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May 12 17:11
• Once this anastomosis was completed, we then took a Y from our arteria ...
+ mp3
Wed Sep 28 01:23:36 2016 mp3
Once this anastomosis was completed, we then took a Y from our arterial line and connected it to the 8-mm graft line. _____ were then deaired and once adequately deaired, we resumed perfusion to the brain and to the heart.
** • The head and _____ (what I hear) - poi
Wed Sep 28 01:32:06 2016 poi

**** • Thanks a lot. - guy
Wed Sep 28 01:33:07 2016 guy


• The aorta here was frankly very friable consistent with a recent disse ...
+ wav
Wed Sep 28 01:19:53 2016 wav
The aorta here was frankly very friable consistent with a recent dissection and use of _____ was used to buttress the repair along the lateral wall of the aorta here.
** • felt + poi
Wed Sep 28 01:29:14 2016 poi
google verification: Often, strips of felt are used to buttress an aortic anastomosis in patients with fragile aortic wall tissue due, for example, to cystic medial necrosis; these strips ...
**** • Thanks a lot. Thanks for the info. - guy
Wed Sep 28 01:29:45 2016 guy


• As such, it was discussed in multidisciplinary fashion related to her ...
+ wav
Wed Sep 28 00:56:50 2016 wav
As such, it was discussed in multidisciplinary fashion related to her possible options including additional thoracic stenting with some debranching surgery as well. However, it was ultimately the _____ that in fact given her age and lack of significant comorbidities that the most durable repair for her was likely to be open surgery.
** • opinion of the group - poi
Wed Sep 28 01:03:52 2016 poi

**** • Thanks a lot. - guy
Wed Sep 28 01:11:25 2016 guy


• We then performed nephroscopy immediately identifying our stone in the ...
+ mp3
Tue Sep 27 23:44:24 2016 mp3
We then performed nephroscopy immediately identifying our stone in the patients renal pelvis. Using the _____ we fragmented the stone into several large pieces, all of which were removed using a two-pronged grasper.
** • I am hearing "lithoclaster" but only able to find LithoClast for verification - poi
Tue Sep 27 23:49:00 2016 poi

**** • Thanks a lot. - guy
Tue Sep 27 23:50:38 2016 guy


• We then introduced a 24-French balloon dilator with the pneumatic devi ...
+ wav
Tue Sep 27 23:41:50 2016 wav
We then introduced a 24-French balloon dilator with the pneumatic device used to dilate the patients nephrostomy tract. At this point in time, we then introduced a 24-French rigid sheath into the patients midpole and removed _____. We then performed nephroscopy
** • our balloon. - poi
Tue Sep 27 23:46:40 2016 poi

**** • Thanks a lot. - guy
Tue Sep 27 23:48:45 2016 guy


• The graft was pulled into the femoral tunnel. Viewing the tunnel ____ ...
+ wav
Tue Sep 27 22:57:41 2016 wav
The graft was pulled into the femoral tunnel. Viewing the tunnel _____ from the anteromedial portal allowed direct visualization of the TightRope button to pass through the previously drilled hole within the lateral femur.
** • en face - MTmom
Tue Sep 27 23:02:13 2016 MTmom

**** • Thanks a lot. - guy
Tue Sep 27 23:03:06 2016 guy


• Preoperative Diagnosis: FIGO GRADE 2 ENDOMETRIAL CARCINOMA. ...
+ wav
Tue Sep 27 21:21:18 2016 wav
Preoperative Diagnosis:
FIGO GRADE 2 ENDOMETRIAL CARCINOMA.

Procedures:
1. EXAM UNDER ANESTHESIA.
2. _____ SENTINEL LYMPH NODE BIOPSY.
3. TOTAL LAPAROSCOPIC HYSTERECTOMY, BILATERAL SALPINGO-OOPHORECTOMY, PELVIC WASHINGS.


** • Left? (make sure it matches context) - poi
Tue Sep 27 21:45:35 2016 poi

**** • Thanks a lot. - guy
Tue Sep 27 21:47:12 2016 guy

** • old wav still there - poi
Tue Sep 27 21:34:38 2016 poi

**** • wav posted again. Thanks. - guy
Tue Sep 27 21:38:26 2016 guy


• What does FIGO stands for here?
+ c d k a k j
Tue Sep 27 21:17:46 2016 c d k a k j
FIGO GRADE 2 ENDOMETRIAL CARCINOMA
** • International Federation of Gynecology and Obstetrics (FIGO) ... + link-poi
Tue Sep 27 21:35:40 2016 link-poi
International Federation of Gynecology and
Obstetrics (FIGO)
**** • Thanks a lot. - guy
Tue Sep 27 21:38:32 2016 guy


• Does sickle cell trait go under heading Hematology?
- g o h m b m
Tue Sep 27 20:17:48 2016 g o h m b m

** • I decided on that heading. Thanks - g o h m b m
Tue Sep 27 20:28:07 2016 g o h m b m


• This is a 51-year-old woman with a complex medical history who had a P ...
+ wav
Tue Sep 27 19:57:49 2016 wav
This is a 51-year-old woman with a complex medical history who had a PCOM aneurysm in the past that underwent a craniectomy and closure, eventually developed wound dehiscence, and underwent multiple scalp flaps for coverage most recently approximately three weeks ago; however, the scalp _____ necrosis she had in area at the T-point of exposed mesh and breakdown this morning and found to have gross purulence from the wound, taken for washout, debridement, possible mesh explant by the neurosurgery team and temporary coverage.
** • I would start new sentence with "She had an area" - poi
Tue Sep 27 20:01:27 2016 poi

** • flap developed - poi
Tue Sep 27 20:00:51 2016 poi

**** • Thanks a lot. Thanks for the correction. - guy
Tue Sep 27 20:07:14 2016 guy


• This is the last one after all. I figured everything else out.
+ mp 3 posted
Tue Sep 27 19:53:43 2016 mp 3 posted
After completion of the liposuction, the suction was turned off and a smoothing technique with passing _____ to equalize the fat was performed.
** • I am still hearing the old mp3 - poi
Tue Sep 27 20:00:03 2016 poi

** • the mp3 does not match with the text - guy
Tue Sep 27 19:59:37 2016 guy

**** • Thanks for pointing that out. I reposted. - mp3 posted
Tue Sep 27 20:03:21 2016 mp3 posted

****** • now just hearing background noise - poi
Tue Sep 27 20:05:31 2016 poi

******** • Dang technology! Probably was me leaving my headphones in (?) I posted again. Thanks - mp3 posted
Tue Sep 27 20:10:46 2016 mp3 posted

********** • did you see my comment below about the setting on power mp3? - poi
Tue Sep 27 20:22:46 2016 poi

************ • I just went there and changed my option to speakers, and it works now!! Thanks! - g o h m b m
Tue Sep 27 20:32:02 2016 g o h m b m

********** • with ______ of the tunnel - poi
Tue Sep 27 20:21:57 2016 poi

************ • Hmm. There is no other mention of tunnel. I had been listening to 'passing of the cannula" + mp3 posted
Tue Sep 27 20:26:32 2016 mp3 posted
But don't quite here that.
************** • I got it: ...and a smoothing fat technique was performed. Thanks for your help, poi. - mp3 posted
Tue Sep 27 20:36:10 2016 mp3 posted

**************** • ... - mp3
Tue Sep 27 20:38:14 2016 mp3

****************** • I will turn this one in now. Have a good night, poi, and thanks again. - mp3 posted
Tue Sep 27 20:38:41 2016 mp3 posted


• There had been an appropriate amount of time for the epinephrine to ta ...
+ mp3 posted
Tue Sep 27 19:27:46 2016 mp3 posted
There had been an appropriate amount of time for the epinephrine to take effect ___ appropriate vasoconstriction.
** • Thank you. - mp3 posted
Tue Sep 27 19:46:01 2016 mp3 posted

** • and cause - what I hear
Tue Sep 27 19:39:29 2016 what I hear

** • suggest you download power mp3 and get rid of that external microphone - poi
Tue Sep 27 19:29:40 2016 poi

**** • sorry, I can't get your blank - poi
Tue Sep 27 19:30:24 2016 poi

****** • I have the power MP3 but don't know how to record w/o external mike. If I just hit record + mp3 posted
Tue Sep 27 19:36:25 2016 mp3 posted
with my headphones still in, the recorded vf is blank.
******** • hmm...that is strange. I don't use an external mic at all - poi
Tue Sep 27 19:47:31 2016 poi

********** • It has to be some setting in my computer, something simple, but I just don't know how to + mp3 posted
Tue Sep 27 19:54:25 2016 mp3 posted
fix it. Thanks, poi.
************ • under options on mp3 recorder, my recording device is + poi
Tue Sep 27 20:04:23 2016 poi
set to "speakers"
************** • It works now!! Thanks! - mp3 posted
Tue Sep 27 20:31:34 2016 mp3 posted

******** • Also, this particular vf is of poor quality that's why it sounds so bad. - mp3 posted
Tue Sep 27 19:39:19 2016 mp3 posted

********** • Too many blanks anyhow. Will turn in to QA. Thank you. - mp3 posted
Tue Sep 27 19:39:52 2016 mp3 posted


• Of note, mucosa was fairly friable and bled easily throughout the proc ...
+ wav
Tue Sep 27 19:10:36 2016 wav
Of note, mucosa was fairly friable and bled easily throughout the procedure _____ post irrigation changes.
** • related to postradiation changes - poi
Tue Sep 27 19:15:41 2016 poi

**** • Thanks a lot. Thanks for the correction. - guy
Tue Sep 27 19:17:05 2016 guy

**** • Thanks a lot. - guy
Tue Sep 27 19:16:22 2016 guy


• This is a 55-year-old male with a history of HIV on HAART, asthma, and ...
+ wav
Tue Sep 27 18:41:18 2016 wav
This is a 55-year-old male with a history of HIV on HAART, asthma, and T2, N2B, M0 right tonsil _____ status post CCRT completed in May of 2014 who recently presented back at hospital with worsening left-sided throat pain, odynophagia, and dysphagia.
** • squam?? (squamous cell carcinoma) - poi
Tue Sep 27 18:44:09 2016 poi

**** • Thanks a lot. - guy
Tue Sep 27 18:47:09 2016 guy


• Limitations of liposuction were discussed and that her abdomen would n ...
+ mp3 posted
Tue Sep 27 18:01:07 2016 mp3 posted
Limitations of liposuction were discussed and that her abdomen would not be completely flat, and ______ possibility of contour irregularities were discussed.


** • in addition the? - poi
Tue Sep 27 18:23:23 2016 poi

**** • Thanks poi. I think I will turn this one in since I am still not 100% sure. - mp3 posted
Tue Sep 27 19:24:04 2016 mp3 posted


• Does the second sentence sound correct. Difficult to hear clearly.
+ g o h m b m
Tue Sep 27 17:51:51 2016 g o h m b m
Bilateral moderate micromastia. She had significant breast parenchyma to cover the implants.
** • sounds fine to me - fwiw-poi
Tue Sep 27 18:25:01 2016 fwiw-poi

**** • Thank you very much. - g o h m b m
Tue Sep 27 19:22:26 2016 g o h m b m


• same hysterectomy as above, s/l inoculated
+ mt
Tue Sep 27 17:06:08 2016 mt
The broad ligament fibroid was dissected by sharp and blunt dissection until it could be **inoculated**. The base of it was carefully cauterized.
** • probably something that was loculated and broken up by doc + sm
Tue Sep 27 17:16:47 2016 sm
Can't document "unloculated" with that as a definition.

• (hyerectomy) s/l "relaxation" but seems odd to me sm pl
+ mt
Tue Sep 27 17:00:07 2016 mt
With the patient in Trendelenburg position, the bowel and omentum were packed out of the pelvis into the abdomen and kept in place using three large gauzes. Abdominal **relaxation** was requested as the patient was tense and pushing the bowel back into the pelvis. Self-retaining Balfour was now in place..... Etc.


** • typo - Hysterectomy - mt
Tue Sep 27 17:05:25 2016 mt


• Subcutaneous tissues were closed using 0 and 2 undyed Vicryl. Can't confirm this.
- Knee surgery
Tue Sep 27 16:51:16 2016 Knee surgery

** • Will just leave as dictated. Forgot to mention MD says "Oh" and 2 undyed Vicryl. - Knee surgery
Tue Sep 27 16:59:23 2016 Knee surgery


• Medication questions
+ mp3
Tue Sep 27 12:57:20 2016 mp3
I am giving nothing for pain. He is to see pain management. Follow up with GI at Stony Brook. His medications on discharge at this point will be _____ 2 mg q. 6h. p.r.n. Tylenol 650 q. 6h. p.r.n., 81 mg aspirin a day, Nicoderm patch every 12 hours, 21 mg, _____75 mg daily, _____ Nexium 40 mg twice day, Carafate 1 g four times a day, folic acid 1 mg a day, gabapentin 800 mg a day, Singulair 10 mg q.d., and Breo Ellipta one puff daily.
** • #1 alprazolam #3 he will go to - taco
Tue Sep 27 13:03:12 2016 taco

**** • thank you - -
Tue Sep 27 14:28:56 2016 -


• Placement of * extrasphincteric cutting setons*.
+ ok?
Tue Sep 27 12:28:20 2016 ok?
PREOPERATIVE DIAGNOSIS: Perianal fistula.
POSTOPERATIVE DIAGNOSIS: Perianal fistula.
SURGICAL PROCEDURE:
1. Examination under anesthesia.
2. Partial fistulotomy.
3. Placement of * extrasphincteric cutting setons*.


• where he lives _____ police. There was
+ wav
Tue Sep 27 12:12:45 2016 wav
I discussed with him the need for followup for his pain management doctor, which he has not been going. He has been having some issues where he lives _____ police. There was some arguing He has no medications. He showed it to me. In order to get it refills, he is going to need to contact the police. We discussed with social services. His GERD is better. I will continue the Carafate and go back to his Nexium and continue with Xanax and anti-psych medications.
** • not sure about blank, but: going to need *a police report* ... We *will discuss* with + m h m n m p
Tue Sep 27 12:16:59 2016 m h m n m p
Social Services.
** • something like "he contacted the police"? or "has had contact with police"? - taco
Tue Sep 27 12:15:28 2016 taco

**** • thanks - -
Tue Sep 27 12:16:41 2016 -


• pulmonary arrest ____ and they referred him back.
+ mp4
Tue Sep 27 12:10:23 2016 mp4
thought there was some pulmonary arrest ____ and they referred him back. He is feeling okay. I discussed with him that kidney function is normal, stay away from anti-nflammatories.
** • mp4 doesn't match. I hear "CAT scan and a sonogram reveals no gallstones" - poi
Tue Sep 27 12:41:01 2016 poi


• does take Nexium _____ Carafate conservative
+ mp3
Tue Sep 27 12:07:19 2016 mp3
Abdominal pain of unclear etiology, normal contrast CT, stable hemoglobin, Protonix b.i.d. He does take Nexium _____ Carafate conservative management and to followup with Stony Brook, which I have discussed with the patient as well.
** • at home, which he feels works better, added Carafate... - taco
Tue Sep 27 12:16:46 2016 taco

**** • thanks - -
Tue Sep 27 12:56:14 2016 -


• history of anxiety _____ arthritis, osteoporosis
+ wav
Tue Sep 27 12:06:02 2016 wav
History is very difficult sometimes to get his full history. When I saw him in the office, he was getting narcotics. He does see pain management, has not got anything since July. He has history of anxiety _____ arthritis, osteoporosis, disc degeneration, fibromyalgia, vertigo, back pain, DVT, UTI, degenerative disc disease, COPD, and TIA. Anyway, his numbness improved. He saw renal. He saw GI as well where they gave him Carafate and felt that he should go back to Stony Brooke where he followup closely.
** • sorry got it - alpha-1 antitrypsin, Marfan syndrome - thnx
Tue Sep 27 12:09:30 2016 thnx


• inline, in-line, or in line
+ verifying
Tue Sep 27 10:34:13 2016 verifying
Skin incision was made _____ with the bony prominence of the ulna.

The fascia was split ______ with the skin incision.


I typed it as "in line" and QA changed and so I just want to verify how it really is supposed to be typed. I find more hits as 2 separate words rather than 1 single word on google search, so I just need feedback.

Thank you in advance!
** • Here is the "in line with" entry in Merriam Webster's Dictionary + Questyr
Tue Sep 27 11:24:08 2016 Questyr
link
**** • so should it be hyphenated? in-line + OP
Tue Sep 27 11:41:23 2016 OP
Definition of inline

Having the parts or units arranged in a straight line; also : being so arranged
****** • I'm not Q, but I totally agree with bkloli that it is two words in your context. - taco
Tue Sep 27 11:45:10 2016 taco

******** • okay thank you! - OP
Tue Sep 27 11:46:07 2016 OP

** • 2 words, in line - Your QA is wrong. - b k l o l i
Tue Sep 27 10:37:14 2016 b k l o l i

**** • okay, thank you so much! That is not the first time I have had this situation :( - OP
Tue Sep 27 10:40:15 2016 OP


• performed up to size 5. A zero ball at increased tension and
+ sm
Tue Sep 27 10:31:56 2016 sm
Reaming was performed with a 53 and 55 and a 56 reamer. A size #56 cup was impacted at 40 degrees of abduction and approximately 25 degrees of anteversion placing the cup just parallel with the anterior wall. Neutral 40 mm liner was impacted with good stability in the cup.

Attention was turned to the femoral side. Box osteotome, canal finder, and broaching were performed up to size 5. A zero ball at increased tension and due to her abduction and contracture, we did not want to exacerbate this; so we trialed this at minus 3.5 x 40 ball appeared with good stability, range of motion, soft tissue tension.
** • Posting content again as changes were made. + sm
Tue Sep 27 10:33:21 2016 sm
Attention was turned to the femoral side. Box osteotome, canal finder, and broaching were performed up to size 5. A zero ball 232 had increased tension and due to her abduction and contracture, we did not want to exacerbate this; so we trialed this at minus 3.5 x 40 ball with good stability, range of motion, soft tissue tension. Leg lengths were approximately equal. Again with the abduction contracture, this created a slightly more difficult templating, so we did go back to the x-rays and confirmed all of our templating sizing.

**** • my guess is a 0 ball to 32 (size in mm) ? not 100% sure though. - b k l o l i
Tue Sep 27 10:39:15 2016 b k l o l i

****** • sorry, the 232 was a timestamp - -
Tue Sep 27 14:32:06 2016 -


• CAT scan _______ (mp4) sonogram shows no gallstones.
+ sm
Tue Sep 27 07:12:20 2016 sm
LABORATORY: Her admission white count was 10,300, it is now 6.9, hemoglobin was 13.9, it is now 12.9, MCV 92. BUN 6, creatinine 0.4. Her lipase was more than 30,000, it now is down to 798. Her amylase was more than 1300, was 786 yesterday. LFTs were normal. Her calcium which was normal on admission is slightly low. CAT scan of the abdomen and pelvis shows diffuse enlargement of the pancreatic body and head with surrounding mesenteric inflammation. CAT scan _______ sonogram shows no gallstones.
** • CAT scan abdomen examination??? is what I think I hear - me
Tue Sep 27 10:39:32 2016 me

** • Does he say "error" when he makes a mistake? S/l "CAT scan - error - sonogram shows..." - taco
Tue Sep 27 09:34:47 2016 taco

**** • Not that I recall. Flagged - ty
Tue Sep 27 10:37:10 2016 ty

** • wrong mp4 ? - b k l o l i
Tue Sep 27 07:40:27 2016 b k l o l i

**** • added again - ty
Tue Sep 27 08:47:35 2016 ty

****** • still hear old one. even closed down IE, brought it back, and nothing. - b k l o l i
Tue Sep 27 09:11:10 2016 b k l o l i

******** • Strange. I can hear it. thanks for trying - -
Tue Sep 27 09:23:53 2016 -


• peptic ulcer disease, dyspepsia, dysphagia, _______ (mp3) disorder. No history of
+ sm
Tue Sep 27 07:08:16 2016 sm
REVIEW OF SYSTEMS: Since her admission, she feels better. She still feels bloated, but has no severe pain and no vomiting. She had no fever, chills. She passes flatus, but had no bowel movement yet. She has no history of peptic ulcer disease, dyspepsia, dysphagia, _______ disorder. No history of hyperlipidemia. No rectal bleeding or change in bowel habits.
** • biliary is what I hear. - b k l o l i
Tue Sep 27 07:39:59 2016 b k l o l i

**** • thank you - -
Tue Sep 27 08:48:59 2016 -


• onset of upper left quadrant pain ______ (wav). Evaluation in the emergency room
+ sm
Tue Sep 27 07:02:20 2016 sm
This is a 50-year-old woman who was admitted who had onset of upper left quadrant pain ______. Evaluation in the emergency room found pancreatitis.
** • _____ for a day. - cant get the 1st wor
Tue Sep 27 07:05:31 2016 cant get the 1st wor

**** • thanks - -
Tue Sep 27 08:47:44 2016 -


• A large pannus which included the umbilicus which was first isolated o ...
+ wav
Tue Sep 27 01:28:47 2016 wav
A large pannus which included the umbilicus which was first isolated on the stalk leaving a large amount of subcutaneous tissue around it to increase its chance of being viable. We then made superior and inferior incisions _____ and below the upper cone which went down to the chest wall. We were careful not to go through the abdominal wall fascia. In most cases, we left a thin layer of subcutaneous tissue over the bevelled off fascia to protect it and help improve healing and also to avoid previous sutures in the lap band port which had been placed in the abdominal wall.
** • and then beveled toward and - poi
Tue Sep 27 01:47:32 2016 poi


• A Y-drape was placed _____ and the patient was brought to the recovery ...
+ mp3
Tue Sep 27 00:46:19 2016 mp3
A Y-drape was placed _____ and the patient was brought to the recovery room in satisfactory condition.
** • Vi-Drape - poi
Tue Sep 27 00:53:34 2016 poi

**** • Thanks a lot. This seems correct. - guy
Tue Sep 27 00:54:00 2016 guy

** • across this? - poi
Tue Sep 27 00:52:17 2016 poi

**** • Thanks a lot. - guy
Tue Sep 27 00:52:58 2016 guy


• Over about a five-minute period, there was a 20-mm drop in the systoli ...
+ wav
Tue Sep 27 00:43:40 2016 wav
Over about a five-minute period, there was a 20-mm drop in the systolic blood pressure; however, the _____ remained satisfactory. A decision was made to repeat the Esmarch dressing and perhaps in 24 to 48 hours, close the incision and insert a pacemaker wire.
** • points? pumps? (these are both wags) - poi
Tue Sep 27 00:54:16 2016 poi

**** • Thanks a lot. - guy
Tue Sep 27 00:55:38 2016 guy


• The Kerlix sponge was removed from between the sternal edges and the c ...
+ mp3
Tue Sep 27 00:32:46 2016 mp3
The Kerlix sponge was removed from between the sternal edges and the chest tube, retrosternal tube, was removed. The right heart appeared to have improved contractility _____ posterior wall of the sternum. A chest spreader was inserted.
** • but it is still in close approximation to the - poi
Tue Sep 27 00:40:04 2016 poi

**** • Thanks a lot. - guy
Tue Sep 27 00:41:34 2016 guy


• The wound will be explored and if feasible, the chest will be closed. ...
+ wav
Tue Sep 27 00:26:11 2016 wav
The wound will be explored and if feasible, the chest will be closed. If that is possible then a permanent pacemaker system would be inserted. For some reasons today, he appears to be in sinus rhythm but has had a history of _____ and pacemaker implantation _____. The risks of this operation were discussed
** • heart block....would seem optimal - pou
Tue Sep 27 00:38:21 2016 pou

**** • Thanks a lot. - guy
Tue Sep 27 00:41:26 2016 guy


• Preoperative Diagnoses: 1. STATUS POST COMPLEX RECONSTRUCTION APPL ...
+ wav
Tue Sep 27 00:12:12 2016 wav
Preoperative Diagnoses:
1. STATUS POST COMPLEX RECONSTRUCTION APPLYING A BIO-BENTALL AND _____ OF THE CORONARY ARTERIES FOR _____ ENDOCARDITIS INVOLVING THE AORTIC WALL AND AORTIC ANNULUS.
2. STATUS POST ESMARCH WOUND CLOSURE DUE TO EXTENSIVE RIGHT HEART DYSFUNCTION.
3. PACEMAKER DEPENDENCE.

** • I think he says for #2 fulminating - Q
Tue Sep 27 00:23:04 2016 Q

**** • Thanks a lot. - guy
Tue Sep 27 00:25:59 2016 guy

** • #1 reinflation - Questyr
Tue Sep 27 00:19:47 2016 Questyr

**** • Thanks a lot. - guy
Tue Sep 27 00:21:02 2016 guy


• A repeat bronchoscopy was performed through the tracheostomy tube wher ...
+ wav
Mon Sep 26 21:37:11 2016 wav
A repeat bronchoscopy was performed through the tracheostomy tube where moderate amounts of _____ secretions were suctioned free. The tracheostomy tube was then secured in place. The patient remained hemodynamically stable throughout the entirety of the procedure.
** • clear-colored - poi
Mon Sep 26 21:49:26 2016 poi

**** • Thanks a lot. - guy
Mon Sep 26 22:15:36 2016 guy


• After informed consent was obtained, the patient was taken to the oper ...
+ mp3
Mon Sep 26 20:32:56 2016 mp3
After informed consent was obtained, the patient was taken to the operating room and placed supine on the operating room table on top of a _____ air heater, after which time the patients left arm was prepped and draped in the usual sterile fashion onto an arm table. The patient was placed under general anesthesia
** • forced convection air heater - gere
Mon Sep 26 20:36:04 2016 gere

**** • Thanks a lot. - guy
Mon Sep 26 20:46:46 2016 guy


• A #15 blade was used to incise the skin and a tonsil clamp used to cre ...
+ wav
Mon Sep 26 20:02:49 2016 wav
A #15 blade was used to incise the skin and a tonsil clamp used to create a transabdominal tract passing the T-tube through. The T-tube was then inserted into the enterotomy and the sutures tied down to secure it snugly within the bowel. _____ sutures using 3-0 silk were then placed circumferentially in four points around the T-tube securing the jejunum flush to the anterior abdominal wall.
** • Stamm (gastrostomy) sutures - gere
Mon Sep 26 20:39:53 2016 gere

**** • Thanks a lot. - guy
Mon Sep 26 20:46:39 2016 guy


• S/l Dunner ureterostomy
- jmp
Mon Sep 26 19:42:32 2016 jmp

** • could you give the sentence before 'Dunner' please. - gere
Mon Sep 26 20:41:06 2016 gere


• Mother is deceased, had hypertension, diabetes, _______ cancer.
- mp3 posted
Mon Sep 26 16:04:32 2016 mp3 posted

** • diabetes mellitus and cancer. - gere
Mon Sep 26 17:02:26 2016 gere

**** • thanks gere - op
Mon Sep 26 17:54:33 2016 op


• A safety wire that is a PTFE **quarter** wire was then placed.
+ ESL sm
Mon Sep 26 14:52:35 2016 ESL sm
There was narrowing in the distal ureter, but I decided to leave it open because I was able to get the scope in without difficulty. A safety wire that is a PTFE **quarter** wire was then placed. I placed a cystoscope again, and I placed a 7-French, 24 cm JJ stent without any string in place.
** • Never mind, it was PTFE coated - OP
Mon Sep 26 15:01:07 2016 OP


• Patient has multiple sclerosis. Please see MP3 uploaded.
+ MP3 - thanks
Mon Sep 26 13:42:02 2016 MP3 - thanks
She has been having symptoms, including tingling and numbness in her face, tongue, fingers, and feet for several years. Other symptoms include fatigue, ____________ concentrating, headache, poor sleep, dry hair.
** • forgetfulness - nm
Mon Sep 26 15:59:01 2016 nm

** • I now hear "difficulty concentrating" - but not word before. :-/ - op
Mon Sep 26 14:24:20 2016 op


• Patient had a previous bimalleolar ankle fracture and underwent ORIF with
+ sm please
Mon Sep 26 13:41:51 2016 sm please
plate and screw fixation. The hardware is painful, and patient elected for removal of hardware.

Eleven screws and the plate were removed. There was extensive scar tissue between the plate and the bone as well as posterior to the bone. This was removed using a combination of s/l win-hail elevator and a rongeur. Each hole was cleaned using a small curette.
** • periosteal? - poi
Mon Sep 26 14:54:30 2016 poi


• If any surgical intervention is needed for the prostate, s/l*button look*should be go
+ Very strong ESL
Mon Sep 26 12:38:28 2016 Very strong ESL
Prostatitic urethra showed bilateral hypertrophy of the prostate gland. It was about 3 cm in length. If any surgical intervention is needed for the prostate, s/l*button look*should be good enough. The bladder mucosa was inspected with 30-degree lenses.
** • can you hear "button TURP"? - taco
Mon Sep 26 12:51:51 2016 taco


• past history of postural tachycardia syndrome as well as ___ and is no medications an
+ WAV
Mon Sep 26 12:24:23 2016 WAV
He has a past history of postural tachycardia syndrome as well as ___ and is no medications and has no known allergies.
** • ok, thanks! - ft
Mon Sep 26 14:19:09 2016 ft

** • distorted sound file. I got nothin' - b k l o l i
Mon Sep 26 13:33:16 2016 b k l o l i

** • anyone have a guess??? - help please!
Mon Sep 26 12:37:41 2016 help please!

**** • sorry, no. I would have to flag that. - mt
Mon Sep 26 13:31:43 2016 mt

**** • I can't hear your wave, just the last old one; can you re-wave? - arty
Mon Sep 26 13:06:06 2016 arty

****** • re posted - .
Mon Sep 26 13:07:05 2016 .


• s/l Dr. Ahmad Basha in Indianapolis area
- doc name
Mon Sep 26 11:07:45 2016 doc name


• number of # for teeth
+ KG
Mon Sep 26 09:31:43 2016 KG
Do I use # or spell out number when referring to teeth?
** • I use No. 1, No. 18... A lot of our accounts don't allow the pound sign. Check your - account rules.
Mon Sep 26 09:32:41 2016 account rules.


• achieving some _______ (wav) material
+ sm
Mon Sep 26 08:01:34 2016 sm
the end of these biopsy procedures, I then placed a fiducial seed via the navigational bronchoscopy channel and this was advanced to the site of the lesion and deployed with confirmation by real time fluoroscopy. Following this, 50 cc of saline was injected via the channel to perform bronchoalveolar lavage. Following this instillation, aspiration was performed as the catheter was removed achieving some _______ material, which is again separately placed in CytoLyt. Upon completion of the procedure, a general clearance bronchoscopy was again performed. Again, no active bleeding was encountered.

• GYN procedures including bilateral oophorectomy, enterolysis, and adhesiolysis
+ RMT
Mon Sep 26 06:46:11 2016 RMT
I split the rectus muscles, developed space of Retzius, identify bladder and free this and drop it down and then finding the top of the bladder, we come around and start freeing the fundus from the anterior abdominal wall and drop it down. We are able to identify fallopian tubes and cornua on each side. S/l Enpact or Impakt is used divide these. The uteroovarian is divided with s/l Enpact or Impakt and then with careful sharp dissection, the anterior abdominal wall was taken down.

This word really sounds like impact, but I'm having no luck in my Google search. I found an orthopedic company with a similar sounding name, but I got the impression it was the name of the company and not their product.
** • I find a LigaSure Impact, so maybe this is what he is talking about. - RMT
Mon Sep 26 07:01:30 2016 RMT


• Once the temporalis fascia was noted to be in place, the incus was fas ...
+ wav
Mon Sep 26 05:10:01 2016 wav
Once the temporalis fascia was noted to be in place, the incus was fashioned into an incus piston graft and was placed over the oval window. Once _____ oval window was noted to be mobile, the temporalis fascia graft was then laid over the entirety of the middle ear.

• Does anyone have the link to download power MP3? Thanks.
- tia
Sun Sep 25 18:43:24 2016 tia

** • I've never had problems with downloads from here. + sm
Mon Sep 26 03:38:59 2016 sm
I do avoid Softonic if at all possible.


**** • That worked. Thanks a lot! - op
Mon Sep 26 09:08:37 2016 op


• Potassium chloride 10 mEq p.o. b.i.d., ___5 mg daily, lisinopril 20 mg daily,Toprol
- *5* mg - pie
Sun Sep 25 04:43:11 2016 *5* mg - pie

** • ... + l p p o m k
Mon Sep 26 05:10:11 2016 l p p o m k

** • mp3 posted - pie
Sun Sep 25 04:43:27 2016 pie

**** • had to upload, thanks to any who tried. - mp3 deleted, pie
Sun Sep 25 05:04:48 2016 mp3 deleted, pie


• scleral ______ s/l "ex crescent" ?
+ sm- tima
Sat Sep 24 14:52:24 2016 sm- tima
he does indeed have an area in the peripapillary location of hypopigmentation without overlying subretinal fluid or detachment. I believe this may represent a scleral ______ s/l "ex crescent" or an area of retinal thinning.
** • I do find a relationship between scleral crescent and hypopigmentation (see link to see + Questyr
Sat Sep 24 15:04:41 2016 Questyr
what you think)
** • excrescent? (it's a word, an adjective meaning "forming an outgrowth" -I'm not 100% sure - it fits (taco)
Sat Sep 24 14:54:54 2016 it fits (taco)


• poochiness- what to do with this word
+ sm
Sat Sep 24 12:42:45 2016 sm
she has some poochiness of her thigh
** • I'd use it - it communicates exactly what was intended - taco
Sat Sep 24 12:53:48 2016 taco

**** • doesn't communicate anything to me. Dog legs? - billybob
Sat Sep 24 13:30:05 2016 billybob

****** • see another definition of pooch... + t
Sat Sep 24 14:56:28 2016 t
Protrude or cause to protrude.
a dress that made her stomach pooch out even more than usual

• Spelling suggestions please for last name s/l kuh-nar-bee. TIA!
- name?
Sat Sep 24 10:48:21 2016 name?

** • I find Connarby at Ancestor.com (see link) + Questyr
Sat Sep 24 15:07:34 2016 Questyr
link
** • Carnaby? - billybob
Sat Sep 24 11:30:19 2016 billybob

**** • Thank you. - OP
Sat Sep 24 14:56:28 2016 OP


• She had previous brain s/l instrumentation due to brain metastasis.
+ pet
Sat Sep 24 07:11:43 2016 pet
Not sure I'm hearing that correctly. The dictation is poor quality. TIA.
** • There's something called brain imaging instrumentation, see message. + Geo
Sat Sep 24 10:03:42 2016 Geo
"Evolution of brain imaging instrumentation. ... Computed tomography (CT) and static magnetic resonance imaging (MRI) are now the most common imaging modalities used for anatomic evaluation of pathologic processes affecting the brain."

**** • Thank you ! - pet
Sat Sep 24 12:54:50 2016 pet


• A second time-out was performed. We now turned our attention towards ...
+ wav
Sat Sep 24 00:06:12 2016 wav
A second time-out was performed. We now turned our attention towards obtaining access and performing our percutaneous nephrolithotomy. The patients entire back was prepped with ChloraPrep with three minutes waited. We then placed _____ in sterile fashion and proceeded towards obtaining access. A retrograde pyelogram was performed through our already placed ureteral stents both at 0 degree as well as 30 degrees without fluoroscopy.



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