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Apr 26 00:36
• This incision was deepened through the subcutaneous tissues and fascia ...
+ mp3
Wed Apr 26 03:12:24 2017 mp3
This incision was deepened through the subcutaneous tissues and fascial layers and the rectus muscles in a muscle sling fashion until an opening sufficient for two fingers was created. The colon was then delivered through the _____ without tension or torsion.
** • nevermind. - guy
Wed Apr 26 03:17:09 2017 guy


• We initially attempted to perform a diagnostic laparoscopy in order to ...
+ wav
Wed Apr 26 02:48:08 2017 wav
We initially attempted to perform a diagnostic laparoscopy in order to assess whether there was an evidence of intraabdominal _____ and to perform lysis of adhesions. However, a vertical midline incision was made above the previous laparotomy incision down to the level of the fascia
** • nevermind. - guy
Wed Apr 26 03:16:59 2017 guy


• The cervical cone biopsy was then resected and sent for permanent path ...
+ wav
Wed Apr 26 00:33:43 2017 wav
The cervical cone biopsy was then resected and sent for permanent pathology. Endocervical curettage was performed with a _____ curette and these curettes were placed _____ to be sent to permanent pathology. The cone bed was then cauterized
** • nevermind. - guy
Wed Apr 26 01:21:20 2017 guy


• Medication that s/l Try-sept
+ h d f m i l
Tue Apr 25 19:14:40 2017 h d f m i l
MEDICATIONS: Levothyroxine, trazodone, Cymbalta, omeprazole, ferrous sulfate, hydrocodone, amlodipine, s/l try-sept, calcium, Tylenol.

Pt with asthma, glaucoma, hypertension, reflux, thyroid disease.
** • I will use Aricept. Perhaps that's it. Thanks - h d f m i l
Tue Apr 25 19:29:19 2017 h d f m i l

**** • If I were guessing, I'd go withTrusopt (for glaucoma) instead of Aricept. - nm
Tue Apr 25 20:31:19 2017 nm

****** • and if it was me, I'd never guess on a medication. I'd flag it and send it on but never - guess. ever.
Tue Apr 25 22:24:44 2017 guess. ever.


• Efforts to pass right internal mammary artery to transverse sinus to r ...
+ wav
Tue Apr 25 19:12:05 2017 wav
Efforts to pass right internal mammary artery to transverse sinus to reach the high marginal branch would not be possible because the _____. Accordingly, this will be used to the anterior descending coronary artery
** • the _______ was not long enough. - poi
Tue Apr 25 19:25:50 2017 poi

**** • mammary pedicle? - nm
Tue Apr 25 19:28:06 2017 nm

****** • Thanks a lot everybody - guy
Tue Apr 25 19:29:52 2017 guy


• Two segments of saphenous vein graft endoscopically harvested from the ...
+ mp3
Tue Apr 25 19:05:18 2017 mp3
Two segments of saphenous vein graft endoscopically harvested from the right lower extremity. Satisfactory _____ were obtained. The pericardium was divided in the midline and attached to wound edges.
** • conduits? - nm
Tue Apr 25 19:25:09 2017 nm

**** • Thanks a lot. - guy
Tue Apr 25 19:31:00 2017 guy

** • can't get this one - poi
Tue Apr 25 19:10:52 2017 poi

**** • Thanks for the effort. - guy
Tue Apr 25 19:12:24 2017 guy


• disease with critical obstructions and a large left anterior descendin ...
+ wav
Tue Apr 25 18:59:13 2017 wav
disease with critical obstructions and a large left anterior descending, first marginal and second marginal circumflex coronary artery. A totally obstructed right coronary artery filled late to an angiography. It was probably the _____. The right coronary artery was normal. In view of these findings, she was advised to undergo surgical revascularization. At the same time, she has undergone extensive workup for possible lupus and this rheumatology workup is in progress.
** • culprit vessel - poi
Tue Apr 25 19:10:16 2017 poi

**** • Thanks a lot. - guy
Tue Apr 25 19:11:54 2017 guy


• multiple endometriotic spots behind the right ovary, _____.
- wav :)
Tue Apr 25 15:22:46 2017 wav :)

** • micro pertubation? - poi
Tue Apr 25 15:33:08 2017 poi

**** • macro - could be
Tue Apr 25 19:08:29 2017 could be


• MUSCULOSKELETAL: Charcot deformity on the right lower extremity, _____ foot sm
+ wav :)
Tue Apr 25 14:59:55 2017 wav :)
experience on the right lower extremity.
** • ? rocker-bottom foot - mt
Tue Apr 25 15:03:09 2017 mt

** • rocker bottom - what I hear
Tue Apr 25 15:02:43 2017 what I hear

**** • thanks guys. - :)
Tue Apr 25 15:22:12 2017 :)


• to try to facilitate a small-as-possible radiation field - hyphenated?
- ??
Tue Apr 25 14:52:13 2017 ??

** • looks fine IMHO - mt
Tue Apr 25 15:03:34 2017 mt


• 2+ follicles in each eye consistent with a ______ s/l "bromonine allergy".
+ any ideas?
Tue Apr 25 14:28:10 2017 any ideas?
Slit lamp examination showed 2 shunts superotemporally in each eye with 2+ rubeosis in the right eye, posterior chamber intraocular lens in each eye, 2+ follicles in each eye consistent with a ______ s/l "bromonine allergy".
** • got it = brimonidine - never mind
Tue Apr 25 14:29:14 2017 never mind


• She has been on vancomycin since January 2015 or 2016?
- :) wav
Tue Apr 25 14:23:19 2017 :) wav

** • S/L 15 to me.?? - k p e c i h
Tue Apr 25 14:40:22 2017 k p e c i h

**** • thanks that is what I heard too but VR put 16 so wanted confirmation. - :)
Tue Apr 25 14:45:54 2017 :)


• She has no issues around __ a washing her hands but she does like a routine.
+ WAV
Tue Apr 25 12:33:32 2017 WAV
She also reports that when she is walking, she feels like everything needs to be equal. She has no issues around __ a washing her hands but she does like a routine.
** • germs or washing - taco
Tue Apr 25 12:40:17 2017 taco

**** • thank you taco! - gg
Tue Apr 25 12:40:26 2017 gg


• preoperative workup showed a **hansy** nodule on the contralateral
+ sm
Tue Apr 25 11:45:15 2017 sm
An excisional biopsy of this small nodule showed an ER positive invasive ductal carcinoma. The preoperative workup showed a **hansy** nodule on the contralateral side, and the biopsy of that nodule showed atypical duct hyperplasia. Based on this findings and the patient's preference, a right therapeutic mastectomy and left prophylactic mastectomy has been performed.
** • hazy? - poi
Tue Apr 25 12:14:19 2017 poi

** • enhancing? - nm
Tue Apr 25 12:11:53 2017 nm


• appeared to be an **elsewhere** failure, located
+ sm
Tue Apr 25 11:44:28 2017 sm
FINDINGS: The patient is a 52-year-old white female with a history of malignant neoplasm of the right breast, treated six years ago with segmental resection, radiation, and chemotherapy. She recently developed what appeared to be an **elsewhere** failure, located in the retroareolar area of the right breast.
** • it's ok + SM
Tue Apr 25 11:48:25 2017 SM
"An elsewhere failure was defined as an ipsilateral breast recurrence... "
**** • ok - thanks
Tue Apr 25 11:53:37 2017 thanks


• Why can't I hear the wav files or the MP3 or 4 files?
+ SM
Tue Apr 25 10:53:14 2017 SM
Do I need to change my computer settings?
** • check internet options, advanced tab, and look for playing sounds...make sure that is + poi
Tue Apr 25 11:24:51 2017 poi
checked
**** • Thanks. I can hear sounds, no problem. I have windows 10 and it's new to me. + op
Tue Apr 25 11:46:52 2017 op
x

• fecal debris with **seeds **
+ ?
Tue Apr 25 10:31:22 2017 ?
In the proximal descending colon, there was a 1-cm adenomatous-type polyp removed with snare cautery and obtained for pathology. Remainder of the descending, sigmoid, and rectum were unremarkable. There were no other masses or mucosal lesions noted. No diverticula were noted. The quality of the prep was good. He had fecal debris with seeds that precluded total illumination of all small lesions. He did have internal hemorrhoids.
** • fecal debris with seeds. Must have eaten something that had seeds in it? I'd go with it - its not uncommon
Tue Apr 25 12:42:44 2017 its not uncommon

** • I don't see anything wrong with "seeds" being in the fecal debris. - taco
Tue Apr 25 11:00:22 2017 taco

** • not sure - flagging
Tue Apr 25 10:46:03 2017 flagging


• GU procedure on male patient
+ RMT
Tue Apr 25 10:22:05 2017 RMT
A 0.035-inch Glidewire was then passed through into the bladder. Following this, serial dilatation with s/l male dilators was performed starting at 18 and going up to 24. With the help of the cystoscope, I was able to dilate initially, and hence, I could start at 18 with the s/l male dilators.

Google keeps leading me to something to do with ordering by mail. For some reason, I think the spelling is mail, but I just can't seem to document it.
** • Sounds good to me.. male dilators as opposed to female dilators. - k p e c i h
Tue Apr 25 10:27:40 2017 k p e c i h

**** • Thanks, kpecih!~nm - RMT
Tue Apr 25 10:29:41 2017 RMT


• uterus was congested _____ 6- to 8-week size.
+ mp3
Tue Apr 25 10:19:32 2017 mp3
FINDINGS: Retained products of conception were retrieved. The uterus was congested _____ 6- to 8-week size. There were no adnexal masses. The patient was disposition to the Recovery Room in stable condition. There were no complications.
** • flagged - -
Tue Apr 25 10:44:45 2017 -


• med s/l argobantin
+ ?
Tue Apr 25 09:18:47 2017 ?
The patient was admitted and underwent a laparoscopic robotically assisted right partial nephrectomy. Postoperatively, he was seen in consultation by Hematology due to the fact that he has a history of AT3 deficiency. He was started on _____ by Hematology and subsequently the patient was discharged, condition improved after he had therapeutic INR.
** • i found argatroban ?? - k p e c i h
Tue Apr 25 10:29:22 2017 k p e c i h

**** • Oh duh... just noticed you posted that! I think today is Monday again. - k p e c i h
Tue Apr 25 10:29:53 2017 k p e c i h

****** • heck, just nevermind. I think it is argatroban pronounced wrong. - k p e c i h
Tue Apr 25 10:30:47 2017 k p e c i h

** • could the "bantin" part of the s/l = vitamin? (see google hits link) + Questyr
Tue Apr 25 09:23:47 2017 Questyr
link
**** • will try that - ty
Tue Apr 25 09:45:17 2017 ty


• A few questions...
+ mp4
Tue Apr 25 08:35:47 2017 mp4
There was also noted to be multiple submucosal myomas noted on the anterior, posterior and _____ surfaces. Subsequent to this, the endometrial curette was removed. The ______ removed from the cervix. The speculum was ______ posterior portion of vagina. The uterus was bimanually palpated. The patient reversed from general anesthesia and taken to recovery room in stable condition.
** • ???removed from the??? - Questyr
Tue Apr 25 09:18:37 2017 Questyr

**** • This is for #3 blank - Q
Tue Apr 25 09:18:53 2017 Q

** • 2. Allis was entered into the cervix. (??) Maybe someone else can get this. I am so + k p e c i h
Tue Apr 25 08:46:26 2017 k p e c i h
unsure of #1 I don't even want to guess. Sorry!

• yielding clear ______ urine
+ mp3
Tue Apr 25 08:29:05 2017 mp3
PROCEDURE NOTE: The patient was taken to the operating room, prepped and draped in usual sterile fashion with induction of general anesthesia. The bladder was catheterized yielding clear ______ urine. She was placed in dorsolithotomy position. Speculum was placed at the anterior and posterior part of the vagina.
** • Sorry, got this. catheterized yielding clear yellow/amber urine. - nm
Tue Apr 25 08:29:39 2017 nm


• anterior and posterior _____ surface.
+ wav
Tue Apr 25 08:24:57 2017 wav
FINDINGS: There were multiple submucous myomas noted on the anterior and posterior _____ surface. There is moderate amount of polypoid tissue retrieved. The patient was disposition to the Recovery Room in stable condition.
** • again, same word as above. Just can't get it! I hate it when that happens. - k p e c i h
Tue Apr 25 08:47:06 2017 k p e c i h

**** • I think somewhere in there is "lateral ?something? surfaces" - Questyr
Tue Apr 25 09:25:32 2017 Questyr


• The wound was then thoroughly irrigated using bacitracin and saline. ...
+ mp3
Tue Apr 25 08:00:44 2017 mp3
The wound was then thoroughly irrigated using bacitracin and saline. The subgaleal #7 JP drain was tunneled and secured to the skin with #0 Vicryl suture. This was _____ submuscularly under the temporalis and the wound was closed with a combination of interrupted #0, 2-0, and 3-0 Vicryl sutures for the galea and staples for the skin
** • Thanks a lot. - guy
Tue Apr 25 08:03:07 2017 guy

** • tunneled - k p e c i h
Tue Apr 25 08:02:24 2017 k p e c i h


• The wound was thoroughly irrigated. Hemostasis was obtained using a c ...
+ mp3
Tue Apr 25 07:51:00 2017 mp3
The wound was thoroughly irrigated. Hemostasis was obtained using a combination of hemostatic agents and bipolar cautery. Papaverine-soaked Gelfoam was placed on the vessels _____ allowed to sit there for a few minutes and then was subsequently removed.
** • on which we were working and just let it sit - k p e c i h
Tue Apr 25 07:58:32 2017 k p e c i h

**** • Thanks a lot. - guy
Tue Apr 25 08:00:13 2017 guy


• A CT angiogram was performed which showed a left-sided PComA and anter ...
+ wav
Tue Apr 25 07:14:56 2017 wav
A CT angiogram was performed which showed a left-sided PComA and anterior crural aneurysms as well as a right-sided _____ segment MCA aneurysm that is 2 mm. The left-sided aneurysms were 3 and 4 mm in size and thus, were more _____ ones to rupture. Thus, the patient was initially planned for an angiogram with possible embolization, though, the aneurysm was found to be too small to support endovascular embolization and thus, decision was made to clip the aneurysms
** • 1. mid and one segment 2. likely than the _____ to rupture. - k p e c i h
Tue Apr 25 08:00:21 2017 k p e c i h

**** • Thanks a lot. - guy
Tue Apr 25 08:02:36 2017 guy


• Attempts were made to restore implant #18 but secondary to pain and di ...
+ mp3
Tue Apr 25 05:06:26 2017 mp3
Attempts were made to restore implant #18 but secondary to pain and discomfort we were unable to provide a proper restoration. After lengthy discussion with _____ and the patient, it was decided that the implant in site #18 would be removed in conjunction with the remaining hardware in place from the previous grafting procedure.
** • nevermind. - guy
Tue Apr 25 05:25:18 2017 guy


• Gentle hydrodissection was performed using BSS to ensure free rotation ...
+ wav
Tue Apr 25 04:16:31 2017 wav
Gentle hydrodissection was performed using BSS to ensure free rotation of the lens nucleus. Given concern for zonular dehiscence, the nucleus was _____ out using phacoemulsification and flipped out of the capsular bag. Viscoat was placed behind the lens
** • agree with bowled out. - nm
Tue Apr 25 07:12:50 2017 nm

** • bowled? - k p e c i h
Tue Apr 25 07:12:07 2017 k p e c i h

**** • Thanks a lot everybody - guy
Tue Apr 25 07:37:43 2017 guy


• The K-wire was subsequently bent and tamped in to make it flush with t ...
+ wav
Mon Apr 24 21:41:59 2017 wav
The K-wire was subsequently bent and tamped in to make it flush with the bone to prevent protrusion. Acceptable reduction and fixation was confirmed on fluoroscopy. Subsequently, a Cotton test was performed to test the syndesmosis and was deemed to be stable and these images were _____ on fluoroscopy. All wounds were copiously irrigated and a layered closure was performed. A sterile dressing was applied and the patient was placed into an AO splint.
** • recorded - poi
Mon Apr 24 22:15:06 2017 poi

**** • Thanks a lot. - guy
Mon Apr 24 22:17:43 2017 guy


• Preoperative Diagnosis: DENTAL CARIES. Procedure: RESTORA ...
+ wav
Mon Apr 24 20:48:03 2017 wav
Preoperative Diagnosis:
DENTAL CARIES.

Procedure:
RESTORATIONS AND EXTRACTIONS OF TEETH.

INDICATIONS: The patient is 6-year-5-month-old male with significant medical findings of seizures diagnosed at age 4 years old, cerebral palsy. Seizures occurred many times a week at night. The patient has interrupted _____ at six months old _____ resuscitated, GI reflux. The patient has multiple carious primary teeth.
** • had interrupted SIDS at six months old, was resuscitated, - maybe?
Mon Apr 24 21:20:52 2017 maybe?

**** • thanks a lot. - guy
Mon Apr 24 21:23:00 2017 guy


• Preoperative Diagnosis: LEFT KNEE DEGENERATIVE JOINT DISEASE. ...
+ wav
Mon Apr 24 19:29:32 2017 wav
Preoperative Diagnosis:
LEFT KNEE DEGENERATIVE JOINT DISEASE.

Procedure:
LEFT TOTAL KNEE ARTHROPLASTY, CRUCIATE RETAINING, CEMENTED.

IMPLANTS:
1. Smith & Nephew Journey II femoral component, size #2.
2. Smith & Nephew Journey II tibial baseplate, size #1.
3. Smith & Nephew _____ highly crosslinked 9-mm poly.

** • deep dish. - billybob
Mon Apr 24 19:46:40 2017 billybob

**** • Thanks a lot. - guy
Mon Apr 24 19:49:05 2017 guy


• Mastopexy: ...to make a full-thickness ____on the inferior aspect of ______
+ mp4 posted
Mon Apr 24 18:27:12 2017 mp4 posted
I then turned my attention to the left breast. A 42 mm cookie cutter was centered on the left nipple. An incision was made using this mark. I then made another incision around the outer periphery of the areola using my preoperative markings. The intervening skin was then deepithelialized. I then used the Bovie electrocautery to make a full-thickness ______ on the inferior aspect of _____. The dissection was carried down to the anterior surface of the capsule
** • I think I hear.....incision on the inferior aspect of this ring. - mp4 posted
Mon Apr 24 18:28:47 2017 mp4 posted

**** • ... + j g o j h m
Mon Apr 24 20:47:42 2017 j g o j h m

**** • Only old mp4 is there. - Questyr
Mon Apr 24 20:36:45 2017 Questyr


• episiotomy for s/l control held delivery sm pl
+ mt
Mon Apr 24 17:52:52 2017 mt
(Baby's feet and right and left shoulder delivered vaginally.)

The baby's body was now given to an assistant to hold while an episiotomy done to facilitate **control held** delivery. Upon the right-sided episiotomy **control held** delivery performed and head was subsequently delivered with ease. (does not s/l head)
** • I would think "controlled head delivery" (see google hits link) + Questyr
Mon Apr 24 20:34:11 2017 Questyr
link

• mastopexy procedure
+ mp3 posted
Mon Apr 24 17:24:51 2017 mp3 posted
At this point, an eccentric circle around the nipple-areola complex was deepithelialized in the superior point, intersecting a mark 19 cm from the sternal notch at the midline. _____ cut medially and laterally to allow appropriate movement of the nipple-areola complex.
** • The dermis? - poi
Mon Apr 24 19:18:04 2017 poi

**** • That's totally it! Thank you so much! - mp3 posted
Mon Apr 24 19:35:21 2017 mp3 posted


• Axillary roll placed in the left axilla. Beanbag was used to ___ position.
- wav :)
Mon Apr 24 14:30:15 2017 wav :)

** • I don't hear a wav? - k p e c i h
Mon Apr 24 15:56:32 2017 k p e c i h


• non-medical word, s/l "shorten/shorn" but does not make sense
+ mt
Mon Apr 24 12:09:43 2017 mt
(ERCP)
GE junction measured 11 mm. Scope passed through. Large occupying fundic mass. Pylorus was visualized and easily traversed. The fundic mass did make it difficult to **shorten** the scope but we are able to achieve the second portion of the duodenum.
** • Yes "shorten" ...see google book hit that describes the maneuver + Questyr
Mon Apr 24 14:08:41 2017 Questyr
link
** • not sure, but keep verb tense the same. Pylorus WAS visualized. but we WERE unable to... + SM
Mon Apr 24 13:37:30 2017 SM
measured. passed through large occupying fundic mass (one sentence, not two).


** • flagged - mt
Mon Apr 24 12:33:39 2017 mt


• Cholecystectomy in 2009, ___ debridement.
- wav :)
Mon Apr 24 12:02:09 2017 wav :)

** • sent in - :)
Mon Apr 24 12:32:58 2017 :)


• Pain lasting ____ seconds to 5 minutes.
- wav :)
Mon Apr 24 11:35:49 2017 wav :)

** • Pain lasts anywhere from 30 seconds to 5 minutes. - taco
Mon Apr 24 11:49:28 2017 taco

**** • Thanks taco - :)
Mon Apr 24 12:00:52 2017 :)


• Are you familiar with cruises?
+ sm please
Mon Apr 24 11:24:58 2017 sm please
Patient needs a total knee replacement.

She has a *s/l England passage cruise* scheduled for this fall and would like to have the knee rehabbed somewhat before that.


** • Think he is saying inland passage - thank you. + OP
Mon Apr 24 11:30:48 2017 OP
x

• The pronator quadratus was covered over the plate and closed to the be ...
+ wav
Mon Apr 24 02:44:33 2017 wav
The pronator quadratus was covered over the plate and closed to the best of our ability; although, there was some significant amount of buttonholing and tear and damage to the _____ from the fracture initially. The subcu was closed with interrupted 2-0 Vicryls
** • PQ (pronator quadratus) - isgal
Mon Apr 24 04:37:47 2017 isgal


• S/L "Portal"
+ TYIA=)
Sun Apr 23 19:40:53 2017 TYIA=)
A 62-blade was used to split the nail. The medial *_____ was removed from the first right toenail. The matrix tissue corresponding to the *_____ was excised. The incision was extended proximally over the IPJ. The overlying soft tissue was reflected from the medial IPJ. The base of the distal phalanx was particularly noted to be hypertrophied. The enlarged bone was resected using the sagittal saw at the medial base of the distal phalanx and the head of the proximal phalanx at the medial IPJ. The area was checked to ensure complete removal of the pressure at the plantar medial IPJ. This was seen. Skin closure was then accomplished using 4-0 Nylon in simple interrupted fashion.
** • could it be "border"? - nm
Mon Apr 24 07:32:44 2017 nm

**** • by jove, I think you've got - it!
Mon Apr 24 07:51:42 2017 it!

** • I can't find anything for portal either. But, 4-0 nylon isn't capitalized. - k p e c i h
Sun Apr 23 21:15:46 2017 k p e c i h

** • I tried, but had no luck confirming your s/l of "portal" - Questyr
Sun Apr 23 20:09:02 2017 Questyr


• EXCISION OF POSTERIOR NECK MASS, 9 CM, MULTILAYERED CLOSURE
+ mp3 posted
Sun Apr 23 16:50:59 2017 mp3 posted
Closure with Dexon deep, nylon skin suture. The incision and _______ approximately 9 cm.
** • ...and sized the lipoma at approximately 9 cm. - nm
Sun Apr 23 16:56:50 2017 nm

**** • Thanks for the answer. The incision and size of the lipoma were + mp3 posted
Sun Apr 23 17:18:27 2017 mp3 posted
approximately 9 cm seems to make more sense though.


• need your opinion
+ may
Sun Apr 23 02:58:33 2017 may
Which one is correct?

A followup case of "operated mastoidectomy" or "operative mastoidectomy"?
** • Depends on what the doctor dictated. If he said operated, I'd give it to him. - k p e c i h
Sun Apr 23 07:58:44 2017 k p e c i h


• Craniotomy - bone graft - s/l* Lyle plant*
- pls help
Sat Apr 22 22:29:35 2017 pls help

** • top right has a link saying "rules" - SM + help us to help you.
Sat Apr 22 23:50:24 2017 help us to help you.
Always post context and full surrounding text. Never make your s/l the first word or the last, give us a running start and what comes after. You may not think we need it, but we do. It helps. So often it also helps to if we know if you're talking about an infant, an elderly man, etc. Or what part of body, what kind of test, etc... If asking about an obscure drug name, give us a summary of the patient's medical history. You don't have to retype all this - just copy and paste it from your report.



• A toast Will Sandberg our beloved friend and webmaster of thegreatdictator.com
+ to webmaster
Sat Apr 22 11:13:02 2017 to webmaster
Thanks for being for us Medical Transcriptionist from around the world for last 15 years..........may you live for eternity and may you have prosperous life...........

thanks again for being with us and for giving us this site........
** • looks like somebody's being sarcastic! - billybob
Sat Apr 22 17:27:08 2017 billybob

**** • belated April Fool's joke? Sure fooled me. I guess it's possibly + vlad
Sun Apr 23 14:02:59 2017 vlad
just a sincere individual wishing to show thanks to you for keeping the site open all these years. Worded oddly with the toast and all, however. Hard to know for sure.
**** • Tell me the same person wrote all those posts, right? - I swear
Sun Apr 23 09:35:05 2017 I swear

** • what? did billybob die? what is this about? - nm
Sat Apr 22 15:32:18 2017 nm

** • thank you so much Will Sandberg for this site.......... - lisa
Sat Apr 22 11:16:08 2017 lisa

** • thank you........ - alfred
Sat Apr 22 11:14:41 2017 alfred

** • ya ......thanks ...so much for this site........... - asheeth
Sat Apr 22 11:14:01 2017 asheeth


• Also, in terms of the upper eyelids, possibility of corneal abrasion, ...
+ mp3
Sat Apr 22 09:02:02 2017 mp3
Also, in terms of the upper eyelids, possibility of corneal abrasion, lagophthalmos, _____ hematoma and other related complication. She was consented for the stated procedures and taken to the operating room.
** • retroorbital - what I hear
Sat Apr 22 09:04:42 2017 what I hear

**** • Thanks a lot. - guy
Sat Apr 22 09:05:09 2017 guy


• now complains of excess skin in the neck and face areas as well as exc ...
+ wav
Sat Apr 22 08:57:10 2017 wav
now complains of excess skin in the neck and face areas as well as excess upper eyelid skin that obstructs vision. Of note, she is also _____ says that her excess skin interferes with her ability to wear hijabs and other garments for her religion and causes her irritation and social anxiety.
** • Muslim - k p e c i h
Sat Apr 22 08:58:06 2017 k p e c i h

**** • Thanks a lot. - guy
Sat Apr 22 09:02:49 2017 guy


• Preoperative Diagnosis: ______ CHRONIC RHINOSINUSITIS. Proce ...
+ wav
Sat Apr 22 02:49:17 2017 wav
Preoperative Diagnosis:
______ CHRONIC RHINOSINUSITIS.

Procedure:
ENDOSCOPIC SINUS SURGERY WITH BILATERAL MAXILLARY ANTROSTOMY, BILATERAL TOTAL ETHMOIDECTOMY, BILATERAL SPHENOIDOTOMY, LEFT FRONTAL SINUSOTOMY, WITH BILATERAL MIDDLE TURBINATE, PARTIAL RESECTION.

** • aspirin-exacerbated respiratory diseases (AERDs)? - billybob
Sat Apr 22 04:16:08 2017 billybob

**** • Thanks a lot. - guy
Sat Apr 22 04:19:05 2017 guy

** • mp3. not wav. sorry. - guy
Sat Apr 22 02:52:46 2017 guy


• The agger nasi was opened up with a Kerrison and the axilla of the mid ...
+ wav
Sat Apr 22 02:42:24 2017 wav
The agger nasi was opened up with a Kerrison and the axilla of the middle turbinate was removed with a Kerrison as well and we were able to use a maxillary sinus probe to identify the frontal sinus outflow tract, but given the dense layer of firm bone in the anterior ethmoid and posterior ethmoid, the frontal sinus outflow tract _____ was not fully opened and visualized. Next, the hemostasis was achieved with suction cautery and with Afrin-soaked pledgets.
** • nevermind. - guy
Sat Apr 22 04:36:12 2017 guy


• **almond butter appearing** fungal elements? does it make sense?
+ guy
Sat Apr 22 02:34:00 2017 guy
There was significant edematous and polypoid mucosa within the right sphenoid as well as almond butter appearing fungal elements which was copiously irrigated and suctioned and removed from the sphenoid.
** • While it is not a common description (at least not for me) one + Questyr
Sun Apr 23 00:01:18 2017 Questyr
can see images of almond butter, and I could imagine fungal elements with such an appearance....but ugh ! (IMO)

• Preoperative Diagnosis: RIGHT DISTAL HUMERUS FRACTURE, ATROPHIC NON ...
+ wav
Fri Apr 21 20:23:47 2017 wav
Preoperative Diagnosis:
RIGHT DISTAL HUMERUS FRACTURE, ATROPHIC NONUNION.

Procedure:
OPEN REDUCTION AND INTERNAL FIXATION AND BONE GRAFTING OF RIGHT DISTAL HUMERUS ATROPHIC NONUNION.

She will be discharged to home today. Her postoperative neurologic exam demonstrated fully intact sensory and motor function in the anterior interosseus, posterior interosseus, and ulnar nerve distribution. She may be admitted overnight for pain control if required. She will return to our clinic in two weeks, at which point the _____ will be taken down. The wound will be inspected and she will begin a protocol of gentle passive and active assisted range of motion exercises to prevent postoperative stiffness.
** • stumbled around splint? - poi
Fri Apr 21 20:42:46 2017 poi

**** • Thanks a lot. - guy
Fri Apr 21 20:49:15 2017 guy


• The reduction of the articular surface was then visualized under image ...
+ wav
Fri Apr 21 19:53:36 2017 wav
The reduction of the articular surface was then visualized under image intensification and found to be acceptable. A five-hole distal lateral humeral plate was then applied to the lateral column and fixed to the articular block using a 2.7 mm locking screw. The plate was then further secured to the articular block using a small pointed reduction forceps. The articular block was then reduced using a plate to the _____ shaft. The reduction was provisionally held using serrated reduction forceps and the reduction and alignment was confirmed on _____ and found to be acceptable.
** • image intensification - nm
Fri Apr 21 20:07:30 2017 nm

** • humeral... - billybob
Fri Apr 21 20:02:03 2017 billybob

**** • Thanks a lot everybody - guy
Fri Apr 21 20:09:56 2017 guy


• Patient receiving s/l ribreca for her malignancy (ovarian cancer)
- OldMT
Fri Apr 21 19:26:26 2017 OldMT

** • Rubraca - nm
Fri Apr 21 20:00:33 2017 nm


• Extensive scar about the fracture site was identified and _____ as nec ...
+ wav
Fri Apr 21 19:24:19 2017 wav
Extensive scar about the fracture site was identified and _____ as necessary. At this point, the decision was made to proceed with an olecranon osteotomy to improve our exposure as we felt the distal articular surface would be unreconstructible without better visualization.
** • removed? - guess
Fri Apr 21 19:32:38 2017 guess

**** • Thanks a lot. - guy
Fri Apr 21 19:34:44 2017 guy


• Breast augmentation. Nipple s/l bars were removed bilaterally.
- :)
Fri Apr 21 18:48:48 2017 :)

** • She had piercings. - :)
Fri Apr 21 18:54:33 2017 :)


• Anal fissure and _____ , and some mild internal hemorroidal disease.
- wav :)
Fri Apr 21 17:58:56 2017 wav :)

** • Got it. Sentinel skin pile. - :)
Fri Apr 21 18:10:20 2017 :)


• How would you type "a one six K-wire" (fracture fixation)?
- CO MT
Fri Apr 21 17:46:07 2017 CO MT

** • Finding 1.6 mm K-wire, I'm guessing that's it - CO MT
Fri Apr 21 17:49:10 2017 CO MT

**** • I have a dictator that says it that way and it is 1.6. - :)
Fri Apr 21 17:59:13 2017 :)

****** • Thanks! Don't know why they have to be so squirrelly, I've heard six two before and it's + CO MT
Fri Apr 21 18:13:20 2017 CO MT
0.062. :\

• Medications include ___ nasal sprays. s/l omezay (elderly pt w/ asthma)
+ 2p1
Fri Apr 21 16:06:00 2017 2p1
Thx.
** • update: sent it off and QA had to send it to the doc to review. - 2p1
Fri Apr 21 17:18:18 2017 2p1

** • sorry - haven't yet figured out how to load sound files. - 2p1
Fri Apr 21 16:07:08 2017 2p1


• Continue treatment with ______ 30 mg twice daily. I hear pantoprazole but it does sm
+ :) wav
Fri Apr 21 15:35:59 2017 :) wav
not come in 30 mg to my knowledge. It comes in 20 and 40.
** • lansoprazole - nm
Fri Apr 21 15:44:32 2017 nm

**** • thank you. This was making me crazy. - :)
Fri Apr 21 15:45:05 2017 :)


• This was ___ through endoscopic means and he
+ WAV
Fri Apr 21 14:16:35 2017 WAV
also had a gastroscopy recently in Bendigo for a bleeding peptic ulcer. This was ___ through endoscopic means and he has been well since then. He was put on PPI regime.
** • arrested? - poi
Fri Apr 21 14:31:07 2017 poi

**** • i think i hear that now. Thank you both for your help! - ft
Fri Apr 21 14:35:11 2017 ft

** • elicited? - mt
Fri Apr 21 14:19:27 2017 mt


• looking for type of suture (location) in partial nephrectomy sm pls
+ mt
Fri Apr 21 14:10:02 2017 mt
We used a barbed Quill suture, ran the corticomedullary junction, secured suture with Hem-o-loks and metal clips. Applied Tisseel foam to the base of the defect.

Began placing our PDS **murr-norrrhaphy** stitches. Ensuring we had good bites of capsule we placed 3 stitches across the defect. (Lower pole kidney)
** • think it might be myorrhaphy - mt
Fri Apr 21 14:19:47 2017 mt


• ASSISTANT: Carlos ___.
+ WAV
Fri Apr 21 12:54:43 2017 WAV
ASSISTANT: Carlos ___.

Dr is in VIC or NSW Australia
** • anyone Carlos Cabalag? - ??
Fri Apr 21 13:03:31 2017 ??


• The patient, at times, can ______ slowly in her infrequent subtle resting and sm
+ wav :)
Fri Apr 21 12:39:20 2017 wav :)
intention tremors and infrequent ______ cogwheel rigidity which may be from multiple sclerosis.

I know he says his but it is a her. LOL
** • move a bit slowly and has infrequent faint cogweel... - taco
Fri Apr 21 12:47:48 2017 taco

**** • "and has" (not "in his/her") - t
Fri Apr 21 12:48:10 2017 t

****** • Thanks for catching that!! - :)
Fri Apr 21 12:51:23 2017 :)


• Pulse of 88, respirations 20, blood pressure 139/_____ O2 saturations 97% on room air
- wav :)
Fri Apr 21 12:29:41 2017 wav :)

** • Old wav still there - poi
Fri Apr 21 12:36:06 2017 poi

**** • Yep sent it in. Posting a new one now. LOL - :)
Fri Apr 21 12:38:02 2017 :)


• having had a _____ appendectomy
+ wav
Fri Apr 21 12:24:38 2017 wav
After removing the polyp, the colonoscope was advanced under direct visualization proximally to the cecum. The ileocecal valve opening and the site of the appendiceal ostia both looked normal. The patient having had a _____ appendectomy. Colonoscope was then withdrawn, inspecting the entire colonic mucosal circumference on withdrawal.
** • past appendectomy - :)
Fri Apr 21 12:30:13 2017 :)




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