web page by Duane Bristow
Medical Record by Duane Bristow
Date Of Birth: 11-09-1946
Height: 5' 3"
Spouse: Duane Bristow
Eva Bristow is a 70 year old female who has had a lumpectomy followed by radiation and chemotherapy for breast cancer in 2004 and now is diagnosed with rheumatoid arthritis and mild cases of pulmonary hypertension and bronchiectasis as well as diastolic dysfunction. The cancer treatments have resulted in ongoing gastrointestinal problems and low grade anemia. She also is overweight and is sleepy during the day and complains of restless legs at night and has hypertension and a low level of type II diabetes probably caused by use of steriods for her rheumatoid arthritis. She also has bladder problems (interstitial cystitis) and her cholesterol levels are high without medication. She uses a nebulizer twice a day with Albuterol and Brovana and Budesonide to alleviate breathing problems due to the bronchiectasis as prescribed by her pulmonologist. She has noticed sinus problems and some back pain and coughing which she attributes to the nebulizer treatments.
After a childhood of recurrent pneumonia and lung problems she had a medically uneventful adulthood except for two children born by c-section. About the age of 45, in the early 1990s, she developed high blood pressure which took several months to bring under control due to the need to find a very specific medication regime which worked for her. Later in that decade she developed osteoarthritis expressed as pain in the knee joints which limited her ability to get exercise by walking and gardening which probably resulted in her subsequent weight gain.
She has a family history of asthma and breast cancer and in 2004 she was diagnosed with breast cancer in the left breast. This was treated with a lumpectomy followed by chemotherapy and radiation. After this she was afflicted with gastrointestinal problems and low grade anemia and restless legs.
She had total knee replacements in 2007 and 2011 and during this time was diagnosed with rheumatoid arthritis. After these surgeries she was still unable to exercise vigorously due to breathing difficulties.
In 2014 she was diagnosed with mild sleep apnea.
It is thought that the bronchiectasis is probably a result of her childhood bouts with lung problems and the diastolic dysfunction was probably caused by the period of time in which her hypertension was out of control. The lung problems and the cancer can probably be partially attributed to a genetic predisposition.
Beginning at the end of September 2016, she noticed pressure in her chest and abdomen and more than usual difficulty breathing and weight gain as well as increased heart rate.
At that time, due to elevated blood potassium levels the Aldactone she was taking for hypertension and edema was reduced in dosage from 200 mg. per day to 0 and then raised to 25 mg. This resulted in her blood pressure increasing from about 130/60 to about 150/85 and edema in her legs and feet severe enough that around Christmas of 2016 fluid began leaking from her legs. Probably due to edema she gained about 30 pounds in weight without aldactone and when she began taking a lower dose of aldactone the weight gain was reduced to about 20 pounds. On April 28, 2017 Dr. Smith told Eva to begin taking 40 mg. Lasix daily in addition to the Aldactone.
On December 1, 2016 Dr. Cherry told Eva that ultrasounds of her Pelvis, Thyroid and Abdomen did not show fluid retention but they did show a nodule on the left lobe of the thyroid and thickening in the lining of the uterus. Later Dr. Sloan in Lexington did a biospy of three thyroid nodules and found them to be benign. Dr. Nall (gynecologist) wants Eva to have a D and C for what is probably a benign polyp in the uterine wall.
On January 19, 2017 Dr. Ahmed, sleep doctor and pulmonologist, said that a breathing test indicated that the lungs were functioning normally but were unable to fully expand probably due to pressure in the chest caused by her weight. He told her to use a CPAP machine and use the rescue inhaler, Ventolin, as needed for breathing problems.
February 9, 2017 - Dr. Lewis, rheumatologist, prescribed hydrocodone for rheumatoid arthritis pain and gave Eva the option of adding Methotrexate in addition to Cimzia.
April 25, 2017 - Three month checkup with Dr. Cherry. She said to use Carafate to coat the stomach if using Pepcid did not completely relieve stomach distress. Weight 240. BP 134/74.
April 28, 2017 - Eva has more trouble getting her breath so she talked to Dr. Smith's nurse on the phone. He told her to start taking 40 mg Lasix daily and to get a blood test at the hospital to check potassium levels and to get a heart catherization in Louisville on May 17.
In addition to the above problems, Eva has also had a pinched nerve in her neck resulting in pain in her right arm and has low bone density.
No known allergies except codeine causes nausea. MEDICINE LIST FOR EVA BRISTOW METFORMIN XR 500 MG 2 TWICE PER DAY Diabetes PEPCID (Famotidine) 40 MG 1 PER DAY heartburn SUCRALFATE 1 GM 3 daily as needed heartburn LIPITOR (Atorvastatin) 20 MG 1 PER DAY cholesterol COZAAR (Losartan) 50 MG 1 PER DAY HBP BYSTOLIC 10 MG 1 PER DAY HBP ASPIRIN 325 MG 1 PER DAY heart CALCIUM + D 600/200 1 THREE TIMES A DAY bones TRAMADOL 50 MG 2 EVERY 4 TO 6 HRS AS NEEDED pain NEURONTIN 600 MG 1/4 PER DAY AT 8 PM shoulder pain CIMZIA INJECTION ONCE A MONTH arthritis METHOTREXATE 2.5 MG 4 EVERY WEEK arthritis FOLIC ACID 1 MG 1 PER DAY arthritis ZOFRAN (Ondansetron) 4 MG 1 PER DAY nausea B VITAMIN COMPLEX 1 PER DAY mouth sores CYSTOPROTEK sub for Elmiron 2-TWICE A DAY interstitial cystitis Align probiotics daily digestive problems Immodium daily digestive problems ALDACTONE (Spironolactone) 25 MG 1 PER DAY fluid retention Lasix (Furosemide) 40 MG 1 per day fluid retention cough syrup - Guaifenesin/Dextromethorphan HBR Ventolin HFA 108MCG/ACT inhaler as needed. Nebulizer with Brovana 15 mcg and Budesonide (Pulmicort) 0.5 mg and Albuterol Sulfate 0.083% IH twice a day for bronchiectasis. For rheumatoid arthritis flare-ups Dr. Lewis prescribed: Acetaminophen/Hydrocodone 325/5 Prednisone 5 mg - 3 tablets daily when needed. FLU SHOT 10-19-2016 Mammogram 12-27-2016 PNEUMONIA SHOT 11-8-2012 SHINGLES SHOT MAY 2008
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