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.
After extensive medical tests over the following 7 or 8 months, the conclusion was that Eva did not have any specific diagnosis that was life threatening or even would be a significant threat to her quality of life, but that the combination of all her problems together was significantly decreasing the quality of her life primarily due to problems breathing caused by fluid retention and lack of ability to lose weight, lack of energy, sleepiness, and gastrointestinal, bladder and restless leg problems as well as attacks of rheumatoid arthritis.
In the summer of 2017, Eva began to have skin problems expressed as reddened, irritated splotches on her neck, below her right breast, on the right of her stomach at the leg bend, around her mouth, and also vaginal itching. This was found to be due to psoriasis and was treated with skin creams. The problems with the mouth were diagnosed as perioral dermatitis.
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.
The Cimzia treatment which is necessary to reduce Eva's rheumatoid arthritis attacks also compromises her immune system so that she has infections that require hospitalization and large doses of antibiotics once or twice per year. These antibiotic treatments tend to upset the probiotic balances in her digestive system so that a prolonged period of probiotic replacement, which is problematic due to general lack of knowledge about the interactions among various species of intestinal flora and fauna, is necessary to get her back to what, for her, passes for normal gastrointestinal processes.
Poor administration of the medications and diet that she requires for daily living by the staff in hospitals also usually results in fluid buildup and other problems which have to be overcome after each hospitalization episode. For example, they seem to think that a diabetic diet is a low fat diet without concern for carbohydrates and that the timing of medications is unimportant as long as they are given.
Dr. Smith reported, after doing a right heart catherization, that he recommends that she adhere to a low sodium, low fat diet; continue treatment for obstructive sleep apnea and maintain systemic blood pressure control. He said he did not find any evidence of pulmonary arterial hypertension.
No known allergies except codeine causes nausea. Drugs: Dyer Drug Albany, Ky 42602 606 387-6444 MEDICINE LIST FOR EVA BRISTOW METFORMIN XR 500 MG 2 TWICE PER DAY Diabetes GLIPIZIDE XL 5 MG 1 PER DAY Diabetes PEPCID (Famotidine) 40 MG 1 PER DAY heartburn SUCRALFATE 1 GM 3 PER DAY AS NEEDED heartburn LIPITOR (Atorvastatin) 20 MG 1 PER DAY cholesterol COZAAR (Losartan) 50 MG 1 PER DAY HBP BYSTOLIC 20 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 1 EVERY 4 TO 6 HRS AS NEEDED pain NEURONTIN 600 MG 1/4 PER DAY AT 8 PM shoulder pain & restless legs CIMZIA INJECTION ONCE A MONTH arthritis ZOFRAN (Ondansetron) 4 MG 1 12 hrs. as needed 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 as needed digestive problems ALDACTONE (Spironolactone) 50 MG 1 PER DAY fluid retention Lasix (Furosemide) 80 MG 1 per day fluid retention Lotrisone 0.05%/1% TO cream once per day candida MetroNidazole 0.75% TO Cream 45 once per day psoriasis Hydrocortisone 2.5% Cream 30 once per day psoriasis Sulfacetamide Sodium 10% TO LOT once per day psoriasis Fluocinonide 0.05% TO Oint TARO apply at bedtime psoriasis on hand cough syrup - Guaifenesin/Dextromethorphan HBR as needed 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 - rarely needed Prednisone 5 mg - 3 tablets daily when needed. FLU SHOT 10-12-2017 Mammogram 12-27-2016 PNEUMONIA SHOT 07-25-2017 SHINGLES SHOT MAY 2008 Blood pressure & heart rate with Bystolic 117 to 125/ 58 to 68 with heart rate 78 to 85
Tests and Labs: