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May 12 17:11
• In terms of DVT prophylaxis, the patient will be started on aspirin 32 ...
+ mp3
Tue Jul 26 23:06:13 2016 mp3
In terms of DVT prophylaxis, the patient will be started on aspirin 325 b.i.d. as well as _____.
** • (I haven't even heard this mp3 yet, but I already like you!:-) + Margaret Walker
Tue Jul 26 23:13:01 2016 Margaret Walker
I belatedly posted to your prior "____CT" question below. Best wishes!
**** • Thanks a lot. - guy
Tue Jul 26 23:15:05 2016 guy

** • got it. thanks. - guy
Tue Jul 26 23:10:49 2016 guy


• The patient will be admitted to the Bellevue Hospital. She will be we ...
+ wav
Tue Jul 26 23:03:10 2016 wav
The patient will be admitted to the Bellevue Hospital. She will be weightbearing as tolerated in the left lower extremity and will begin physical therapy tomorrow. When she is cleared from physical therapy _____ p.o. pain medication, she will be discharged home to be seen in implant clinic in two weeks for a wound check.
** • "and converted to" or some equivalent, makes med sense (I have not yet listened.) - Margaret Walker
Tue Jul 26 23:14:33 2016 Margaret Walker

**** • (In fact, I find that I no longer remember how one listens to a WAV file. Billybob?) - Margaret Walker
Tue Jul 26 23:17:09 2016 Margaret Walker

****** • You should just be able to click on send/listen to wav - poi
Tue Jul 26 23:20:36 2016 poi

******** • Thanks, poi. I did that, but probably after clicking too many "wrong" options. + Mgt
Tue Jul 26 23:28:57 2016 Mgt
I will keep trying.
********** • if u use internet explorer instead of any other browser, just clicking on + guy
Tue Jul 26 23:34:48 2016 guy
send/listen to WAV files (for wav files) and send/listen to MP3 files (for mp3 files) will do.
************ • I have no clue as to my default browser. I think I railed at IE and changed to Chrome + Margaret
Tue Jul 26 23:38:28 2016 Margaret
Your tips are gratefully received. I'll work at them.
****** • did you get a new computer Margaret? I thought you were having problems + poi
Tue Jul 26 23:18:47 2016 poi
with your MAC hearing files
******** • Good to hear from you, poi! + Margaret Walker
Tue Jul 26 23:27:03 2016 Margaret Walker
I was on HP-oid home-made computer 1978-2015. Now I have Apple products, desktop, MacBookAir, and a g** d**g iPhone 5s for my prior android. So I am essentially and effectively "incommunicado." I live at the perimeter of Silicon Vally, for crying out loud! I guess what I really need is a teenage neighborhood geek to tutor me!

I hope you are doing well and having fun!

Fondly,
Margaret Walker


********** • hahahahaha. u made my day mam!!! - guy
Tue Jul 26 23:28:27 2016 guy

************ • Guy, you are most welcome to call me Word Board's "token very-old (crazy) lady. + Margaret
Tue Jul 26 23:35:08 2016 Margaret
(The "crazy" is optional, depending on the context. Word substitutes for "lady" are also acceptable (to me, if not to Billybob.:-)
** • and her pain is controlled on - poi
Tue Jul 26 23:13:24 2016 poi

**** • Thanks a lot everybody - guy
Tue Jul 26 23:15:21 2016 guy


• The final 9 mm poly was then inserted. The wound was copiously irriga ...
+ mp3
Tue Jul 26 22:56:55 2016 mp3
The final 9 mm poly was then inserted. The wound was copiously irrigated. Once again, at this time using Betadine lavage followed by the _____ lavage, the tourniquet was let down and adequate hemostasis was achieved.
** • irrigated once again, this time using....saline - poi
Tue Jul 26 23:00:00 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 23:02:01 2016 guy


• A posterior referencing guide was then used; however, given the amount ...
+ wav
Tue Jul 26 22:48:28 2016 wav
A posterior referencing guide was then used; however, given the amount of hypoplasticity in the lateral condyle posterior referencing guide was referenced off the _____ line as well as epicondylar access. The femur was sized to a size #2.
** • wide size line? (did not verify) - poi
Tue Jul 26 22:58:17 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 22:59:23 2016 guy


• A full-thickness incision was made from the distal lateral aspect of t ...
+ guy
Tue Jul 26 22:13:23 2016 guy
A full-thickness incision was made from the distal lateral aspect of the right foot extending towards the fluctuance at the plantar foot proximal medial. Malodorous, **yellow, discolored** purulence in copious amount was noted. **Black, yellow** necrotic tissue was noted.


** • I would type black/yellow - poi
Tue Jul 26 22:15:45 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 22:16:27 2016 guy


• All bony prominences were well padded and then the patient had SCD boo ...
+ mp3
Tue Jul 26 21:12:22 2016 mp3
All bony prominences were well padded and then the patient had SCD boots that were placed. The machine was turned on _____. The table was then rotated approximately 90 degrees
** • in addition? - poi
Tue Jul 26 21:36:08 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 21:40:54 2016 guy


• The patient was brought to the operating room and placed supine on the ...
+ wav
Tue Jul 26 21:07:36 2016 wav
The patient was brought to the operating room and placed supine on the operating table. The Anesthesia team then placed a left upper extremity _____. Infraclavicular block was placed by the Anesthesia team as well.
** • feed??? - poi
Tue Jul 26 21:38:02 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 21:40:47 2016 guy


• The stone did not appear impacted, nor was it obstructing. A 200-micr ...
+ wav
Tue Jul 26 20:26:34 2016 wav
The stone did not appear impacted, nor was it obstructing. A 200-micron laser was then used to fragment the stone into four discrete pieces. _____ was then removed and a 1.9 nitinol basket was then used to extract each fragment from the ureter.
** • fluoro - poi
Tue Jul 26 20:57:24 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 21:07:12 2016 guy


• A retrograde pyelogram was performed to confirm full exploration of th ...
+ wav
Tue Jul 26 20:21:30 2016 wav
A retrograde pyelogram was performed to confirm full exploration of the renal pelvis _____. At this time, the flexible ureteroscope was brought down the ureter.
** • and calyces - poi
Tue Jul 26 20:22:16 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 20:23:13 2016 guy


• The ACL remnants and menisci were also removed and external tibial ali ...
+ mp3
Tue Jul 26 19:28:09 2016 mp3
The ACL remnants and menisci were also removed and external tibial alignment guide was then used to create a proximal tibial cut. The rest was then made _____ as well as appropriate varus and valgus _____ posterior slope. The tibia was trialed with a size #2 baseplate and appropriate size tibial drill and punch were used.
** • nevermind. - guy
Tue Jul 26 19:41:44 2016 guy


• A midline incision and medial parapatellar approach to the knee was ma ...
+ wav
Tue Jul 26 19:22:33 2016 wav
A midline incision and medial parapatellar approach to the knee was made. Skin flaps were _____ elevated and laterally, medial fat pads and subpatellar fat pads were removed. _____ distal femur was incised in order to visualize the anterior cortical surface. A medial release was also performed. The patella subluxed and the knee flexed.
** • nevermind. - guy
Tue Jul 26 19:41:37 2016 guy


• The patient is a 58-year-old female with a history of left total knee ...
+ wav
Tue Jul 26 19:07:45 2016 wav
The patient is a 58-year-old female with a history of left total knee done at 2013 at outside hospital, presents with right knee pain who has failed conservative management _____ physical therapy, and injections, as well as NSAID as indicated.
** • including - poi
Tue Jul 26 19:12:51 2016 poi

**** • Thanks a lot. - guy
Tue Jul 26 19:17:46 2016 guy


• After completing four "quads" of antibiotics, decision was mad ...
+ guy
Tue Jul 26 18:43:15 2016 guy
After completing four "quads" of antibiotics, decision was made to proceed with definitive treatment.
** • trials? - Oasis
Tue Jul 26 18:47:55 2016 Oasis

**** • Thanks a lot. - guy
Tue Jul 26 19:04:15 2016 guy


• Family history is significant for ___ issues in the family.
- mp3
Tue Jul 26 15:46:19 2016 mp3

** • parathyroid (s/l she starts to say hyp-- and changes her mind) - taco
Tue Jul 26 15:48:04 2016 taco

**** • ... - thanks
Tue Jul 26 15:54:11 2016 thanks


• Family history is significant for a brother who was born at ___ gestation who had an
- mp3
Tue Jul 26 14:25:43 2016 mp3

** • triplet - isgal
Tue Jul 26 14:31:30 2016 isgal


• placement of the _____ cages. S/l Realto
+ jg
Tue Jul 26 12:53:56 2016 jg
I reviewed the x-rays from last time. Everything looks fine as far as the placement of the s/l realto cages.

surgery was sacroiliac fusion.
** • never mind, I found it - l p d d e l
Tue Jul 26 13:05:09 2016 l p d d e l

**** • what was it? - ah
Tue Jul 26 13:35:52 2016 ah


• She has also been having palpitations ____ guarding her chest.
- mp3
Tue Jul 26 10:09:36 2016 mp3

** • She was - poi
Tue Jul 26 10:20:12 2016 poi

**** • ... - thanks
Tue Jul 26 10:27:19 2016 thanks


• L5-S1 disc, which was a s/l*spondy-lee-gridge* and bulging disc.
+ sm
Tue Jul 26 09:54:26 2016 sm
We found the extruded fragment in the canal above the L5-S1 disc space and removed a mushy disc material from this area. We passed a probe along the L5 nerve root above. We then looked at the L5-S1 disc, which was a s/l*spondy-lee-gridge* and bulging disc. There was a rent in the annular fibers attached to the bone. There was separation between the bone and the annular fibers.
** • That's the only thing I could figure out, too..Thanks y'all! - OP
Tue Jul 26 10:10:26 2016 OP

** • which has a spondylotic ridge? - taco
Tue Jul 26 10:01:49 2016 taco

** • spondylotic ridge? - isgal
Tue Jul 26 10:01:40 2016 isgal


• At birth, he had some respiratory difficulties, underdeveloped _____ as per Mom.
- mp3
Tue Jul 26 09:48:19 2016 mp3

** • ? flap ? - b k l o l i
Tue Jul 26 09:51:41 2016 b k l o l i

**** • ... - thanks
Tue Jul 26 09:57:29 2016 thanks


• doc spells "teynotol" 200 mg 2 times a day
+ sm
Tue Jul 26 08:51:09 2016 sm
pat has MS
** • Possibly Tegretol - Oasis
Tue Jul 26 09:01:36 2016 Oasis

**** • ty - op
Tue Jul 26 09:06:34 2016 op


• s/l bo land therapy
+ sm
Tue Jul 26 08:13:16 2016 sm
conservative treatments including stretching, boland therapy, and massage therapy

• The patient is a 71-year-old gentleman with a 1 cm PET-positive nodule ...
+ mp3
Tue Jul 26 02:42:05 2016 mp3
The patient is a 71-year-old gentleman with a 1 cm PET-positive nodule found on his upper lobe, found after an abnormal chest x-ray. _____ presents for diagnosis and treatment.
** • PET doesn't show takeup anywhere else. - isgal
Tue Jul 26 04:48:50 2016 isgal


• According to the patient, the last time she experienced this episode was at the sm
+ :) wav
Tue Jul 26 00:00:32 2016 :) wav
age of 15 and at that time she went to the emergency room and had __________ .
** • Might be helpful to know what "this episode" was. - Questyr
Tue Jul 26 02:23:46 2016 Questyr


• With the aid of the operating microscope, it was apparent that these n ...
+ guy
Mon Jul 25 23:05:55 2016 guy
With the aid of the operating microscope, it was apparent that these nerve ends *in/and* both sides matched quite nicely with respect to caliber and location
** • Thanks a lot. - guy
Tue Jul 26 02:41:19 2016 guy

** • I would think *on* - fwiw-poi
Mon Jul 25 23:25:47 2016 fwiw-poi


• branches at their appropriate level, deep to the superficial temporal ...
+ mp3
Mon Jul 25 23:00:44 2016 mp3
branches at their appropriate level, deep to the superficial temporal fascia but superficial to the superficial layer of the deep temporal fascia. _____ these were dissected free from the surrounding tissue. A nerve stimulator was used to confirm that these were in fact the nerves controlling the frontalis muscle
** • I hear *4 distinct*, though not sure it fits with incomplete sentence. + imo-poi
Mon Jul 25 23:27:41 2016 imo-poi
She might have also been correcting and there is nothing at the blank.
** • flagged. Thanks to anyone who tried. - guy
Mon Jul 25 23:11:28 2016 guy


• Upon examination, it was apparent that the patients wound extended to ...
+ mp3
Mon Jul 25 22:57:40 2016 mp3
Upon examination, it was apparent that the patients wound extended to the temporalis muscle at its largest _____. The inferior and superior poles of this laceration however were not as deep
** • depth - poi
Mon Jul 25 22:59:22 2016 poi

**** • Thanks a lot. - guy
Mon Jul 25 23:00:52 2016 guy


• Negative for nausea, vomiting, diarrhea, constipation, hematemesis, melena, no ____sm
+ :) wav
Mon Jul 25 22:38:04 2016 :) wav
in bowel habits. Appetite good.
** • bowel change - poi
Mon Jul 25 22:59:14 2016 poi

**** • Thanks poi. - :)
Mon Jul 25 23:08:51 2016 :)


• resents to the emergency room from Dr. __________ office because of elevated sm
+ :) wav
Mon Jul 25 22:22:02 2016 :) wav
blood pressure.
** • Coworker got this one. - :)
Mon Jul 25 22:36:02 2016 :)


• We will check her orthostatic vital signs as she is dehydrated. If negative MRI sm
+ wav :)
Mon Jul 25 22:09:03 2016 wav :)
can be obtained in the morning to rule out any posterior __________ cerebrovascular accident.
** • Got this one. Thanks - :)
Mon Jul 25 22:11:33 2016 :)


• She has been started on chemotherapy since March of this year and about to sm
+ :) wav
Mon Jul 25 21:42:31 2016 :) wav
finish it and is scheduled for biopsy and __________ after that.


** • PET scan? - billybob
Mon Jul 25 21:53:19 2016 billybob

**** • Thanks Billybob. Just in the nick of time, was going to send in with a blank. - :)
Mon Jul 25 21:55:55 2016 :)


• Hyponatremia
+ ESL
Mon Jul 25 20:15:36 2016 ESL
Serum sodium 127, following use of "samscod" given interval sodium 134.
** • Got it! + b o h b c p
Mon Jul 25 20:28:06 2016 b o h b c p
Samsca

• the ovarian cyst ruptured s/l reezing clear fluid. (doesn't s/l leaking)
- mt
Mon Jul 25 13:46:56 2016 mt

** • must be oozing - mt
Mon Jul 25 13:50:38 2016 mt


• methylene blue, _______ incision was done utilizing
+ mp3
Mon Jul 25 13:38:04 2016 mp3
At this point, the wound was irrigated profusely with 0.9% normal saline solution utilizing 10 cc syringe and a 35-gauge needle. Approximately 60 cc were utilized for the irrigation under pressure. Once all markings were performed with methylene blue, _______ incision was done utilizing a 15 scalpel through the mucocutaneous tissue and orbicularis oculi muscle over the level of the tissue was excised.
** • in elliptical fashion an? - nm
Mon Jul 25 14:59:16 2016 nm


• No history of loss of consciousness or ______ injury.
+ wav
Mon Jul 25 13:32:57 2016 wav
COMMENTS: No history of loss of consciousness or ______ injury.

CONDITION ON DISCHARGE: Good.

FINDINGS: This is a 22-month-old male patient who comes to Good Samaritan Hospital referred by his family physician presenting with continuous ragged and jagged laceration located in the lateral aspect of the left upper lid.
** • eye globe? - poi
Mon Jul 25 13:43:57 2016 poi

** • eye glass? - taco
Mon Jul 25 13:40:51 2016 taco

**** • thanks - -
Mon Jul 25 13:52:31 2016 -


• dental surgery, help with preop diagnosis. sm pls
+ mt
Mon Jul 25 13:03:40 2016 mt
Preop Dx: Anterior maxillary alveolar fracture involving segments "one one two one."

Would that be 11 and 21?


** • Plse disregard - OP
Mon Jul 25 13:11:40 2016 OP

**** • Did U find the answer? If so, what was it? - Questyr
Mon Jul 25 13:24:28 2016 Questyr

****** • hi, doc refers to circumdental wires at 11, 12 and 21, 22 later in report - mt
Mon Jul 25 13:25:37 2016 mt


• Teenager with a distal radius fracture.
+ sm please
Mon Jul 25 12:52:10 2016 sm please
The ulna has an open physis but the radius has a physeal bar without significant remodeling.

X-rays of the right wrist demonstrate neutral ulnar variance today as opposed to 1 to 2- ulnar variance at the last visit, consistent with his physeal arrest of the distal radius but open physis of the ulna. He has s/l adaptive DISI deformity. He has nearly completely consolidated distal physis and approximately 20 degrees of dorsal tilt.
** • Yes to "adaptive DISI deformity" (see google hits) + Q
Mon Jul 25 13:10:56 2016 Q
Here are some cut and pasted Google hit examples

Dorsal intercalated segment instability (DISI) is one of the types of instability involving ... distal radius fracture: compensatory DISI; radius malunion: adaptive DISI.



Treatment of Distal Radius Frx Malunion - Wheeless' Textbook of ...



www.wheelessonline.com/.../treatment_of_distal_...








Wheeless' Textbook of Orthopaedics




Jan 4, 2013 - look for dorsal tilt of the lunate (DISI deformity); - excessive dorsal tilt is associated w/ ulnar mid carpal instability (or carpus adaptive DISI); ...


DISI and VISI Deformities - wikiRadiography



www.wikiradiography.com/page/DISI+and+VISI+Deformities






Introduction The recognition of DISI ( dorsal intercalated segmental instability ) ... adapted from ... The very large scapholunate angle suggests a DISI deformity.


Wrist Arthroscopy - Page 81 - Google Bo
**** • Thank you! - nm
Mon Jul 25 13:15:11 2016 nm

** • I think it s/b 1-2 ulnar variance (not 1 to 2-) (think he's + Questyr
Mon Jul 25 13:07:51 2016 Questyr
referring to mm of variance...see google hits to see what you think)
**** • Thanks, Questyr. I will look into that. To quote him, though, + sm
Mon Jul 25 13:12:34 2016 sm
he says, "...1 to 2 minus ulnar variance." I'll see if there is anything in a previous document to verify.

Thanks again!
****** • This article might help...making it -1 to -2 (I think) + Q
Mon Jul 25 13:28:19 2016 Q
Ulnar variance and subchondral bone mineralization patterns in the distal articular surface of the radius.

Giunta RE1, Biemer E, Mller-Gerbl M.



Author information



Abstract

PURPOSE:

Based on biomechanical experiments in specimens it is accepted widely that ulnar length determines loading of distal articular surface of the radius with ulna-minus variance increasing and ulna-plus variance decreasing the loading of the lunate compartment. Nevertheless a direct assessment of the actual loading conditions in the living is currently impossible. The aim of the present study is therefore to evaluate subchondral bone mineralization patterns to provide further information about the role of ulnar length in load transmission through the radiocarpal joint.

METHODS:

Twelve wrists of healthy subjects with an average age of 33 years and an average congenital ulna-minus wrist of -2.8 mm (range, -4 to -1 mm) were examined by means of com

• Does punctuation look correct? (see inside)
+ OP
Mon Jul 25 09:06:42 2016 OP
The patient reportedly is currently a 57-year-old right-handed, never married, African American female with 9 years of education completed.
** • See message also here is a good grammar and punctuation site. Your + Questyr
Mon Jul 25 12:37:05 2016 Questyr
example would be number 1.
The patient reportedly is currently a 57-year-old, right-handed, never married, African American female with 9 years of education completed.

**** • Click on the box at the top of the page to get to the index for other questions. Hope it + Q
Mon Jul 25 12:38:54 2016 Q
helps.
** • I went with no commas, only the period at the end of the sentence! - OP
Mon Jul 25 10:03:20 2016 OP


• FINDINGS: Bilateral micromastia with good symmetry and healthy ______ ...
+ mp3 posted
Mon Jul 25 08:59:41 2016 mp3 posted
FINDINGS: Bilateral micromastia with good symmetry and healthy ___________ below the muscle.
** • Where is everyone this morning?? - mp3 posted
Mon Jul 25 09:05:08 2016 mp3 posted

**** • ... - mp3 deleted
Mon Jul 25 09:11:27 2016 mp3 deleted


• Abdominoplasty. Umbilicus, inferior split?
+ d g m p c f
Mon Jul 25 08:49:27 2016 d g m p c f
Once these were placed, the site of the umbilicus was noted and incised as an inverted V. This area was defatted and the umbilicus was presented. " It's inferior split" was affixed to the lower flap of the opening.
** • I used 'inferior split' as I found documentation of the umbilical flap being split. Thaks - d g m p c f
Mon Jul 25 09:02:27 2016 d g m p c f


• s/p breast implant placement, now with wound dehiscence.
+ mp3 posted
Mon Jul 25 08:39:29 2016 mp3 posted
Attention was then turned to the right breast. Markings were placed around the prior inframammary crease incision. ThisThe entire scar as well as the areas _______________ and peri-incisional skin was excised using a 15 blade.
** • It is...the areas of intention... Thanks - mp 3 posted
Mon Jul 25 09:01:38 2016 mp 3 posted


• We had a lobster jaw on proximally, we could see that the proximal piece albeit *webe
+ sm
Mon Jul 25 07:21:31 2016 sm
Therefore, we reduced the fracture, we drilled a unicortical hole in the distal piece to put in a bone hook and pulled distally. We had a lobster jaw on proximally, we could see that the proximal piece albeit *weber B*. The proximal piece was quite loose and free from the syndesmosis and the syndesmosis itself was disrupted. We reduced it and held it with a pointed bone reduction clamp and since we could not lag across it, we slid the plate below it. We assessed our reduction prior to putting on the plate both laterally, anteriorly, and by the spike and also by x-ray and saw that there was still residual shift of the talus and the mortise, but it was improving and the fracture was lined up well on the AP and oblique and lateral.
** • NOTE: I would think it s/b lobster claw (see link) + Questyr
Mon Jul 25 12:44:19 2016 Questyr
(Here are some samples of google hits)

Lobster Claw Forceps - AR-8943-23 ... Instructions For Use. DFU-0023 Instruments (English) DFU-0023 Instrumentos ... Surgical Evaluation Price Quote.



Surgical Instrumentation, Ringed/ Common Stringer Instruments - Quizlet



https://quizlet.com/.../surgical-instrumentation-ringed-common-stringer-instru...





Quizlet




A tool I am creating to help me, and everyone else know surgical instruments at a glance. This will be an ever ... Sometimes referred to as " Lobster Claw".
**** • Sorry. Can't think what your s/l might be. - Q
Mon Jul 25 12:45:43 2016 Q


• Postoperatively from this, she had been supported on **central VA-ECMO ...
+ mp3
Mon Jul 25 03:37:28 2016 mp3
Postoperatively from this, she had been supported on **central VA-ECMO. Last week she returned to the operating room for a trial of weaning to isolated _____. This was successful but here lungs were still poor and she required an oxygenator to be cut into the circuit. **
** • LVAD (left ventricular assist device) - isgal
Mon Jul 25 05:59:46 2016 isgal


• Chest x-ray shows _________ known hilar contours. _________ the aorta is tortuous sm
+ wav :)
Mon Jul 25 03:12:41 2016 wav :)
with calcific atherosclerosis.
** • wav doesn't match - isgal
Mon Jul 25 06:01:26 2016 isgal


• Procedure: PRIMARY LOW-TRANSVERSE C-SECTION WITH DOUBLE-LAYER CLOSU ...
+ wav
Mon Jul 25 02:48:30 2016 wav
Procedure:
PRIMARY LOW-TRANSVERSE C-SECTION WITH DOUBLE-LAYER CLOSURE VIA PFANNENSTIEL INCISION _____ EXTENSION.

Postoperative Diagnosis:
A 26-YEAR-OLD GRAVIDA 1, PARA 0 AT 40 WEEKS AND 5 DAYS WITH ARREST OF DESCENT AND A PLACENTAL ABRUPTION.


• Breast Biopsy
+ ESL
Mon Jul 25 00:40:34 2016 ESL
the patient had a breast biopsy, ultrasound-guided, core, of a 5.4 mm mass in the right breast and placement of a "wing ship" marker.
** • I find a "wing clip" (see link) ...also no comma after guided + Questyr
Mon Jul 25 01:07:44 2016 Questyr
link
**** • type....wing clip....in the Find Box at the top of the page - Q
Mon Jul 25 01:08:24 2016 Q

****** • Thank you... - b o h b c p
Mon Jul 25 01:21:05 2016 b o h b c p


• I then made an incision just above the ________ peritoneal dialysis catheter where sm
+ wav :)
Sun Jul 24 23:57:33 2016 wav :)
I could feel that the catheter was entering the abdominal cavity.
** • I think I hear "outpatient" - Questyr
Mon Jul 25 01:03:49 2016 Questyr


• Unresponsiveness possibly due to lidocaine push...
+ b o h b c p
Sun Jul 24 21:43:26 2016 b o h b c p
Possibilities include having "total shower emboli" from going from ventricular tachycardia to regular sinus rhythm.
** • shower emboli is legit, if that is what you're wondering. - just me
Sun Jul 24 21:59:46 2016 just me


• She had "poor mulfunction" or s/l "pomofunction" with lap band. Procedure is an EGD.
- k
Sun Jul 24 12:15:26 2016 k

** • Never mind. "port malfunction" Thanks - k
Sun Jul 24 12:16:05 2016 k

**** • Are you sure that pt even has a port? if lap band is bariatric in nature, usually not.) + Margaret
Sun Jul 24 15:01:27 2016 Margaret
I believe your syllables might be "poor bowel function," a decent reason to do EGD after lap band.
****** • A Lap Band fill is when the doctor takes a needle (about 3 inches long) and inserts it + ?? link about port
Sun Jul 24 20:57:22 2016 ?? link about port
nto the port that is located slightly under your skin on your abdominal wall. Once the needle makes it way into your port the doctor then injects saline. The saline travels down the tube attached to the port and into the balloon (your Lap Band).

• medication s/l Ol-daz-O-tron 80 mg, q8h prn...please sm for PMH
+ ne
Sun Jul 24 10:52:16 2016 ne
PMH: Metastatic adenocarcinoma to the liver, cardiac dysrhythmias presenting a pacemaker defibrillator, hypertension, schizophrenia.


Meds:
Pantoprazole 40 mg daily, <s/l Oldazotron>-- 80 mg q8h prn, Dilaudid 4 mg q4h, furosemide 40 mg daily, mirtazapine 50 mg at bedtime, Plavix 75 mg daily, Flomax 0.4 mg daily, Toprol 25 mg daily, Xarelto 50 mg daily, Lorazepam 1 mg q6h prn.
** • ondansetron ? - jr
Sun Jul 24 10:54:20 2016 jr

**** • Yes! That's it, thanks! - ne
Sun Jul 24 10:54:38 2016 ne


• I recommended proceeding to the operating room. At __________ she was found to sm
+ :) wav
Sat Jul 23 21:59:20 2016 :) wav
have acute suppurative appendicitis without perforation.
** • exploration - nm
Sun Jul 24 07:22:41 2016 nm


• This is a shoulder labral repair
+ k o e o e c
Sat Jul 23 16:02:00 2016 k o e o e c
The posterior labrum appeared to be intact with just some mild bruising, indicative of a s/l "contra-koo" type lesion.
** • Thanks - but I found it "contre-coup" - k o e o e c
Sat Jul 23 16:03:38 2016 k o e o e c


• Evaluations for renal insufficiency
+ b o h b c p
Sat Jul 23 13:18:41 2016 b o h b c p
The liver is grossly normal with "noncautious" CT appearance
** • "noncancerous" is the first thing that comes up, see link. + billybob
Sat Jul 23 15:09:40 2016 billybob
link
**** • Thank you + b o h b c p
Sat Jul 23 18:18:32 2016 b o h b c p
I though it could be noncontrast too?

• preemie 3 day, question D20 of light and Dancing feeds? They both sound like that
+ o a o m p p
Sat Jul 23 12:53:47 2016 o a o m p p
taking fluids of 120 mL/kg/day with D20 of light and then dancing feeds of mother's milk. On this regimen, his glucose has now been in the normal range.

** • "advancing feeds" "day-20-of-life," usually worded 20th day of life (mayB 2 avoid hyphens - Margaret Walker
Sun Jul 24 14:53:52 2016 Margaret Walker

** • D20 meaning 20% dextrose? see link + isgal
Sun Jul 24 06:41:42 2016 isgal
link
**** • (no idea where light fits in there, which is probably what you're really asking) - isgal
Sun Jul 24 06:46:04 2016 isgal

** • the 2nd is advancing.. Sigh - o a o m p p
Sat Jul 23 12:54:33 2016 o a o m p p


• s/l Culturelle ** ENT-uh-gulls ** formula
+ MT10
Sat Jul 23 08:42:24 2016 MT10
He takes Culturelle ** formula with fiber probiotic daily.
** • Gentle-Go('s) - nm
Sat Jul 23 09:29:34 2016 nm

**** • Thanks much! - MT10
Sat Jul 23 09:44:58 2016 MT10


• By the morning of 07/22/16, he was noted to be **further lethargic and ...
+ mp3
Sat Jul 23 04:56:48 2016 mp3
By the morning of 07/22/16, he was noted to be **further lethargic and the ____ CT showed hydrocephalus** and a right PCA infarct as well as bilateral cerebellar hypodensities with crowding in the posterior fossa.
** • A pesky suggestion from an "old fart." + Margaret Walker
Tue Jul 26 23:10:47 2016 Margaret Walker
I'm glad you became sure that you had correctly devined the word your dictator intended to fit into the blank space you indicated prior to "CT."

BUT, I urge you, yourself, to become a conscientious mentor of your MD colleagues by making this negligible change in your style of re-posting to "call off us dogs."

Rather than posting "nevermind," which effectively calls us dogs off but teaches us nada, zip, zero, why not post your solution for the blank, such as "contrast CT," "repeat CT," "store-bought Saint Elsewhere CT," or even "sry; too big a mess to explain."

I'm not usually such a "meanie." Early in my MD education (1966-1969) my mentor of the "problem-oriented chart," Dr Larry Weed, kept repeating "With S.O.A.P., strive to achieve a patient care record that guides and teaches" ("others," understood.


** • nevermind. - guy
Sat Jul 23 05:14:39 2016 guy


• This is a 58-year-old gentleman who is a DOC resident at Rikers Island ...
+ wav
Sat Jul 23 04:50:08 2016 wav
This is a 58-year-old gentleman who is a DOC resident at Rikers Island with a past medical history significant for HIV, hypertension, diabetes, hep C, who presented two days ago to an outside hospital with dizzy, vomiting, slurred speech. He then was transferred to Bellevue for further workup and developed nausea and vomiting, had left facial droop and a _____ was called. On noncontrast head CT imaging bilateral hypodensities in the cerebellum were noticed.
** • nevermind. - guy
Sat Jul 23 05:14:32 2016 guy


• She reports that the goiter has enlarged in size such that it now caus ...
+ wav
Sat Jul 23 03:53:32 2016 wav
She reports that the goiter has enlarged in size such that it now causes difficulty breathing when lying flat and when sleeping. The goiter was ultrasounded and biopsied multiple times which showed _____ class 2.

Procedure:
RIGHT THYROID LOBECTOMY AND ISTHMUSECTOMY, AND RECURRENT LARYNGEAL NERVE MONITORING.

Postoperative Diagnosis:
RIGHT THYROID GOITER.


• We then removed our dual-lumen catheter and passed our flexible ureter ...
+ wav
Sat Jul 23 02:10:48 2016 wav
We then removed our dual-lumen catheter and passed our flexible ureteroscope over one of our two sensor wires into the kidney and then removed the wire. The other was kept as a safety wire. _____ all calyces of this patients right kidney, again seeing Randall's plaques but no evidence of renal stones. We then
** • We went in - Questyr
Sat Jul 23 02:48:56 2016 Questyr

**** • Thanks a lot. - guy
Sat Jul 23 02:56:19 2016 guy


• He underwent cardiac catheterization two days prior to operation. Thi ...
+ wav
Sat Jul 23 00:06:57 2016 wav
He underwent cardiac catheterization two days prior to operation. This revealed an ulcerated lesion of left main coronary artery at a totally obstructed left descending coronary artery. The _____ distal and antegrade collateral flow. Additional obstruction noted in the circumflex marginal coronary artery and in the midportion of the posterior descending coronary artery.
** • nevermind. - guy
Sat Jul 23 00:47:13 2016 guy




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