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May 12 17:11
• The right testis measures 17 mm in long diameter and 8 x 10 mm in ________ diameter.
- mp3 posted
Sat May 28 23:43:40 2016 mp3 posted

** • got it - broad diameter - thanks
Sat May 28 23:47:37 2016 thanks

**** • You can't have 8 x 10 as that would be an "area" size not a "diameter" size. - Questyr
Sun May 29 01:49:22 2016 Questyr

****** • 17 x 8 x 10 - nnm
Sun May 29 10:58:42 2016 nnm

******** • iow, I'd change "and 8" to "x 8." - nnm
Sun May 29 11:00:34 2016 nnm


• I prescribed the patient 1000 mg of s/l Depakene azalol and then will TIA!
+ drug?
Sat May 28 18:08:37 2016 drug?
Pt with seizures and bipolar.

I prescribed the patient 1000 mg of ___ and then will lower the dose to 500 mg twice a day.
** • Flagging and moving on. Thanks. - OP
Sun May 29 00:23:15 2016 OP


• s/l cristorian or crustorian (trying to hear historian, but can't get it) sm plse
+ mt
Sat May 28 12:38:38 2016 mt
On exam: She is alert and awake, in no obvious distress. As mentioned above she was lucid, **appearing very cristorian. Heart rate 65...etc

I can hear as above OR
"She was lucid period and very crustorian." (cannot hear oriented in that at all).
** • plse disregard + mt
Sat May 28 12:40:28 2016 mt
think I over-thought that.

"(period) A very good historian)

• The thecal sac was also exposed. I then identified the L4 pedicle and ...
+ mp3
Sat May 28 04:31:51 2016 mp3
The thecal sac was also exposed. I then identified the L4 pedicle and then I was able to identify the exiting L4 nerve root. Right at the <____> of the nerve root was a large contained disk herniation which was removed in a piecemeal fashion. All 3 fragments were removed.
** • axilla - vlad
Sat May 28 07:06:29 2016 vlad


• The patient is a 59-year-old male who presents with left L4 radiculopa ...
+ wav
Sat May 28 04:23:40 2016 wav
The patient is a 59-year-old male who presents with left L4 radiculopathy which correlates with MRI L-spine finding of left L3-L4 paracentral disk herniation that has been ongoing for 6 weeks with no improvement. His leg feels <____> and buckles. He presents today for definitive treatment with the above-mentioned surgery.
** • weak - vlad
Sat May 28 07:04:40 2016 vlad


• then Goldman was used to reduce the perpendicular plate posteriorly. ...
+ mp3
Sat May 28 03:14:10 2016 mp3
then Goldman was used to reduce the perpendicular plate posteriorly. Excellent opening of the nasal passage was noted with Goldman <____> right to left side following this case. Attention was then directed to turbinate. Suction Bovie was used
** • with the Goldman being able to easily pass from the... - billybob
Sat May 28 03:57:27 2016 billybob

**** • Thanks a lot - guy
Sat May 28 04:11:53 2016 guy


• Extreme care was taken not to damage the mucosa with the dissection. ...
+ wav
Sat May 28 03:06:12 2016 wav
Extreme care was taken not to damage the mucosa with the dissection. Following this, a Takahashi was used to reduce the perpendicular plate of the ethmoid which was deviated. The quilting sutures were placed <____> to close the defect and then Goldman was used to reduce the perpendicular plate posteriorly.

• Under general anesthesia, the patient was prepped and draped in a ster ...
+ mp3
Sat May 28 02:58:16 2016 mp3
Under general anesthesia, the patient was prepped and draped in a sterile fashion. Marcaine with epinephrine was injected <____> and around the lower mandible and cocaine was placed on 1 x 3 pledgets after vasoconstriction around the septum.
** • got it. thanks. - guy
Sat May 28 03:13:46 2016 guy


• cc: <____>, Primary Care Physician Eugene, OR ...
+ wav
Sat May 28 02:43:33 2016 wav
cc: <____>, Primary Care Physician

Eugene, OR

• The patient is a 54-year-old female who presents with neck pain and bi ...
+ wav
Sat May 28 02:06:01 2016 wav
The patient is a 54-year-old female who presents with neck pain and bilateral C6 radiculopathy with weakness and numbness which correlates with findings <____> C5-C6 disk protrusion with moderate central canal stenosis <____>. She has maximized nonsurgical treatment and presents for definitive treatment with the above-mentioned surgery.
** • broad...and spondylolisthesis. - billybob
Sat May 28 02:17:05 2016 billybob

**** • Thanks a lot - guy
Sat May 28 02:19:31 2016 guy


• ASSISTANT: <____>, PA-C Eugene, OR ...
+ wav
Sat May 28 01:10:36 2016 wav
ASSISTANT: <____>, PA-C

Eugene, OR
** • Justin Goble -- what I hear + see link
Sat May 28 01:27:53 2016 see link
link
**** • Thanks a lot - guy
Sat May 28 01:37:23 2016 guy


• Next, on the right side a 371 cubic centimeters style #15 Allergan gel ...
+ wav
Fri May 27 23:39:44 2016 wav
Next, on the right side a 371 cubic centimeters style #15 Allergan gel implant was put in place. Following this, a layered wound closure was accomplished using deep and subcu sutures of 3-0 Monocryl. The periareolar area was closed with a <____> suture of 3-0 Gore-Tex and the skin was closed using a running subcuticular suture of 4-0 V-Loc.
** • purse-string pinwheel (see google hits) + Questyr
Fri May 27 23:41:08 2016 Questyr
link
**** • pursestring (per The Surgical Word Book) - Q
Fri May 27 23:42:11 2016 Q

****** • Vera Pyle's shows it as either/or (with or without hyphen) - Q
Fri May 27 23:43:15 2016 Q

******** • Thanks a lot - guy
Fri May 27 23:46:15 2016 guy


• **Aron** is assistant name, not patient name
+ mp3
Fri May 27 23:00:12 2016 mp3
**Aron** was present during the entire case and assisted with every portion of the procedure from positioning to retraction <_____>.
** • Could he be changing his mind to "positioning and retraction"...although his + Q
Fri May 27 23:15:30 2016 Q
use of the word "from" could be affected by changing "to" to "and". So I really don't know what to recommend if this is indeed the correction he made. Sorry.
**** • Thanks a lot. yeah i think the same. - guy
Fri May 27 23:23:18 2016 guy

** • Might also be **Aaron** or **Erin**...I listened B4, but could not find it googling. I'll + Questyr
Fri May 27 23:12:40 2016 Questyr
listen for your blank now.
**** • Thanks for the effort. - guy
Fri May 27 23:15:08 2016 guy


• Attention was turned to meticulous repair of the deltoid. The 2-mm dr ...
+ mp3
Fri May 27 22:55:13 2016 mp3
Attention was turned to meticulous repair of the deltoid. The 2-mm drill was used to make 2 drill holes in the acromion. A #2 Ultrabraid was passed through this <____> passed through the deltoid in a mattress fashion. This was oversewn using four #2 Ultrabraid sutures in a simple interrupted fashion.
** • so it could be - Questyr
Fri May 27 22:57:57 2016 Questyr

**** • Thanks a lot - guy
Fri May 27 22:58:53 2016 guy


• Following re-irrigation, the entire repair was circumferentially overs ...
+ mp3
Fri May 27 22:39:41 2016 mp3
Following re-irrigation, the entire repair was circumferentially oversewn using the #2 Ultrabraid suture in a simple interrupted fashion. One of the sutures was not cut posteriorly so that the lens could be incorporated into the <____> repair. Two ArthroCare MULTIFIX anchors were used to create the <____> construct.

PROCEDURE PERFORMED: Left shoulder arthroscopy, biceps tenotomy, subacromial decompression, and open rotator cuff repair.


** • #2 two-row - Q
Fri May 27 22:50:56 2016 Q

** • #1 two-row - Questyr
Fri May 27 22:50:33 2016 Questyr

**** • Thanks a lot - guy
Fri May 27 22:54:22 2016 guy


• ASSISTANT: <____> Creve Coeur, MO ...
+ wav
Fri May 27 22:36:15 2016 wav
ASSISTANT: <____>

Creve Coeur, MO

• INDICATIONS: The patient is a 50-year-old who had an instant <___ ...
+ mp3
Fri May 27 22:03:32 2016 mp3
INDICATIONS: The patient is a 50-year-old who had an instant <____> felt a tearing sensation in her left shoulder. MRI confirmed a full-thickness rotator cuff tear.
** • I hear "58-year-old who had an incident recently where she" - Questyr
Fri May 27 22:32:34 2016 Questyr

**** • Thanks a lot - guy
Fri May 27 22:35:57 2016 guy


• PREOPERATIVE DIAGNOSIS: Left rotator cuff tear. POSTOPERATIVE D ...
+ wav
Fri May 27 21:58:25 2016 wav
PREOPERATIVE DIAGNOSIS: Left rotator cuff tear.

POSTOPERATIVE DIAGNOSIS: Full-thickness, retracted, reverse L-shaped tear of the supraspinatus of the left shoulder with disruption of biceps <____>.

PROCEDURE PERFORMED: Left shoulder arthroscopy, biceps tenotomy, subacromial decompression, and open rotator cuff repair.

** • sling (see google hits) + Questyr
Fri May 27 22:30:58 2016 Questyr
link
**** • Thanks a lot - guy
Fri May 27 22:35:43 2016 guy


• There is no discharge. No s/l flack-lenz. In addition, there is an ulcer TIA!
+ extremity exam?
Fri May 27 20:57:08 2016 extremity exam?
There are 2 incisions on the right lateral thigh with some spacer devices in them. There is no discharge. No ___. In addition, there is an ulcer over the heel.
** • fluctuance - Oasis
Fri May 27 21:10:20 2016 Oasis


• coronary artery disease with prior s/l axis stenting of the obtuse marginal. TIA!
+ card?
Fri May 27 19:01:26 2016 card?
Patient has a history of known coronary artery disease with prior ____ stenting of the obtuse marginal. Patient also had stenting of the RCA.
** • NM. Clearly states Taxus later. - OP
Fri May 27 19:13:15 2016 OP


• not making sense to me-see message on allergies
+ sm
Fri May 27 14:44:31 2016 sm
ALLEGIES: S/l Celiac, dairy allergen.
** • probably means gluten and dairy, but I would transcribe as is. IMO - mt
Fri May 27 15:30:07 2016 mt

**** • agree - b k l o l i
Fri May 27 17:48:56 2016 b k l o l i


• s/l romp-pah-sawj sm for context pls
+ mt
Fri May 27 13:44:28 2016 mt
pt has Hill-Sachs deformity of knee, may consider **romp-pah-sawj** when assessed intraoperatively
** • just found it *remplissage* - mt
Fri May 27 13:45:57 2016 mt


• just for interest, a whole plastics OR report, no site listed, skin flaps & all! Nm
- mt
Fri May 27 12:55:46 2016 mt


• nerve damage in shoulder. Hear the word cephalic but next word is mush
+ sm
Fri May 27 12:02:26 2016 sm
We also have the results of the EMG. MRI of the shoulder does not have abnormal findings, which is good. He notes it does show that the cephalic s/l (2 syllables) nerve root is not working which would explain why the shoulder is drooping and he some diminished function.
** • nevermind-correcting himself and it's accessory nerve - op
Fri May 27 12:09:31 2016 op


• s/l spinary muscles
+ jg
Fri May 27 09:05:46 2016 jg

There is some mild intrinsic hand muscle atrophy on the left especially in the ulnar distribution. She had diminished reflexes in the left upper extremity. Deltoid and infraspinatus were at about 4/5. The brachioradialis and biceps were near normal. The triceps was about 4/5, and the wrist extensors and finger extensors were about 4/5. Ulnar strength was about 4/5, as was median distribution. There were no obvious sensory deficits that could be easily mapped out, but the arm appeared to be diffusely desensitized to some degree.

Compared to the prior studies dated March 31, 2016, the results show significant improvement in the left upper extremity both in terms of nerve conduction, late responses, and motor recruitment. There is improvement in the radial, ulnar, and median distribution. There was also improvement in the left deltoid. The s/l splinary muscles were not checked.

• He has also had _______ coronary stent in 2013
+ wav
Fri May 27 07:20:39 2016 wav
The patient has had epidural steroid injections in the past. He has also had _______ coronary stent in 2013, and coronary bypass surgery dates back to 1995.

The patients family history is notable for heart disease.

** • his last - isgal
Fri May 27 07:26:18 2016 isgal

**** • thanks - -
Fri May 27 07:45:22 2016 -


• Appropriate risks and benefits of surgery had been discussed with the ...
+ wav
Fri May 27 04:41:33 2016 wav
Appropriate risks and benefits of surgery had been discussed with the patient. Appropriate safety time-out had been taken <____> risks and benefits <____>. The patient was supine under general anesthesia. We gently ranged his right shoulder.

• Then, at that time after negative aspiration, 30 of Kenalog along with ...
+ mp3
Fri May 27 04:02:00 2016 mp3
Then, at that time after negative aspiration, 30 of Kenalog along with 1 mL of 0.25% Marcaine was injected <____> into the joint.
** • nevermind. - guy
Fri May 27 04:11:32 2016 guy


• The 22-gauge needle was advanced down to the SI joint to the inferiorm ...
+ wav
Fri May 27 03:36:12 2016 wav
The 22-gauge needle was advanced down to the SI joint to the inferiormost aspect of the joint where a distinctive pop was appreciated and bone was contacted. The needle was then backed off and <____> contrast delineated spread into the joint and out of the joint.
** • nevermind. - guy
Fri May 27 04:11:25 2016 guy


• As per the husband, the patient was confused over the last couple of weeks with sm
+ wav :)
Fri May 27 03:04:28 2016 wav :)
speech and __________ weakness.
** • ...the patient states she had frequent falls. - billybob
Fri May 27 03:33:17 2016 billybob

**** • Thanks. - :)
Fri May 27 04:11:48 2016 :)

**** • Thanks a lot - guy
Fri May 27 03:53:31 2016 guy

****** • oops. sorry. not my post. - guy
Fri May 27 03:54:05 2016 guy


• PREOPERATIVE DIAGNOSES: 1. Status post fall. 2. Lumbar facet art ...
+ mp3
Fri May 27 03:04:21 2016 mp3
PREOPERATIVE DIAGNOSES:
1. Status post fall.
2. Lumbar facet arthropathy.
3. Lumbar facet synovitis and inflammation.
4. Lumbar radiculopathy.
5. Disc herniation with neural foraminal stenosis <____> lumbar radiculopathy.


** • ?non myelopathic" lumbar radiculopathy. - :)
Fri May 27 03:07:42 2016 :)

**** • Thanks a lot - guy
Fri May 27 03:11:10 2016 guy


• CT head showed no acute intracranial abnormality, chronic subdural hematomas ______sm
+ :) wav pending
Fri May 27 02:27:52 2016 :) wav pending
with minimal subacute hemorrhage in the left frontal subdural hematoma, no acute hemorrhage identified.
** • Already sent it in. - :)
Fri May 27 03:03:14 2016 :)

** • pls post your wav. u should have posted it after my acknowledge below. - guy
Fri May 27 03:02:58 2016 guy

**** • You could just erase you wav. That way people don't have to follow + every post - sm
Fri May 27 03:41:33 2016 every post - sm
to see when someone's question has been answered.

• The patients head was rotated towards the left initially where the &# ...
+ mp3
Fri May 27 02:26:00 2016 mp3
The patients head was rotated towards the left initially where the <____> from the thoracic spine was initiated
** • I think I hear "enumeration" - Questyr
Fri May 27 02:38:54 2016 Questyr

**** • Thanks a lot - guy
Fri May 27 02:44:02 2016 guy


• The patient was transferred to the operating room and placed in a pron ...
+ wav
Fri May 27 02:20:43 2016 wav
The patient was transferred to the operating room and placed in a prone position in a way so that the cervical facet <____> were identified. The patients head was rotated towards the left initially where
** • and positioned in a way...layers - billybob
Fri May 27 02:33:44 2016 billybob

**** • Thanks a lot - guy
Fri May 27 02:35:10 2016 guy


• I stressed it back to 90 degrees of flexion and there was no disruptio ...
+ mp3
Fri May 27 00:21:28 2016 mp3
I stressed it back to 90 degrees of flexion and there was no disruption of the repair site, so I irrigated out the wounds, let the tourniquet down, and then closed with 2-0 Vicryl, 3-0 Monocryl, and then <____> subcuticular suture with <____> Steri-Strips, a bulky dressing. The brace was applied and he went to the recovery room.
** • the assistant did a - Q
Fri May 27 00:59:13 2016 Q

** • #2 Benzoin and - Questyr
Fri May 27 00:58:54 2016 Questyr

**** • Thanks a lot - guy
Fri May 27 01:00:21 2016 guy


• An incision over the anterior aspect of the knee from the quad tendon ...
+ wav
Fri May 27 00:14:28 2016 wav
An incision over the anterior aspect of the knee from the quad tendon _____ patella was made and dissection was carried down through the subcutaneous tissue

POSTOPERATIVE DIAGNOSIS: Rupture of the quadriceps tendon of the left knee.

PROCEDURE PERFORMED: Repair of the left quadriceps tendon.

** • I think I hear "all the way to the" - Questyr
Fri May 27 00:58:23 2016 Questyr

**** • Thanks a lot - guy
Fri May 27 01:00:12 2016 guy


• The soft tissue was elevated from the fracture site and it was externa ...
+ wav
Thu May 26 23:59:40 2016 wav
The soft tissue was elevated from the fracture site and it was externally rotated <____>. I went ahead and pulled the foot down, internally rotated it, and then helped reduced it with the bone holding clamp.
** • and shortened - nm
Fri May 27 00:05:33 2016 nm

**** • Thanks a lot - guy
Fri May 27 00:08:19 2016 guy


• A total of 450 cc of tumescent was injected and a total of 250 cc of a ...
+ wav
Thu May 26 23:34:12 2016 wav
A total of 450 cc of tumescent was injected and a total of 250 cc of aspirate was obtained from the axilla, 50 cc was injected into each side and approximately 25 cc was aspirated from each side. At this time, the fat was placed into <____> cannulae for injection after <____> and the fat was then injected into the upper medial breast on both sides.
** • She says "cannula" (singular...not cannulae plural) - Questyr
Thu May 26 23:56:27 2016 Questyr

** • 1. 3 cc 2. it was purified - nm
Thu May 26 23:39:19 2016 nm

**** • Thanks a lot - guy
Thu May 26 23:42:44 2016 guy


• The pocket appeared to be too large, too wide laterally, and also too ...
+ wav
Thu May 26 23:20:49 2016 wav
The pocket appeared to be too large, too wide laterally, and also too low inferiorly. Capsulorrhaphy sutures were placed inferiorly using 2-0 PDS, laterally a lateral capsular flap was elevated and sutured to the lateral capsule using 2-0 PDS. Capsulotomy was performed superiorly to expand the pocket. At this time, <____> and the patient was <____> contour. Again, the skin was prepped with Betadine and pocket was copiously irrigated with triple antibiotic irrigation. A Blake drain was placed and identical
** • I think I hear #2 ____ and she did have good - Q
Thu May 26 23:25:26 2016 Q

** • I think I hear #1 "the sizer was used" - Questyr
Thu May 26 23:24:51 2016 Questyr

**** • Thanks a lot - guy
Thu May 26 23:26:46 2016 guy


• Please help with op report for cholecystectomy.
+ M
Thu May 26 23:18:53 2016 M
The skin incisions were closed with 4-0 Monocryl suture. s/l Epistles?? were placed. TIA

• At this time, the pocket was copiously irrigated with triple antibioti ...
+ mp3
Thu May 26 23:03:19 2016 mp3
At this time, the pocket was copiously irrigated with triple antibiotic irrigation and hemostasis was assured <____> bilaterally. The incision was prepped with Betadine and the gloves were changed.
** • A ??? drain was placed and brought out laterally - nm
Thu May 26 23:23:50 2016 nm

**** • I think I hear "A Blake drain was placed and brought out laterally" - Q
Thu May 26 23:26:38 2016 Q

** • I hear something like "___________ was brought out laterally." - Questyr
Thu May 26 23:22:39 2016 Questyr

**** • Thanks a lot everybody + guy
Thu May 26 23:26:14 2016 guy
PROCEDURE PERFORMED: Removal of bilateral breast tissue expanders and placement of silicone gel breast implants, bilateral capsulotomy, liposuction of bilateral anterior axilla, fat grafting to bilateral breasts.

• At this time, different sizers were used to determine the best implant ...
+ wav
Thu May 26 23:00:13 2016 wav
At this time, different sizers were used to determine the best implant that would provide the most pleasant contour for the patient. <____> Allergan style 410 and also the InSPIRA <____> smooth, round implants were tried. It was felt that the round high profile implants would give the best contour for the patient.
** • The anatomically shaped 2. line of - nm
Thu May 26 23:06:31 2016 nm

**** • Thanks a lot - guy
Thu May 26 23:15:24 2016 guy


• The capsule was examined and appeared to be thin and pliable. Capsulo ...
+ wav
Thu May 26 22:55:27 2016 wav
The capsule was examined and appeared to be thin and pliable. Capsulotomy was performed superiorly to <____> the pocket. At this time, different sizers were used to determine the best implant that would provide the most pleasant contour for the patient
** • expand - nm
Thu May 26 22:58:48 2016 nm

**** • Thanks a lot - guy
Thu May 26 22:59:46 2016 guy


• She was then taken to the operating room and placed supine on the oper ...
+ wav
Thu May 26 22:49:52 2016 wav
She was then taken to the operating room and placed supine on the operating room table. After adequate general anesthesia was established, the <____> prepped and draped in standard sterile fashion.

POSTOPERATIVE DIAGNOSIS: History of breast cancer.

PROCEDURE PERFORMED: Removal of bilateral breast tissue expanders and placement of silicone gel breast implants, bilateral capsulotomy, liposuction of bilateral anterior axilla, fat grafting to bilateral breasts.


** • the torso was - nm
Thu May 26 22:53:10 2016 nm

**** • Thanks a lot - guy
Thu May 26 22:53:57 2016 guy


• This was followed by left breast radiation which she completed in Dece ...
+ wav
Thu May 26 22:44:07 2016 wav
This was followed by left breast radiation which she completed in December 2015. She was <____> and now presents for her second stage surgery. She was counseled extensively regarding the risks, benefits, complications, and alternatives to the proposed surgery.
** • fully expanded - nm
Thu May 26 22:47:13 2016 nm

**** • Thanks a lot - guy
Thu May 26 22:48:45 2016 guy


• The patient is a 33-year-old female who had previously undergone bilat ...
+ wav
Thu May 26 22:37:37 2016 wav
The patient is a 33-year-old female who had previously undergone bilateral mastectomy with placement of tissue expanders in September 2015 for a left-sided breast cancer. This was followed by left breast radiation <____> in December 2015.
** • which she completed - nm
Thu May 26 22:40:44 2016 nm

**** • Thanks a lot - guy
Thu May 26 22:41:01 2016 guy


• Virtually no external rotation in abduction. Fairly good flexion to 100 degrees, ___
+ mp3 posted
Thu May 26 20:50:58 2016 mp3 posted
80 degrees.

shoulder exam
** • pure abduction? - nm
Thu May 26 20:57:16 2016 nm

**** • thanks - OP
Thu May 26 21:16:40 2016 OP


• SVA, please help
+ acrossmiles
Thu May 26 20:30:26 2016 acrossmiles
doc says,

Few dental restoration is noted.

is/are? restoration/s?

thanks
** • yup. thanks :-) - acrossmiles
Thu May 26 21:10:37 2016 acrossmiles

** • Could he just be saying "Few dental restorations noted." ??? - Questyr
Thu May 26 20:33:41 2016 Questyr


• The patient was also admitted in April 2016 for the same problem and at that time, sm
+ wav :)
Thu May 26 19:24:29 2016 wav :)
Dr. **** was consulted, who evaluated the patient and recommended to discharge the patient __________ with the Foley catheter and the need for further followup at the **** Medical Center with his urologist.
** • I think she is saying "to me" - Questyr
Thu May 26 19:29:09 2016 Questyr

**** • Thanks Q. - :)
Thu May 26 20:56:14 2016 :)


• west or West?
+ gt
Thu May 26 18:00:59 2016 gt
He did ski a number of times out west and the shoulder worked well for him.
** • Thank you. - gt
Thu May 26 18:07:33 2016 gt

** • capitalize - sm + taco
Thu May 26 18:06:06 2016 taco
Capitalize points of the compass when they designate geographical parts of a country, region or city.

Google: "out west" capitalization

• multiroot nerve issue or multiroute nerve issue?
+ tia
Thu May 26 17:43:50 2016 tia
IMPRESSION: This is an abnormal study. It is difficult to say, but I do think the patient has significant bilateral carpal tunnel syndrome. In addition, I also think she has a left cubital tunnel syndrome. I cannot entirely rule out cervical radiculopathy, especially with the poor compound muscle action potentials of the median and ulnar motor nerves, especially on the left. However, the findings would suggest a *multiroot/route nerve issue*, and in an 84-year-old, this may be insurmountable. However, fixing her carpal tunnels might be somewhat beneficial and reduce symptoms. Clinical correlation is recommended.
** • I'd say "multiroot" (or multi-root) as in nerve roots... + taco
Thu May 26 18:12:58 2016 taco
when I Google multiroot with "carpal tunnel" I don't get a whole lot of hits, but the ones I get look pretty good.
**** • ... - thanks
Thu May 26 18:32:48 2016 thanks


• Pelvic "iliectasis" ?
+ k
Thu May 26 16:05:35 2016 k
CT indicated a very large bladder and mild left-sided pelvic "iliectasis"

Thanks for any help!
** • Pelvicaliectasis (all one word) + taco
Thu May 26 18:02:36 2016 taco
(can't post a link, but this is what comes up when you Google it)

Pelvicaliectasis is a term used to describe a dilated renal pelvis and calyces. It is not synonymous with the word hydronephrosis. Hydronephrosis is a term used to describe a dilated renal pelvis and calyces that are specifically caused by an obstructive process.
**** • An even better suggestion (I've no doubt U R right.) - Q
Thu May 26 18:35:21 2016 Q

** • Perhaps "pelviectasis" (see link) + Questyr
Thu May 26 16:17:39 2016 Questyr
link

• urodynamics ____ trials
+ wav
Thu May 26 15:06:00 2016 wav
BRIEF HISTORY: A 79-year-old male, postop retention, status post hernia repair, elevated PSA, diagnosed with prostate cancer, BPH, bladder outlet obstruction confirmed, urodynamics ____ trials. Plan for radiation but needs to void prior with a TURP.


** • failed multiple void - nm
Thu May 26 15:36:04 2016 nm

**** • thanks - -
Fri May 27 07:06:55 2016 -


• We then everted the patella. It was very s/l "abb er nay ic" however the sm
+ mt
Thu May 26 13:43:53 2016 mt
thickness of it was approximately 5 mm laterally.
** • eburnated? - nm
Thu May 26 14:08:42 2016 nm

**** • darn! Just flagged it. Thank you that must be it. - mt
Thu May 26 14:14:26 2016 mt


• graduated stepwise or graduated, stepwise??
+ dk
Thu May 26 12:58:22 2016 dk
He needs to do that in a graduated stepwise fashion.
** • Thanks. That is what I did. - dk
Thu May 26 14:44:25 2016 dk

** • I would think "graduated, stepwise" (see grammar link, item 5..see what you think) + Questyr
Thu May 26 14:21:03 2016 Questyr
link

• doc says Quote "pins and needlely" needlely not a word but quoted
+ use it?
Thu May 26 11:56:47 2016 use it?
thumb is a little "pins and needlely"
** • I would BTJMO - Questyr
Thu May 26 11:59:17 2016 Questyr

**** • agree - me
Thu May 26 12:04:25 2016 me


• ulnar-sided wrist pain
+ b o h b c p
Thu May 26 11:52:28 2016 b o h b c p
He is still able to perform most activities "with cross rope" but has significant pain with rotation.

The audio is really not good.


• s/l plet-ary or fluttery
+ Alicia
Thu May 26 11:35:00 2016 Alicia
Patient has pacemaker with episodes of oversensing and episodes of atrial flutter detected by the device.

Sentence: The patient was seen for a routine check today. She had 1 episode of oversensing with a sensing s/l plet-ary or fluttery in unipolar.
** • Sent in. - Alicia
Thu May 26 11:45:19 2016 Alicia


• pat had shoulder surgery, then fell and had leg injury and getting wound care
+ sm
Thu May 26 11:15:27 2016 sm
I would hate for her to develop bacteremia s/l "that is seated" her right shoulder.
** • listening again s/l that "a seeded" her ... - op
Thu May 26 11:19:56 2016 op

**** • seeded does make sense, seeding of the shoulder by bacteria in blood - "uh, seeded"
Thu May 26 11:51:40 2016 "uh, seeded"

**** • preceded - ?
Thu May 26 11:28:46 2016 ?

****** • anteceded-earlier in time - IMO
Thu May 26 11:33:56 2016 IMO

******** • Sorry, bu I don't think any of these make sense here. - dre
Thu May 26 11:44:45 2016 dre

********** • glad I waited on this- thanks all - for the help
Thu May 26 12:04:01 2016 for the help


• looking for name of gag in tongue tie procedure. s/l side bev. Sm
+ mt
Thu May 26 11:05:22 2016 mt
the patient had the **side bev gag** placed
** • never mind, I think she is just saying "side mouth gag" - mt
Thu May 26 11:09:18 2016 mt


• After proper drape and prep and repeat time-out procedure, fluoroscopy ...
+ wav
Thu May 26 09:04:20 2016 wav
After proper drape and prep and repeat time-out procedure, fluoroscopy was used to establish midlateral and direct anterior portal utilizing **ASIS and a line from the greater trochanter**. <____> atraumatically entering the capsule. A small capsular release was made where the labrum was evaluated
** • I hear "the scope" but that's all. Need more coffee. - nm
Thu May 26 09:32:27 2016 nm

**** • Thanks a lot - guy
Thu May 26 09:38:14 2016 guy


• We then broke off the *paddles*.
+ sm
Thu May 26 09:01:53 2016 sm
I then with fluoroscopy and intraoperative EMGs, percutaneously placed pedicle screws at L4 and L5 bilaterally. We were able to get all the pedicle screws in without much difficulty and none of the screws caused any nerve root irritation up to 25 milliamps. With the four screws in place, we were able to place a longitudinal member and locked down the locking caps. We then broke off the paddles.
** • See reference to "paddles" in this link (do a ctrl F with "paddle.") + Oasis
Thu May 26 09:22:20 2016 Oasis
link



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