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Mar 17 22:14
• again was drained _____ amount of
+ mp4
Thu Mar 23 07:12:28 2017 mp4
The bladder again was drained _____ amount of urine since it had been drained following the earlier repair. The midline was infiltrated with approximately 10 mL of Pitressin solution diluted in 1:1 ratio with normal saline.

• reduction of the _____. Hemostasis appeared
+ wav
Thu Mar 23 07:09:37 2017 wav
Therefore, an anterior colporrhaphy was performed with side-to-side reduction of the defect utilizing 2-0 Vicryl suture material with excellent reduction of the _____. Hemostasis appeared to be adequate and several strips of Xeroform soaked with thrombin were placed into each paravesical space to further enhance hemostasis.

• performed and after the _____ and the next procedure
+ mp3
Thu Mar 23 07:09:07 2017 mp3
Again, the anterior vaginal wall was closed with trimming. After trimming a portion of vaginal wall, cystoscopy was performed and after the _____ and the next procedure was performed which was a midurethral sling.

• Preoperative Diagnosis: _____ RIGHT EYE. Procedure: ENUCL ...
+ wav
Thu Mar 23 04:20:50 2017 wav
Preoperative Diagnosis:
_____ RIGHT EYE.

Procedure:
ENUCLEATION WITH SCLERAL-WRAPPED HYDROXYAPATITE IMPLANT OF THE RIGHT EYE.

** • blind pupil ? - nnm
Thu Mar 23 04:48:08 2017 nnm

**** • Thanks a lot. - guy
Thu Mar 23 04:53:46 2017 guy


• Preoperative Diagnosis: CHRONIC OTITIS MEDIA. Procedure: ...
+ mp3
Thu Mar 23 01:33:01 2017 mp3
Preoperative Diagnosis:
CHRONIC OTITIS MEDIA.

Procedure:
RIGHT TYMPANOMASTOIDECTOMY.

On exam in the office, the patient was noted to have a 40% inferior perforation, but no evidence of cholesteatoma. Given that the patients right ear was chronically draining with no improvement on _____, decision was made to take him to the operating room for right tympanomastoidectomy.
** • nevermind. - guy
Thu Mar 23 01:55:09 2017 guy


• This is a 69-year-old gentleman with a history of longstanding hearing ...
+ wav
Thu Mar 23 01:25:10 2017 wav
This is a 69-year-old gentleman with a history of longstanding hearing loss, right greater than left side. The patient is unsure of what the etiology is; however, he recalls getting _____ blood in his right ear. He has had a hearing loss ever since.
** • nevermind. - guy
Thu Mar 23 01:54:56 2017 guy


• The cartilage was then carefully shaved, cut down to the size of the p ...
+ mp3
Wed Mar 22 23:30:55 2017 mp3
The cartilage was then carefully shaved, cut down to the size of the perforation and cartilage was carefully split using a 0-degree scope and holding the cartilage with an alligator. The _____ introduced into the external auditory ear canal. Then, the cartilage was gently pushed into place
** • I can't get it either, but I don't think there's a period after alligator - Questyr
Thu Mar 23 00:20:15 2017 Questyr

**** • Thanks for the correction. - guy
Thu Mar 23 01:25:42 2017 guy

** • can't get it - poi
Wed Mar 22 23:34:12 2017 poi

**** • Thanks for the effort. - guy
Wed Mar 22 23:35:09 2017 guy


• The incision was made on the posterior aspect of the tragus and the ca ...
+ mp3
Wed Mar 22 23:18:51 2017 mp3
The incision was made on the posterior aspect of the tragus and the cartilage was harvested using short sharp scissors taking care to _____ perichondrium on both sides of the cartilage. Once the cartilage was harvested, Gelfoam with epinephrine placed within the tragal cartilage harvest site and the site was closed with 5-0 fast. The cartilage was then carefully shaved, cut down to the size of the perforation and
** • impede? - poi
Wed Mar 22 23:29:48 2017 poi

**** • Thanks a lot. - guy
Wed Mar 22 23:30:30 2017 guy


• PREOPERATIVE DETAILS: This is a 7-year-old male with a history of chr ...
+ wav
Wed Mar 22 23:11:38 2017 wav
PREOPERATIVE DETAILS: This is a 7-year-old male with a history of chronic otitis media, status post bilateral myringotomy and tubes at the age of (bad audio here) right tympanic membrane perforation has improved in size; however, has not closed. The mother _____ drainage. The patient _____ ear infection in five months.
** • just ______ future drainage? - poi
Wed Mar 22 23:33:05 2017 poi

** • 2. has not - poi
Wed Mar 22 23:27:37 2017 poi

**** • has not had - poi
Wed Mar 22 23:58:03 2017 poi

**** • Thanks a lot. - guy
Wed Mar 22 23:30:17 2017 guy


• s/l "windmill" or "watermelon" proptosis
+ tia
Wed Mar 22 20:40:20 2017 tia
External exam was within normal limits with the exception of what appears to be ______ s/l "windmill" or "watermelon" proptosis in the right eye.

The patient has optic atrophy with proptosis. I made arrangements for the patient to have an MRI of the head and orbit.
** • this is all I could find in Stedman's Ophthalmology + from Stedman's
Wed Mar 22 20:47:20 2017 from Stedman's
proptosis

axial proptosis
ipsilateral proptosis
Moran proptosis
unilateral proptosis

• Then, coblation was used on each pass three times, first at 3 cm, then ...
+ mp3
Wed Mar 22 20:07:59 2017 mp3
Then, coblation was used on each pass three times, first at 3 cm, then 2 cm, then 1 cm, five seconds at each point. The turbinates were noted to shrink down after the _____ on the right. Next, the left side was addressed in a similar fashion.
** • FYI note that it s/b Coblation (capped) as it still have a live trademark - Questyr
Wed Mar 22 20:19:07 2017 Questyr

**** • Thanks a lot. - guy
Wed Mar 22 22:01:16 2017 guy

** • treatment - poi
Wed Mar 22 20:09:35 2017 poi

**** • Thanks a lot. - guy
Wed Mar 22 20:11:41 2017 guy


• Both during insertion of the Crowe-Davis and suspension, the surgical ...
+ wav
Wed Mar 22 19:51:24 2017 wav
Both during insertion of the Crowe-Davis and suspension, the surgical team was very careful not to extend the neck for more than was necessary. Next, the palate was inspected and palpated and there was no evidence of _____. The patient had a short palate. The patients tonsils were noted to be 2+ and adenoids were only 20% obstructive.
** • any cleft, although - nm
Wed Mar 22 20:10:13 2017 nm

**** • Thanks a lot. - guy
Wed Mar 22 20:11:31 2017 guy

** • ... - ny
Wed Mar 22 20:09:34 2017 ny


• Preoperative Diagnosis: BILATERAL HEARING LOSS. Procedure: ...
+ wav
Wed Mar 22 18:44:59 2017 wav
Preoperative Diagnosis:
BILATERAL HEARING LOSS.

Procedure:
BILATERAL EXAM UNDER ANESTHESIA AT THE EARS, MYRINGOTOMY, AND TYMPANOSTOMY TUBES BILATERALLY, AS WELL AS AN AUDITORY BRAINSTEM REFLEX BY AUDIOLOGY.

After several audiograms that demonstrated type B tympanogram and mild-to-moderate hearing loss bilaterally with poor reliability _____ cerumen, in the office he was not able to tolerate cerumen removal well and there was limited visualization of the TM, so he was referred for the OR for cerumen removal as well as exam under anesthesia and possible myringotomy and tubes as well as ABR with audiology.
** • due to? - poi
Wed Mar 22 19:15:28 2017 poi

**** • Thanks a lot. - guy
Wed Mar 22 19:19:33 2017 guy


• were shaved to be smooth, _______ bone allograft and bone
+ mp4
Wed Mar 22 15:43:47 2017 mp4
At this time compression across the ostomy site and bunion was checked under fluoroscopy and confirmed to be adequate. At this time utilizing a burr all rough edges on the left first metatarsal were shaved to be smooth, _______ bone allograft and bone cement were introduced to the left foot at ostomy site and applied to augment stability and bone healing process. The bone allograft was inserted into proximal plantar shaft of the first metatarsal and then fixated with bone cement and DBX was also used to increase strength and density along with the function and shape of the first metatarsal.
** • Synthes DBX?? - nm
Wed Mar 22 16:03:42 2017 nm

** • Interceed is waht I hear - e h p h c i
Wed Mar 22 15:57:37 2017 e h p h c i

**** • thank you - nm
Wed Mar 22 17:32:10 2017 nm


• Due to this poor left ________ bone quality, postop outcome was guarded
+ mp3
Wed Mar 22 15:43:03 2017 mp3
There was severe cystic formation throughout the left first metatarsal shaft. The cystic formation left the entire shaft of the bone hollow, which was not visualized on x-ray or C-arm. Due to this poor left ________ bone quality, postop outcome was guarded and need for bone cement and bone allograft and DBX was decided. At this time with proper AO principle and techniques, osteomed partially threaded cannulated 2.4 x 12 mm and 2.4 x 14 mm screws were placed distally from dorsomedial to plantar lateral direction.
** • 1st met (metatarsal) - e h p h c i
Wed Mar 22 16:49:50 2017 e h p h c i

**** • thanks - -
Wed Mar 22 17:30:59 2017 -

** • MP3 doesn't match? - e h p h c i
Wed Mar 22 15:58:18 2017 e h p h c i

**** • added again - not sure what is happening - -
Wed Mar 22 16:45:40 2017 -


• antibiotic prophylaxis local _____ block was administered to the left
+ wav
Wed Mar 22 15:41:37 2017 wav
PROCEDURE: The patient was brought to the operating room and placed supine on the operating table. After adequate IV sedation and IV antibiotic prophylaxis local _____ block was administered to the left foot in Mayo block fashion and a digital block utilizing 1% mix of 1% lidocaine plain and 0.5% Marcaine plain, a total of 20 cc used. The left foot was then prepped and draped in the usual aseptic fashion.
** • infiltrate (Google suggests infiltration)? - billybob
Wed Mar 22 18:31:56 2017 billybob

** • wav doesnt match? - e h p h c i
Wed Mar 22 15:58:49 2017 e h p h c i

** • wav doesnt match? - e h p h c i
Wed Mar 22 15:58:48 2017 e h p h c i

**** • added again - -
Wed Mar 22 16:44:51 2017 -


• metatarsal scapho ________ use of bone allograft
+ mp3
Wed Mar 22 14:55:14 2017 mp3
OPERATION:
1. Left foot first metatarsal scapho ________ use of bone allograft with bone paste and cement.
2. Left foot first MPJ extensor digitorum longus tendon lengthening, extensor digitorum brevis tenotomy.
3. Left foot second digit arthroplasty of proximal interphalangeal joint and hemiphalangectomy of middle phalanx.
4. Application of bivalve cast on the left foot.

** • it is scarf osteotomy, but I'm still trying to find out if it is capitalized or an + Questyr
Wed Mar 22 15:13:52 2017 Questyr
acronym or what.
**** • From what I can tell it is not capitalized. One article I found + Q
Wed Mar 22 15:31:16 2017 Q
indicated the type of cut (Z osteotomy) is likened to carpentry scarf joint term and is not named after a person. Also in the archives someone posted that scarf osteotomy is not capitalized in Stedman's. I looked in The Surgical Word Book and the procedure is not listed there. Based on those, I would not cap it. BTJMO
****** • ty - -
Wed Mar 22 15:39:12 2017 -


• left second digit _________ deformity with arthralgia
+ wav
Wed Mar 22 14:53:52 2017 wav
PREOPERATIVE DIAGNOSIS: Painful left foot bunion deformity and left second digit _________ deformity with arthralgia secondary to psoriatic arthritis.
** • claw toe - Questyr
Wed Mar 22 15:07:12 2017 Questyr


• entrapped right ventricular pacing lead *in the header*
+ ?
Wed Mar 22 14:12:46 2017 ?
is an 84-year-old woman with an entrapped right ventricular pacing lead in the header secondary to a stripped set screw and a nonfunctioning left ventricular pacing lead as part of her biventricular pacemaker system. She is in chronic atrial fibrillation and the atrial lead is not currently active. She has reached the elective replacement indicator.
** • Might be....header is apparently a term used...see google hits link + Questyr
Wed Mar 22 15:33:37 2017 Questyr
link

• ESL help - Patient with CLL
+ mt
Wed Mar 22 13:55:44 2017 mt
The options of referring the patient to s/l Academic Center regarding the evaluation of s/l mennin therapy was discussed with the patient.
** • I find this article on menin....see what you think + Questyr
Wed Mar 22 15:37:17 2017 Questyr
link

• We will _____ cardiac cath today
+ wav
Wed Mar 22 13:26:13 2017 wav
PLAN: Consider cardiac catheterization prior to discharge, consider anticoagulation also. The patient was given one dose of Xarelto. We will _____ cardiac cath today and hopefully get a CAT done in the morning and then we will probably start Xarelto or anticoagulation.
** • never mind, got it - will hold off until - nm
Wed Mar 22 13:26:57 2017 nm


• multiple questions
+ wav
Wed Mar 22 12:22:13 2017 wav
HISTORY OF PRESENT ILLNESS: This unfortunate Haitian male admitted _____ in the last several months. He is 43-year-old with a known history of _____ frequent crises ______. Comes in with generalized pains involving the upper extremities, shoulders, lower extremity. The baseline hemoglobin is about 8 gm. He has not required transfusion today. He does not have any signs of fever.


** • #2 is "probably" sickle cell disease, but not clear enough - mm
Wed Mar 22 13:09:29 2017 mm

** • flagging - -
Wed Mar 22 12:39:22 2017 -


• muffled/stumbling on word and not sure what do wants
+ mm
Wed Mar 22 11:41:12 2017 mm
(Bilateral knee arthroplasty)
We everted the patella. There was some arthritis here so we did osteotomize it and made our three lug hole drills and ***salf tapella** tracking which were happy with.

I know the last word is patella, but not sure about the one before it.

** • flaged - mm
Wed Mar 22 11:50:41 2017 mm


• dissection was performed ______ the carotid sheath
+ wav
Wed Mar 22 09:37:13 2017 wav
The incision was carried down with #15 blade scalpel to the skin and subcutaneous tissues. Monopolar electrocautery was used to divide the soft tissues dividing the platysma in line with the skin incision. Finger dissection was performed ______ the carotid sheath, which was kept laterally. Trachea and esophagus was kept medially. Dissection was performed.
** • palpate - nm
Wed Mar 22 09:45:35 2017 nm

**** • thanks - -
Wed Mar 22 10:48:07 2017 -


• Comma help: Rotation test positive for a minimal, antalgic, left-sided decrease in
+ sm
Wed Mar 22 08:54:16 2017 sm
Rotation Test positive for a minimal, antalgic, left-sided decrease in rotation with pain in the affected region.

Too many commas? Should it be minimal, antalgic left-sided decrease?

TIA!
** • I would use no commas in that sentence. - fwiw -taco
Wed Mar 22 09:05:10 2017 fwiw -taco

**** • Thanks for replying. I'd be interested to know why. I hate commas, just sayin. :) - OP
Wed Mar 22 10:00:26 2017 OP

****** • I know there is a good reason - something about cumulative vs coordinate adjectives - :)-- taco
Wed Mar 22 10:07:36 2017 :)-- taco

******** • Ah, yes, I saw that in researching. Will have to figure that out. Thank you! - OP
Wed Mar 22 10:08:38 2017 OP


• 13-year-old boy with fibular and talar neck fractures.
+ sm please
Wed Mar 22 07:16:24 2017 sm please
His mother has been giving him some "capital O, capital O, capital D, s" CrossFit workouts in lieu of PE, and this has made him feel a whole lot better.

I cannot seem to find/verify OODS. Is anyone familiar with this?
** • WODs ? (workout of the day) see link + nnm
Wed Mar 22 08:33:03 2017 nnm
link
**** • That's what I thought but I don't hear a "W" at all. Thank you for your link. + OP
Wed Mar 22 09:05:41 2017 OP
x
** • I find pood CrossFit workout - SM + e h p h c i
Wed Mar 22 07:59:32 2017 e h p h c i
Quite often we use terms in CrossFit that may sound strange or that you are not ... used for kettlebells; common ones: 1 pood =36 lbs; 1.5 pood = 54 lbs; 2 pood ...
**** • Thank you. - nm
Wed Mar 22 08:09:11 2017 nm

**** • pood is (SM) + e h p h c i
Wed Mar 22 08:00:51 2017 e h p h c i
is a unit of mass equal to 40 funt (, Russian pound). Plural: pudi or pudy. It is approximately 16.38 kilograms (36.11 pounds). It was used in Russia, Belarus, and Ukraine





• Given the findings of papillary thyroid cancer in the right lobe, the ...
+ mp3
Wed Mar 22 05:34:10 2017 mp3
Given the findings of papillary thyroid cancer in the right lobe, the patient was counseled that she should undergo a right hemithyroidectomy. Of note, the thyroid ultrasound had also showed a small nodule in the left thyroid lobe; however, _____ was less than 0.5 cm. Because the patient had a thyroid nodule measuring 1.4 cm _____ diameter and given her female gender and lack of concerning features of her case, she opted to undergo right hemithyroidectomy
** • 2. is "in greatest" - e h p h c i
Wed Mar 22 05:43:45 2017 e h p h c i

**** • Thanks a lot. - guy
Wed Mar 22 05:58:56 2017 guy


• This is a 41-year-old woman, otherwise healthy who was referred for th ...
+ wav
Wed Mar 22 05:20:17 2017 wav
This is a 41-year-old woman, otherwise healthy who was referred for thyroid nodule which had been followed with multiple thyroid ultrasounds over the past several years. There was a right thyroid nodule identified in June of 2016. After this nodule was FNA-ed and found to have _____ she was referred to XXX for surgical intervention.
** • nevermind. - guy
Wed Mar 22 06:04:01 2017 guy

**** • If she spoke clearly instead of mumbling... - e h p h c i
Wed Mar 22 06:05:36 2017 e h p h c i


• The patient was also found to have a cavitary lesion in his chest whic ...
+ mp3
Wed Mar 22 03:52:42 2017 mp3
The patient was also found to have a cavitary lesion in his chest which was concerning for TB. He was placed on airborne isolation for concern of TB and a workup to _____ was begun. The patient also had a creatinine elevation to 3.0 which was elevated per report. Per report, the baseline creatinine was in the low 1s. A Foley catheter
** • workup for TB was begun (he changed his mind there) - e h p h c i
Wed Mar 22 04:00:23 2017 e h p h c i

**** • Thanks a lot. - guy
Wed Mar 22 04:04:47 2017 guy


• Preoperative Diagnosis: BILATERAL HYDRONEPHROSIS. Procedure: ...
+ wav
Wed Mar 22 03:44:22 2017 wav
Preoperative Diagnosis:
BILATERAL HYDRONEPHROSIS.

Procedure:
CYSTOSCOPY, BILATERAL RETROGRADE PYELOGRAM, AND ATTEMPTED LEFT URETEROSCOPY.

INDICATIONS FOR PROCEDURE: This is a 76-year-old male with a history of diabetes and hypertension. He recently noted to lose 20 pounds in the last several months. His son took him to a hospital _____ where he was diagnosed with a swollen kidney and a chest problem. He was told he needed to seek care elsewhere to fix those problems.
** • in Belize (or == and believes) ? Was he out of the country at some point? - e h p h c i
Wed Mar 22 04:01:28 2017 e h p h c i

**** • Thanks a lot. i don't know but that must be it. - guy
Wed Mar 22 04:04:35 2017 guy


• Preoperative Diagnosis: RIGHT TIBIA NONUNION, STATUS POST APPLICATI ...
+ wav
Tue Mar 21 21:51:12 2017 wav
Preoperative Diagnosis:
RIGHT TIBIA NONUNION, STATUS POST APPLICATION OF EXTERNAL FIXATOR WITH INTERCALARY FREE FIBULAR ALLOGRAFT.

Procedure:
REMOVAL OF EXTERNAL FIXATOR.

INDICATIONS: This is a 30-year-old male well known to the orthopedic tumor service with a history of right tibial adamantinoma, status post right tibia lesion resection and placement of intercalary allograft with plate fixation in May of 2013. His postop course was complicated by a right tibia nonunion. In November of 2016, he was taken to the OR for _____ procedure with the plastic surgery service for application of a ring external fixator and insertion of a intercalary free fibular autograft by the plastic surgery service.
** • nevermind. - guy
Tue Mar 21 22:38:27 2017 guy


• Preoperative Diagnosis: RIGHT SCAPULAR MASS. Procedure: R ...
+ wav
Tue Mar 21 19:38:14 2017 wav
Preoperative Diagnosis:
RIGHT SCAPULAR MASS.

Procedure:
RIGHT SCAPULA INCISIONAL BIOPSY.

INDICATIONS: This is a 26-year-old healthy male followed in the orthopedic tumor clinic for evaluation of a right shoulder mass ____ first noticing the mass after a motorcycle accident _____ one year prior, reports the mass is slowly growing until present. He was seen in clinic several weeks ago.
** • He first noticed the ... in Haiti - poi
Tue Mar 21 19:41:40 2017 poi

**** • He reports noticing the - poi
Tue Mar 21 19:42:21 2017 poi

****** • Thanks a lot. - guy
Tue Mar 21 19:49:12 2017 guy


• Preoperative Diagnosis: RIGHT HAND WOUND AND RIGHT LOWER EXTREMITY ...
+ wav
Tue Mar 21 18:42:31 2017 wav
Preoperative Diagnosis:
RIGHT HAND WOUND AND RIGHT LOWER EXTREMITY WOUND.

Procedure not dictated

The patient was doing well until about postoperative day #8 when he was noted to have right hand swelling requiring urgent reoperation which showed a hematoma and failure at anastomosis. The anastomosis had to be redone with additional vein graft. The patient had significant swelling and soft tissue defect _____ initial operation and the reoperation, therefore, the patient at the initial operation had _____ placed and subsequently he was closed loosely.
** • I can't get #2, sorry - poi
Tue Mar 21 18:47:49 2017 poi

** • 1. both at the - poi
Tue Mar 21 18:45:01 2017 poi

**** • Thanks a lot. - guy
Tue Mar 21 18:49:38 2017 guy


• and ____ 10 mg/mL solution 0.5 mL or 5 mg by mouth every 12 hours.
+ mp3 - med name
Tue Mar 21 16:32:59 2017 mp3 - med name
His current medications include amiodarone 5 mg/mL suspension taking 20 mL or 100 mg by mouth twice a day, digoxin 0.05 mg/mL taking 1.6 mL or 80 mcg by mouth every 12 hours, and ____ 10 mg/mL solution 0.5 mL or 5 mg by mouth every 12 hours.
** • got it - op
Tue Mar 21 16:41:41 2017 op


• Need help with type of shoe...
+ i f h e b o
Tue Mar 21 16:01:30 2017 i f h e b o
She was seen at an urgent care center where she was told that she had a possible fracture of the toe. She was placed into a **s/l surf-less shoe**.
** • Never mind, got it! It's surgical shoe. :) - i f h e b o
Tue Mar 21 16:09:06 2017 i f h e b o


• Sensation intact. _____ 2+ pulses.
+ wav
Tue Mar 21 14:41:51 2017 wav
Decreased range of motion secondary to pain. Range of motion of the shoulders, forward flexion 0 to 140 degrees, internal rotation to S1, external rotation to 60 degrees with pain on extreme range of motion. Equivocal Hawkins test. Positive Neers test. Positive OBrians test. Cuff strength is 4/5. Grip strength is 4+/5. Neurovascular intact. Sensation intact. _____ 2+ pulses.
** • Sensation intact to light touch. - taco
Tue Mar 21 14:43:39 2017 taco

**** • :( - thanks
Tue Mar 21 14:51:33 2017 thanks


• Hi. s/l 5 mm 'gal-vacceo cannula for liposuction. Thanks
- rm
Tue Mar 21 14:18:13 2017 rm

** • not sure, but I found "Del Vecchio" (named after a liposucking plastic surgeon) - taco
Tue Mar 21 14:26:11 2017 taco

**** • haha! named after a what?? haha! - poi
Tue Mar 21 14:34:21 2017 poi

****** • haha - glad I made you laugh (my original phrase didn't fit on subject line) - :) ---t
Tue Mar 21 14:42:43 2017 :) ---t

**** • Thank you! That must be it. - rm
Tue Mar 21 14:33:50 2017 rm


• She was born 30 weeks premature. Would you change this?
- tia
Tue Mar 21 13:37:38 2017 tia

** • I would put "born *at* 30 weeks, premature" if that is what was meant. - fwiw-t
Tue Mar 21 13:45:41 2017 fwiw-t

** • maybe just put a comma after weeks - e h p h c i
Tue Mar 21 13:45:22 2017 e h p h c i

**** • thanks to you both - op
Tue Mar 21 13:47:31 2017 op


• He does not have any loss of conciousness or change in neurological _____, however sm
+ wav :)
Tue Mar 21 13:20:39 2017 wav :)
since yesterday he has had persistent headache that would not go away.
** • sounds to me like "things' - fwiw-poi
Tue Mar 21 13:28:38 2017 fwiw-poi

**** • Thanks poi. That's what I thought I heard but did not make sense to me. - :)
Tue Mar 21 13:46:04 2017 :)

****** • I thought it made sense, just not proper medical jargon lol - poi
Tue Mar 21 13:50:43 2017 poi


• Pain is constant _______ the first thing in the morning she has a significant sm
+ wav :)
Tue Mar 21 11:38:42 2017 wav :)
amount of pain when she tries to get out of the bed that she has to literally crawl to her bathroom.
** • still hearing old wav - poi
Tue Mar 21 12:35:31 2017 poi

**** • was waiting for other to be answered. Sent it in. - :)
Tue Mar 21 13:19:06 2017 :)

****** • please do not post your question if you are not going to post your sound file, + poi
Tue Mar 21 13:21:42 2017 poi
it wastes the time of the helpers as we continue to try to hear the sound file. Thank you.
******** • Agree w/poi. I've probably tried to listen a dozen times (previous wav solved long ago) - t
Tue Mar 21 13:30:17 2017 t

********** • fluff to taco + poi
Tue Mar 21 16:25:54 2017 poi
what?? you agree with me?? (jokin!)

• turbinate was very large ______ the concha bullosa
+ wav
Tue Mar 21 11:29:48 2017 wav
The left side was examined first. This was the side without the deviated septum and could be well visualized. The middle turbinate was very large ______ the concha bullosa. The anterior portion of the middle turbinate was incised and a portion of middle turbinate was then removed. The middle turbinate inferiorly became floppy and at this point in time, the inferior portion of the middle turbinate was resected along with the concha bullosa.
** • from - e h p h c i
Tue Mar 21 11:55:01 2017 e h p h c i

**** • thanks - -
Tue Mar 21 11:58:54 2017 -


• We then proceeded to finish the case as the patient had very small ves ...
+ mp3
Tue Mar 21 10:30:41 2017 mp3
We then proceeded to finish the case as the patient had very small vessels and no great place for bypass to increase her flow to her foot _____ all we could we do. So, the right cath incision was closed with 3-0 Vicryl sutures and skin staples.
** • foot, but we had done - e h p h c i
Tue Mar 21 10:31:54 2017 e h p h c i

**** • Thanks a lot. - guy
Tue Mar 21 10:33:27 2017 guy


• We exchanged the micropuncture with a 7-French sheath in order to plac ...
+ wav
Tue Mar 21 10:27:29 2017 wav
We exchanged the micropuncture with a 7-French sheath in order to place a Zilver PTX 7 x 60 mm stent at the takeoff of the right common iliac artery. The stent was _____ with a 6 mm x 6 cm balloon dilation catheter. Completion angiogram revealed
** • expanded - e h p h c i
Tue Mar 21 10:32:12 2017 e h p h c i

**** • Thanks a lot. - guy
Tue Mar 21 10:33:04 2017 guy


• Given the concern for an embolic event causing her cold foot, we decid ...
+ mp3
Tue Mar 21 10:14:11 2017 mp3
Given the concern for an embolic event causing her cold foot, we decided to proceed to open below the knee thrombectomy. To do this, we turned our attention to the right lower extremity and made approximately 6-cm incision just below the medial _____. We then dissected bluntly and sharply to visualize the popliteal artery _____ and the anterior tibial artery. This required us to open both posterior compartments of the lower leg.
** • medial knee. ..popliteal and where it branched ________ - nm
Tue Mar 21 10:25:04 2017 nm

**** • Thanks a lot. - guy
Tue Mar 21 10:27:19 2017 guy

** • #1 - knee #2 - and where it branched into the TP trunk - taco
Tue Mar 21 10:23:57 2017 taco

**** • Thanks a lot. - guy
Tue Mar 21 10:24:17 2017 guy


• To achieve the right lower extremity angiogram, we accessed the left f ...
+ wav
Tue Mar 21 10:08:32 2017 wav
To achieve the right lower extremity angiogram, we accessed the left femoral artery via _____ micropuncture. The micropuncture sheath was then exchanged with the 5-French sheath and using an Omni flush catheter, we first proceeded with right lower extremity angiogram.
** • "ultrasound-guided" is what she means, but she says "ultraground sided") - taco
Tue Mar 21 10:22:30 2017 taco

**** • Thanks a lot. - guy
Tue Mar 21 10:23:59 2017 guy


• "metastatic lung cancer to brain" make sense?
+ guy
Tue Mar 21 09:59:42 2017 guy
This is a 79-year-old female recently diagnosed with metastatic lung cancer to brain who was found to have a cold right foot while being treated on the medicine.
** • Perfect sense. + G
Tue Mar 21 10:06:45 2017 G
nm
**** • Thanks a lot. - guy
Tue Mar 21 10:08:21 2017 guy


• engaged. The _____ was removed and the
+ wav
Tue Mar 21 09:22:38 2017 wav
This was then packed into the appropriate level. This did not show any backing out abilities and indicated good pullout strength. Appropriate tension was then dialed into each limb of the suture. The anchor was then engaged. The _____ was removed and the excess sutures were cut. The rotator cuff was fully reapproximated to the greater tuberosity. Holes were then made anterior and posterior to the anchor region to help with Crimson Duvet effect. A
** • instrument - e h p h c i
Tue Mar 21 09:59:08 2017 e h p h c i

**** • thank - you
Tue Mar 21 10:02:35 2017 you


• We entered into the bowel. We put the red rubber catheter in taking c ...
+ mp3
Tue Mar 21 08:39:08 2017 mp3
We entered into the bowel. We put the red rubber catheter in taking care to make sure it was running distally, then tied down our pursestring. We then _____ with five or six stitches and then tacked to the chest wall at the entrance site in four quadrants. Once that was done, we then closed the wound with loop PDS, Vicryl and Monocryl.
** • is it a jejunostomy? If so, she is saying "witzeled up" - taco
Tue Mar 21 08:45:28 2017 taco

**** • yes it is. Thanks a lot. - guy
Tue Mar 21 08:52:22 2017 guy


• Preoperative Diagnosis: ESOPHAGEAL PERFORATION. Procedure: ...
+ wav
Tue Mar 21 08:18:16 2017 wav
Preoperative Diagnosis:
ESOPHAGEAL PERFORATION.

Procedure:
ENDOSCOPY, RIGHT THORACOTOMY, REPAIR OF ESOPHAGEAL PERFORATION, INTERCOSTAL MUSCLE FLAP, DECORTICATION, LAPAROTOMY, JEJUNOSTOMY TUBE PLACEMENT, AND FLEXIBLE BRONCHOSCOPY.

ANESTHESIA: General with double-lumen endotracheal tube.

ESTIMATED BLOOD LOSS: _____ cc.

FLUIDS: 3000 cc of crystalloid and 1 unit of packed red blood cells.

** • several hundred, 700, over 100? I can't decide... - e h p h c i
Tue Mar 21 08:39:32 2017 e h p h c i

**** • m hearing several hunder cc after hearing again. Thanks a lot. - guy
Tue Mar 21 08:54:55 2017 guy

**** • Thanks. will flag it. - guy
Tue Mar 21 08:42:26 2017 guy


• Preoperative Diagnosis: A 36-YEAR-OLD GRAVIDA 9, PARA 6-0-3-6 ON PO ...
+ wav
Tue Mar 21 07:45:58 2017 wav
Preoperative Diagnosis:
A 36-YEAR-OLD GRAVIDA 9, PARA 6-0-3-6 ON POSTPARTUM DAY #1, STATUS POST NORMAL SPONTANEOUS VAGINAL DELIVERY, DESIRING PERMANENT STERILIZATION.

Procedure:
BILATERAL TUBAL LIGATION VIA MODIFIED POMEROY METHOD.

The surgical table was then tilted to the patients right and a Babcock retractor was used to grasp the left fallopian tube. The fallopian tube was sequentially re-grasped using Babcock until the fimbriated edge was visualized. A modified Pomeroy technique was then used to perform the partial salpingectomy. A _____ was made in the mid isthmic region and doubly ligated using #0 plain suture. The mesosalpinx within the loop was pierced and a 2-cm segment of tube was excised and submitted to pathology.
** • knuckle - taco
Tue Mar 21 08:16:49 2017 taco

**** • Thanks a lot. - guy
Tue Mar 21 08:18:39 2017 guy


• We also had to cover the anus with a small opening, so that the VAC wo ...
+ mp3
Mon Mar 20 22:17:00 2017 mp3
We also had to cover the anus with a small opening, so that the VAC would _____. At the end of the case, the VAC was functioning appropriately with no leak.



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