Family History: Father-Died of MI in 70's Mother lived into her 90s and was healthy Brother 87 with CAD and ICD placed a year ago Brother 79-healthy Sister in her 90's had stroke at age [**Age over 90 **] Physical Exam: General: Elderly gentleman lying supin in NAD. Vitals:t. 96 BP 122/52 P 104 R 20 O2sats 99% on 2L Wt. 77.6 kg CV: irreularly, irregular, no murmur Pulm:CTA b/l Abd: +BS, soft, NT/ND Ext: 3+ pitting edema on right up to hip, 2+ pitting edema on left up to knee ROS: Denies N/V, abdominal pain, dysuria, fever, chills. Pertinent Results: [**2139-5-25**] 11:26PM PTT-131.1* [**2139-5-25**] 03:34PM GLUCOSE-372* UREA N-52* CREAT-1.3* SODIUM-141 POTASSIUM-4.4 CHLORIDE-105 TOTAL CO2-26 ANION GAP-14 [**2139-5-25**] 03:34PM ALT(SGPT)-285* AST(SGOT)-211* ALK PHOS-190* TOT BILI-0.4 [**2139-5-25**] 03:34PM CALCIUM-7.8* PHOSPHATE-3.0 MAGNESIUM-2.2 [**2139-5-25**] 03:34PM WBC-9.5 RBC-4.11* HGB-13.2* HCT-39.7* MCV-97 MCH-32.2* MCHC-33.3 RDW-14.9 [**2139-5-25**] 03:34PM PLT COUNT-119* [**2139-5-25**] 03:34PM PT-17.4* PTT-150* INR(PT)-2.0 [**2139-5-28**] 01:16PM BLOOD Glucose-265* UreaN-68* Creat-1.7* Na-137 K-4.2 Cl-103 HCO3-25 AnGap-13 [**2139-5-28**] 05:05PM BLOOD Creat-1.7* [**2139-5-28**] 01:16PM BLOOD ALT-235* AST-102* LD(LDH)-1065* AlkPhos-158* TotBili-0.4 [**2139-5-28**] 01:16PM BLOOD Mg-2.2 [**2139-5-27**] 04:04PM BLOOD Smooth-NEGATIVE [**2139-5-27**] 04:04PM BLOOD [**Doctor First Name **]-NEGATIVE [**2139-5-27**] 06:20AM BLOOD IgG-439* IgM-94 [**2139-5-27**] 06:20AM BLOOD HCV Ab-NEGATIVE [**2139-5-25**] 03:34PM BLOOD WBC-9.5 RBC-4.11* Hgb-13.2* Hct-39.7* MCV-97 MCH-32.2* MCHC-33.3 RDW-14.9 Plt Ct-119* [**2139-5-27**] 06:20AM BLOOD WBC-8.4 RBC-3.86* Hgb-12.3* Hct-37.8* MCV-98 MCH-31.9 MCHC-32.5 RDW-15.2 Plt Ct-104* [**2139-5-30**] 06:15AM BLOOD WBC-13.3* RBC-3.38* Hgb-10.6* Hct-32.5* MCV-96 MCH-31.5 MCHC-32.7 RDW-15.3 Plt Ct-166 [**2139-5-31**] 05:13AM BLOOD WBC-13.9* RBC-2.88* Hgb-9.0* Hct-27.0* MCV-94 MCH-31.3 MCHC-33.3 RDW-15.2 Plt Ct-138* [**2139-5-25**] 03:34PM BLOOD PT-17.4* PTT-150* INR(PT)-2.0 [**2139-5-27**] 03:12PM BLOOD PT-13.2 PTT-64.7* INR(PT)-1.2 [**2139-5-30**] 06:15AM BLOOD PT-26.2* PTT-58.7* INR(PT)-4.6 [**2139-5-31**] 05:13AM BLOOD PT-32.1* PTT-44.9* INR(PT)-6.8 [**2139-5-25**] 03:34PM BLOOD Glucose-372* UreaN-52* Creat-1.3* Na-141 K-4.4 Cl-105 HCO3-26 AnGap-14 [**2139-5-27**] 06:20AM BLOOD Glucose-274* UreaN-50* Creat-1.2 Na-141 K-4.1 Cl-105 HCO3-27 AnGap-13 [**2139-5-29**] 06:25AM BLOOD Glucose-127* UreaN-83* Creat-2.2* Na-139 K-4.5 Cl-103 HCO3-25 AnGap-16 [**2139-5-30**] 06:15AM BLOOD Glucose-151* UreaN-104* Creat-3.5* Na-136 K-4.9 Cl-103 HCO3-20* AnGap-18 [**2139-5-31**] 05:13AM BLOOD Glucose-106* UreaN-130* Creat-4.5* Na-137 K-5.2* Cl-106 HCO3-18* AnGap-18 [**2139-5-25**] 03:34PM BLOOD ALT-285* AST-211* AlkPhos-190* TotBili-0.4 [**2139-5-28**] 01:16PM BLOOD ALT-235* AST-102* LD(LDH)-1065* AlkPhos-158* TotBili-0.4 [**2139-5-30**] 06:15AM BLOOD ALT-174* AST-107* LD(LDH)-1132* AlkPhos-125* TotBili-0.3 [**2139-5-28**] 01:16PM BLOOD GGT-417* [**2139-5-30**] 06:15AM BLOOD TotProt-3.8* Albumin-2.0* Globuln-1.8* Phos-6.5*# Mg-2.2 Iron-62 [**2139-5-30**] 06:15AM BLOOD Ammonia-49* Brief Hospital Course: 84 y/o man with PMH significant for ischemic cardiomyopathy (EF in the 30s, 2+ TR, 2+ MR) admitted on [**5-25**] for placement of BiV pacer. Prior to admission, the pt had been admitted to [**Hospital1 3325**] on [**6-18**] with several weeks of generalized fatigue. He was ruled out for MI. However, the pt was found to have new onset rapid atrial fibriallation with a rate in the 110s. He also had a 13 beat run of NSVT and up to three second pauses. This prompted the transfer for possible BiV pacer. During the OSH admission, the pt was also found to have a UTI and was started on treatment with ceftriaxone. In addition, he developed a right LE DVT and was started on treatment with a heparin drip. . Following admission at [**Hospital1 18**], the pt was seen by EP and underwent placement of a BiV pacemaker on [**5-28**]. The procedure was uncomplicated. However, the pt began to have dramatically decreased urine output (less than 500 cc on [**5-28**]) and a rising Hct. His creatinine went from 1.3 on admission --> 1.7 on [**5-28**] --> 2.2 on [**5-29**] --> 3.5 on [**5-30**] --> 4.5 on [**5-31**]. A renal consult was obtained on [**5-30**]. They felt that his ARF picture was most consistent with ATN but extensive evaluation and treatment (dialysis) was deferred as the pt decided to become CMO. In addition to the repidly worsening renal failure, a hepatology consult was obtained as the pt was found to have elevated transaminitis and fatty infiltration of the liver. Further evaluation of this will also be deferred at this time. Pt also began to suffer from hypotension starting on [**5-28**]. This has continued. . Prior to the pt becoming CMO, he was transferred to the CCU on [**5-30**] when it was considered that more agressive treatments might be benificial. It was thought that his multisystem failure (severe ARF, hepatic failure, hypotension) was most likely [**12-31**] poor forward flow from his CHF/CM. Upon transfer, the pt decided that he wanted to be DNR/DNI. He was very clear about his wishes not to have heroic measures, further treatment, or anything that might cause him discomfort. His family was present and supported him in his decision to be comfort measures only. Therefore, the pt was transferred to the floor for CMO care. He was maintained on morphine drip, and all other medications held. At 5pm on [**6-1**], housestaff (Dr. [**First Name8 (NamePattern2) **] [**Name (STitle) 4154**]) was called to bedside to pronounce Mr. [**Known lastname **] death. On exam, his pupils were fixed and dilated, and he had no pulse, respirations, or heart sounds. He was pronounced dead at 5:05pm. His family declined a post-mortem examination. Medications on Admission: asa 81, KCL, insulin, alphagan eye gtts, lispro insulin, ceftriaxone, avandia, aldactone, lasix 20, lisinopril 15, coreg 3.125 [**Hospital1 **], heparin 900u/hour. (recently decreased as PTT 128 this morning)- PTT due for 4pm. Discharge Medications: None Discharge Disposition: Home with Service Discharge Diagnosis: Congestive heart failure Acute renal failure Hepatic failure Discharge Condition: Deceased Discharge Instructions: N/A Followup Instructions: N/A [**First Name11 (Name Pattern1) 900**] [**Last Name (NamePattern1) 2882**] MD, [**MD Number(3) 2883**] ICD9 Codes: 5849, 4280, 4271
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Medical Text: Admission Date: [**2198-3-2**] Discharge Date: [**2198-3-3**] Date of Birth: [**2145-3-3**] Sex: F Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2485**] Chief Complaint: BRBPR Major Surgical or Invasive Procedure: Blood transfusions History of Present Illness: 52 F with metastatic cholangiocarcinoma to liver and lungs, dxed [**2196**], with bright red blood in her stool x past month. On [**2198-2-26**], she was going to but did not receive her second cycle of carboplatin/Taxol with sorafenib. She received her first cycle of [**Doctor Last Name **]/Taxol/sorafenib 3 weeks ago, which she appeared to have tolerated well initially, but has had significant weakness and SOB x weeks afterward. Her Hct was found to be 18, she was transfused 2 URBC. Today in followup with Dr. [**First Name (STitle) **] [**Name (STitle) **], her Hct was 18, and she noted that she has been having small amounts of BRBPR in her stool, no melena, no hemoptysis. Sorafenib was stopped. Past Medical History: Cholangiocarcinoma w/ liver mets dx [**2196**], s/p common hepatic duct stent [**12-2**], s/p 2 cycles, last chemo [**1-17**] (cis/gem) GERD Mastitis after first pregnancy 2 separate breast bx??????s (both neg) Migraines [**Doctor First Name **] Hx: Appendectomy with L oopherectomy about 30 yrs ago Diagnostic laproscopy for suspected endometriosis (neg) Recent FNA of thyroid nodule (neg) Social History: Lives in [**Location 620**] with husband and daughter, one other daughter at college. She is employed as a social worker. She [**Name2 (NI) 100360**] 1mile 2-3x per week, does not drink, smoked socially (tobacco and marijuana) 30 years ago. Denies current drug use although she states she had a dependency on pain-killers 30 years ago. Family History: Mother died of breast CA as did Grandmother and two maternal great-aunts. One aunt died of pancreatic CA and another from stomach CA. She denies other familial illnesses. She gets regular mammogram and screening but does not want genetic screening for BRCA. Physical Exam: VS: 99.1 / 122/80 / 12 / 92 / 99% RA GEN: Pleasant thin female in no acute distress, in bed HEENT: PERRL, no LAD, JVD flat, anicteric sclerae LUNGS: CTA B HEART: RRR, no m/r/g ABD: Very mild epigastric tenderness to palpation, no rebound, no guarding, soft, +BS, ND EXTR: No c/c/e NEURO: [**6-2**] motor, normal gait SKIN: No rash Pertinent Results: Hct: 18.4 - 24.8 - 27 - 29.4 . [**2198-3-2**] 10:40AM BLOOD WBC-8.2 RBC-2.17* Hgb-6.3* Hct-18.4* MCV-85 MCH-29.0 MCHC-34.2 RDW-22.7* Plt Ct-127* [**2198-3-2**] 07:16PM BLOOD WBC-5.4 RBC-3.04*# Hgb-8.8*# Hct-24.8*# MCV-82 MCH-29.0 MCHC-35.5* RDW-20.0* Plt Ct-76* [**2198-3-3**] 04:00AM BLOOD WBC-6.1 RBC-3.38* Hgb-9.8* Hct-27.0* MCV-80* MCH-29.1 MCHC-36.3* RDW-19.1* Plt Ct-70* [**2198-3-3**] 01:32PM BLOOD WBC-6.6 RBC-3.57* Hgb-10.1* Hct-29.4* MCV-82 MCH-28.2 MCHC-34.3 RDW-19.6* Plt Ct-71* [**2198-3-2**] 07:16PM BLOOD PT-22.3* PTT-22.3 INR(PT)-1.1 [**2198-3-2**] 07:16PM BLOOD Glucose-96 UreaN-18 Creat-0.5 Na-139 K-4.2 Cl-106 HCO3-25 AnGap-12 [**2198-3-2**] 07:16PM BLOOD CK-MB-1 cTropnT-<0.01 [**2198-3-2**] 07:16PM BLOOD Albumin-2.9* Calcium-8.0* Phos-2.4* Mg-2.1 Iron-238* Brief Hospital Course: 52 F with metastatic cholangiocarcinoma to liver and lungs, dxed [**2196**], with bright red blood in her stool x past month. Hospital course by problem: . # BRBPR: Appears to be mild and chronic over a month. [**Month (only) 116**] be associated with sorafenib treatment, but this drug was only started [**2197-2-5**], and she received only one treatment dose. She has received Avastin in the past. The patient was given 3u of PRBCs with an improvement in her hematocrit to 29 from 18. She was hemodynamically stable and not experiencing melana or hematochezia. She ambulated without significant presyncopal symptoms. GI was consulted who recommended an EGD and colonoscopy with 2-3 days following her initial evaluation. We discharged the patient with instructions on how to communicate with the GI team to set up her procedures. . # Metastatic cholangiocarcinoma: Most recent treatment was [**2197-2-5**] of Cycle 1 of [**Doctor Last Name **]/taxol/sorafenib. Cycle 2 was held on [**2-26**] for low Hct. Most recent CT abd [**2198-1-31**]. Followed by Dr. [**First Name (STitle) **] [**Name (STitle) **]. We ordered a CT of the torso for the patient to get done as on outpatient. We also continued her actigall. . # Chronic abdominal pain: Well controlled on dilaudid 1-2mg q 3 hours prn. . # Depression: We continued Celexa per home regimen. Medications on Admission: 1. Ursodiol 300 mg QD 2. Lorazepam 0.5 mg Q8H 3. Citalopram Hydrobromide 40 QD 4. Ciprofloxacin 500 mg QD 5. Prochlorperazine 10 mg Q6H prn 6. Dilaudid 1-2 mg Q3H prn 7. Methylphenidate 5 [**Hospital1 **] 8. Potassium & Sodium Phosphates [**Telephone/Fax (3) 4228**] mg Packet PO BID 9. Potassium Chloride 20 mEq Packet QD 10. Loperamide 2 mg prn Discharge Medications: 1. Ursodiol 300 mg Capsule Sig: One (1) Capsule PO once a day. 2. Lorazepam 0.5 mg Tablet Sig: One (1) Tablet PO three times a day as needed for anxiety. 3. Citalopram 40 mg Tablet Sig: One (1) Tablet PO once a day. 4. Prochlorperazine 10 mg Tablet Sig: One (1) Tablet PO every six (6) hours as needed for nausea. 5. Dilaudid 2 mg Tablet Sig: 0.5-1 Tablet PO every four (4) hours as needed for pain. 6. Methylphenidate 5 mg Tablet Sig: One (1) Tablet PO twice a day. Discharge Disposition: Home Discharge Diagnosis: Primary: - BRBPR - cholangiocarcinoma - anemia Secondary: - Migraines - s/p appy Discharge Condition: well Discharge Instructions: You were admitted with with bleeding out of your rectum. We treated you with three units of blood and you were evaluated by the GI physicians. Your hematocrit stabilized. . The GI physicians would like to perform an EGD and colonoscopy on Tuesday, [**3-6**]. Dr. [**First Name4 (NamePattern1) 14992**] [**Last Name (NamePattern1) 9746**] will call you on Sunday to discuss the prep. You may eat normally today. On Sunday, please switch to a full liquid diet. Please avoid seeds and high fiber foods in the meantime. On Monday night, please have nothing to eat after midnight. . Please take your medications as instructed. Please contact your doctor if you feel short of breath, chest pain, fever, chills, weakness. . Please have a CT scan done on [**2198-3-5**]. You need to contact the radiology department by [**Telephone/Fax (1) **] to confirm this appointment. Followup Instructions: Please have a colonoscopy and EGD on Tuesday. Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) 100361**] will call you to set this up. . Please call [**Telephone/Fax (1) **] to confirm your CT scan for [**2198-3-5**]. The time needs to be confirmed by phone. Please followup with Dr. [**Last Name (STitle) **] within the next two weeks. ICD9 Codes: 2875, 2859, 311
{ "dataset_link": "https://huggingface.co/datasets/ricardosantoss/ehrcomplete_icdfiltered", "dataset_name": "ehrcomplete-icdfiltered", "id": 7590 }
Medical Text: Admission Date: [**2183-8-17**] Discharge Date: [**2183-9-13**] Date of Birth: [**2143-12-24**] Sex: M Service: MEDICINE Allergies: Patient recorded as having No Known Allergies to Drugs Attending:[**First Name3 (LF) 2297**] Chief Complaint: shortness of breath -> admitted to the floor then transferred to the ICU for hypotension and hypoxic respiratory failure Major Surgical or Invasive Procedure: - nasotracheal intubation - central line placement History of Present Illness: 39 y.o. male with past history of morbid obesity, sleep apnea, who was admitted originally with rapid weight gain, increasing exertional dyspnea, and lower extremity edema. He was initially admitted to the MICU for desaturations. While in the MICU, patient subsequently became obtunded and was found to have acidosis from hypercarbic respiratory failure and required nasotracheal intubation. While evaluating the etiology of his respiratory failure, echocardiogram revealed severe global reduction in LV systolic function with EF of 20%. Given this finding and above symptoms consistent with failure, PA catheter was placed for tailored diuresis and patient was transferred to CCU. . While in the CCU, patient was diuresed ~6 litres on furosemide and dobutamine gtt. This did not improve his oxygenation. Despite this, his hypoxia persisted even as FiO2 was increased to 100% and PEEP increased to 20. Given lack of improvement in oxygenation, shunt physiology was then evaluated with bubble echocardiogram but this did not reveal right-to-left shunting. Next, a trial of inhaled nitric oxide was attempted to relieve his elevated pulmonary artery hypertension, in case this was contributing to his hypoxia. Again, no improvement was noted and this was discontinued. Finally, a diagnosis of ARDS was then entertained and patient was placed on APRV mode for ventilation and paralyzed with cisatracurium. At this point, given concern for ARDS, it was decided to transfer patient back to MICU service. A Chest CT was obtained en route to further characterize the question of ARDS and also to evaluate a possible infectious source of recurrent fevers patient had been having, but the results of imaging did not correlate with the clinical diagnosis. Of note, prior to transfer, patient was transiently hypotensive, presumably from overdiuresis and responded well to normal saline 1 liter bolus. Past Medical History: Morbid Obesity Social History: The patient lives in [**Location **] with his family including sister and grandparents. He is employed as an assistant manager at Domino's pizza. Tobacco: 1 PPD x 5 years -> 5 pack-year ETOH: None Illicits: None including IVDU Family History: Father - [**Name (NI) 3730**] unknown type Mother - [**Name (NI) 3730**] unknown type - denies family history of cardiac disease, cardiomyopathy, liver disease Physical Exam: Vitals: T-99.8 BP-145/76 HR-102 RR-20 O2- 92% on APRV (PHigh 38, PLow 14, High Time 2.6, Low time 0.4). . General: Morbidly obese Asian Male intubated, paralyzed HEENT: NCAT, EOMI. Sclera anicteric, nasotracheal tube in left nares, right nares occluded by clot formation. Neck: Obese, right IJ PA catheter in place Chest: Coarse breath sounds bilaterally Cor: Distant heart sounds, No M/G/R Abdomen: Markedly obese and distended. Firm but not rigid to palpation with blanching erythema. Skin is chronically indurated, + striae and anasarca. Extremity: Chronic venous stasis changed, + pitting edema bilaterally. Warm with good pulses Pertinent Results: [**2183-9-13**] 04:05AM BLOOD WBC-9.9 RBC-4.87 Hgb-11.4* Hct-35.4* MCV-73* MCH-23.3* MCHC-32.1 RDW-16.8* Plt Ct-282 [**2183-9-10**] 04:43AM BLOOD Neuts-58.4 Lymphs-25.4 Monos-3.0 Eos-12.6* Baso-0.5 [**2183-8-27**] 04:05AM BLOOD Hypochr-1+ Anisocy-1+ Poiklo-NORMAL Macrocy-NORMAL Microcy-1+ Polychr-NORMAL [**2183-9-13**] 04:05AM BLOOD Plt Ct-282 [**2183-9-12**] 03:58AM BLOOD PT-14.3* PTT-31.2 INR(PT)-1.3* [**2183-9-13**] 04:05AM BLOOD Glucose-97 UreaN-46* Creat-2.0* Na-146* K-4.4 Cl-117* HCO3-19* AnGap-14 [**2183-9-12**] 03:58AM BLOOD ALT-29 AST-28 AlkPhos-158* TotBili-0.5 [**2183-9-1**] 04:17AM BLOOD Lipase-127* [**2183-8-17**] 06:25AM BLOOD CK-MB-8 cTropnT-0.02* [**2183-8-16**] 10:30PM BLOOD CK-MB-8 cTropnT-0.02* proBNP-1625* [**2183-9-13**] 04:05AM BLOOD Calcium-8.5 Phos-4.8* Mg-2.0 [**2183-8-17**] 06:25AM BLOOD Triglyc-133 HDL-37 CHOL/HD-4.1 LDLcalc-89 [**2183-8-17**] 05:00PM BLOOD TSH-5.7* [**2183-8-17**] 05:00PM BLOOD T4-5.8 [**2183-8-17**] 05:00PM BLOOD Cortsol-21.7* [**2183-8-31**] 04:39AM BLOOD Vanco-16.8 [**2183-9-13**] 04:19AM BLOOD Type-ART Temp-38.3 PEEP-20 pO2-89 pCO2-35 pH-7.38 calTCO2-22 Base XS--3 Intubat-INTUBATED Vent-CONTROLLED [**2183-9-12**] 07:09PM BLOOD Lactate-1.8 Na-147 K-4.3 [**2183-9-12**] 07:09PM BLOOD O2 Sat-92 [**2183-9-12**] 07:09PM BLOOD freeCa-1.21 . CHEST (PORTABLE AP) [**2183-9-13**] 2:54 AM CHEST (PORTABLE AP) Reason: Assess for interval changes s/p ET tube change from nose to [**Hospital 93**] MEDICAL CONDITION: 39 year old man with resp failure, reintubated. REASON FOR THIS EXAMINATION: Assess for interval changes s/p ET tube change from nose to oral. STUDY: AP chest [**2183-9-13**]. HISTORY: 39-year-old man with respiratory failure. Assess for interval change. FINDINGS: Comparison is made to previous study from [**9-12**], [**2182**]. The study is very limited due to technique and poor inspiratory effort. The patient has cardiomegaly. There is likely no interval change with bilateral pleural effusions, left retrocardiac opacity and pulmonary edema. . [**9-4**] ECHO Conclusions: The left ventricular cavity is mildly dilated. Due to suboptimal technical quality, a focal wall motion abnormality cannot be fully excluded. Overall left ventricular systolic function is moderately depressed (LVEF= 30-35 %). The right ventricular cavity is dilated. Right ventricular systolic function appears depressed. The aortic valve is not well seen. The mitral valve leaflets are not well seen. The estimated pulmonary artery systolic pressure is normal. There is a trivial/physiologic pericardial effusion. Compared with the prior studies (images reviewed) of [**2183-8-31**] and [**2183-8-21**], unable to adequately compare ventricular function, although function may have been more vigorous (estimated ejection fraction then ~40%) in the study of [**2183-8-21**] in which images were of better quality. . CT SINUS/MANDIBLE/MAXILLOFACIAL W/O CONTRAST [**2183-8-20**] 5:24 PM CT SINUS/MANDIBLE/MAXILLOFACIA Reason: r/o infection; PLEASE DO WITHOUT CONTRAST [**Hospital 93**] MEDICAL CONDITION: 39 year old man with 39 year old man with abdominal distention, DOE for 3 weeks with LE edema, [**Hospital1 **]-V heart failure w/ fevers REASON FOR THIS EXAMINATION: r/o infection; PLEASE DO WITHOUT CONTRAST CONTRAINDICATIONS for IV CONTRAST: ARF INDICATION: Fever and abdominal distension. History of heart failure. TECHNIQUE: Multidetector CT imaging of the sinuses was performed without intravenous contrast and displayed in 2.5 mm axial collimation. No comparison is available. FINDINGS: The patient is intubated. There is near complete opacification of all of the visualized paranasal sinuses and of the mastoid air cells. There is only partial aeration of the left frontal sinus. Frontal sinus demonstrates no aerosolization. An endotracheal tube passes through the left naris. An orogastric tube is present. The mastoid air cells are poorly pneumatized, although there is also partial opacification of the bilateral mastoid air cells. Visualized portions of the brain are unremarkable. IMPRESSION: Near total opacification of the paranasal sinuses and mastoid air cells. These may reflect retained fluid due to prolonged intubation, but CT cannot distinguish sterile from infection fluid. . CT ABDOMEN W/O CONTRAST [**2183-8-20**] 5:25 PM CT CHEST W/O CONTRAST; CT ABDOMEN W/O CONTRAST Reason: r/o infectious process Field of view: 60 [**Hospital 93**] MEDICAL CONDITION: 39 year old man with 39 year old man with abdominal distention, DOE for 3 weeks with LE edema, [**Hospital1 **]-V heart failure w/ fevers REASON FOR THIS EXAMINATION: r/o infectious process CONTRAINDICATIONS for IV CONTRAST: ARF;ARF INDICATION: Abdominal distention, dyspnea on exertion, and lower extremity edema with fever, evaluate for infectious process. TECHNIQUE: Multidetector CT imaging of the chest, abdomen, and pelvis was performed without intravenous contrast. Oral contrast was administered. Multiplanar reconstructions were obtained. CT OF THE CHEST WITHOUT CONTRAST: The exam is limited by the patient's inability to raise the arms above the head as well as a significant artifact secondary to marked subcutaneous anasarca and obesity. Bibasilar consolidations and bilateral pleural effusions (right greater than left) have worsened in the interval. Scattered triangular pulmonary nodules measuring up to 6 mm, likely represent small lymph nodes, are indeterminant. Swan-Ganz catheter appears to terminate in the main hepatic artery though evaluation is limited by cardiac motion. The patient is intubated with the ET tube terminating in the mid thoracic trachea. The airways are patent to the subsegmental level. The heart is enlarged. The great vessels of the mediastinum are, otherwise, unremarkable. There is no pathologic adenopathy. CT ABDOMEN WITHOUT CONTRAST: Again, evaluation is markedly limited. There is diffuse anasarca of the soft tissues and small ascites throughout the abdomen and pelvis that may be secondary to third spacing. Within the limitations of a noncontrast scan, the gallbladder, spleen, stomach, adrenal glands, and kidneys are unremarkable. The liver contour is abnormal with a small right lobe and prominent caudate. This may be secondary to chronic heart failure. There is very mild stranding about the pancreas that is nonspecific and likely secondary to third spacing. Small bowel loops are of normal caliber. There are no masses or adenopathy. There is no pneumoperitoneum. CT PELVIS WITHOUT CONTRAST: Again evaluation is markedly limited. The rectum, sigmoid, and large bowel is unremarkable. There is a small anasarca in the pelvis. A Foley catheter is in situ, and the bladder appears normal. No isolated fluid collections are identified. There is a left fat-containing inguinal hernia. BONE WINDOWS: The osseous structures are unremarkable. IMPRESSION: 1. Limited, but no radiographic explanation for fevers. 2. Marked anasarca, small ascites. 3. Worsening bibasilar atelectases with small pleural effusions. 4. Cardiomegaly. 5. Scattered pulmonary nodules measuring up to 6 mm. Re-evaluation in 6 to 12 months is recommended when patient's condition improves. 6. Small right hepatic lobe and prominent caudate, possibly secondary to chronic heart failure. . Brief Hospital Course: He was initially admitted to the MICU for desaturations. While in the MICU, patient subsequently became obtunded and was found to have acidosis from hypercarbic respiratory failure and required nasotracheal intubation. While evaluating the etiology of his respiratory failure, echocardiogram revealed severe global reduction in LV systolic function with EF of 20%. Given this finding and above symptoms consistent with failure, PA catheter was placed for tailored diuresis and patient was transferred to CCU. . While in the CCU, patient was diuresed ~6 litres on furosemide and dobutamine gtt. This did not improve his oxygenation. Despite this, his hypoxia persisted even as FiO2 was increased to 100% and PEEP increased to 20. Given lack of improvement in oxygenation, shunt physiology was then evaluated with bubble echocardiogram but this did not reveal right-to-left shunting. Next, a trial of inhaled nitric oxide was attempted to relieve his elevated pulmonary artery hypertension, in case this was contributing to his hypoxia. Again, no improvement was noted and this was discontinued. Finally, a diagnosis of ARDS was then entertained and patient was placed on APRV mode for ventilation and paralyzed with cisatracurium. At this point, given concern for ARDS, it was decided to transfer patient back to MICU service. A Chest CT was obtained en route to further characterize the question of ARDS but pt not found to have it. After transfer to MICU, on [**8-22**] pt had episode of hypotension and hypoxia. An ECHO was done to r/o shunt physiology and the bubble study was negative. Pt was continued on APRV with dobutamine and paralytics. . The patient is a 39 year old Male with morbid obesity and no consistent medical care who presented with 3 weeks of weight gain, exertional dyspnea, now found to have severe cardiomyopathy and CHF and persistent hypoxia . #. Hypercarbic/Hypoxic Respiratory Failure - Hypercarbic component may be largely secondary to chronic obesity hypoventilation and obstructive sleep apnea with superimposed insult of CHF. Hypoxic component originally felt to be due to CHF. However, there are no clear infiltrates suggestive of edema on recent CT. Pt also has global hypokinesis and cardiomyopathy which may have been caused by a viral myocarditis or other ? etiology. Pt originally on dobutamine gtt for low BP and to maintain renal perfusion, UOP. ECHO showed no signifcant elevated pulmonary artery pressure but multiple repeat ECHos continued to demonstrate LVEF 15-20% with no seeming improvement in cardiac function. Pt was sedated with midazolam and fentanyl and methadone. Increased Valium to 30mg TID with attempt to reduce Midazolam gtt which was persistantly unsuccessful. Pt maintained on APRV most of MICU stay with inability to wean down settings. [**9-12**] Switched from APRV to AC ventilation. Pt was changed from NT intubation to ETT on [**9-11**]. The goal was to reduce PEEP and Fio2 requirements in order to possibly set pt up for a trach. -On [**9-13**] at 10am pt went into V. Fibb; given pts code status, he was not rescitated with CPR or defibrillation. . # Sinusitis on head CT - Patient apparently had symptoms of this prior to admission, and likely exacerbated by nasotracheal intubation. CT scan with opacification of bilateral maxillary sinus suggestive of sinusitis. Pt initially treated iwth Vanc and Cefepime which was discontinued b/c it was unlikely penetrating and pt has had negative cultures until [**9-11**]. On [**9-11**] pt [**Name (NI) **] tube changed to ETT. ENT consulted and took a middle meatal culture. Culture with PMNs but no microorganisms seen. Also need to watch for any indications of spread to skull or orbit. . #Fever - The most likely source is the sinusitis, however pt taken off abx given negative cultures from blood, urine, sputum and middle meatal culture. As of [**9-13**] two blood cultures were positive for Coag negative Staph. Vanc started on [**9-13**]. negative. RUQ U/S negative for cholecystitis. Resiting of the central line was planned for 9.22 given new positive blood cultures and continued spiking of fevers. . #[**Name (NI) 97683**] Pt began having short runs of [**Name (NI) 6059**]. It was decided per the team initially not to treat with BB or amiodarone given pt had low HR and often went down into the 40s. Additionally pts renal function and UOP depended on higher BP to maintain adequate output. Cards was consulted and felt that the pt may benefit from a calcium channel blocker for HTN but didn't have any indications for amiodarone at the time. On [**9-13**] the decision was made to begin Metoprolol 12.5mg TID in order to control the runs of [**Month/Year (2) 6059**]. . # Acute renal failure- Renal consulted; felt it was most likely cardiogenic renal hypoperfusion causing ATN. Held on Lasix b/c pts cardiac function is preload dependent and would like to avoid removing fluids to keep is cardiac function optimal. Pts creatinine trended down since admission and UOP maintained adequate over following 2 weeks. Pts meds were renally dosed and he was evaluated for HD by renal team but had no indications over course of stay. Pt started on phosphate binder for high phosphorus level. # [**Name (NI) 6059**] - Unclear etiology, electrolytes okay. Will hold on starting an ACE given elevated Creatinine. Can consider Amiodarone vs BB but will hold off for now. No further episodes overnight. - Spoke with cards- no recs urgent need to start anything but did recommend calcium channel blocker if needed. . #Hypernatremia - Unclear etiology; pt treated with free water boluses through NGT. . . Medications on Admission: none Discharge Medications: none Discharge Disposition: Expired Discharge Diagnosis: chf, cardiopulmonary failure, multisystem organ failure Discharge Condition: expired Discharge Instructions: none Followup Instructions: none ICD9 Codes: 4254, 4280, 5849, 2875, 2760, 4271
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Medical Text: Admission Date: [**2122-12-5**] Discharge Date: [**2123-1-20**] Date of Birth: [**2040-12-16**] Sex: F Service: CARDIOTHORACIC Allergies: Ace Inhibitors Attending:[**First Name3 (LF) 165**] Chief Complaint: increasing dyspnea Major Surgical or Invasive Procedure: R thoracotomy and MVR (SJ mechanical 23 mm valve)[**12-14**] History of Present Illness: 81 yo F with increasing SOB presented to [**Hospital1 **], underwent cardiac cath, echo which showed moderate to severe MR. [**First Name (Titles) **] [**Last Name (Titles) 15929**]s was angioplastied. She was transferred for further intervention. Past Medical History: Rheumatic Heart Disease (s/p bioprosthetic AVR), HTN, Depression, heart failure, hyperlipidemia, Breast CA s/p lumpectomy & XRT, s/p Hysterectomy, PPM Social History: denies etoh, tobacco Family History: sister AMI @ 64 Physical Exam: NAD HR 63 RR 18 BP 101/49 Kungs CTAB CV RRR Abdomen benign Extrem warm, no edema Mild varicosities Pertinent Results: [**2122-12-5**] 07:15PM GLUCOSE-102 UREA N-50* CREAT-1.7* SODIUM-141 POTASSIUM-4.0 CHLORIDE-100 TOTAL CO2-28 ANION GAP-17 [**2122-12-5**] 07:15PM estGFR-Using this [**2122-12-5**] 07:15PM ALT(SGPT)-10 AST(SGOT)-14 LD(LDH)-177 ALK PHOS-71 AMYLASE-123* TOT BILI-0.3 [**2122-12-5**] 07:15PM LIPASE-118* [**2122-12-5**] 07:15PM ALBUMIN-3.6 CALCIUM-9.7 PHOSPHATE-3.9 MAGNESIUM-2.5 [**2122-12-5**] 07:15PM WBC-9.7 RBC-3.66* HGB-11.3* HCT-32.7* MCV-89 MCH-31.0 MCHC-34.6 RDW-15.4 [**2122-12-5**] 07:15PM PLT COUNT-382 [**2122-12-5**] 07:15PM PT-14.6* PTT-30.4 INR(PT)-1.3* [**2122-12-5**] 06:16PM URINE COLOR-Yellow APPEAR-Clear SP [**Last Name (un) 155**]-1.021 [**2122-12-5**] 06:16PM URINE BLOOD-NEG NITRITE-NEG PROTEIN-NEG GLUCOSE-NEG KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-MOD [**12-27**] CT Torso: INDICATION: 82-year-old female status post mitral valve repair with question of increased right hemothorax. No comparison studies. TECHNIQUE: MDCT-acquired axial images of the chest, abdomen and pelvis were performed without IV contrast. Multiplanar reformations were obtained. CT CHEST WITHOUT IV CONTRAST: Patient is status post sternotomy with intact wires. A left cardiac pacer is present with leads terminating within the right atrium and ventricle. There is extensive aortic and mitral annulus calcification and there has been aortic and mitral valve prosthetic repair. Aortic calcifications extend up along the greater vessels which are mildly ectatic. The main pulmonary artery is large at 3.7 cm. There are multiple mediastinal lymph nodes which are enlarged, most notable within the precarinal region measuring 1.8 x 1.5 cm. Additional nodes are present within the right paratracheal, AP window stations. There is a small pericardial effusion. There are enlarged epicardial nodes, the largest 15 x 12 mm (2/38). There is an enlarged left retrocrural lymph node at 23 x 9 mm. The lungs are diffusely emphysematous, most notable at the apices with mild bullous changes. There is diffuse interstitial thickening which is asymmetric and most consistent with pulmonary edema with a small to moderate-sized fluid denisty right pleural effusion with no evidence of blood density. There is trace fluid within the left pleura. CT ABDOMEN WITHOUT IV CONTRAST: Within the caudate lobe of the liver, there is a 1.2 x 1.2 cm hypodensity that is incompletely characterized. There are several gallstones in an otherwise unremarkable gallbladder. There are multiple lymph nodes within the porta hepatis and portocaval region. For example, anterior to the IVC on series 2, image 55, there is a 15 x 9 mm lymph node. The pancreas is unremarkable. A nasogastric tube terminates within the distal stomach. There are extensive atherosclerotic aortic calcifications that extend into the mesenteric vessels with heavy calcification seen at the origins of the celiac and more notably SMA. The spleen is bulky. The right adrenal gland measures 1.6 x 1.9 cm, demonstrating fluid-density Hounsfield units likely representing an adenoma. The left adrenal gland is not well visualized. The kidneys are unremarkable. The unopacified small and large bowel are within normal limits. There is no mesenteric lymphadenopathy. CT PELVIS WITHOUT IV CONTRAST: There is a small amount of intraperotoneal fluid extending along the paracolic gutters and most notable anterior to the rectum on the right. Additionally, there is diffuse stranding within the subcutaneous tissues of the lower torso. There is no iliac lymphadenopathy. Overlying the left femoral vascular sheath, there is a 3.6 x 2.0 cm mildly hyperdense mass likely representing hematoma, possibly from recent left femoral access. BONE WINDOWS: There are no suspicious lytic or sclerotic osseous lesions. IMPRESSION: 1. No evidence of hemothorax. Small right pleural effusion with moderate asymmetric pulmonary edema. 2. Status post mitral and aortic valve replacements with extensive mitral anulus and aortic valvular and aortic calcifications. 3. Mediastinal and periportal lymphadenopathy and borderline enlarged spleen. Recommend correlating with prior history to determine the cause of these findings. These findings would fit with prior history of lymphoma, sarcoidosis, or possibly tuberculosis. 4. Gallstones. 5. No evidence of retroperitoneal hematoma. 6. Small intraperitoneal fluid, most notable in the pelvis along with subcutaneous edema and right pleural effusion. Together, these findings ay be representing a unifying cause such as third spacing. 7. Large left groin hyperdense collection, most consistent with hematoma. 8. Emphysema. 9. Focal liver hypodensity in caudate lobe, incompletely characterized. Although probably a benign cyst, a mutliphasic MRI would better evaluate this lesion is there is further clinical concern. 10. Right adrenal adenoma. [**12-28**] ECHO (TEE) There is mild left atrial enlargement. Mild spontaneous echo contrast is seen in the left atrial appendage. No mass/thrombus is seen in the left atrium or left atrial appendage. A color Doppler signal is seen in the mid-interatrial septum with bidirectional flow c/w a secundum atrial septal defect. After agitated saline injection, there is prompt appearance of contrast in the left atrium c/w a bidirectional shunt. There is symmetric left ventricular hypertrophy with normal cavity size. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. There are simple atheroma in the ascending aorta. There are complex (>4mm, non-mobile) atheroma in the descending thoracic aorta. A well-seated bioprosthetic aortic valve prosthesis is present. No aortic regurgitation is seen. However evaluation of the aortic bioprostesis is limited by acoustic shadowing from the mitral mechanical valve. A bileaflet mechanical mitral valve prosthesis is present. The valve is well seated with good disc motion and normal gradient. There is a small paravalvular leak with regurgitation on the anteroseptal and inferior aspect of the interatrial septum. There is a very small pericardial effusion. CONCLUSION: Well seated bileaflet mitral valve with good disc motion/normal gradient, but small para valvular leak. Secundum type atrial septal defect with bidirectional flow. [**1-1**] ECHO (TEE) The left atrium is dilated. A patent foramen ovale or a small ASD is present. Doppler evaluation suggests predominantly left-to-right shunting during the study, with a Qp:Qs of 1.4. Regional left ventricular wall motion is normal. Overall left ventricular systolic function is normal (LVEF>55%). Right ventricular chamber size and free wall motion are normal. A bioprosthetic aortic valve prosthesis is present. The prosthetic aortic valve leaflets appear normal. Mild (1+) central aortic regurgitation is seen. A bileaflet mitral valve prosthesis is present. The mitral prosthesis appears well seated, with normal leaflet/disc motion and transvalvular gradients. Mitral regurgitation is present but cannot be quantified. [Due to acoustic shadowing, the severity of mitral regurgitation may be significantly UNDERestimated.] Moderate to severe [3+] tricuspid regurgitation is seen. There is moderate pulmonary artery systolic hypertension. There is no pericardial effusion. IMPRESSION: Small left-ro-right shunt, likely through the atrial septum. Preserved global biventricular systolic function. Normally-functioning mechanical mitral prosthesis. Aortic valve bioprosthesis with mild central regurgitation. Moderate to severe tricuspid regurgitation. Moderate pulmonary hypertension. [**1-15**] Sputum Culture: GRAM STAIN-FINAL; RESPIRATORY CULTURE-FINAL {STENOTROPHOMONAS (XANTHOMONAS) MALTOPHILIA, ACINETOBACTER BAUMANNII} Brief Hospital Course: She underwent preop workup for MVR. She had a UTI for which she was started on cipro. Dental consult recommended extractions which she underwent on [**12-10**]. She remained on IV lasix for diuresis. She was taken to the operating room on [**12-15**] where she underwent MVR (mechanical) via right thoracotomy. She was transferred to the ICU in critical but stable condition on levophed, epinephrine, milrinone, and propofol. She was given 48 hours of vancomycin for perioperative prophylaxis since she was in the hospital preop. She had afib immediately postop and was cardioverted. She failed spontaneous breathing trial on POD #2. Her milrinone was dc'd on POD #2 and she was transfused 2 units. She was extubated on POD #3, however was tired and continued to require bipap or high flow mask, she as started on tube feeds. She was started on heparin/coumadin given her afib and mechanical valve. Right chest tube was placed for 500 cc on [**12-21**]. She continued to require nightly bipap, her work of breathing increased and she was reintubated on [**12-24**]. Coumadin was held for supratherapeutic INR. WBC increased and she was pancultured. She was transfused for HCT 23. CT scan was negative for RP bleed. She was started on antibiotics for VAP, and bronched on [**12-28**]. TEE showed ASD. Thoracic surgery was consulted and she underwent tracheostomy and PEG tube placement on [**12-30**]. She was made DNR on [**1-2**]. Family meetings was held including ethicas consult and Vent wean attempts continued. She failed trach mask trial. Synthroid was started for TSH 10. She was seen by pulmonology, her nebulizers were increased, diuresis continued. She was started on theophylline. The Patient was made CMO on [**1-20**]. At 6PM, [**1-20**], the patient was placed on trach mask. The patient expired at 6:25 PM, [**1-20**]. Medications on Admission: Simvastatin 10', Lasix 40', Toprol 25', Aspirin 325', Imdur 30', Paxil 10' Discharge Medications: Expired Discharge Disposition: Extended Care Discharge Diagnosis: MR now s/p MVR post op respiratory failure s/p trach/PEG chronic diastolic heart failure Rheumatic Heart Disease (s/p bioprosthetic AVR), HTN, Depression, heart failure, hyperlipidemia, Breast CA s/p lumpectomy & XRT, s/p Hysterectomy, PPM Discharge Condition: Expired Discharge Instructions: Expired Followup Instructions: Expired [**Name6 (MD) **] [**Name8 (MD) **] MD [**MD Number(2) 173**] ICD9 Codes: 5990, 486, 5185, 4019, 2724, 2859
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Medical Text: Admission Date: [**2113-7-10**] Discharge Date: [**2113-7-13**] Service: VASCULAR SURGERY CHIEF COMPLAINT: Asymptomatic right carotid artery stenosis. HISTORY OF THE PRESENT ILLNESS: The patient is a 79-year-old nondiabetic white female with CAD, cardiac dysrhythmia, hypertension, severe COPD, oxygen-dependent for approximately one year, who was noted to have carotid bruits several years ago with noninvasive studies indicating no significant stenosis on the right side and 60-79% stenosis on the left. Recent follow-up carotid noninvasives showed the right side 90-99% stenosis on the right. The patient denied any history of TIAs or dizziness. The patient was seen by her pulmonologist, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 745**], prior to carotid surgery. Dr. [**First Name (STitle) 745**] was concerned that the patient was at increased risk for complications secondary to her pulmonary disease which might result in need for mechanical ventilation with difficulty in weaning. The patient was given a course of steroids which was tapered prior to surgery in order to maximize her pulmonary function. PAST MEDICAL HISTORY: 1. CAD. 2. Cardiac dysrhythmia: Treated with Norpace and Persantine. 3. Severe air-flow obstruction with chronic respiratory failure, both hypoxemic and hypercarbic. FEV1/FVC ratio equals 47% in [**2113-5-7**]. 4. GERD. 5. Large hiatal hernia. 6. Upper GI bleed times two while on aspirin. 7. Pneumonia one to two years ago at [**Hospital3 7362**]. 8. Arthrosis. 9. Osteoarthritis. PAST SURGICAL HISTORY: 1. Cholecystectomy in [**2057**]. 2. Hysterectomy in [**2082**]. 3. Cataract extraction O.S. in [**2106**]. ALLERGIES: 1. Codeine causes chest pain and arm pain. 2. Aspirin contributed to two recent upper GI bleeds. ADMISSION MEDICATIONS: 1. Disopyramide 150 mg p.o. q. six hours. 2. Accupril 10 mg p.o. q.d. 3. Hydrochlorothiazide 12.5 mg p.o. q.d. 4. Nexium 40 mg p.o. q.d. 5. Oruvail 150 mg p.o. q.d. 6. Multivitamin one p.o. q.d. 7. Combivent inhaler two puffs q.i.d. 8. Prednisone taper. 9. Darvocet p.r.n. pain. 10. Cyclobenzaprine p.r.n. FAMILY HISTORY: Father died at age 64 with Alzheimer's disease. Mother died at age 71 secondary to kidney cancer. One brother had esophageal cancer. One sister died of Berylliosis. Five children in good health. SOCIAL HISTORY: The patient is a widow. She lives alone and is independent, using her oxygen as needed. She quit smoking cigarettes in [**2092-9-5**] after smoking one pack per day for 39 years. The patient's husband was a two pack per day cigarette smoker until his death. PHYSICAL EXAMINATION ON ADMISSION: Vital signs: Pulse 102, blood pressure 155/74, 02 saturation on 2 liters 02 equals 93%. Height 5' 2", weight 130 pounds. General: Alert, cooperative white female in no acute distress. HEENT: Normocephalic. Pupils equal and reactive to light. Sclerae anicteric. Neck: Range of motion within normal limits. No lymphadenopathy or thyromegaly. Carotids: Palpable with bruits, right greater than left. No JVD. Chest: Increased A/P diameter with kyphosis. Heart: Regular rate and rhythm with occasional extra beat. There was a II/VI systolic ejection murmur. Lungs: Clear bilaterally. Abdomen: Soft, nontender, no masses. No hepatosplenomegaly. Extremities: Warm. No cyanosis, clubbing, or edema. Pedal pulses were 2+ bilaterally. Neurologic: Nonfocal. LABORATORY/RADIOLOGIC DATA: On admission, hematocrit 41.2, platelets 521,000. PT 12.6, PTT 22.3, INR 1.1. Sodium 145, potassium 4.4, BUN 33, creatinine 1.0, glucose 60. Chest x-ray showed no acute pulmonary disease, large hiatal hernia present. Khyphosis of the thoracic spine with multiple compression deformities. EKG on [**2113-7-5**] showed a sinus rhythm at a rate of 95 with supraventricular extrasystole. HOSPITAL COURSE: The patient was admitted to the hospital on [**2113-7-11**] following an uneventful right carotid endarterectomy. At the end of surgery, the patient was neurologically intact. Immediately following surgery, the patient's systolic blood pressure was maintained at greater than 120 with a Neo-Synephrine drip. The Neo-Synephrine drip could not be weaned readily and the patient was transferred to the SICU for further treatment. The patient received Kefzol perioperatively. On postoperative day number two, the patient developed EKG changes which were concerning for a possible LAD lesion. The Cardiology Service recommended a cardiac catheterization as soon as possible. Dr. [**Last Name (STitle) 1391**] suggested waiting two to three weeks postoperatively would decrease the risk of the patient developing a neck hematoma. The Cardiology Service agreed to medically manage the patient since her cardiac isoenzymes were flat. Disopyramide was resumed. The patient refused cardiac catheterization. The patient developed a rapid atrial fibrillation with a ventricular response of 160. She was anticoagulated with heparin. She converted to normal sinus rhythm with IV Lopressor. Disopyramide was resumed. Valsartan 80 mg p.o. q.d. was started. The patient was transfused 1 unit of packed red blood cells on [**2113-7-13**] for a hematocrit of 28. The patient's post transfusion hematocrit was 31. At the time of discharge, the patient's neck incision was clean, dry, and intact. The patient was neurologically intact. She was instructed to follow-up with Dr. [**Last Name (STitle) 1391**] in one week for staple removal from her incision. DISCHARGE MEDICATIONS: 1. The patient was to resume all her preadmission medications. 2. Hydrochlorothiazide was increased from 12.5 mg to 25 mg p.o. q.d. 3. Accupril was increased from 10 mg to 20 mg p.o. q.d. 4. Valsartan 80 mg p.o. q.d. DISPOSITION: Home. CONDITION ON DISCHARGE: Satisfactory. PRIMARY DIAGNOSIS: 1. Asymptomatic right carotid artery stenosis. 2. Right carotid endarterectomy on [**2113-7-10**]. SECONDARY DIAGNOSIS: 1. Postoperative hypotension treated with Neo-Synephrine drip: Resolved. 2. Blood loss anemia; status post transfusion of 1 unit of packed rd blood cells. 3. Rapid atrial fibrillation: Resolved after treatment with IV Lopressor. 4. Coronary artery disease: Possible left anterior descending lesion. Cardiac catheterization recommended, but declined by patient. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 4417**] Dictated By:[**Last Name (NamePattern1) 3954**] MEDQUIST36 D: [**2113-7-19**] 07:21 T: [**2113-7-19**] 19:21 JOB#: [**Job Number 51747**] ICD9 Codes: 496
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Medical Text: Admission Date: [**2186-11-14**] Discharge Date: [**2186-12-8**] Date of Birth: [**2120-9-10**] Sex: M Service: CARDIOTHORACIC Allergies: Codeine Attending:[**First Name3 (LF) 2969**] Chief Complaint: esophageal cancer Major Surgical or Invasive Procedure: transthoracic esophagectomy History of Present Illness: Mr. [**Known lastname **] is a 66-year-old patient with biopsy- proven carcinoma of the mid-esophagus from about 25 cm to 29 cm from the incisors. He completed induction chemoradiotherapy under the care of his physicians at [**Location (un) 5164**] and was seen after completing this with evidence for a partial response radiographically. A transthoracic resection of the mid-esophagus and lymphadenectomy is planned. Past Medical History: HTN, hyperlip, trig neuralgia, esopg ca Social History: lives w/ wife Physical Exam: general: well appearing male in NAD. HEENT: unremarkable Chest: lungs CTA bilat Cor: RRR S1, S2 Abd: soft, Nt, Nd, +BS extrem: no C/C/E neuro: A+Ox3 Pertinent Results: [**2186-12-5**]: barium swallow: Conray was used in this study. Contrast passes promptly through the anastomosis into the distal stomach. A thin stream of contrast is seen extravasating from the anastomotic site and tracking to the right of the neoesophagus and collecting slightly more distally. This collection did not drain during the course of this study. IMPRESSION: Findings consistent with a small contained leak at the site of the cervical anastamosis, as described above. Brief Hospital Course: Pt was admitted and taken to the OR for Transthoracic esophagectomy. Apical bullectomy. Left cervical esophagogastrostomy. Feeding jejunostomy. OR course uncomplicated. Had epidural, right chest tube to sxn, cervical JP to bulb abd feeding j-tube to gravity. Remained intubated post op and admitted to the CSRU for ventilatory support. Pt was extubated on POD#1. Post op course was complicated by tacycardia, readmission to the ICU for pulmonary hygiene on POD#6 and POD#9 for leukocytosis and persistant cervical anastomtic leak with bilious drainage from chest tube and JP drain, left pleural effusion which was tapped under ultrasound for 1100cc, and post op anemia for which he was transfused. Escalating doses of beta blockade to maintain HR control. Maintained on triple abx for emperic coverage which were d/c'd 24hrs prior to d/c after negative culture data. Chest tube and JP drain were d/c'd once they were no longer draining bilious fluid. NPO status maintained d/t anastomotic leak which was still evident per barium swallow done just prior to d/c. Trophic tube feeds started via J-tube and titrated to goal once bowel function returned. Pain was well controlled on roxicet elixir via J-tube. Pt will return in one week for a repeat barium swallow and follow up w/ Dr. [**Last Name (STitle) **]. Medications on Admission: diltiazem, nexium, zyban, lipitor, tegretol Discharge Medications: 1. Oxycodone-Acetaminophen 5-325 mg/5 mL Solution [**Last Name (STitle) **]: 5-10 MLs PO Q4-6H (every 4 to 6 hours) as needed. Disp:*300 ML(s)* Refills:*0* 2. Erythromycin Ethylsuccinate 200 mg/5 mL Suspension for Reconstitution [**Last Name (STitle) **]: Five (5) ML PO q8hrs (). Disp:*450 ML(s)* Refills:*2* 3. Lansoprazole 30 mg Tablet,Rapid Dissolve, DR [**Last Name (STitle) **]: One (1) Tablet,Rapid Dissolve, DR [**Last Name (STitle) **] DAILY (Daily). Disp:*30 Tablet,Rapid Dissolve, DR(s)* Refills:*2* 4. Metoprolol Tartrate 50 mg Tablet [**Last Name (STitle) **]: Two (2) Tablet PO TID (3 times a day): Crush tablet and completely dissolve in 50cc water and instill via J-tube. Disp:*180 Tablet(s)* Refills:*2* 5. insulin pls check you finger stick very 6 hrs and dose yourself with sliding scale regular insulin. 6. regular insulin disp one vial with 2 refills regular insulin per sliding scale q 6hrs based on finger stick 7. NPH insuin 2units sq qam and 4 units sq qpm disp one vial with one refill 8. insulin syringes 100 unit insulin syringes disp one box with 2 refills. 9. tube feed replete w/ fiber cycle over 18hrs goal 100c/hr Discharge Disposition: Home With Service Facility: [**Hospital 2255**] [**Name (NI) 2256**] Discharge Diagnosis: esophageal CA s/p transthoracic esophagectomy, apical bullectomy, L-cervical esophagogastrostomy, feeding jej'omy ([**11-14**]), c/b bile in chest tube; L-thoracentesis for effusion([**11-24**]) Discharge Condition: good Discharge Instructions: Call Dr.[**Doctor Last Name 4738**] office [**Telephone/Fax (2) 170**]if you have any fever, chills, redness or drainage from your incision sites, inability to tolerate tube feeds, nausea, vomiting. If your feeding tube falls out, call Dr.[**Doctor Last Name 4738**] office immediately or go to the nearest emergency room to have the tube replaced immediately. Call Dr.[**Doctor Last Name 4738**] office [**Telephone/Fax (2) 170**]if you have any fever, chills, redness or drainage from your incision sites, inability to tolerate tube feeds, nausea, vomiting. If your feeding tube falls out, call Dr.[**Doctor Last Name 4738**] office immediately or go to the nearest emergency room to have the tube replaced immediately. Followup Instructions: You have a follow up appointment with Dr. [**Last Name (STitle) **] on thursday [**12-14**] at 4:30pm in the [**Hospital Ward Name 23**] Clinical Center [**Location (un) **]. You need to report to [**Hospital Ward Name **] clinical center [**Location (un) **] at 9am for a barium swallow. Completed by:[**2186-12-11**] ICD9 Codes: 5119, 4019, 2724, 3051
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Medical Text: Admission Date: [**2168-8-8**] Discharge Date: Service: HISTORY OF PRESENT ILLNESS: Patient is a 77-year-old male who presented with chest pain, history of coronary artery disease at baseline sustained a cardiac catheterization and found to have two vessel disease and a low ejection fraction. PAST MEDICAL HISTORY: Significant for hypertension, coronary artery disease, hematochromatosis, hemachromatosis, hypothyroidism, high cholesterol and anemia. MEDICATIONS: Aspirin, Imdur, Metoprolol, simvastatin, Synthroid, Lasix, sublingual nitroglycerin and Lisinopril. ALLERGIES: Patient no known drug allergies. PHYSICAL EXAMINATION: He was afebrile. His vital signs were stable. No jugular venous distention. He had crackles bilaterally, right greater than left, regular rate and rhythm with no murmurs, rubs or gallops. His abdomen was benign. His extremities were warm and well-perfused with no edema. LABORATORIES: BUN 26, creatinine 1.3, hematocrit 35.9 with white blood cell count of 11.7. HOSPITAL COURSE: The patient was taken to the Operating Room on [**2168-8-8**] where a coronary artery bypass graft times three was performed. Patient did well postoperatively and was transferred to the CSRU where he was fully weaned from the ventilator. Patient continued to do well and was extubated postoperatively. Patient was evaluated by Physical Therapy for mobility and ambulation and he did well. Patient was transferred on postoperative day number two to the floor. His chest tube was removed. His Foley was removed and his wires were removed on postoperative day number three. He continued to ambulate and Physical Therapy cleared him to go home. For episodes of agitation, he was given a little bit of Haldol, but did well and was stopped from his Haldol. Patient was discharged home on postoperative day number four after clearing Physical Therapy and stairs with instructions to follow-up with his primary care physician in one to two weeks. He was also instructed to follow-up with Dr. [**Last Name (STitle) **] in four weeks and also to follow-up with Cardiology in the Congestive Heart Failure Clinic in two to four weeks. Patient discharged home in stable condition. DISCHARGE MEDICATIONS: 1. Motrin. 2. Lopressor 50 mg po b.i.d. 3. Synthroid po b.i.d. 4. Simvastatin 10 mg po q.d. 5. Colace 100 mg po b.i.d. 6. KCL 20 mEq po b.i.d. 7. Lasix 20 mEq po b.i.d. 8. Aspirin 325 mg po q.d. DISCHARGE STATUS: Patient was discharged home. DISCHARGE CONDITION: Stable. [**First Name11 (Name Pattern1) 1112**] [**Last Name (NamePattern1) **], M.D. [**MD Number(1) 3113**] Dictated By:[**Doctor Last Name 94723**] MEDQUIST36 D: [**2168-8-18**] 12:25 T: [**2168-8-18**] 12:25 JOB#: [**Job Number **] ICD9 Codes: 4280, 2449, 2720
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Medical Text: Admission Date: [**2135-1-17**] Discharge Date: [**2135-1-19**] Date of Birth: [**2099-9-11**] Sex: F Service: CCU HISTORY OF PRESENT ILLNESS: The patient is a 35-year-old woman, who is a current smoker, with family history of early coronary artery disease, who developed acute, severe chest pressure while at work as an emergency medical technician. The patient initially thought this was musculoskeletal; however, she became diaphoretic, and the chest discomfort persisted. So, she was brought to an outside hospital in [**Hospital1 8**], [**State 350**]. At the outside hospital, the patient received 3 sublingual Nitroglycerin, as well as aspirin, without relief of pain. The patient was then given Nitroglycerin drip, as well as started on heparin drip. The patient had a cardiac arrest at the outside hospital. It was unclear whether it was ventricular tachycardia versus ventricular fibrillation, as the outside hospital did not send any ECG strips. The cardiac arrest responded to 3 shocks with the defibrillator with return to normal sinus rhythm. The patient was also started on lidocaine at the outside hospital. ECG at the outside hospital showed inferior lead ST elevation with reciprocal changes throughout. The patient was emergently transferred to [**Hospital1 18**] for coronary catheterization. At arrival to the cath lab, the patient reportedly had mild residual discomfort. In the coronary cath lab at [**Hospital1 18**], the patient was found to have 95% distal right coronary artery occlusion which received angioplasty, as well as a stent. The patient developed bradycardia during catheterization and hypotension which responded to dopamine which was started, as well as IV fluids and atropine. Dopamine and lidocaine were discontinued in the catheterization lab. The patient was started on Neo-Synephrine; however, in the cardiac catheterization lab for hypotension just prior to transfer to the coronary care unit. Upon arrival to the coronary care unit, the patient complained of right groin pain at the site of catheterization, but otherwise denied any shortness of breath, chest pain, chest pressure, nausea, vomiting, diaphoresis, or any other symptoms. The patient also denied palpitations. PAST MEDICAL HISTORY: The patient is obese, otherwise without significant past medical history. SOCIAL HISTORY: The patient is a current cigarette smoker. FAMILY HISTORY: The patient with an uncle who had a myocardial infarction in his 30s, as well as a grandfather with a myocardial infarction in his 50s. The patient's parents both passed away from pulmonary emboli when they were elderly and bed bound. The patient works as an EMT in [**Hospital1 8**]. ALLERGIES: No known drug allergies. MEDICATIONS AT HOME: None. PHYSICAL EXAM ON ADMISSION: An obese, young Caucasian woman lying in bed, mildly agitated, but in no apparent distress. Physical exam was within normal limits. The patient was afebrile, heart rate 90, regular rate, blood pressure 127/80. Heart exam within normal limits with normal S1, S2, no murmurs appreciated, no S3 or S4. Lungs were clear to auscultation bilaterally. Patient with mild chest tenderness to palpation in the sternal area. The remainder of the physical exam was within normal limits. Right groin site of catheterization with some mild oozing of blood, as well as a small, stable hematoma. The patient's pulses were 2+ throughout. DIAGNOSTICS ON ADMISSION: ECG upon arrival to the coronary care unit showed normal sinus rhythm at 68, normal intervals, axis within normal limits. It showed ST elevations in II, III and AVF, 1 mm in II, 2 mm in III and AVF with reciprocal ST depressions in I and AVL with T wave inversions, as well as [**Street Address(2) 4793**] depression in V2. The patient's chemistries were within normal limits except for potassium of 3.4 from the outside hospital. CARDIAC CATHETERIZATION: Please refer to the full report for further details. It was notable for a 95% distal right coronary artery stenosis which was stented, but with good TIMI to distal flow even prior to stent. It also showed a diffuse 40% proximal LAD stenosis. The left main was normal. The patient's filling pressures were slightly elevated in the cath lab with a right atrial pressure of 15, right ventricular pressure of 38/20, PA pressure of 38/28, and wedge pressure of 28. CONCISE SUMMARY OF HOSPITAL COURSE: This 35-year-old female, a smoker, brought in from an outside hospital with substernal chest pain, as well as inferior lead ST elevation, status post coronary catheterization at [**Hospital1 18**] with stent placement. The patient notably had cardiac arrest at the outside hospital which responded to defibrillation. The patient transferred to coronary care unit after coronary catheterization for further monitoring. 1) CORONARY ARTERY DISEASE: Patient with inferior myocardial infarction status post right coronary artery stent. The patient was started on aspirin, Plavix, Lipitor 20 qd, as well as Integrilin for 18 hours. The patient was started on low dose beta blocker which was titrated up the day after admission. The patient also was adamant that she will quit smoking, as well as maintain a cardiac diet and exercise regimen. The patient's early myocardial infarction was concerning for possible abnormal coagulation underlying problem. The patient's family history also concerning, as well as parents who both had pulmonary emboli, although both were reportedly bed bound at the time. Recommend outpatient work-up of coagulation studies. This was passed on to the primary care physician via [**Name Initial (PRE) **] telephone conversation prior to discharge. The patient had no further symptoms of coronary artery disease throughout her hospital stay. The patient's ECG normalized; however, she did develop inferior Q waves by the day after her myocardial infarction. The patient's creatine kinase also trended up to a max of approximately 1,500 and then trended down again. The patient's lipid profile was obtained and showed a total cholesterol of 140, triglycerides 198, HDL 33, LDL 67. 2) HEMODYNAMICS: The patient arrived from the catheterization lab on Neo-Synephrine which was titrated off overnight. The patient's blood pressure tolerated this well, did not require pressors, and also tolerated the beta blocker well. 3) RHYTHM: The patient remained in normal sinus rhythm throughout the remainder of her hospital stay. The patient did have a short run of 10 beats of ventricular tachycardia on her first night in the coronary care unit. Other than this, the patient's rhythm was normal sinus rhythm with very occasional premature ventricular complexes seen on telemetry. 4) PUMP: The patient's echocardiogram showed an ejection fraction of 45-50%, as well as focal, severe hypokinesis of the basal half of the inferior wall. The remainder of the echocardiogram was within normal limits with 1+ mitral regurgitation seen. Please refer to the full report for further details. 5) FLUID, ELECTROLYTES AND NUTRITION: The patient maintained on a cardiac diet throughout her hospital stay which she tolerated well. 6) PROPHYLAXIS: The patient was on Integrilin initially and then ambulated well. The patient also on a bowel regimen as needed. 7) CODE STATUS: Full code. Communication was daily with the patient. 8) ACCESS: The patient initially with a Swan-Ganz catheter that was placed in the catheterization lab which was discontinued. The patient did have a small femoral artery hematoma that was stabilized with direct pressure and was stable x 48 hours at discharge. CONDITION ON DISCHARGE: Stable. DISCHARGE STATUS: To home. DISCHARGE DIAGNOSES: Inferior wall myocardial infarction. DISCHARGE MEDICATIONS: 1. Aspirin 325 mg qd. 2. Plavix 75 mg qd. 3. Lipitor 20 mg qd. 4. Toprol XL 50 mg qd. FOLLOW-UP PLANS: 1. The patient to follow-up with her primary care physician, [**Last Name (NamePattern4) **]. [**Last Name (STitle) 26773**], within the next 2 weeks. I spoke to Dr. [**Last Name (STitle) 26773**] over the phone with a brief update of the hospital course and the importance of close follow-up with PCP, [**Name10 (NameIs) 3**] well as cardiologist. 2. The patient has an appointment with Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 17437**] who is a cardiologist who the patient's primary care physician referred to. [**First Name8 (NamePattern2) **] [**First Name8 (NamePattern2) **] [**Name8 (MD) **], M.D. [**MD Number(1) 7169**] Dictated By:[**Name8 (MD) 16731**] MEDQUIST36 D: [**2135-1-19**] 12:18 T: [**2135-1-19**] 12:26 JOB#: [**Job Number 108811**] ICD9 Codes: 4271, 9971, 3051
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Medical Text: Admission Date: [**2124-4-4**] Discharge Date: [**2124-5-1**] Date of Birth: [**2078-7-22**] Sex: F Service: SURGERY Allergies: Penicillins / Sulfonamides / Aspirin / Cephalexin / Wellbutrin / Doxycycline / Compazine / Ciprofloxacin Attending:[**First Name3 (LF) 1556**] Chief Complaint: Thigh pain, sepsis Major Surgical or Invasive Procedure: [**2124-4-4**]: 1. Incision and drainage of bilateral thighs. 2. Cystoscopy, urethroscopy, removal of tension-free vaginal tape- obturator mesh sling. [**2124-4-12**]: 1. Incision and drainage of right thigh with subcutaneous tissue and fascial biopsy. 2. Incision and drainage of left thigh. [**2124-4-20**]: Change of wound vac [**2124-4-25**]: Split thickness skin graft, right thigh, 15 cm x 9 cm. History of Present Illness: 45F s/p patient status post TVT obturator procedure at [**Hospital1 **] [**2124-3-22**] states she began to have thigh pain 3 days after the surgery. She was sent to the ED by her PCP for failure to thrive and was found to be hypotensive in the 70s. After 6 liters of fluid and doses of Vancomycin, imipenem, and clindamycin her blood pressure returned to her norm (SBP 90s). By report the patient also had fevers at home. Past Medical History: PMH: IBS, GERD, TBI, Migraine, Depression PSH: R shoulder [**2120**], bladder sling [**2123**], nasal surgery NOS Social History: The patient does not work. She is on disability from her TBI. She was a special needs teacher and was hit in the temporal lobe. She smokes cigarettes. She does not drink alcohol. She has 1 son. She is single. She has good family support from her mother and father Family History: Non contributory Physical Exam: On admission: 98 121 76/55 16 100 NAD no respiratory distress abdomen tender suprapubic and bilateral lower quadrants pelvic exam unremarkable by report from GYN extrensive blanching erythema extending from groin to mid thigh, incisions appear well-healed At Discharged: 98.3 97.4 95 94/58 18 95RA NAD, Comfortable, frail woman looking older that stated age Lungs: Clear b/l CV: mild tachy, no m/r/g Abd: soft, non-tender, non-distended Ext: R inner thigh with skin graft with near 100% take, L inner thigh with wet-to-dry dressing, no induration or swelling edges healing well. posterior legs, skin sloughing areas healing well Pertinent Results: Radiology: [**4-4**] C/A/P CT with contrast:(PRELIM) Moderate bilateral pleural effusions with septal thickening seen throughout the lungs compatible with pulmonary edema. Diffuse bowel wall thickening and edema, involving both small and large bowel loops with marked mucosal hyperenhancement, suggestive of shock bowel. Diffuse periportal edema with new moderate ascites. Wedge shaped area of low attenuation in the right kidney (2:63), may reflect an infarct. Heterogeneous enhancement pattern of the spleen, likely moire pattern from contrast timing. New locules of air in the right groin, with wound in the medial thighs bilaterally, likely reflect post-surgical changes following exploration. Anasarca. [**2124-4-11**] CT A/P IMPRESSION: 1. Slight decrease in size of pleural effusion and ascites. 2. Interlobular septal thickening and patchy consolidation at both lung bases. Findings consistent with pulmonary edema and superimposed pneumonia. 3. Foci of low attenuation in the spleen could represent small parenchymal infarcts. 4. Fluid within the intermuscular fascia and muscles of the medial compartment of both thighs has slightly increased in comparison to the prior scan, but no new areas of gas are seen with the muscles or subcutaneous tissues. Echocardiogram [**2124-4-7**] Conclusions Left ventricular wall thicknesses and cavity size are normal. There is moderate global left ventricular hypokinesis (LVEF = 30%). Right ventricular chamber size and free wall motion are normal. Trivial mitral regurgitation is seen. The estimated pulmonary artery systolic pressure is normal. There is a trivial/physiologic pericardial effusion. IMPRESSION: Moderate global left ventricular systolic dysfunction. Compared with the prior study (images reviewed) of [**2124-4-5**], the findings are similar. LV systolic function may have been slightly underestimated on the prior study. Pathology: [**2124-4-12**] skin and soft tissue : DIAGNOSIS: I. Right thigh, skin and subcutaneous tissue (A-B): Skin with ulceration and subcutaneous tissue with acute inflammation, fat necrosis and focal abscess formation. II. Right thigh, fascia (C): Gangrenous necrosis of soft tissue. Micro: [**2124-4-4**] - implant - BETA STREPTOCOCCUS GROUP A [**2124-4-12**] - right thigh - [**Female First Name (un) **] ALBICANS [**2124-4-15**] - yeast [**4-15**] Stool - CDiff negative Labs: [**2124-4-5**] 03:53AM BLOOD WBC-34.8*# RBC-3.67* Hgb-10.8* Hct-32.0* MCV-87 MCH-29.3 MCHC-33.6 RDW-16.6* Plt Ct-163 [**2124-4-5**] 08:37AM BLOOD WBC-42.0* RBC-3.62* Hgb-10.5* Hct-31.5* MCV-87 MCH-29.1 MCHC-33.4 RDW-16.4* Plt Ct-142* [**2124-4-5**] 12:41PM BLOOD WBC-38.0* RBC-3.53* Hgb-10.2* Hct-30.1* MCV-86 MCH-28.9 MCHC-33.8 RDW-16.5* Plt Ct-101* [**2124-4-7**] 03:41AM BLOOD WBC-30.3* RBC-2.55* Hgb-7.5* Hct-22.0* MCV-86 MCH-29.6 MCHC-34.3 RDW-16.7* Plt Ct-38* [**2124-4-9**] 12:48PM BLOOD WBC-16.9* RBC-3.33* Hgb-9.5* Hct-28.7* MCV-86 MCH-28.7 MCHC-33.2 RDW-16.7* Plt Ct-49* [**2124-4-17**] 02:47AM BLOOD WBC-15.2* RBC-2.68* Hgb-7.7* Hct-23.7* MCV-88 MCH-28.8 MCHC-32.7 RDW-16.5* Plt Ct-357 [**2124-4-18**] 02:18AM BLOOD WBC-12.2* RBC-2.55* Hgb-7.3* Hct-22.4* MCV-88 MCH-28.5 MCHC-32.4 RDW-16.6* Plt Ct-422 [**2124-4-19**] 05:45AM BLOOD WBC-11.6* RBC-2.55* Hgb-7.4* Hct-22.9* MCV-90 MCH-29.1 MCHC-32.5 RDW-17.0* Plt Ct-428 [**2124-4-25**] 04:59AM BLOOD PT-13.6* PTT-31.6 INR(PT)-1.2* [**2124-4-4**] 11:55AM BLOOD Glucose-71 UreaN-76* Creat-5.9*# Na-132* K-3.6 Cl-94* HCO3-14* AnGap-28* [**2124-4-5**] 03:53AM BLOOD Glucose-198* UreaN-48* Creat-2.6* Na-135 K-3.0* Cl-103 HCO3-16* AnGap-19 [**2124-4-5**] 12:41PM BLOOD Glucose-208* UreaN-34* Creat-1.9* Na-137 K-3.0* Cl-98 HCO3-20* AnGap-22* [**2124-4-5**] 08:57PM BLOOD Glucose-187* UreaN-28* Creat-1.6* Na-131* K-3.3 Cl-94* HCO3-24 AnGap-16 [**2124-4-6**] 06:51AM BLOOD Glucose-124* UreaN-22* Creat-1.2* Na-134 K-3.5 Cl-96 HCO3-26 AnGap-16 [**2124-4-15**] 03:56AM BLOOD Glucose-96 UreaN-25* Creat-0.9 Na-138 K-3.3 Cl-105 HCO3-26 AnGap-10 [**2124-4-19**] 05:45AM BLOOD Glucose-82 UreaN-9 Creat-0.6 Na-137 K-3.7 Cl-112* HCO3-19* AnGap-10 [**2124-4-26**] 04:50AM BLOOD Glucose-93 UreaN-8 Creat-0.5 Na-138 K-3.5 Cl-107 HCO3-25 AnGap-10 [**2124-4-4**] 11:55AM BLOOD ALT-39 AST-149* CK(CPK)-2620* AlkPhos-111* TotBili-0.6 [**2124-4-5**] 08:57PM BLOOD ALT-40 AST-148* LD(LDH)-358* CK(CPK)-2299* AlkPhos-80 TotBili-0.6 [**2124-4-9**] 03:30AM BLOOD ALT-24 AST-39 CK(CPK)-163 AlkPhos-122* Amylase-42 TotBili-0.7 [**2124-4-13**] 04:26AM BLOOD ALT-4 AST-45* CK(CPK)-83 AlkPhos-168* TotBili-0.6 [**2124-4-13**] 04:26AM BLOOD Albumin-1.7* Calcium-8.6 Phos-4.0 Mg-1.6 Brief Hospital Course: The patient presented to the emergency room on [**4-4**] in septic shock. She was given 6 L IVF and 1 dose of vancomycin, clindamycin, and imipenem prophylactically for concern for septic shock with necrotizing fascitis. A central line was placed and both surgery and GYN were consulted. GYN noted nl pelvic exam with well healed TVT incision. CT imaging confirmed soft tissue infection to b/l thighs extending to femur and thus it was decided to take the pt to the OR urgently for emergent exploration and removal of her TVT. In the OR, it was discovered that pt had completely viable fascia and tissue with no necrosis. A minimal amount of pus was found in the R. inner thigh which was sent for culture. Pt was continued on IV vancomycin, clindamycin, and meropenem. She was admitted to the ICU where she was on 2 vasopressors and in acute renal failure and was initiated on CVVH. She received a repeat pan CT with contrast notable for shock liver, shock bowel, and R. kidney infarct. She remained intubated, sedated on midazolam and fentanyl. [**4-5**] POD 1 continued on ventilatory support, CVVH, vasopressors, vanco/clinda/[**Last Name (un) 2830**], IVIG 50g given [**4-6**] POD 2 25gm IVIG given, continued on ventilatory support, CVVH, vasopressors, vanco/clinda/[**Last Name (un) 2830**] [**4-7**] POD 3 25gm IVIG given, continued on ventilatory support, CVVH, vasopressors, vanco/clinda, transfused one unit RBC, TNP initiated, cefepime started, cefepime desensitization started for allergy history, meropenem stopped [**4-8**] continued on ventilatory support, CVVH, vasopressors, vanco/clinda, TPN, levothyroxine started, ancef started, cefepime stopped [**4-11**]- dobhoff tube placed, tube feeds started [**4-12**] - flagyl started, continued ventilatory support, CVVH, vanco/clinda, vasopressors weaned off, one unit of RBC transfused, OR for debridement [**4-14**] - successfully extubated, continued vanco/clinda/flagyl, tube feeds [**4-15**] - fluconazole added for yeast in urine, dobhoff removed, started regular diet [**4-18**] - transferred to the floor, foley catheter removed, OOB and ambulating with PT, continued fluc, [**Last Name (un) 2830**] [**4-20**] - pateint taken back to OR for VAC change to R inner thigh, no complications [**Date range (1) 3047**] - ambulating with PT on floor, progressed to regular diet, normalizing of labs. [**4-25**] - Taken to OR for STSG to R thigh without complication. VAC left on as bolster to the graft for 3 days [**4-28**] - Vac change, graft with near 100% take, other wounds healing well with granulation tissue and wound care [**5-1**] - Vac taken down with continued 100% take of graft, xeroform dressing left in place. Patient ambulatory with PT assistance, tolerating regular diet, voiding without assistance. Still weak from prolonged hospital stay but doing significantly better and ready for d/c to rehab to [**Hospital1 **] in [**Hospital1 8**]. Pt, family, nursing and MD staff all agree that pt is ready for d/c to rehab with f/u in 2 weeks. Medications on Admission: Albuterol 90 mcg q3-6prn, Alprazolam .125-.375 [**Hospital1 **]/hsprn, Amantadine 100 mg syrup qd, Abilify 2.5-5hs, Azelastine 1 spray nasal qid prn, Relpax 20-40 prn migraine, Fluoxetine 60mg qd, Flovent 110mcg x4 [**Hospital1 **], Atrovent 17mcg 2 [**Hospital1 **] or qid prn, Synthroid 50 5days/week 100 2 days/week, Pantoprazole 40'',Topiramate 50qam 100qpm, Trazodone 50-150 hs prn, Nasacort 55 both nostrils daily, Discharge Medications: 1. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**11-20**] Drops Ophthalmic PRN (as needed) as needed for dry eyes. 2. Aripiprazole 5 mg Tablet Sig: One (1) Tablet PO at bedtime as needed for anxiety/agitation. 3. Nystatin 100,000 unit/g Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 4. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 5. Alprazolam 0.25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) as needed for anxiety. 6. Fluoxetine 20 mg Capsule Sig: Three (3) Capsule PO DAILY (Daily). 7. Topiramate 50 mg Tablet Sig: One (1) Tablet PO qam. 8. Topiramate 100 mg Tablet Sig: One (1) Tablet PO at bedtime. 9. Trazodone 100 mg Tablet Sig: One (1) Tablet PO at bedtime as needed for anxiety/agitation. 10. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed for pain. 11. Levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO 2X/WEEK ([**Doctor First Name **],SA). 12. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO 5X/WEEK (MO,TU,WE,TH,FR). 13. Polyvinyl Alcohol-Povidone 1.4-0.6 % Dropperette Sig: [**11-20**] Drops Ophthalmic PRN (as needed) as needed for dry eyes. 14. Aripiprazole 10 mg Tablet Sig: 0.5 Tablet PO QHS (once a day (at bedtime)) as needed for anxiety/agitation. 15. Nystatin 100,000 unit/g Cream Sig: One (1) Appl Topical [**Hospital1 **] (2 times a day). 16. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: One (1) Tablet PO Q4H (every 4 hours) as needed for pain. 17. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One (1) Tablet, Delayed Release (E.C.) PO Q12H (every 12 hours). 18. Alprazolam 0.25 mg Tablet Sig: One (1) Tablet PO TID (3 times a day) as needed for anxiety. 19. Fluoxetine 20 mg Capsule Sig: Three (3) Capsule PO DAILY (Daily). 20. Topiramate 25 mg Tablet Sig: Two (2) Tablet PO QAM (once a day (in the morning)). 21. Topiramate 100 mg Tablet Sig: One (1) Tablet PO QPM (once a day (in the evening)). 22. Trazodone 50 mg Tablet Sig: Two (2) Tablet PO HS (at bedtime) as needed for anxiety/insomnia. 23. Levothyroxine 100 mcg Tablet Sig: One (1) Tablet PO 2X/WEEK ([**Doctor First Name **],SA). 24. Levothyroxine 50 mcg Tablet Sig: One (1) Tablet PO 5X/WEEK (MO,TU,WE,TH,FR). 25. Oxycodone-Acetaminophen 5-325 mg Tablet Sig: 1-2 Tablets PO Q4H (every 4 hours) as needed. Discharge Disposition: Extended Care Facility: [**Hospital6 85**] - [**Location (un) 86**] Discharge Diagnosis: 1. Toxic shock syndrome with myocardial depression 2. Bilateral thigh cellulitis and epidermolysis 3. Sepsis 4. Acute renal failure Discharge Condition: Mental Status: Clear and coherent. Level of Consciousness: Alert and interactive. Activity Status: Out of Bed with assistance to chair or wheelchair. Discharge Instructions: Please resume all regular home medications , unless specifically advised not to take a particular medication. Also, please take any new medications as prescribed. Please get plenty of rest, continue to ambulate several times per day, and drink adequate amounts of fluids. Avoid lifting weights greater than [**3-27**] lbs until you follow-up with your surgeon, who will instruct you further regarding activity restrictions. Avoid driving or operating heavy machinery while taking pain medications. Please follow-up with your surgeon and Primary Care Provider (PCP) as advised. Incision Care: *Please call your doctor or nurse practitioner if you have increased pain, swelling, redness, or drainage from the incision site. *Avoid swimming and baths until your follow-up appointment. *You VAC and Aquacel dressings will be changed in Rehab as orderred Followup Instructions: Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 1207**], MD Phone:[**Telephone/Fax (1) 4775**] Date/Time:[**2124-4-24**] 10:45 [**Location (un) **]. [**Location (un) **], [**Numeric Identifier 4774**] . Provider: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern1) **], MD Phone: [**Telephone/Fax (1) 3201**] Date/Time Friday [**2124-5-19**] 1:30 ICD9 Codes: 5845, 5185, 2762, 2875
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Medical Text: Admission Date: [**2109-11-25**] Discharge Date: [**2109-12-7**] Date of Birth: [**2066-5-8**] Sex: M Service: MEDICINE Allergies: Azithromycin / Augmentin / Klonopin / Aspirin / Atorvastatin / Escitalopram / Amlodipine Attending:[**First Name3 (LF) 898**] Chief Complaint: Decreased MS Major Surgical or Invasive Procedure: intubation and mechanical ventilation History of Present Illness: 43 year-old male with PMH of CAD, [**Hospital **] transferred from the MICU. Originally, presented with after a week of flu like illness with altered mental status and thought to have seroquel OD (prior OD on CCB/BB). Intubated at [**Hospital1 **] [**Location (un) 620**] for airway protection. Of note, U Tox, S Tox are negative. (though were + for TCA at OSH). However, it was determined that no meds were missing when partner counted them. Therefore, episode of altered mental status is not completely understood. While in the MICU, patient's sedation was lightened and he self extubated. An LP was performed for HAs and showed xanthochromia in all 4 tubes. to exclude possibility of a traumatic tap, LP was repeated and showed 3550 RBCs in tube 4 without any microorganisms. This was concerning for SAH vs herpes vs mycotic aneurysm. PCR for HSV is currently pending. CTA was performed on day of transfer and read pending at time of this note. MRI spine was ordered to rule out aneurysm/AVM but patient could not tolerate the procedure secondary to nausea. He now feels back to normal in terms of his thinking and fairly decent in terms of his mood. However, he continues to experience vertigo and nausea especially when he lays flat. Patient now without headaches. Past Medical History: Past Medical History: 1. CAD- s/p multiple stents with stent to LAD, pRCA, RCA, D1, mid LCX at various times within the past 8 months. Cath [**2108-4-13**] showed no flow limiting disease with EF=50%. 6 caths since [**11-20**]. His outpatient cardiologist notes that he has a severe coronary vasculopathy (based on his having quickly developed seperate coronary occlusions in rapid succession; this is why the stents were each inserted on seperate occassions; this is also in the context of presently having clear coronaries) 2. Hypertension 3. Hyperlipidemia 4. Tremor--essential 5. s/p hernia repair PCP is [**Last Name (NamePattern4) **]. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **]. Cardiologist is [**Doctor Last Name 5293**] at [**Hospital1 18**]. Past Psychiatric History: Has had inpatient admissions x 2 on D4 this summer. Both of these were serious suicide attempts by OD, prompting ICU admissions. Had stay at [**Location (un) 1475**] for ETOH in past. Followed outpatient by Dr. [**Last Name (STitle) 48615**] in [**Location (un) 620**] ([**Telephone/Fax (1) 48618**]. 4 prior suicide attempts: deliberately crashing car @ 18yo wnen intoxicated (reported on this interview), OD ~10 years ago (noted to SW), OD about 2 months ago leading to MICU admit and OD on Benadryl also leading to brief MICU admit. Has had ECT since [**2108-5-17**], which has been helpful. Was receiving maintenance therapy once per week until late [**Month (only) 216**], then increased to 3x/week secondary to continued symptoms of depression. Last ECt tx was at least 1 week ago (delayed secondary to medical issues). Social History: Born in [**State 5111**], 2nd of 6 children (5 sisters). Moved around as a child secondary to father's position in Navy, ultimately settling on Cape for high school. Had 1 and half years at [**Hospital3 **] Community College. Took care of mother before she died from cancer, took care of prior parner before he died from cancer. Lives with partner ([**Name (NI) **]), partner's sister and mother. [**Name (NI) **] 3 year old Yorkshire terrier, [**Doctor Last Name 3077**]. Enjoys playing with dog, tending to garden, unable to do much of either secondary to illness. Works in kitchen at [**Hospital1 **]-[**Last Name (un) 4068**]. Currently applying for disability. Substance Abuse History: Smokes one pack tobacco a day. H/o EtOH dependence with Section 35 to [**Location (un) 1475**] ~15 years ago, in AA, sober since with just one day of drinking in the spring. Distant h/o experimentation with MJ as teenager. Family History: Father with EtOH dependence. Great aunt with ?depression, completed suicide. Physical Exam: Vitals: T:97.2 P:75 R:12 BP:117/79 SaO2:100% on AC 650/125 x 12 100% 7.24/42/335 General: Intubated and sedated HEENT: NC/AT, PERRLA, but sluggish, EOMI without nystagmus, no scleral icterus noted, ET at 21cm Neck: supple, no JVD or carotid bruits appreciated Pulmonary: Lungs CTA bilaterally without R/R/W Cardiac: RR, nl. S1S2, no M/R/G noted Abdomen: Obese, soft, NT/ND, hypoactive bowel sounds, no masses or organomegaly noted. Extremities: No C/C/E bilaterally, 2+ radial, DP and PT pulses b/l. Skin: no rashes or lesions noted. Neuro: Sedated. no hypertonia Pertinent Results: [**2109-11-25**] 09:00PM GLUCOSE-298* UREA N-33* CREAT-2.5*# SODIUM-142 POTASSIUM-4.1 CHLORIDE-112* TOTAL CO2-17* ANION GAP-17 [**2109-11-25**] 09:00PM ALT(SGPT)-17 AST(SGOT)-18 CK(CPK)-95 ALK PHOS-79 AMYLASE-51 TOT BILI-0.2 [**2109-11-25**] 09:00PM LIPASE-60 [**2109-11-25**] 09:00PM cTropnT-<0.01 [**2109-11-25**] 09:00PM CK-MB-NotDone [**2109-11-25**] 09:00PM ASA-NEG ETHANOL-NEG ACETMNPHN-NEG bnzodzpn-NEG barbitrt-NEG tricyclic-NEG [**2109-11-25**] 09:00PM URINE HOURS-RANDOM [**2109-11-25**] 09:00PM URINE HOURS-RANDOM [**2109-11-25**] 09:00PM URINE GR HOLD-HOLD [**2109-11-25**] 09:00PM URINE bnzodzpn-NEG barbitrt-NEG opiates-NEG cocaine-NEG amphetmn-NEG mthdone-NEG [**2109-11-25**] 09:00PM WBC-18.9*# RBC-3.77* HGB-12.4* HCT-34.7* MCV-92 MCH-32.9* MCHC-35.8* RDW-12.9 [**2109-11-25**] 09:00PM NEUTS-88.1* BANDS-0 LYMPHS-8.1* MONOS-0.7* EOS-2.4 BASOS-0.7 [**2109-11-25**] 09:00PM HYPOCHROM-NORMAL ANISOCYT-NORMAL POIKILOCY-NORMAL MACROCYT-NORMAL MICROCYT-NORMAL POLYCHROM-NORMAL [**2109-11-25**] 09:00PM PLT SMR-NORMAL PLT COUNT-401# [**2109-11-25**] 09:00PM URINE COLOR-Straw APPEAR-Clear SP [**Last Name (un) 155**]-1.011 [**2109-11-25**] 09:00PM URINE BLOOD-LG NITRITE-NEG PROTEIN-TR GLUCOSE-250 KETONE-NEG BILIRUBIN-NEG UROBILNGN-NEG PH-5.0 LEUK-NEG [**2109-11-25**] 09:00PM URINE RBC->50 WBC-21-50* BACTERIA-FEW YEAST-NONE EPI-0 [**2109-11-25**] 08:28PM TYPE-ART PO2-335* PCO2-42 PH-7.24* TOTAL CO2-19* BASE XS--8 INTUBATED-INTUBATED [**2109-11-25**] 08:28PM TYPE-ART PO2-335* PCO2-42 PH-7.24* TOTAL CO2-19* BASE XS--8 INTUBATED-INTUBATED [**2109-11-25**] 08:28PM TYPE-ART PO2-335* PCO2-42 PH-7.24* TOTAL CO2-19* BASE XS--8 INTUBATED-INTUBATED [**2109-11-25**] 08:28PM TYPE-ART PO2-335* PCO2-42 PH-7.24* TOTAL CO2-19* BASE XS--8 INTUBATED-INTUBATED CXR: 1.9 IMPRESSION: Appropriate placement of endotracheal tube and nasogastric tube. Prominence of the pulmonary vasculature likely relates to patient position. CXR:[**11-27**] FINDINGS: The patient has been extubated. There is a left-sided subclavian central venous catheter with the tip in the upper to mid SVC. Cardiac and mediastinal silhouettes appear within normal limits. No focal pulmonary opacities, pleural effusions, or evidence of pneumothorax. Osseous structures appear unremarkable. CT HEAD: [**11-26**] FINDINGS: There is no sign for the presence of an intracranial hemorrhage, mass effect, or shift of normally midline structures. There is no evidence for minor or major vascular territory infarction. The density values of the brain parenchyma are normal. There is no overt extracranial pathology seen other than mild bilateral ethmoid sinus mucosal thickening. MR HEAD [**11-27**] FINDINGS: The right vertebral artery distal to the origin of the right posterior inferior cerebellar artery is extremely hypoplastic. Additionally, there are bilateral fetal-type posterior cerebral arteries, the latter finding presumably correlating with the rather diminutive basilar artery. Within the limitations of MR angiography, there is no definite sign for the presence of an aneurysm, although conventional angiography remains the standard study necessary to more unequivocal exclusion of this pathological process. There are no areas of hemodynamically significant stenosis identified. Within the limitations of coverage of this study, there is no overt sign for the presence of a vascular malformation. CTA HEAD: [**11-29**] IMPRESSION: No evidence of aneurysm. A preliminary report of no subarachnoid hemorrhages seen, no aneurysm detected on axial images was provided by Dr. [**Last Name (STitle) 41684**] and confirmed by Dr. [**Last Name (STitle) **]. Echo: [**12-3**] Conclusions: The left atrium is normal in size. Left ventricular wall thickness, cavity size, and systolic function are normal (LVEF>55%). Regional left ventricular wall motion is normal. Tissue velocity imaging demonstrates an E/e' <8 suggesting a normal left ventricular filling pressure. Right ventricular chamber size and free wall motion are normal. The aortic valve leaflets (3) appear structurally normal with good leaflet excursion and no aortic regurgitation. The mitral valve appears structurally normal with trivial mitral regurgitation. There is no mitral valve prolapse. The pulmonary artery systolic pressure could not be quantified. There is no pericardial effusion. Compared with the report of the prior study (tape unavailable for review) of [**2108-6-7**], the findings are similar. Based on [**2100**] AHA endocarditis prophylaxis recommendations, the echo findings indicate a low risk (prophylaxis not recommended). Clinical decisions regarding the need for prophylaxis should be based on clinical and echocardiographic data. MRCSpine [**12-4**] CONCLUSION: No radiological explanation for the clinical and laboratory abnormalities noted in your history. ADDENDUM: There is a mild Chiari I malformation of the cerebellar tonsils, with the tonsillar tips approximately 5 mm below the plane of the foramen magnum. Additionally, there are type 2 degenerative endplate changes involving the C5-6 and C6-7 interspaces. Finally, there is a mild degree of congenital narrowing of the AP diameter of the cervical spinal canal from the C3 through C6-7 levels. MR [**Last Name (Titles) 48643**] [**12-4**] CONCLUSION: No radiological explanation for the clinical and laboratory abnormalities noted in your history. ADDENDUM: There is a mild Chiari I malformation of the cerebellar tonsils, with the tonsillar tips approximately 5 mm below the plane of the foramen magnum. Additionally, there are type 2 degenerative endplate changes involving the C5-6 and C6-7 interspaces. Finally, there is a mild degree of congenital narrowing of the AP diameter of the cervical spinal canal from the C3 through C6-7 levels. MR [**Last Name (Titles) **] 1//18 FINDINGS: There is mild facet joint degenerative change bilaterally at the L5-S1 interspace, with a 2 mm subchondral cyst involving the left S1 superior articular facet. There is no other overt lumbar spinal pathology seen. The rootlets of the cauda equina do appear apposed at the L4-5 interspace level. Most probably, this finding relates to the relatively diminished size of the thecal sac secondary to the presence of abundant epidural fat at this locale. CONCLUSION:No definite signs for the presence of spinal pathology accounting for the clinical and laboratory findings noted in your history. However, meningitis can be easily overlooked by even contrast enhanced MRI. Brief Hospital Course: 43 yo male with multiple h/o of SI, CAD s/p PCI, p/w apnea/bradycardia/hypotension in setting of OD. Per HCP, only Seroquel was unaccounted for at home (2300mg...is usually on 150gm/day). Further inquiry revealed a HA preceding the pt's unresponsiveness. The patient's running problems were MS changes, Infection, hypotension, Acidosis, respiratory failure, CAD, ARF, nausea and vertigo. . MS changes: Initially thought to be due to seroquel OD, but history did not ultimately support this initial diagnosis. Ddx includes CNS infection (likely viral given non-toxic appearance and prodrome 1 week prior), SAH (supported by xanthochromia on LP x 2), trauma (no outward evidence of this), HIV sequela. Intubated [**12-19**] airway protection and self extubated. MS cleared. However, story remains unclear. Psych consultant believed that he was not actively SI and felt that suicide attempt with OD was unlikely the cause of episode. U Tox, S Tox were negative. (though were + for TCA at OSH). Pt was stabalized in the ICU and eventually transferred on HD 3 to the floor. His MS [**First Name (Titles) **] [**Last Name (Titles) 48644**]y improved in this process without a clear diagnosis. Pt had fever on [**11-27**] and so was covered with levo/flagyl and was cultured. Culture data as follows: [**11-26**]: BCx with MSSA (1/4 bottles), GNR (1/4 bottles) [**11-26**]: Sputum with staph aureus [**Last Name (un) 36**] pending [**11-27**]: Sputum with staph aureus [**11-28**]: Sputum with staph aureus Treated with Clinda rather than levo/flagyl since [**11-28**] (emperic to cover poss comm acquired MRSA). CXR does not indicate a PNA from aspiration (though there did seem to be an aspiration while pt was intubated). It was later decided that levo/vanc was a preferable treatment while pt was in house. Suspician for a true infection was low per clinical picture, and it was rather suspected that the growth may have been an unusual contaminant, however, antiobiotics were administered in case culture was true. Pt was discharged to finish 14 day course of levo. . The CSF revealed persistant blood and xanthocromia and high protein on two occasions. Pt was covered with empiric acyclovir until CSF PCR demonstrated no HSV. On workup, pt had MRI suggesting chiari malformation hypoplastic r vert, small posterior art, no aneurysm seen, no acute stroke. CTA was also negative for aneurism or bleed. Defect of the spinal cord such as AVM or aneurism was suspected due to hyperasthesia in chest but MR showed no abnormality. The last possibility that had to be ruled out was a sentinal bleed from a small cranial aneurism that was being missed by MR/CTA, so a angiogram was performed which did not demonstrate any major abnormalities on discussion with the radiologist, however a formal read is pending as of discharge date. . Hypotension: Pt presented with hypotension, considered a seroquel vs neurovasc event. Resolved on [**11-27**]. Pt [**Name (NI) **] by enzymes. . Acidosis: PT was in primary metabolic on arrival. Which resolved after stabilization and intubation. . Resp Failure: Pt presented with respiratory failure and was intubated on [**11-26**]. Self extubated [**11-27**] and doing well. . CAD: ASA, Plavix (allergies noted; only makes him bleed), held BB/CCB due to low blood pressure. . ARF: Cr 2.2 on presentation: (baseline 0.7): Kept MAP >65mm. FENA was elevated. ATN is likely given hypotension and high FeNa. Slowly resolved over course of stay to a Cr=1.3. UA appears infected, but UCx showed no growth. Pt was stabalized, feeling well in good mood with no headache, pain, vertigo, nausea, or any other major complaints and discharged on [**2109-12-7**] Medications on Admission: Atorvastatin Calcium 40 mg Tablet PO QD Amlodipine Besylate 5 mg PO QAM Clopidogrel Bisulfate 75 mg qAM Metoprolol Tartrate 75 mg PO BID Aspirin 325 mg qd Quetiapine Fumarate 25mg qAM, 50mg noon, 75mg qHS Gemfibrizole 600mg po bid Topomax 75mg po qd Neurontin 800mg po qHS Cymbalta 60mg po qd Discharge Medications: 1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 2. Clopidogrel 75 mg Tablet Sig: One (1) Tablet PO DAILY (Daily). 3. Albuterol 90 mcg/Actuation Aerosol Sig: 1-2 Puffs Inhalation Q6H (every 6 hours) as needed. 4. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q4-6H (every 4 to 6 hours) as needed. 5. Quetiapine 25 mg Tablet Sig: Five (5) Tablet PO HS (at bedtime). 6. Levofloxacin 500 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours) for 5 days. Disp:*4 Tablet(s)* Refills:*0* 7. Duloxetine 30 mg Capsule, Delayed Release(E.C.) Sig: One (1) Capsule, Delayed Release(E.C.) PO BID (2 times a day): speak with your doctor about returning to your normal dose. 8. Quetiapine 25 mg Tablet Sig: One (1) Tablet PO Q24H (every 24 hours). 9. Quetiapine 25 mg Tablet Sig: Two (2) Tablet PO BID (2 times a day) as needed. 10. Gabapentin 400 mg Capsule Sig: Two (2) Capsule PO DAILY (Daily). 11. Gemfibrozil 600 mg Tablet Sig: One (1) Tablet PO BID (2 times a day). 12. Meclizine 12.5 mg Tablet Sig: Two (2) Tablet PO TID (3 times a day) for 7 days. Disp:*42 Tablet(s)* Refills:*0* 13. Toprol XL 25 mg Tablet Sustained Release 24HR Sig: One (1) Tablet Sustained Release 24HR PO once a day. Disp:*30 Tablet Sustained Release 24HR(s)* Refills:*2* 14. Lisinopril 5 mg Tablet Sig: One (1) Tablet PO once a day. Disp:*30 Tablet(s)* Refills:*2* 15. Atorvastatin 40 mg Tablet Sig: One (1) Tablet PO once a day. 16. Outpatient Lab Work please ask your doctor's office to check your chem 7 and draw a blood culture in 1 week. The results must be called to Dr. [**Name (NI) 42449**] office. Discharge Disposition: Home Discharge Diagnosis: altered mental status depression bacteremia h.flu pneumonia hematochezia CAD sp stents Discharge Condition: good Discharge Instructions: Please continue your home medications, as administered by your partner. [**Name (NI) **] were found to have blood in your stool, so you need to have this followed up. Please ask your doctor [**First Name (Titles) **] [**Last Name (Titles) **] you for a colonoscopy. Please call your doctor if you have further confusion, fevers, headaches, or notice blood in your stool. Please discuss further adjustment of your psych medications with your outpatient psychiatrist. We've stopped your amlodipine. Instead you will be on toprol and lisinopril. Please have your doctor's office check your blood pressure and your lab work. Please finish a course of levaquin. Followup Instructions: Please [**Last Name (Titles) **] an appointment to see your PCP: [**Name10 (NameIs) **],[**Name11 (NameIs) **] [**Telephone/Fax (1) 17753**] in the next 2 weeks. Please request a repeat guiac as you were positive during your stay and may require a screening colonoscopy. You should also see your psychiatrist in the next 2 weeks. Please [**Telephone/Fax (1) **] an appointment to see Dr. [**First Name (STitle) 9046**] [**Name (STitle) 7994**] in neurology Phone: [**Telephone/Fax (1) 541**] in the next [**12-20**] weeks. Completed by:[**2109-12-9**] ICD9 Codes: 5845, 7907, 2762, 5990, 2724, 4019
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Medical Text: Admission Date: [**2169-1-9**] Discharge Date: [**2169-1-31**] Date of Birth: [**2095-1-26**] Sex: F Service: CSU HISTORY OF PRESENT ILLNESS: The patient is a 73 year old woman, status post a motor vehicle accident in [**2168-1-10**], during which she was not injured, but she went to the local Emergency Room. A chest x-ray done at that time looked suspicious and a follow up CAT scan was obtained which showed a thoraco-abdominal aneurysm. She was advised to see a cardiothoracic surgeon, which she did, following which she was scheduled for a thoraco-abdominal aneurysm repair. PAST MEDICAL HISTORY: The patient's past medical history is significant for hypertension, hypercholesterolemia, osteoarthritis, non-insulin dependent diabetes mellitus and low back pain. PAST SURGICAL HISTORY: Past surgical history is significant for a left breast lumpectomy, a cholecystectomy, right hand ganglion resection and a T and A. MEDICATIONS: Meds at home include Avandia, 4 mg q a.m.; aspirin, 81 mg daily; Toprol, 10 mg daily; Lipitor, 10 mg daily; Hydrochlorothiazide, 12.5 mg daily; and Celebrex, which the patient stopped prior to admission. SOCIAL HISTORY: Smokes one half to one pack of cigarettes per day times 33 years. Occasional ETOH use. Denies any other recreational drug use. She has three children and lives with her husband. FAMILY HISTORY: Father died of an MI. Mother died of old age. PHYSICAL EXAMINATION: Weight 214 pounds, height 5 feet 4 inches. Vital signs: Temperature 98.9. Heart rate 81. Blood pressure 137/58. Respiratory rate 18. O2 sat 97 percent on room air. General: No acute distress. Neurologic: Alert and oriented times four. No focal deficits. Respiratory: Respiratory clear to auscultation bilaterally. Cardiovascular: Regular rate and rhythm. S1 and S2. Abdomen: Soft and nontender, non-distended with normoactive bowel sounds and a well healed cholecystectomy scar. No bruits appreciated. Extremities: Warm and well perfused with no ulcers and bilateral lower extremity edema. LABORATORY DATA: White count 10.6, hematocrit 41, platelets 215. Sodium 145, potassium 4.2, chloride 107, CO2 31, BUN 18, creatinine 0.8, glucose 110. LFT's within normal limits. Albumin 4.6. UA was negative. Chest x-ray showed no cardiopulmonary processes and the patient was consented for a thoracoabdominal aneurysm repair. HOSPITAL COURSE: On the first of [**Month (only) 956**] the past was brought to the operating room. Please see the OR report for full details. In summary, the patient had a thoracoabdominal aneurysm resection and replacement of the descending aorta with a number 28 Hemashield graft from the distal left subclavian to the suprailiac. She tolerated the operation and was transferred from the operating room to the Cardiothoracic Intensive Care Unit. At the time of transfer the patient was in sinus rhythm at 70 beats per minute with a mean arterial pressure of 71 and a CVT of 15. The patient did well in the immediate postoperative period. Her anesthesia was reversed. The sedation was weaned to the point where the patient was following commands and moving all four extremities, and then her sedation was reinstated. She remained ventilated throughout the course of the operative day, requiring nitroglycerin and Propofol to maintain an adequate blood pressure. On postoperative day the patient continued to do well. By chest x-ray it appeared that the patient had a left-sided infiltrate and a bronchoscopy was done at that time which showed both left upper and left lower lobe mucous plugging, following which the patient's oxygenation remained a problem, and therefore she was a slow wean from the ventilator. On postoperative day two the patient remained hemodynamically stable. She continued to slowly wean from the ventilator. However, she did have periods of atrial fibrillation for which she was begun on beta blockade, as well as Amiodarone. Additionally the patient underwent a second bronchoscopy, which showed tenacious secretions in both left upper and lower airways. Finally the patient was cardioverted from atrial fibrillation into sinus rhythm. On postoperative day three the patient continued to do well. She unfortunately went back into atrial fibrillation following a short run of sinus rhythm after cardioversion. She continued to slowly wean from her vaso-active medications. We were unable to make any progress in her ventilatory status, and neurologically the patient's sedation was held to the point where she would follow commands and move all extremities. However, she became increasingly agitated and required re-sedation. Over the next several days, the patient remained hemodynamically stable. Several attempts were made to wean the patient from the ventilator, however they were all unsuccessful. On postoperative day six the patient again underwent a bronchoscopy, during which cultures were obtained and sent to the laboratory. The bronchoscopy again showed left upper lobe secretions that were tenacious and a clear right airway. Over the next several days the patient remained hemodynamically stable. The decision was made to bronch the patient on a daily basis, following which several attempts were again made to wean the patient from the ventilator. Each attempt was unsuccessful. By postoperative day 13 the patient was able to be weaned to pressure support ventilation with 5 of pressure support and 5 of PEEP support. The patient tolerated this well. Throughout the day she was rested on increased pressure support overnight and the following morning returned to [**4-13**] and extubated. The patient failed extubation after several hours, was reintubated. Bronchoscopy was done at that time that showed patent right upper and lower lobes, and completely obstructed left lower lobe with mucous plugs in the left upper lobe as well. At that time the patient additionally required PEEP 12 in order to oxygenate adequately and a plan was made for the patient to undergo a tracheostomy on the following day. On [**2169-1-26**] the patient underwent tracheostomy with a number 8 Pore-Tex. The procedure was tolerated well and there were no complications. Following tracheostomy the patient was able to be placed back on pressure support ventilation, and within several days was successfully weaned to trach collar vent, tolerating placement of the tracheostomy. The patient was seen by the speech and swallow service. On the [**1-30**] she underwent a bedside swallow evaluation, as well as a video assisted swallow evaluation, which she passed without restriction. Her diet was advanced at that time. At that time the decision was made that the patient was stable and ready to be transferred to rehabilitation. Rehabilitation screening process was done. At the time of this dictation, which is the [**1-31**], the patient's physical exam is as follows: General: No acute distress. Neurological: Alert and oriented and moves all extremities. Follows commands. Respiratory: The patient with a number 8 Pore-Tex trach ventilating with a 40 percent trach mask, coarse breath sounds throughout, somewhat diminished in the left lower lobe. Cardiovascular: Regular rate and rhythm. S1 and S2 with no murmurs. Left thoracoabdominal incision with staples. Small areas of erythema but no drainage. Abdomen: Soft and nontender and non-distended with normoactive bowel sounds. Extremities: Warm and well perfused with 1 plus bilateral edema. The skin additionally a red, yeasty-looking rash in the groin and the buttocks, currently being treated with Miconazole powder. LABORATORY DATA: White count 12.5, hematocrit 32, platelets 325, PT 14, PTT 25, INR 1.3. Sodium 134, potassium 4.6, chloride 96, CO2 30, BUN 41, creatinine 0.8, glucose 127. CONDITION ON DISCHARGE: The patient's condition at the time of discharge is good. DISCHARGE DIAGNOSES: 1. Status post thoracoabdominal aneurysm repair with a number 28 Hemashield graft from the distal left subclavian to the suprailiac done on [**1-10**]. 2. Status post tracheostomy with a number 8 Pore-Tex done on [**1-26**]. 3. Hypertension. 4. Hypercholesterolemia. 5. Osteoarthritis. 6. Diabetes mellitus type 2. 7. Low back pain. 8. Cholecystectomy. 9. Breast CA, status post lumpectomy. DISCHARGE MEDICATIONS: The patient's discharge medications include: 1. Aspirin, 81 mg daily. 2. Colace, 100 mg [**Hospital1 **]. 3. Atrovent inhaler, [**Hospital1 **]. 4. Lansoprazole, 30 mg daily. 5. Albuterol inhaler, 4 puffs q4h. 6. Metoprolol, 50 mg tid. 7. Avandia, 4 mg daily. 8. Amiodarone, 400 mg [**Hospital1 **] times 7 days, then 400 mg daily times 7 days, then 200 mg daily. 9. Miconazole Powder, [**Hospital1 **] prn. 10. Vancomycin, 1 gram q12h times 3 days, the last dose being on [**2169-2-3**]. DI[**Last Name (STitle) **]ION: The patient is to follow up with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **] two to three weeks after discharge from rehabilitation, and follow up with Dr. [**Last Name (Prefixes) **] four weeks following discharge from [**Hospital **] [**Hospital **] [**First Name (Titles) **] [**Last Name (Titles) **]. ADDENDUM: The patient tube feed regime is intact with fiber via Dobbhoff tube at 65 cc per hour until the patient is taking adequate oral nutrition, at which time tube feeds and Dobbhoff can be discontinued. [**Doctor Last Name **] [**Last Name (Prefixes) **], M.D. [**MD Number(1) 1288**] Dictated By:[**Last Name (NamePattern4) 1718**] MEDQUIST36 D: [**2169-1-31**] 11:41:59 T: [**2169-1-31**] 12:23:31 Job#: [**Job Number 46105**] ICD9 Codes: 5185, 5180, 486, 9971, 496, 4019, 2720, 3051
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Medical Text: Admission Date: [**2131-4-25**] Discharge Date: [**2131-4-27**] Date of Birth: [**2131-4-25**] Sex: M Service: NB HISTORY OF PRESENT ILLNESS: The patient is a 2850 gram, 41 week gestation male infant pregnancy. Mother is a 29 year- old, Gravida I, Para 0 to I mother. [**Name (NI) **] prenatal screens were unremarkable with blood type 0 positive, antibody screen negative, RPR nonreactive, Rubella immune. Hepatitis B surface antigen negative and group B strep negative. The pregnancy was uncomplicated. Her labor was complicated by maternal fever to 102.9 and fetal tachycardia and rupture of membranes for 15 hours prior to delivery. She was treated with antibiotics 2 hours prior to delivery and delivery was by vaginal route with Apgars of 8 and 9. The baby was admitted to the newborn intensive care unit for assessment. At birth was noted a large port-wine stain on the left side of the face. PHYSICAL EXAMINATION: Vital signs: Temperature on admission was 100.3; heart rate 162; respiratory rate of 46; blood pressure 64/33 with a mean of 44 and oxygen saturation of 96% in room air. Weight was 2850 grams. Length was 19 inches or 48.2 cm and head circumference was 33.5 cm. Baby appeared well with weight appropriate for gestational age. Exam of the head revealed a soft, anterior fontanel that was flat with mobile sutures. A port wine stain was present on the left side of the face in the trigeminal region. It was approximately 6 x 4 cm. There was a branching macule extending primarily from the lower lid to the cheek at the level of the angle of the mouth. This is in a V-2 or [**4-24**] distribution. The rest of the physical examination revealed palate intact. Respiratory: Breath sounds clear. Cardiac exam was unremarkable with no murmur. Abdominal exam was unremarkable. Three vessel cord was noted to be present. External genitalia were normal with testes descended bilaterally. Hip exam normal. Neurologic exam normal. REVIEW OF SYSTEMS: Infectious disease: The patient had a sepsis evaluation including a CBC and blood culture. Blood culture has shown no growth. The CBC revealed a white count of 17,800 with 70% polys and 1% bands. 48 hour blood cultures were negative and antibiotics were discontinued. The baby has had a stable temperature and no other clinical signs of sepsis. The baby is taking [**Name (NI) 37112**] formula and is tolerating feedings well. Discharge weight: 2880 grams. Baby had consultation with dermatology. He was seen by Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) 38485**] who felt that the lesion on his face was consistent with a port wine stain and felt that he was a good candidate for laser therapy. Sturge-[**Doctor Last Name 11586**] syndrome was felt to be unlikely because of the V-2 distribution. Referral to Dr. [**First Name8 (NamePattern2) 4134**] [**Last Name (NamePattern1) 24529**] of dermatology is planned and an appointment should be scheduled with Dr. [**First Name (STitle) 24529**]. The phone number is [**Telephone/Fax (1) 53430**]. Patient was also seen by ophthalmology consultant, Dr. [**Last Name (STitle) **] from [**Hospital3 1810**] and assessment was unremarkable. The ophthalmologic evaluation was within normal limits. There was very mild hemorrhages noted in the right eye. These were felt to be related to birth and no follow-up or intervention was felt to be needed. Follow-up with ophthalmology has been scheduled. The date of the follow-up is [**6-27**] at 2:30 p.m. at [**Last Name (un) 58397**] IV [**Hospital3 **] with Dr. [**Last Name (STitle) 5444**]. The patient was also evaluated by neurology, Dr. [**First Name (STitle) **] [**Name (STitle) **]. They felt that the baby's neurologic exam was unremarkable but they did recommend assessment with a MRI and this will be scheduled in the near future with follow-up to be arranged with neonatal neurology clinic in 4 to 6 weeks after the MRI has been performed. Baby had a bilirubin checked and it was 8.2 at 38 hours of life. Neurosensory screen: The baby had a hearing screen performed and passed in both ears. The baby received vitamin K routine newborn dose and erythromycin and hepatitis B vaccine. CONDITION ON DISCHARGE: Good. DISCHARGE DISPOSITION: The baby will be discharged to home in the care of his parents. FOLLOW UP: (1) Dr. [**Last Name (STitle) 1256**] of [**Hospital3 **] Health Center. Fax #[**Telephone/Fax (1) 40665**]. [**Hospital3 29903**]: [**Telephone/Fax (1) 40664**]. Appointment will be scheduled with Dr. [**Last Name (STitle) 1256**] for Monday morning, [**4-30**]. (2) Dr. [**Last Name (STitle) 5444**], Ophthalmology [**2131-6-27**], 2:30 pm. (3) Dr. [**Last Name (STitle) 36469**] or [**Doctor Last Name **], Neonatal Neurology Program in [**3-29**] weeks, Phone [**Telephone/Fax (1) 38046**]. (4) Dr. [**First Name (STitle) 24529**], Dermatology, [**Telephone/Fax (1) 53430**]. (5) MRI, requst has been sent to CH radiology, they are to contact family with appointment date and time. Phone: [**Telephone/Fax (1) 66648**]. CARE RECOMMENDATIONS: 1. Feedings at discharge: [**Telephone/Fax (1) 37112**] 20 calories per ounce p.o. ad lib. 2. State newborn screen has been sent. Results are pending. DISCHARGE DIAGNOSES: 1. Term infant. 2. Rule out sepsis. 3. Port wine stain, rule out Sturge-[**Doctor Last Name 11586**]. [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) **], [**MD Number(1) 55750**] Dictated By:[**Last Name (NamePattern4) 55751**] MEDQUIST36 D: [**2131-4-26**] 16:30:43 T: [**2131-4-26**] 17:43:07 Job#: [**Job Number 66649**] ICD9 Codes: V290, V053