tokens: Admission Date : 2019-09-27 Discharge Date : 2019-10-07 Date of Birth : 1959-01-27 Sex : M Service : CARDIOTHORACIC Allergies : Patient recorded as having No Known Allergies to Drugs Attending : Luis JG Lavoie , M.D. Chief Complaint : exertional angina Major Surgical or Invasive Procedure : 10-01 CABG x 3 History of Present Illness : 60 yo M with exertional angina -> positive ETT -> cath with severe 3VD Past Medical History : HTN DM cataracts s/p removal of in Mayotte c/b enucleated CMED CSRU urinary incontinence Social History : farmer in Mayotte - tob - etoh lives with wife and oldest son Family History : father with ? Mi at unknown age Physical Exam : NAD 76 184/87 18 Teeth in poor repair lungs ctab ant / lat distant heart sounds , RRR Abdomen benign extrem warm , no edema , no varicosities , 2+ pedal pulses Pertinent Results : 2019-10-07 05:30 AM BLOOD WBC - 6.5 RBC - 3.23 * Hgb - 9.5 * Hct - 27.6 * MCV - 86 MCH - 29.4 MCHC - 34.4 RDW - 14.0 Plt Ct - 356 # 2019-10-07 05:30 AM BLOOD Plt Ct - 356 # 2019-10-04 06:50 AM BLOOD PT - 13.2 * PTT - 32.1 INR(PT) - 1.2 * 2019-10-07 05:30 AM BLOOD Glucose - 156 * UreaN - 20 Creat - 1.0 Na - 140 K - 3.8 Cl - 99 HCO3 - 31 AnGap - 14 Brief Hospital Course : He was taken to the operating room on 2019-10-01 where he underwent a CABG x 3 . He was transferred to the CMED CCU in critical but stable condition . He was extubated by POD #1 . He was weaned from his vasoactive drips and transferred to the floor on POD #2 . He was seen by speech and swallowing who recommended NPO , he then underwent a video swallow after which he was changed to a diet of thin liquids and soft solids , and felt that his eeating may be limited by his loose teeth . Dentistry and OMFS were consulted , and he had four front teeth removed on 10-04 . He did well post operatively and he was ready for discharge on 2019-10-07 . Medications on Admission : lisinopril , protonix , glipizide , metformin , asa Discharge Medications : 1. Aspirin 81 mg Tablet , Delayed Release ( E.C. ) Sig : One ( 1 ) Tablet , Delayed Release ( E.C. ) PO DAILY ( Daily ). Disp :* 30 Tablet , Delayed Release ( E.C. )(s)* Refills :* 0 * 2. Pantoprazole 40 mg Tablet , Delayed Release ( E.C. ) Sig : One ( 1 ) Tablet , Delayed Release ( E.C. ) PO Q24H ( every 24 hours ). Disp :* 30 Tablet , Delayed Release ( E.C. )(s)* Refills :* 0 * 3. Metoprolol Tartrate 50 mg Tablet Sig : One ( 1 ) Tablet PO BID ( 2 times a day ). Disp :* 60 Tablet (s)* Refills :* 0 * 4. Docusate Sodium 150 mg / 15 mL Liquid Sig : One ( 1 ) PO BID ( 2 times a day ). Disp :* QS 1 month * Refills :* 0 * 5. Oxycodone - Acetaminophen 5-325 mg Tablet Sig : 1-2 Tablets PO every 4-6 hours as needed for pain . Disp :* 50 Tablet (s)* Refills :* 0 * 6. Clopidogrel 75 mg Tablet Sig : One ( 1 ) Tablet PO DAILY ( Daily ). Disp :* 30 Tablet (s)* Refills :* 0 * 7. Atorvastatin 10 mg Tablet Sig : One ( 1 ) Tablet PO DAILY ( Daily ). Disp :* 30 Tablet (s)* Refills :* 0 * 8. Glipizide 5 mg Tablet Sig : One ( 1 ) Tablet PO BID ( 2 times a day ). Disp :* 60 Tablet (s)* Refills :* 0 * 9. Lisinopril 10 mg Tablet Sig : One ( 1 ) Tablet PO DAILY ( Daily ). Disp :* 30 Tablet (s)* Refills :* 0 * 10. Hydrochlorothiazide 25 mg Tablet Sig : One ( 1 ) Tablet PO once a day . Disp :* 30 Tablet (s)* Refills :* 0 * Discharge Disposition : Home with Service Discharge Diagnosis : CAD HTN DM cataracts s/p removal c/b enucleated left CMED CSRU urinary incontinence ? TIA Discharge Condition : Good . Discharge Instructions : Call with fever , redness or drainage from incision or weight gain more than 2 pounds in one day or five in one week . Shower , no baths , no lotions , creams or powders to incisions . No lifting more than 10 pounds or driving until follow up with surgeon . Followup Instructions : Dr. Dewhurst 2 weeks Dr. Burns 4 weeks Chad Barbara MD 49-703 Completed by : Theresa Leonore NP 80-BXH 2019-10-07 @ 1229 Signed electronically by : DR. Eugene Offutt on : MON 2019-10-07 12:44 PM ( End of Report )