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Aug 29 17:20
• Does this sentence make sense??? thanks for reading. + jk
Sun Sep 7 17:26:34 2008 jk
Today she describes point tenderness in the anterolateral aspect of her ankle as long as her s/l pain coursing posterior to the medial malleolus.
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Sun Sep 7 17:32:11 2008 mmx
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Sun Sep 7 17:31:25 2008 more sense?
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• On examination... no palpable s/l spleg-an-opathy or thyromegaly. + j d m m a k
Sun Sep 7 16:46:35 2008 j d m m a k
On examination today she was well nourished and in no acute distress. There is no jaundice or scleral icterus and no palpable s/l spleganopathy or thyromegaly. The chest was clear, heart sounds were normal. The abdomen was soft with a tender fullness in the right upper quadrant which may represent a distended gallbladder. An ultrasound carried out a couple years ago has demonstrated a large single stone within the gallbladder.
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Sun Sep 7 17:06:34 2008 .
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Sun Sep 7 17:07:23 2008 seriously?
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Sun Sep 7 17:11:08 2008 .
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Sun Sep 7 17:12:01 2008 -
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Sun Sep 7 16:48:43 2008 ygl
might be starting to say splenomegaly and realized he was in the wrong place for that)?
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Sun Sep 7 16:50:01 2008 j d m m a k
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Sun Sep 7 17:08:25 2008 mho
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Sun Sep 7 16:48:34 2008 j d m m a k
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• posted wav file - lil
Sun Sep 7 16:11:50 2008 lil
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Sun Sep 7 17:31:50 2008 a c d a c a
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Sun Sep 7 16:16:51 2008 m e o b g k
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Sun Sep 7 16:16:25 2008 Smiley
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Sun Sep 7 16:12:11 2008 m e o b g k
gentleman with a history of eye problem. He is scheduled to have an eye surgery. He reportedly had a __________ help with the surgery.
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• s/l *devant ovulation* any guesses? thanks + b e f n p d
Sun Sep 7 16:09:43 2008 b e f n p d
The patient is 28 years of age, gravida 0, longstanding history of ovarian cysts and problems *devant* ovulation. Ultrasound basically negative.
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• please sm + amanda
Sun Sep 7 16:09:16 2008 amanda
The lesion did appear to be delivered with its capsule from its origin on the region of the bone.
Does this make sense? My doc loves to mumble.
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Sun Sep 7 16:39:52 2008 nm
removed it with its capsule from there.
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• ...post "seefev" rhabdomyolysis...renal consultation...esl + hootie
Sun Sep 7 16:00:25 2008 hootie
She was recently admitted to the hospital from August 14 to August 21 with an episode of severe hyponatremia and hyponatremic encephalopathy. The patient was aggressively treated with a combination of hypertonic saline and intravenous conivaptan. The patient had extensive evaluation, and workup was consistent with polydipsia manifested by markedly low urinary osmolality as low as 70. Her urine sodium was 14. Serum osmolality was appropriately low. TSH and cortisol levels were normal. The patient's hyponatremia improved with free water restriction, and she was discharged home with a serum sodium around 132, with an instruction to limit her oral fluids to about a quart a day and to avoid hydrochlorothiazide. During her last hospitalization, the patient also developed severe rhabdomyolysis with a CPK as high as the 50,000 range, presumably secondary to post ______**seefev* rhabdomyolysis and hypokalemia and hypophosphatemia.
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Sun Sep 7 16:30:05 2008 hootie
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• Topical cream that sounds like acutacornizol cream? + a c d a c a
Sun Sep 7 15:47:31 2008 a c d a c a
History of large B-cell lymphoma and coronary artery bypass grafting. I think the cream is for skin site but there is nothing that says one way or the other.
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Sun Sep 7 15:55:57 2008 a c d a c a
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• Is there a drug as valsar? ... + Moustafa
Sun Sep 7 15:45:04 2008 Moustafa
Is there a drug as valsar?
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Sun Sep 7 15:58:16 2008 a n n l b a
receptor antagonist; treatment for heart failure
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• anyone heard of Darvostatin eye drops? - nm
Sun Sep 7 15:20:56 2008 nm
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Sun Sep 7 15:34:37 2008 whowhatwhenwhy
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Sun Sep 7 15:27:13 2008 Smiley
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• Use of s/l "restorator" on lower limbs, in a restorative program. + e j f n o f
Sun Sep 7 14:53:01 2008 e j f n o f
(Nursing home patient)
Patient has been started on the restorative program regularly, ambulating with a rolling walker up to 300 feet with 1 assist. Also use of the s/l "restorator" bilateral lower limbs.
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Sun Sep 7 15:22:47 2008 g f g e d c
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Sun Sep 7 16:46:48 2008 e j f n o f
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• is there anything called patellofemoral "Budges" brace?, sm + Jimmy
Sun Sep 7 14:43:52 2008 Jimmy
PLAN: At this point, I think the most appropriate next step is to continue physical therapy. I am going to give him patellofemoral ___ (1:10) brace to help with lateral patellar alignment, and I will plan on seeing him back if his pain or problem persists. We talked about the importance of continuing strengthening of his quad in the interim.
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Sun Sep 7 15:07:33 2008 Txczech
Patellofemoral - BREG
BREG’s PTO is the leading patellofemoral brace on the market. The PTO is a unique design that is proven to normalize patellar tracking through its patented ...
www.breg.com/products/bracing/soft_bracing/lower
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• Related to back pain + Mostafa
Sun Sep 7 14:34:09 2008 Mostafa
We will need to enroll him in the Baylos trial, is there something called Baylos trial or something close to it.
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Sun Sep 7 14:40:56 2008 Txczech
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Sun Sep 7 14:59:42 2008 nmt
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Sun Sep 7 15:04:25 2008 perplexed
something, now they appear to be asking the same ?
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• coronary angioplasty with a drug-eluting S/L everlomatous? stent to the mid RCA - nm
Sun Sep 7 14:03:35 2008 nm
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Sun Sep 7 14:07:54 2008 a c d a c a
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• procedures: S/L peripheral vascular dx studied? bilat enal artery showed 80% stenosi - nm
Sun Sep 7 14:02:07 2008 nm
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Sun Sep 7 14:15:34 2008 nm
under procedures she dictates:
S/L Peripheral vascular disease studied? bilateral renal artery showed 80% stenosis.
(this is for a heart discharge summary and the PVD being listed as a procedure does not seem right to me, I was just wondering if anyone had heard of something like that)
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Sun Sep 7 14:29:20 2008 LiliK
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Sun Sep 7 14:09:44 2008 a c d a c a
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Sun Sep 7 14:10:09 2008 a c d a c a
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Sun Sep 7 14:09:25 2008 LiliK
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• Math help please! sm + g k d j e e
Sun Sep 7 13:43:43 2008 g k d j e e
Prematurity of 24 weeks of gestational age
ESL doc is stating: The patient is currently 46 days old with postconceptional age of 34 7th weeks. Exactly stated. UGH!
What is it? Thanks so much!
I just don't hear 30-4/7th weeks
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Sun Sep 7 13:46:05 2008 Questyr
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Sun Sep 7 13:47:23 2008 g k d j e e
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• Can't hear a word re: conjunctivitis + sm
Sun Sep 7 13:38:13 2008 sm
PERRLA, EOMI. Conjunctivae show some mild injection. There is some s/l "colla redding" around the eyelashes, mostly on the right. The throat appears normal.
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Sun Sep 7 13:41:16 2008 Txczech
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Sun Sep 7 13:43:55 2008 nm
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• he patient was placed on *promatine* or *bromatine* for low BP? nm - ESL nm
Sun Sep 7 13:05:51 2008 ESL nm
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Sun Sep 7 13:08:25 2008 Txczech
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Sun Sep 7 13:10:17 2008 g k d j e e
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Sun Sep 7 13:15:02 2008 Txczech
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• is there anything called "Bailla" study? SM + Jimmy
Sun Sep 7 12:50:15 2008 Jimmy
I explained to the patient in full detail on anatomic models the approach for the lateral branch blocks and the s/l "Baillah" study
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Sun Sep 7 13:06:18 2008 Mostafa
Try to think of it as an acronym, maybe that is so. Good luck
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Sun Sep 7 13:09:03 2008 nm
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Sun Sep 7 13:01:10 2008 Margaret
especially if this doc has a Southeastern US accent.
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Sun Sep 7 12:55:24 2008 more context.
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Sun Sep 7 12:59:39 2008 Jimmy
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Sun Sep 7 13:03:53 2008 nm
helps if we have the exact sentences to try to follow the doctor's train of thought.
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Sun Sep 7 13:15:55 2008 h e j g a l
I explained to the patient in full detail on anatomic models the approach for the lateral branch blocks and the s/l "bailah" study. She is eager to proceed with this study. She is also eager to start therapy after some pain relief to increase her exercise stamina as well as her tolerance for physical activity. I also recommended Skelaxin today as a daytime medication to supplement her Klonopin and Lortab. Her medication currently consists of Sular 10 mg, Diovan, Glucophage twice a day, Lortab one in the morning and one at night and Clonazepam 0.5 at bedtime. She denies any new allergies to medication.
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• is there anything called "Bailla" study? SM + Jimmy
Sun Sep 7 12:46:35 2008 Jimmy
I explained to the patient in full detail on anatomic models the approach for the lateral branch blocks and the s/l "Bailah" study
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• activities such as s/l "hobees" and playing with her grandchildren - h e j g a l
Sun Sep 7 12:42:56 2008 h e j g a l
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Sun Sep 7 13:09:48 2008 guessing
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Sun Sep 7 13:03:27 2008 LiliK
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Sun Sep 7 12:55:38 2008 Txczech
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Sun Sep 7 12:54:38 2008 g f g e d c
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Sun Sep 7 12:49:56 2008 a c d a c a
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Sun Sep 7 12:50:32 2008 h e j g a l
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Sun Sep 7 12:56:25 2008 nj
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• Pap smear and breast exam done "in tot" + m e d e c n
Sun Sep 7 12:30:42 2008 m e d e c n
This is part of his plan.
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Sun Sep 7 12:35:10 2008 nm
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Sun Sep 7 12:45:47 2008 a c d a c a
morning.
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Sun Sep 7 12:34:55 2008 a c d a c a
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Sun Sep 7 12:32:31 2008 nmt
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• WAV file, thanks, laminotomy. + a c d a c a
Sun Sep 7 12:26:48 2008 a c d a c a
he was turned prone on the Enders frame. ___Needle ______ incision was made with the use of the x-ray and a 1-inch linear skin incision was made to the left of midline.
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Sun Sep 7 12:29:03 2008 me
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Sun Sep 7 12:46:28 2008 a c d a c a
straight from one of their samples!
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Sun Sep 7 12:33:54 2008 a c d a c a
used it without question ever since!
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Sun Sep 7 12:46:16 2008 nm
ng the original mistake. :D
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Sun Sep 7 12:39:31 2008 just me
sent by my supervisors and QA supervisors. I have found gross errors in every one they have ever sent, no matter where I have worked. You'd think someone trying to "help" would verify the quality of the work they are recommending, ya know? But apparently it doesn't work that way, lol.
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Sun Sep 7 12:44:31 2008 hootie
...because they usually originate with the physician, but I still change anything incorrect I see.
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• Regarding beta-blocker - what word would you use here? + nm
Sun Sep 7 12:24:52 2008 nm
The patient was "over blockated" in the past with her beta-blocker.
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Sun Sep 7 15:07:25 2008 g e f e i m
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Sun Sep 7 12:34:31 2008 nm
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Sun Sep 7 12:25:59 2008 a c d a c a
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Sun Sep 7 12:57:27 2008 m2
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Sun Sep 7 12:28:27 2008 nm
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• I agree with Dr. Chin that violaceous growth on the base of the tongue is likely beni - violaceous???nm
Sun Sep 7 12:22:49 2008 violaceous???nm
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Sun Sep 7 12:25:51 2008 g f g e d c
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Sun Sep 7 12:30:51 2008 g k d j e e
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Sun Sep 7 12:23:38 2008 g k d j e e
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• WAV file sent for below sound alike of siculation, fasciculation? - a c d a c a
Sun Sep 7 12:03:40 2008 a c d a c a
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Sun Sep 7 12:05:17 2008 a c d a c a
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Sun Sep 7 12:11:09 2008 a c d a c a
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• ESL. Pt w/brain CA. MRI showed mass effect on the optic nerve and optic s/l tracks. - nmt
Sun Sep 7 12:02:00 2008 nmt
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Sun Sep 7 12:09:40 2008 nm
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Sun Sep 7 12:09:06 2008 Smiley
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Sun Sep 7 12:10:38 2008 nmt
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• amylase and ? + i c k i l l
Sun Sep 7 12:00:25 2008 i c k i l l
because of a family history of pancreatic cancer, we will also obtain an amylase and in the office on Monday and proceed to CT scan, ultrasound, or magnetic resonance angiography pending the lab results.
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Sun Sep 7 12:10:11 2008 g f g e d c
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Sun Sep 7 12:02:21 2008 nm
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Sun Sep 7 12:03:19 2008 i c k i l l
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• Distraction of the fracture fragments was performed to correct the s/l willa slope. + Help please.
Sun Sep 7 11:57:27 2008 Help please.
1. Open reduction and internal fixation of the fracture of the left distal radius with bone allograft.
2. Decompression of median nerve left wrist and left hand.
3. Application of a long-arm cast.
A laminar spreader was placed between the fracture fragments and distraction of the fracture fragment was performed to correct the s/l willa slope. The area between the fracture fragments was packed with a large amount of cancellous bone allograft to pack the area.
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Sun Sep 7 12:02:41 2008 Tigger
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Sun Sep 7 12:03:53 2008 OP thanks
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Sun Sep 7 12:01:33 2008 nh
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Sun Sep 7 12:00:55 2008 OP
He says this 3 times in the report. Here is another example.
X-rays showed the radius length and s/l wuller slope was obtained and the fracture site was packed with a large amount of bone grafting.
Thanks.
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• Sounds like saculations, would it be fasciculation? + a c d a c a
Sun Sep 7 11:55:28 2008 a c d a c a
pancreatic duct was first cannulated and is of normal size no ______, strictures or cutoffs.
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Sun Sep 7 12:01:02 2008 a c d a c a
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Sun Sep 7 11:57:55 2008 nm
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• *fifty-five zero* high power field sm + huh?
Sun Sep 7 11:30:20 2008 huh?
tumor measuring 3 cm with six mitosis per *fifty-five zero* high-power field with negative resection margin.
Never have heard it like this, how to transcribe, is that 55.0 or 550? Not finding much on google about it.
Thanks!
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Sun Sep 7 12:27:21 2008 thanks everyone!
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Sun Sep 7 12:19:48 2008 nm
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Sun Sep 7 11:46:19 2008 nm
To calculate the diameter of the high-power field, divide the magnification of your high power (40X) by the magnification of the low power (10X); 40/10 = 4. Then, divide the diameter of the low-power field in micrometers (1500 µm) by this quotient (4). The answer is the diameter of the high-power field in micrometers. In this example, the diameter of the high-power field is 1500/4 = 375 mm.
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Sun Sep 7 11:36:00 2008 50
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• Pt with tubes in ear. When the s/l emula was placed he had symptoms of tinnitus - j d m m a k
Sun Sep 7 11:18:57 2008 j d m m a k
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Sun Sep 7 11:23:21 2008 nm
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• Pt fell out of her chair and has bleeding from the "angle ease uh" mouth as well as - the forhead.
Sun Sep 7 10:56:40 2008 the forhead.
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Sun Sep 7 11:03:07 2008 f p b i n p
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• neuro Topamax concerns + sm
Sun Sep 7 10:38:21 2008 sm
She took Topamax in the past. My notes reflect her report that this actually helped, but she was concerned about various potential risks such as s/l p?stroms and thought she did have a slight degree of cognitive blunting.
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Sun Sep 7 10:54:15 2008 ??
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Sun Sep 7 10:47:31 2008 smiley
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Sun Sep 7 10:56:58 2008 ?
Major side effects include weight loss, kidney stones, cognitive blunting, and other neurotoxic effects.
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• word help - sm + o o p d m i
Sun Sep 7 10:28:34 2008 o o p d m i
His lower ribs protrude as do many postop "s/l nus" patients, and this will be something that becomes less of an issue as he grows.
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Sun Sep 7 12:40:45 2008 JM
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Sun Sep 7 10:53:28 2008 passthru
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Sun Sep 7 10:43:44 2008 smiley
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Sun Sep 7 10:57:55 2008 thanks anyways
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• EMG + sn
Sun Sep 7 09:32:19 2008 sn
. Today, she denies any problem with her hand, despite previous visit EMG showing residual left median neuropathy s/l cross to this.
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Sun Sep 7 09:50:04 2008 n
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Sun Sep 7 09:45:12 2008 d h j b a i
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Sun Sep 7 09:38:13 2008 nm
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• probably will flag but do you have a good guess? 15 mm or 50 mm liver mass? + hootie
Sun Sep 7 09:28:19 2008 hootie
CT scan of the chest showed no evidence of pulmonary embolus. There were large bilateral pleural effusions and bibasilar consolidation. The abdomen was essentially unremarkable with no evidence of ascites or mass. There was a short infrarenal abdominal dissection, which was described as unchanged from previous. There was a ____15 (or 50?) mm right lower lobe liver lesion, which was also unchanged, and a right adrenal angiomyolipoma was also unchanged. Chest x-ray was compatible with congestive heart failure.
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Sun Sep 7 09:41:29 2008 hootie
I would think it more likely they would say 5 cm rather than 50 mm. I'll check some old reports and see what can find. Thanks everyone.
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Sun Sep 7 09:39:03 2008 smiley
you probably should flag to be safe. Most of the docs I type for say five-oh or one-five to clarify because they sound so much alike.
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Sun Sep 7 09:40:35 2008 not OP/sm
not being clear on numbers. 15 and 50 are so alike. Also, many times 50 and 60 sound the same to me when doc is in a rush.
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Sun Sep 7 09:44:11 2008 hootie
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Sun Sep 7 09:37:44 2008 nmt
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Sun Sep 7 09:28:50 2008 hootie
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Sun Sep 7 09:38:08 2008 sm
seems it could be either one, though is a 2-inch lesion pretty darn big? Would flag unless something else in report gives you a better sense.
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• Her neck is supple, no appreciable lymphadenopathy or thyromegaly is/are noted. - He says is
Sun Sep 7 09:19:12 2008 He says is
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Sun Sep 7 09:26:10 2008 is cause it is or
2. When two or more singular nouns or pronouns are connected by or or nor, use a singular verb.
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Sun Sep 7 09:23:20 2008 nm
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• can't get this one, anybody? S/L diveloxitine (meds). - n
Sun Sep 7 09:17:02 2008 n
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Sun Sep 7 09:21:28 2008 smiley
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Sun Sep 7 09:27:31 2008 .
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• I had never heard of this and just thought I'd share SM - jee
Sun Sep 7 09:08:44 2008 jee
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Sun Sep 7 09:16:26 2008 thanks, jee--passthr
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Sun Sep 7 09:18:26 2008 jee
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• labs to check drug levels + sm
Sun Sep 7 08:53:22 2008 sm
I would like to check s/l seromyin, ferritin, B12 level and thyroid.
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Sun Sep 7 09:04:19 2008 passthru
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Sun Sep 7 09:07:19 2008 karen
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• WAV file, thanks. + a c d a c a
Sun Sep 7 08:51:23 2008 a c d a c a
2. He has an AICD pacemaker.
3. Confusion probably _______ of dementia.
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Sun Sep 7 08:58:01 2008 billybob
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Sun Sep 7 09:06:38 2008 a c d a c a
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Sun Sep 7 08:57:23 2008 a c d a c a
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• word help - sm + f p h c i m
Sun Sep 7 08:48:09 2008 f p h c i m
Her repair remains intact, although the left lower ribs which were "s/l so-e-symmetric" continue to protrude.
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Sun Sep 7 09:06:50 2008 passthru
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