chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Differential white blood cell count, Dyspnoea, Electrocardiogram, Fatigue
Clinical narrative: COUGH, FEVER, FATIGUE, SHORTNESS OF BREATHE
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Full blood count, International normalised ratio, Metabolic function test, Prothrombin time, Pyrexia
Clinical narrative: COUGH, FEVER, FATIGUE, SHORTNESS OF BREATHE
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Urine analysis
Clinical narrative: COUGH, FEVER, FATIGUE, SHORTNESS OF BREATHE
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Electrocardiogram abnormal, Pain in extremity
Clinical narrative: chest pain and left arm pain
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Urticaria
Clinical narrative: About two weeks after I've had hives under my arm pits. Same arm as the shot was admitted.  Nothing new has changed in diet, soap, etc. Very itchy almost like a rash. Has now moved to both arm put area.
Age: 12.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy
Clinical narrative: Bell's Palsey
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Aphasia, Body temperature increased, Chills, Confusional state, Disorientation
Clinical narrative: Within 2 minutes of receiving the vaccine I felt very confused and disoriented. I was  dizzy and unable to speak for several minutes. I was  told to sit  in a chair for a few minutes prior to returning to my  in surgery.  I sat there for at least 30 minutes before I started feeling better. I left and walked back to the main building and within the hour started running a high temp and chilling along with an intense headache. I left and went home and started having body aches and continued chills and fevers through out the evening and night . This continued for 4 days.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Headache, Pain
Clinical narrative: Within 2 minutes of receiving the vaccine I felt very confused and disoriented. I was  dizzy and unable to speak for several minutes. I was  told to sit  in a chair for a few minutes prior to returning to my  in surgery.  I sat there for at least 30 minutes before I started feeling better. I left and walked back to the main building and within the hour started running a high temp and chilling along with an intense headache. I left and went home and started having body aches and continued chills and fevers through out the evening and night . This continued for 4 days.
Age: 16.0
Sex: F
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: Dosage to a minor under 18
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: Vaccinated with Janssen on 3/31/21.  Symptom onset 7/11/21 with shortness of breath, nausia, sore throat and fatigue.  Tested positive for Covid-19 on 7/11/2021
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Chest discomfort, Computerised tomogram, Dizziness, Dyspnoea
Clinical narrative: About 15 to 30 mins after vaccine wait time I started to pass out, heavy chest, shortness of breath, elevated heart rate, dizziness, and light headed was told in ER I was having allergic reaction. Was kept for observation
Age: 36.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram, Heart rate increased, Hypersensitivity, Sinus tachycardia
Clinical narrative: About 15 to 30 mins after vaccine wait time I started to pass out, heavy chest, shortness of breath, elevated heart rate, dizziness, and light headed was told in ER I was having allergic reaction. Was kept for observation
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Erythema, Peripheral swelling, Pyrexia
Clinical narrative: Redness, swelling in the arm and fever.
Age: 53.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Erythema, Pain in extremity, Peripheral swelling
Clinical narrative: Redness, swelling in the arm and fever.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Chest pain, Computerised tomogram thorax abnormal, Echocardiogram normal, Ejection fraction abnormal
Clinical narrative: Pt was admitted to the hospital on 7/9/21 c/o pleuritic chest pain and was diagnosed with a Left sided pulmonary emboli. Because of her history of cerebral aneurysms she was treated cautiously with lovenox/Coumadin bridging at the direction of neurology. She was discharged home on 7/12/21  to follow up with her primary care with close blood work monitoring. Her venous dopplers were negative for deep vein thrombosis. She has no prior history of blood clots, does not take birth control, no family hx of blood clots, does not smoke, has had no recent/prolonged immobility or travel and no recurrence of cancer that has been in remission for 8 years, no obesity.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Pleuritic pain, Pulmonary embolism, Ultrasound Doppler normal
Clinical narrative: Pt was admitted to the hospital on 7/9/21 c/o pleuritic chest pain and was diagnosed with a Left sided pulmonary emboli. Because of her history of cerebral aneurysms she was treated cautiously with lovenox/Coumadin bridging at the direction of neurology. She was discharged home on 7/12/21  to follow up with her primary care with close blood work monitoring. Her venous dopplers were negative for deep vein thrombosis. She has no prior history of blood clots, does not take birth control, no family hx of blood clots, does not smoke, has had no recent/prolonged immobility or travel and no recurrence of cancer that has been in remission for 8 years, no obesity.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Eczema, Erythema, Eye swelling, Feeling hot
Clinical narrative: After 4 hours of  1st injection started to feel heat and swelling of face.  In the morning woke up to red swollen cheeks and eyes.  Itching sporadic over entire body.   Eczema that was dormant flared on legs and upper arms.   Severe headache which did not respond to Tylenol.
Age: 54.0
Sex: F
Vaccine: COVID19
Symptoms: Headache, Ocular hyperaemia, Pruritus, Swelling face
Clinical narrative: After 4 hours of  1st injection started to feel heat and swelling of face.  In the morning woke up to red swollen cheeks and eyes.  Itching sporadic over entire body.   Eczema that was dormant flared on legs and upper arms.   Severe headache which did not respond to Tylenol.
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Bone pain, Fatigue, Hypertension, Laboratory test, Muscular weakness
Clinical narrative: Muscle Weakness, Extremely tired, high blood pressure, Muscle aches and bone aches
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, X-ray
Clinical narrative: Muscle Weakness, Extremely tired, high blood pressure, Muscle aches and bone aches
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Urticaria
Clinical narrative: Hives all over body.
Age: 79.0
Sex: M
Vaccine: COVID19
Symptoms: Blindness, Migraine, Muscular weakness, Visual impairment
Clinical narrative: eyes distorted, couldnt see, migraine daily, legs weak, arms weak
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth
Clinical narrative: Hard bump under skin, red itchy spot on arm at injection site, warm to the touch, swollen.   Visible for about 48 hours.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Chest pain, Cough, Dizziness, Gait inability
Clinical narrative: After Moderna shot on 7/8/21 around 6:55p.m., patient complained throat swelled up, numbness of face and tongue, airway closing up, fast heart rate (heart rate went from 80 to 144bpm in a few minutes). Benadryl 50mg was given around 7:05pm but patient did not feel better. Epinephrine 0.3mg was injected around 7:15p.m. Patient felt better. Around 9 p.pm, patient felt hurt in stomach and dizzy that she could not walk and needed to be escort on wheelchair. With patient's agreement, I called 911 and ambulance came. BP measured 140/90mmHg. Patient was escorted her to the hospital.  On 7/9/21, pharmacy manager called to follow up and patient was doing fine with no symptom. On 7/12/21@12:31p.m, pharmacist called to follow up, patient complained patient has mild rash on skin and leg, light cough, chest pain, slight tingling on tongue and weird taste. Patient will visit her primary care doctor on 7/13/21.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Heart rate increased, Hypoaesthesia, Hypoaesthesia oral, Paraesthesia oral, Pharyngeal swelling
Clinical narrative: After Moderna shot on 7/8/21 around 6:55p.m., patient complained throat swelled up, numbness of face and tongue, airway closing up, fast heart rate (heart rate went from 80 to 144bpm in a few minutes). Benadryl 50mg was given around 7:05pm but patient did not feel better. Epinephrine 0.3mg was injected around 7:15p.m. Patient felt better. Around 9 p.pm, patient felt hurt in stomach and dizzy that she could not walk and needed to be escort on wheelchair. With patient's agreement, I called 911 and ambulance came. BP measured 140/90mmHg. Patient was escorted her to the hospital.  On 7/9/21, pharmacy manager called to follow up and patient was doing fine with no symptom. On 7/12/21@12:31p.m, pharmacist called to follow up, patient complained patient has mild rash on skin and leg, light cough, chest pain, slight tingling on tongue and weird taste. Patient will visit her primary care doctor on 7/13/21.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Respiratory tract oedema, Taste disorder
Clinical narrative: After Moderna shot on 7/8/21 around 6:55p.m., patient complained throat swelled up, numbness of face and tongue, airway closing up, fast heart rate (heart rate went from 80 to 144bpm in a few minutes). Benadryl 50mg was given around 7:05pm but patient did not feel better. Epinephrine 0.3mg was injected around 7:15p.m. Patient felt better. Around 9 p.pm, patient felt hurt in stomach and dizzy that she could not walk and needed to be escort on wheelchair. With patient's agreement, I called 911 and ambulance came. BP measured 140/90mmHg. Patient was escorted her to the hospital.  On 7/9/21, pharmacy manager called to follow up and patient was doing fine with no symptom. On 7/12/21@12:31p.m, pharmacist called to follow up, patient complained patient has mild rash on skin and leg, light cough, chest pain, slight tingling on tongue and weird taste. Patient will visit her primary care doctor on 7/13/21.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus
Clinical narrative: Extreme itchiness
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Cough, Fatigue, Insomnia, Laboratory test
Clinical narrative: (1) Swelling behind left knee- approximately 1 month after vaccine  (2) Pain inside left thigh and leg area - recurring since taking vaccine, nothing done, just noted (3) Wake up with stiffness in left side of neck approximately 2 times per week- recurring approximately 1 month after taking vaccine (4) Developed a dry cough - present and recurring everyday, approximately 1 month after vaccine (5) Severe insomnia noted after taking vaccine - developed approximately 2 months following vaccine (5) Severe lack of energy and body tiredness
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Musculoskeletal stiffness, Pain in extremity, Peripheral swelling, Ultrasound scan, X-ray
Clinical narrative: (1) Swelling behind left knee- approximately 1 month after vaccine  (2) Pain inside left thigh and leg area - recurring since taking vaccine, nothing done, just noted (3) Wake up with stiffness in left side of neck approximately 2 times per week- recurring approximately 1 month after taking vaccine (4) Developed a dry cough - present and recurring everyday, approximately 1 month after vaccine (5) Severe insomnia noted after taking vaccine - developed approximately 2 months following vaccine (5) Severe lack of energy and body tiredness
Age: 71.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Herpes zoster, Pain, Pruritus
Clinical narrative: Shingles on the left chest, underarm and left shoulder plate. Rash and blisters heal after one month. PHN continues with severe pain, burning, and itching.
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Asymptomatic COVID-19, COVID-19, Exposure to SARS-CoV-2, SARS-CoV-2 test positive
Clinical narrative: ASYMPTOMATIC
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Anosmia, COVID-19, Cough, Fatigue, Headache
Clinical narrative: Vaccinated with Pfizer on 2/22/21 and 3/15/21.  Symptom onset on 6/28/21 - cough, muscle ache, nausea, loss of smell, sore throat, headache, fatigue.  Tested positive for Covid-19 on 7/9/21
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Nausea, Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: Vaccinated with Pfizer on 2/22/21 and 3/15/21.  Symptom onset on 6/28/21 - cough, muscle ache, nausea, loss of smell, sore throat, headache, fatigue.  Tested positive for Covid-19 on 7/9/21
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Condition aggravated, Migraine, Tinnitus
Clinical narrative: I am a migraine sufferer. After getting the first Pfizer Vaccine my migraine headaches escalated I had three headaches between the first and second vaccine shot. I have also continued to have more headaches than normal since receiving the vaccine. I have had a total of six headaches to date since receiving the first vaccine.. Normally I have less than six migraine headaches in a whole year. I have also developed a constant ringing in my ears which started the day of or the day after I got the first shot.
Age: 26.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Dizziness, Hypotonia, Urinary incontinence
Clinical narrative: At approximately 1058, patient reported feeling lightheaded in vaccination chair. Painted closed eyes and slumped over in vaccination chair. Patient was slumped over for approximately 2 seconds.  Nurse supported patient in vaccination chair. Patient opened her eyes immediately. Patient was alert and oriented to person, place, time and situation. Patient reported urinating in chair. Patient reported severe needle phobia, anxiety disorder and history of urination when exposed to needles. Patient given water. Patient able to drink water. Patient offered anti-gravity chair. Two nurses assisted patient into anti-gravity chair. At 1101, nurse assessed patient vital signs: blood pressure 107/84 mmHg, pulse 70 beats/minute, and SpO2 98%. At 1110, patient vital signs reassessed: blood pressure 110/80 mmHg, pulse 80 beats/minute, and SpO2 98%. Patient reported feeling dizzy. Patient given juice. Patient able to juice. At 1120, nurse reassessed patient vital signs: blood pressure 110/82 mmHg, pulse 76 beats/minute, and SpO2 98%. Patient report she felt "better". At 1132, patient reassessed. Patient reported not feeling anxious. Patient able to stand and reported feeling "a little lightheaded". Patient offered to stay for further observation. Patient refused to stay for further observation. Lead nurse educated patient on signs/symptoms of when to seek emergency care, to sign up on v-safe, and to follow up with primary care provider. At 1133, patient left facility with steady gait and unlabored respirations.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Crying, Depression
Clinical narrative: Chief Complaint   covid since last friday, getting more SOB, was 88% RA  History of Present Illness     Patient is a 58-year-old male with a history of ADHD, Depression, sleep apnea on CPAP, hypertension, hypercholesterolemia, and type 2 diabetes presenting for concerns of shortness of breath after being diagnosed with Covid.  Patient first started having symptoms 10 days ago with fevers, diarrhea, and malaise.  He tested positive for Covid 8 days ago, despite being vaccinated with the Pfizer vaccine in February.  He states that he has been getting progressively more short of breath, to the point where he is having to take breaks while going upstairs to his bedroom.  He called EMS to the scene, who state that when they arrived that he was saturating 88% on room air, so he was placed on a nonrebreather.  Patient states that his fevers have stopped and the biggest issue that he is having is his shortness of breath.  He does endorse some intermittent swelling in his lower extremities, which he takes furosemide for. Furthermore, patient started crying thrice during the interview, seemed depressed but had no thoughts of hurting himself. He denies any history of heart failure or heart attacks.  He also denies any chest pain. Chest Xray was done in the ED and it showed severe diffuse bilateral lung consolidation, consistent with Covid 19 pneumonia.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Diarrhoea, Dyspnoea, Lung consolidation, Malaise, Peripheral swelling
Clinical narrative: Chief Complaint   covid since last friday, getting more SOB, was 88% RA  History of Present Illness     Patient is a 58-year-old male with a history of ADHD, Depression, sleep apnea on CPAP, hypertension, hypercholesterolemia, and type 2 diabetes presenting for concerns of shortness of breath after being diagnosed with Covid.  Patient first started having symptoms 10 days ago with fevers, diarrhea, and malaise.  He tested positive for Covid 8 days ago, despite being vaccinated with the Pfizer vaccine in February.  He states that he has been getting progressively more short of breath, to the point where he is having to take breaks while going upstairs to his bedroom.  He called EMS to the scene, who state that when they arrived that he was saturating 88% on room air, so he was placed on a nonrebreather.  Patient states that his fevers have stopped and the biggest issue that he is having is his shortness of breath.  He does endorse some intermittent swelling in his lower extremities, which he takes furosemide for. Furthermore, patient started crying thrice during the interview, seemed depressed but had no thoughts of hurting himself. He denies any history of heart failure or heart attacks.  He also denies any chest pain. Chest Xray was done in the ED and it showed severe diffuse bilateral lung consolidation, consistent with Covid 19 pneumonia.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, SARS-CoV-2 test positive
Clinical narrative: Chief Complaint   covid since last friday, getting more SOB, was 88% RA  History of Present Illness     Patient is a 58-year-old male with a history of ADHD, Depression, sleep apnea on CPAP, hypertension, hypercholesterolemia, and type 2 diabetes presenting for concerns of shortness of breath after being diagnosed with Covid.  Patient first started having symptoms 10 days ago with fevers, diarrhea, and malaise.  He tested positive for Covid 8 days ago, despite being vaccinated with the Pfizer vaccine in February.  He states that he has been getting progressively more short of breath, to the point where he is having to take breaks while going upstairs to his bedroom.  He called EMS to the scene, who state that when they arrived that he was saturating 88% on room air, so he was placed on a nonrebreather.  Patient states that his fevers have stopped and the biggest issue that he is having is his shortness of breath.  He does endorse some intermittent swelling in his lower extremities, which he takes furosemide for. Furthermore, patient started crying thrice during the interview, seemed depressed but had no thoughts of hurting himself. He denies any history of heart failure or heart attacks.  He also denies any chest pain. Chest Xray was done in the ED and it showed severe diffuse bilateral lung consolidation, consistent with Covid 19 pneumonia.
Age: 49.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Hyperhidrosis, Hypertension
Clinical narrative: Pt developed sweats, hypertension and chest pain the day after receiving the second dose.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Anosmia, COVID-19, Cough, Fatigue, Headache
Clinical narrative: Had Vaccine Pfizer on 2/22/21 and 3/15/21.  Symptom onset 6/28- cough, muscle ache, nausea, loss of smell, sore throat, headache and fatigue. Tested positive for Covid -19 on 7/9/21
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Oropharyngeal pain, SARS-CoV-2 test positive
Clinical narrative: Had Vaccine Pfizer on 2/22/21 and 3/15/21.  Symptom onset 6/28- cough, muscle ache, nausea, loss of smell, sore throat, headache and fatigue. Tested positive for Covid -19 on 7/9/21
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site reaction, Injection site swelling, Injection site warmth, Rash erythematous
Clinical narrative: Large Grape Sized Bump at Injections Site with Swelling, Red Rash and Heat
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Cough, Headache, Nasal congestion, Oropharyngeal pain
Clinical narrative: Dx Cough ? Nasal Congestion ? Sore Throat ? Headache Reason for Visit
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: Dx Cough ? Nasal Congestion ? Sore Throat ? Headache Reason for Visit
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Atrial flutter, Bone pain, Cardioversion, Echocardiogram, Electrocardiogram
Clinical narrative: Artial Flutter  Extreme neck and right arm pain and weakness, including collarbone pain
Age: 63.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Muscular weakness, Neck pain, Pain in extremity
Clinical narrative: Artial Flutter  Extreme neck and right arm pain and weakness, including collarbone pain
Age: 13.0
Sex: F
Vaccine: COVID19
Symptoms: Blood alkaline phosphatase normal, Blood iron normal, Blood thyroid stimulating hormone decreased, Mean platelet volume normal, Thyroxine free normal
Clinical narrative: 10 days after her second vaccine, patient had bloodwork done for a previous vision problem (Visual Snow) and her TSH came back very low: 0.10. She repeated the bloodwork 11 days later, resulting in an even lower TSH level: 0.02.  Her FT4 is 1.62, and her Free T3 is 5.8.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain, Back pain, Blood lactic acid, Blood urine present, COVID-19
Clinical narrative: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib who presents to the ED after one day nausea and vomiting. Patient reports he is doing well until yesterday when he begins to have some abdominal pain on his left side radiating into his back. He has chronic back pain but feels like this pain is different. He did tolerate diet yesterday. This morning, he had 3 vomiting episode and watery bowel movement. He also endorses burning pain when urinating today. He states that he had several UTIs previously. Patient has chronic productive cough from COPD history but denies increase or worsening of cough.   In the ED, he was found to be tachycardic HR 106 and febrile T 38.4. Labs notable for Hgb 11.1, lactic acid 1.8, and mild transaminitis (chronic). UA showed WCC, blood, leukocyte, and RBC. Patient was given 1L IVF and started on vanc and meropenem. CXR was unremarkable. Troponin negative. Covid from RPP came back positive. Patient stated that he had Covid previously in Jan 2021 and had both Covid vaccines on January.   Of note, patient was diagnosed with marginal zone lymphoma on Jan 2019 and was on 6 cycles of bendamustine and rituximab previously in 2019, with current plan of observation. He was also diagnosed with left cell renal carcinoma on Sept 2018 s/p L nephrectomy 2018, SBRT. Metastatic disease was confirmed on Jan 2020 and patient is currently on cabozantinib. He has notable side effects while on treatment including neuropathy and thrombocytopenia.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Cough, Diarrhoea, Dysuria, Haemoglobin decreased
Clinical narrative: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib who presents to the ED after one day nausea and vomiting. Patient reports he is doing well until yesterday when he begins to have some abdominal pain on his left side radiating into his back. He has chronic back pain but feels like this pain is different. He did tolerate diet yesterday. This morning, he had 3 vomiting episode and watery bowel movement. He also endorses burning pain when urinating today. He states that he had several UTIs previously. Patient has chronic productive cough from COPD history but denies increase or worsening of cough.   In the ED, he was found to be tachycardic HR 106 and febrile T 38.4. Labs notable for Hgb 11.1, lactic acid 1.8, and mild transaminitis (chronic). UA showed WCC, blood, leukocyte, and RBC. Patient was given 1L IVF and started on vanc and meropenem. CXR was unremarkable. Troponin negative. Covid from RPP came back positive. Patient stated that he had Covid previously in Jan 2021 and had both Covid vaccines on January.   Of note, patient was diagnosed with marginal zone lymphoma on Jan 2019 and was on 6 cycles of bendamustine and rituximab previously in 2019, with current plan of observation. He was also diagnosed with left cell renal carcinoma on Sept 2018 s/p L nephrectomy 2018, SBRT. Metastatic disease was confirmed on Jan 2020 and patient is currently on cabozantinib. He has notable side effects while on treatment including neuropathy and thrombocytopenia.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Laboratory test, Nausea, Neuropathy peripheral, Pain, Productive cough
Clinical narrative: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib who presents to the ED after one day nausea and vomiting. Patient reports he is doing well until yesterday when he begins to have some abdominal pain on his left side radiating into his back. He has chronic back pain but feels like this pain is different. He did tolerate diet yesterday. This morning, he had 3 vomiting episode and watery bowel movement. He also endorses burning pain when urinating today. He states that he had several UTIs previously. Patient has chronic productive cough from COPD history but denies increase or worsening of cough.   In the ED, he was found to be tachycardic HR 106 and febrile T 38.4. Labs notable for Hgb 11.1, lactic acid 1.8, and mild transaminitis (chronic). UA showed WCC, blood, leukocyte, and RBC. Patient was given 1L IVF and started on vanc and meropenem. CXR was unremarkable. Troponin negative. Covid from RPP came back positive. Patient stated that he had Covid previously in Jan 2021 and had both Covid vaccines on January.   Of note, patient was diagnosed with marginal zone lymphoma on Jan 2019 and was on 6 cycles of bendamustine and rituximab previously in 2019, with current plan of observation. He was also diagnosed with left cell renal carcinoma on Sept 2018 s/p L nephrectomy 2018, SBRT. Metastatic disease was confirmed on Jan 2020 and patient is currently on cabozantinib. He has notable side effects while on treatment including neuropathy and thrombocytopenia.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Red blood cells urine, SARS-CoV-2 test positive, Tachycardia, Thrombocytopenia
Clinical narrative: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib who presents to the ED after one day nausea and vomiting. Patient reports he is doing well until yesterday when he begins to have some abdominal pain on his left side radiating into his back. He has chronic back pain but feels like this pain is different. He did tolerate diet yesterday. This morning, he had 3 vomiting episode and watery bowel movement. He also endorses burning pain when urinating today. He states that he had several UTIs previously. Patient has chronic productive cough from COPD history but denies increase or worsening of cough.   In the ED, he was found to be tachycardic HR 106 and febrile T 38.4. Labs notable for Hgb 11.1, lactic acid 1.8, and mild transaminitis (chronic). UA showed WCC, blood, leukocyte, and RBC. Patient was given 1L IVF and started on vanc and meropenem. CXR was unremarkable. Troponin negative. Covid from RPP came back positive. Patient stated that he had Covid previously in Jan 2021 and had both Covid vaccines on January.   Of note, patient was diagnosed with marginal zone lymphoma on Jan 2019 and was on 6 cycles of bendamustine and rituximab previously in 2019, with current plan of observation. He was also diagnosed with left cell renal carcinoma on Sept 2018 s/p L nephrectomy 2018, SBRT. Metastatic disease was confirmed on Jan 2020 and patient is currently on cabozantinib. He has notable side effects while on treatment including neuropathy and thrombocytopenia.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Transaminases increased, Troponin normal, Urine analysis, Urine leukocyte esterase positive, Vomiting
Clinical narrative: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib who presents to the ED after one day nausea and vomiting. Patient reports he is doing well until yesterday when he begins to have some abdominal pain on his left side radiating into his back. He has chronic back pain but feels like this pain is different. He did tolerate diet yesterday. This morning, he had 3 vomiting episode and watery bowel movement. He also endorses burning pain when urinating today. He states that he had several UTIs previously. Patient has chronic productive cough from COPD history but denies increase or worsening of cough.   In the ED, he was found to be tachycardic HR 106 and febrile T 38.4. Labs notable for Hgb 11.1, lactic acid 1.8, and mild transaminitis (chronic). UA showed WCC, blood, leukocyte, and RBC. Patient was given 1L IVF and started on vanc and meropenem. CXR was unremarkable. Troponin negative. Covid from RPP came back positive. Patient stated that he had Covid previously in Jan 2021 and had both Covid vaccines on January.   Of note, patient was diagnosed with marginal zone lymphoma on Jan 2019 and was on 6 cycles of bendamustine and rituximab previously in 2019, with current plan of observation. He was also diagnosed with left cell renal carcinoma on Sept 2018 s/p L nephrectomy 2018, SBRT. Metastatic disease was confirmed on Jan 2020 and patient is currently on cabozantinib. He has notable side effects while on treatment including neuropathy and thrombocytopenia.
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: White blood cells urine positive
Clinical narrative: Patient is a 70 year old male with RCC s/p left nephrectomy (2018), marginal zone lymphoma (2018) s/p 6 cycles chemotherapy, diabetes, HTN, CAD, esophageal strictures with multiple dilations, esophageal perforation causing constrictive carditis necessitating a cardiac window, and recurrent RCC from lymph node biopsy now on Cabozantinib who presents to the ED after one day nausea and vomiting. Patient reports he is doing well until yesterday when he begins to have some abdominal pain on his left side radiating into his back. He has chronic back pain but feels like this pain is different. He did tolerate diet yesterday. This morning, he had 3 vomiting episode and watery bowel movement. He also endorses burning pain when urinating today. He states that he had several UTIs previously. Patient has chronic productive cough from COPD history but denies increase or worsening of cough.   In the ED, he was found to be tachycardic HR 106 and febrile T 38.4. Labs notable for Hgb 11.1, lactic acid 1.8, and mild transaminitis (chronic). UA showed WCC, blood, leukocyte, and RBC. Patient was given 1L IVF and started on vanc and meropenem. CXR was unremarkable. Troponin negative. Covid from RPP came back positive. Patient stated that he had Covid previously in Jan 2021 and had both Covid vaccines on January.   Of note, patient was diagnosed with marginal zone lymphoma on Jan 2019 and was on 6 cycles of bendamustine and rituximab previously in 2019, with current plan of observation. He was also diagnosed with left cell renal carcinoma on Sept 2018 s/p L nephrectomy 2018, SBRT. Metastatic disease was confirmed on Jan 2020 and patient is currently on cabozantinib. He has notable side effects while on treatment including neuropathy and thrombocytopenia.
Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Erythema, Pain in extremity, Sleep disorder
Clinical narrative: In April I started noticing bright red dots on my legs.  The dots have spread to my stomach.  In May I started experiencing achy legs when I went to bed, which was grown worse and now sometimes interferes with my sleep.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Guillain-Barre syndrome, Lumbar puncture abnormal
Clinical narrative: Gullain Barre Syndrome
Age: 40.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Back pain, Heavy menstrual bleeding, Pelvic pain
Clinical narrative: I got the shot on the first day of my menstrual cycle. About two hours after getting the shot, I experienced excessive bleeding for the next seven hours. For four of those hours I bled through a Tampon every half hour. In addition, to the bleeding, there was a lot of lower back pain, pain in the hips and general pelvic region.
Age: 42.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Feeling hot, Flushing, Sensation of foreign body
Clinical narrative: WITHIN 15-20 MINUTES OF RECEIVING THE SECOND VACCINATION,  SHE BECAME "HOT",   FLUSHED IN THE FACE, AND FELT LIKE SHE HAD A "LUMP" IN HER THROAT. SHE DID HAVE SOME COUGHING  WITH REPEATED ATTEMPTS TO CLEAR HER THROAT. A NURSE AND FELT IT BEST TO USE AN INHALER THAT WAS SUPPLIED IN THE ANAPHYLAXIS KIT BROUGHT TO THE CLINIC WITH THE VACCINES. SHE DID 2 PUFFS OF A VENTOLIN INHALER AND TOOK BENADRYL 25MG BY MOUTH.  THE SYMPTOMS DID NOT WORSEN AND  SHE SAID SHE FELT BETTER WITHIN AN HOUR OF TAKING THE MEDICATIONS. THE ONLY COMPLAINT THAT SHE HAD WAS EXCESSIVE DROWSINESS SECONDARY TO THE BENADRYL.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Biopsy, Blood culture, C-reactive protein, Full blood count, HIV test
Clinical narrative: immediate rash over much of outside upper left arm, some itch, swelling, pain, not very serious or debilitating, subsided in ten days.  New rash with edema in upper extremities, fever 98-103F, fluid in lungs; June 10-16, 2021.  ER administered prednisone, tapering off on June 30.  July 3 rash returned aggressively, no fever, no edema; taking prednisone again.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Immediate post-injection reaction, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling
Clinical narrative: immediate rash over much of outside upper left arm, some itch, swelling, pain, not very serious or debilitating, subsided in ten days.  New rash with edema in upper extremities, fever 98-103F, fluid in lungs; June 10-16, 2021.  ER administered prednisone, tapering off on June 30.  July 3 rash returned aggressively, no fever, no edema; taking prednisone again.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: International normalised ratio, Lung disorder, Metabolic function test, Pyrexia, Rash
Clinical narrative: immediate rash over much of outside upper left arm, some itch, swelling, pain, not very serious or debilitating, subsided in ten days.  New rash with edema in upper extremities, fever 98-103F, fluid in lungs; June 10-16, 2021.  ER administered prednisone, tapering off on June 30.  July 3 rash returned aggressively, no fever, no edema; taking prednisone again.
Age: 69.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Red blood cell sedimentation rate, SARS-CoV-2 test, Treponema test, Urine analysis
Clinical narrative: immediate rash over much of outside upper left arm, some itch, swelling, pain, not very serious or debilitating, subsided in ten days.  New rash with edema in upper extremities, fever 98-103F, fluid in lungs; June 10-16, 2021.  ER administered prednisone, tapering off on June 30.  July 3 rash returned aggressively, no fever, no edema; taking prednisone again.
Age: 53.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Gait disturbance, Pain in extremity, Paraesthesia
Clinical narrative: Patient experienced weakness, tingling , pain in legs for about 15 minutes 20 days after first shot, then experienced the same thing again and could not physically walk for 15 minutes and continued experiencing pain, then it subsided. and has not recurred. patient does not have a primary care provider to report to.
Age: 45.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia, Back pain, Carpal tunnel syndrome, Pain in extremity
Clinical narrative: Arm pain since second injection in right arm, progressively gets worse, pain now in elbow and shoulder and back / shoulder blade area.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Ageusia, Anosmia, Chest pain, Chills, Cough
Clinical narrative: PATIENT SAYS SHE HAS BEEN SICK SINCE LAST VACCINE. SHE SAYS SHE HAS FEVER/CHILLS, NASAL CONGESTION, COUGH,HEADACHE, NAUSEA,VOMITING, DIARRHEA, CHEST PAIN, ACHES AND PAINS, AND LOSS OF TASTE ANS SMELL
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Diarrhoea, Headache, Malaise, Nasal congestion, Nausea
Clinical narrative: PATIENT SAYS SHE HAS BEEN SICK SINCE LAST VACCINE. SHE SAYS SHE HAS FEVER/CHILLS, NASAL CONGESTION, COUGH,HEADACHE, NAUSEA,VOMITING, DIARRHEA, CHEST PAIN, ACHES AND PAINS, AND LOSS OF TASTE ANS SMELL
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia, SARS-CoV-2 test negative, Vomiting
Clinical narrative: PATIENT SAYS SHE HAS BEEN SICK SINCE LAST VACCINE. SHE SAYS SHE HAS FEVER/CHILLS, NASAL CONGESTION, COUGH,HEADACHE, NAUSEA,VOMITING, DIARRHEA, CHEST PAIN, ACHES AND PAINS, AND LOSS OF TASTE ANS SMELL
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Blood test, Dysarthria, Euphoric mood, Hypertension, Incoherent
Clinical narrative: I was not coherent, losing consciousness. I would act like I was high, my speech was slurred. I had swelling in my hands, legs, and feet, I went to the ER on June 2nd. I had a blood clot that disappeared. I had pain throughout my body. I now have high blood pressure and have been put on a medication
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Loss of consciousness, Pain, Peripheral swelling, Thrombosis
Clinical narrative: I was not coherent, losing consciousness. I would act like I was high, my speech was slurred. I had swelling in my hands, legs, and feet, I went to the ER on June 2nd. I had a blood clot that disappeared. I had pain throughout my body. I now have high blood pressure and have been put on a medication
Age: 43.0
Sex: M
Vaccine: COVID19
Symptoms: Muscle twitching
Clinical narrative: Severe facial, vocal and cervical twitching
Age: 53.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Colitis ulcerative, Colonoscopy, Condition aggravated, Gastrointestinal haemorrhage
Clinical narrative: G.I. Bleed from Ulcerative Colitis
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Pruritus, Rash
Clinical narrative: itching on arms and legs with rash.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: Burning sensation, Magnetic resonance imaging, Nerve injury, Pain in extremity, Scan
Clinical narrative: Lower leg down to foot had a burning, severe pain. Healthcare professional diagnosed with nerve damage.  Currently seeing a Neurosurgeon. Dr.
Age: 61.0
Sex: F
Vaccine: COVID19
Symptoms: X-ray
Clinical narrative: Lower leg down to foot had a burning, severe pain. Healthcare professional diagnosed with nerve damage.  Currently seeing a Neurosurgeon. Dr.
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram, Gait disturbance, Magnetic resonance imaging, Paraesthesia, Scan
Clinical narrative: Bad pin and needles in feet, having trouble walking
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Computerised tomogram, Gait inability, Guillain-Barre syndrome, Lumbar puncture, Magnetic resonance imaging
Clinical narrative: Bad pin and needles in feet, having trouble walking
Age: 38.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Paraesthesia
Clinical narrative: Bad pin and needles in feet, having trouble walking
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Arthralgia, Cardiac imaging procedure abnormal, Chills, Computerised tomogram normal
Clinical narrative: Eight hours after receiving the first dose, I experienced flu like symptoms, muscle aches, joint pain, chills, headache, and a fever. Then those symptoms went away. I had pain in the injection site for two days. In April 2021, I spent 4 nights in the hospital. I was diagnosed with Myocarditis. I was also hospitalized for 3 days in May as well. On the 8th of July, I spent 1 day in the hospital. I received blood thinners when I was in the hospital. I am currently taking anti inflammatory medication.
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram, Echocardiogram normal, Electrocardiogram normal, Headache, Influenza like illness
Clinical narrative: Eight hours after receiving the first dose, I experienced flu like symptoms, muscle aches, joint pain, chills, headache, and a fever. Then those symptoms went away. I had pain in the injection site for two days. In April 2021, I spent 4 nights in the hospital. I was diagnosed with Myocarditis. I was also hospitalized for 3 days in May as well. On the 8th of July, I spent 1 day in the hospital. I received blood thinners when I was in the hospital. I am currently taking anti inflammatory medication.
Age: 22.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site pain, Myalgia, Myocarditis, Pyrexia
Clinical narrative: Eight hours after receiving the first dose, I experienced flu like symptoms, muscle aches, joint pain, chills, headache, and a fever. Then those symptoms went away. I had pain in the injection site for two days. In April 2021, I spent 4 nights in the hospital. I was diagnosed with Myocarditis. I was also hospitalized for 3 days in May as well. On the 8th of July, I spent 1 day in the hospital. I received blood thinners when I was in the hospital. I am currently taking anti inflammatory medication.
Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Arthropod bite, Rash, Rash pruritic, Urticaria
Clinical narrative: Hives/rash, itchy bumps like bugs bites. Elbows, forearms,  lower legs, hand/fingers, feet.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Pain in extremity, Paraesthesia, Peripheral swelling
Clinical narrative: Almost immediately these symptoms appeared:  Extremely achy joints, swollen index finger on right hand, feet and hands hurt, facial filler in right side of chin dissolved completely.  Approximately two weeks after vaccine feet and lower legs have pins and needles feel with nerves tingling.  This is a 24 hour a day problem and quite concerning.  My joints pop and creak like they suddenly  aged and have no lubrication.  These are all NEW symptoms/issues.  I?m concerned that this is a long term and/or permanent medical issue for me!  I WOULD LIKE SOME ANSWERS!!!!!
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Cardiac ablation, Hyperhidrosis, Laboratory test, Near death experience, Palpitations
Clinical narrative: On May 19th, nineteen days after my second Pfizer vaccine, I collapsed at the farmer's market. I was vomiting, sweating intensely, with my heart racing at 180 bpm.  A stranger called 911 and I was given adenosine in the ambulance to stop my heart to break the cycle and reset my heart rhythm. I could have died. After multiple tests in the hospital,  I was told that I had SVT supra ventricular tachycardia.  A second cardiac episode occurred on June 1st, and I was once again given adenosine in the ambulance to stop my racing heart at 190 BPM and taken to the hospital where I stayed for 2 days.  After speaking with several cardiologists, I was told that I had to have a heart procedure.  On June 21,  I had a heart ablation, and I am still recovering.
Age: 64.0
Sex: F
Vaccine: COVID19
Symptoms: Supraventricular tachycardia, Syncope, Vomiting
Clinical narrative: On May 19th, nineteen days after my second Pfizer vaccine, I collapsed at the farmer's market. I was vomiting, sweating intensely, with my heart racing at 180 bpm.  A stranger called 911 and I was given adenosine in the ambulance to stop my heart to break the cycle and reset my heart rhythm. I could have died. After multiple tests in the hospital,  I was told that I had SVT supra ventricular tachycardia.  A second cardiac episode occurred on June 1st, and I was once again given adenosine in the ambulance to stop my racing heart at 190 BPM and taken to the hospital where I stayed for 2 days.  After speaking with several cardiologists, I was told that I had to have a heart procedure.  On June 21,  I had a heart ablation, and I am still recovering.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Back pain, Dysarthria, Dysgeusia, Fatigue, Limb discomfort
Clinical narrative: I received the Johnson vaccine , At the time i felt tired and have been feeling since then and off and on again tired episodes my low back is constantly hurting and i feel like i need to be stretched out if i move my body to the side slightly i all of sudden feel a tingling sensation on my skin more on my stomach skin and it goes to my tongue it goes away but it stays throughout the day  I suddenly feel like a metal/ acidic taste on my mouth when the tingling is happening.  I also noticed that my legs are slow to respond like when i get up and walk i feel my legs heavy . Also have noticed im slurring a lot of words at times like my tongue cant move  and notice a tingling sensation along with it.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Muscular weakness, Paraesthesia, Paraesthesia oral, Tongue movement disturbance
Clinical narrative: I received the Johnson vaccine , At the time i felt tired and have been feeling since then and off and on again tired episodes my low back is constantly hurting and i feel like i need to be stretched out if i move my body to the side slightly i all of sudden feel a tingling sensation on my skin more on my stomach skin and it goes to my tongue it goes away but it stays throughout the day  I suddenly feel like a metal/ acidic taste on my mouth when the tingling is happening.  I also noticed that my legs are slow to respond like when i get up and walk i feel my legs heavy . Also have noticed im slurring a lot of words at times like my tongue cant move  and notice a tingling sensation along with it.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray, Computerised tomogram, Dizziness, Electrocardiogram, Hospitalisation
Clinical narrative: Unexplained persistent dizziness that lasted for approximately 2 weeks.
Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging, Neurological examination
Clinical narrative: Unexplained persistent dizziness that lasted for approximately 2 weeks.
Age: 57.0
Sex: M
Vaccine: COVID19
Symptoms: Death
Clinical narrative: Discovered dead in residence three days after vaccination.  Last seen alive on day of vaccination
Age: 75.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Bell's palsy
Clinical narrative: Patient developed symptoms that appear like Bell's Palsy on May 17, 2021 and reported to the ED on May 18, 2021. She was treated with a short course of prednisone and Valtrex. Symptoms improved within 2 weeks, but continue to linger about 8 weeks later.
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Asthenia, Basedow's disease, Blood test, Fatigue
Clinical narrative: Pt. states received Phizer 1st dose 03/08/2021, sore arm, headache, and fatigue. Received 2nd Phizer shot 03/31/2021 and within a week started the fatigued, nauseous, heart palpations, stomach issues, tremors through the body, mood swings, issue with right eye (Cotton Wool Spots), weight lost, heat intolerance, weakness. Diagnosed with Graves Disease, 6 weeks of treatment. Beta-blockers prescribed. Most of the thyroid symptoms have went away, anti-thyroid medications have resolved underlining issues.