Abdominal Pain Plan

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TAKKE NOTES

Ved Henry Wiseman

HYPOTHYROIDISM VS HYPERTHYROIDISM

Ved VIKASHNEE PILLAY NAIDU

Hormones

Ved Estefania Chumi

3750 - P1 HTA

Ved Premi Mohanavelu

Abdominal Pain Plan

Relief

Time

Percocet

Warm Compress

Morphine push

Symptoms

light with some sensation of constipation

Some diarrhea

Vomit

Light amounts with some relief

Intense Pain just below sternum

Pain is treated with pain meds and subsides after a few hours.

Most likely

Gallstones

Wants to run MRCP to examine the bile ducts in the gallbladder.

Doctor thinks this the most likely and that my episodes may have been caused by passing gallstones.

Diagnostics

Recommend MRCP

Examines the bile ducts and may detect presence of gallstones.

Concern: 6"metal in distal 3rd of right arm. Will this cause a problem with the MRCP>?

Concern: Cost

Endoscopy 3/20

ultrasound 3/15

Clear

Blood Work 3/14

celiac- clear

H. Pylori-Clear

Dr Geraghty Visit 3/1

Discussed recent visits to ER. Tried to build a diagnostics plan but got recommendation to contact GI Specialist ( Dr. Fierman ) for further consultation .

Subsequent Call to Dr Fieman's office yielded appointment with PA on 3/15

Contacted Dr. G's office three times to attempt to get an appointment sooner than 3/15 or recommend another GI Specialist.

Cursory Vitals Check

ER Visit 3/1

ER Visit 2/23

Urine Sample

Blood work

CT Scan

Chest X-Ray

Dark spot upper right portion of lung

Negative

Causes

Pneumothorax

Pneumonia

Pleurisy

Pericarditis

Peptic Ulcer

Upper endoscopy

Non ulcer stomach pain

Non-Hodgkins Lymphoma

Mesenteric Ischemia

The only symptom associated is abdominal pain.

Heart Attack

GERD GastroEsophageal Reflux Disease

Hepatitis

only abdominal pain

Angina

Heart scan shows Zero blockages

Uremia

Mostly a consequence of kidney failure, If that is the case, other indicators should be present to indicate such,

Thoracic Aortic Aneurism

Not likely-Chest X-Ray was clear

Mesenteric Thrombosis

Would have been found in CT Scan

Diabetic Keto acidosis

Blood work eliminates

Appendicitis

Physicalpalpations and CT Scan

Possible but most signs absent

Intestinal Obstruction

Adhesion history

Cholongitis

Pancreatitis

Usually from gallstones or heavy alcohol use

10-15% have unknown cause

Does blood work show presence of these two enzymes: amylase and lipase

Cholecystisis

Duodenitis