chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Electrocardiogram abnormal, Haemoglobin normal, Hypoxia, Lactic acidosis, Malaise
Clinical narrative: DISCHARGE SUMMARY -- Medical Center   Patient MRN:                                Account Number:  Admitted: 10/23/2023 Discharge Date: 11/01/23    PCP Handoff    Recommended Outpatient Testing o Follow Up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 69 y.o. male patient of MD with history of blindness, deafness, intellectual disability, seizures, dysphagia and PEG tube dependent, Barrett's esophagus who was admitted with COVID-19 PNA.   Acute hypoxemic respiratory failure 2/2 COVID-19 infection Date of onset of symptoms: 10/21/23 Symptoms present on admission: hypoxia Date of COVID positive test: 10/23/23 Vaccination status: Vaccinated Imaging: CXR with no acute findings Oxygen requirements on admission: Non-rebreather Current oxygen requirements: Weaned to RA 10/31 Medical therapy: Completed remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/1/23 CM following for discharge planning  Intermittently requires low dose NC. DC with O2   Sepsis, resolved Lactic acidosis, resolved SIRS POA with COVID 19 and Possible UTI as source  Initially was on Vanc/Zosyn Now tailored to Cefepime 10/25-10/31 Remdesivir as above Mgmt of UTI as below    Pseudomonas UTI UA with signs of infection Ucx with Pseudomonas Completed cefepime 10/31   Elevated troponin Initial troponin 31 > 29 -- flat trend Initial EKG showed sinus tachycardia Suspect demand ischemia in setting of sepsis Management of sepsis above   Cerebral palsy Spastic quadriplegia in setting of cerebral palsy Blindness, Deafness Presented from SNF Has baclofen pump, managed  Is blind and deaf at baseline Continue home baclofen pump (settings verified by pharmacist)   PEG tube dependent History of dysphagia and aspiration--NPO Baseline tube feed settings (Jevity 1.5, 230 mL at 9 AM, 1 PM, 5 PM, 9 PM, with 300 free water flushes) Initiated tube feeds with Isosource Dietitian following   Seizures Continue home Keppra Precautions  Barrett's esophagus Continue home PPI   Iron deficiency anemia Initial Hgb 14.2 No obvious bleeding Continue home ferrous sulfate   Constipation Continue home MiraLAX and senna-docusate
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Myocardial ischaemia, Pseudomonas test positive, SARS-CoV-2 test positive, Sepsis, Sinus tachycardia
Clinical narrative: DISCHARGE SUMMARY -- Medical Center   Patient MRN:                                Account Number:  Admitted: 10/23/2023 Discharge Date: 11/01/23    PCP Handoff    Recommended Outpatient Testing o Follow Up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 69 y.o. male patient of MD with history of blindness, deafness, intellectual disability, seizures, dysphagia and PEG tube dependent, Barrett's esophagus who was admitted with COVID-19 PNA.   Acute hypoxemic respiratory failure 2/2 COVID-19 infection Date of onset of symptoms: 10/21/23 Symptoms present on admission: hypoxia Date of COVID positive test: 10/23/23 Vaccination status: Vaccinated Imaging: CXR with no acute findings Oxygen requirements on admission: Non-rebreather Current oxygen requirements: Weaned to RA 10/31 Medical therapy: Completed remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/1/23 CM following for discharge planning  Intermittently requires low dose NC. DC with O2   Sepsis, resolved Lactic acidosis, resolved SIRS POA with COVID 19 and Possible UTI as source  Initially was on Vanc/Zosyn Now tailored to Cefepime 10/25-10/31 Remdesivir as above Mgmt of UTI as below    Pseudomonas UTI UA with signs of infection Ucx with Pseudomonas Completed cefepime 10/31   Elevated troponin Initial troponin 31 > 29 -- flat trend Initial EKG showed sinus tachycardia Suspect demand ischemia in setting of sepsis Management of sepsis above   Cerebral palsy Spastic quadriplegia in setting of cerebral palsy Blindness, Deafness Presented from SNF Has baclofen pump, managed  Is blind and deaf at baseline Continue home baclofen pump (settings verified by pharmacist)   PEG tube dependent History of dysphagia and aspiration--NPO Baseline tube feed settings (Jevity 1.5, 230 mL at 9 AM, 1 PM, 5 PM, 9 PM, with 300 free water flushes) Initiated tube feeds with Isosource Dietitian following   Seizures Continue home Keppra Precautions  Barrett's esophagus Continue home PPI   Iron deficiency anemia Initial Hgb 14.2 No obvious bleeding Continue home ferrous sulfate   Constipation Continue home MiraLAX and senna-docusate
Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Systemic inflammatory response syndrome, Troponin increased, Urinary tract infection pseudomonal, Urine analysis abnormal
Clinical narrative: DISCHARGE SUMMARY -- Medical Center   Patient MRN:                                Account Number:  Admitted: 10/23/2023 Discharge Date: 11/01/23    PCP Handoff    Recommended Outpatient Testing o Follow Up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 69 y.o. male patient of MD with history of blindness, deafness, intellectual disability, seizures, dysphagia and PEG tube dependent, Barrett's esophagus who was admitted with COVID-19 PNA.   Acute hypoxemic respiratory failure 2/2 COVID-19 infection Date of onset of symptoms: 10/21/23 Symptoms present on admission: hypoxia Date of COVID positive test: 10/23/23 Vaccination status: Vaccinated Imaging: CXR with no acute findings Oxygen requirements on admission: Non-rebreather Current oxygen requirements: Weaned to RA 10/31 Medical therapy: Completed remdesivir and steroids Consultants following: None Anticipated special isolation end date: 11/1/23 CM following for discharge planning  Intermittently requires low dose NC. DC with O2   Sepsis, resolved Lactic acidosis, resolved SIRS POA with COVID 19 and Possible UTI as source  Initially was on Vanc/Zosyn Now tailored to Cefepime 10/25-10/31 Remdesivir as above Mgmt of UTI as below    Pseudomonas UTI UA with signs of infection Ucx with Pseudomonas Completed cefepime 10/31   Elevated troponin Initial troponin 31 > 29 -- flat trend Initial EKG showed sinus tachycardia Suspect demand ischemia in setting of sepsis Management of sepsis above   Cerebral palsy Spastic quadriplegia in setting of cerebral palsy Blindness, Deafness Presented from SNF Has baclofen pump, managed  Is blind and deaf at baseline Continue home baclofen pump (settings verified by pharmacist)   PEG tube dependent History of dysphagia and aspiration--NPO Baseline tube feed settings (Jevity 1.5, 230 mL at 9 AM, 1 PM, 5 PM, 9 PM, with 300 free water flushes) Initiated tube feeds with Isosource Dietitian following   Seizures Continue home Keppra Precautions  Barrett's esophagus Continue home PPI   Iron deficiency anemia Initial Hgb 14.2 No obvious bleeding Continue home ferrous sulfate   Constipation Continue home MiraLAX and senna-docusate
Age: 68.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: Patient received a duplicate dose of this vaccine
Age: 68.0
Sex: M
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: VACCINE FROZEN INSTEAD OF REFRIGERATED
Age: 49.0
Sex: M
Vaccine: UNK
Symptoms: Angiocardiogram, Cardiac monitoring abnormal, Cardiac stress test normal, Chest discomfort, Cough
Clinical narrative: Chest pressure, intermittent tachycardia, cough, SOB, fever, nausea, vomiting, diarrhea and altered mental status. Cough and SOB remain persistent. Trial of carvedilol for 2 weeks to improve palpitations with no improvement.
Age: 49.0
Sex: M
Vaccine: UNK
Symptoms: Diarrhoea, Dyspnoea, Echocardiogram, Echocardiogram abnormal, Ejection fraction decreased
Clinical narrative: Chest pressure, intermittent tachycardia, cough, SOB, fever, nausea, vomiting, diarrhea and altered mental status. Cough and SOB remain persistent. Trial of carvedilol for 2 weeks to improve palpitations with no improvement.
Age: 49.0
Sex: M
Vaccine: UNK
Symptoms: Electrocardiogram normal, Magnetic resonance imaging heart, Mental status changes, Nausea, Palpitations
Clinical narrative: Chest pressure, intermittent tachycardia, cough, SOB, fever, nausea, vomiting, diarrhea and altered mental status. Cough and SOB remain persistent. Trial of carvedilol for 2 weeks to improve palpitations with no improvement.
Age: 49.0
Sex: M
Vaccine: UNK
Symptoms: Pyrexia, Sinus rhythm, Supraventricular tachycardia, Tachycardia, Ventricular extrasystoles
Clinical narrative: Chest pressure, intermittent tachycardia, cough, SOB, fever, nausea, vomiting, diarrhea and altered mental status. Cough and SOB remain persistent. Trial of carvedilol for 2 weeks to improve palpitations with no improvement.
Age: 49.0
Sex: M
Vaccine: UNK
Symptoms: Ventricular hypertrophy, Vomiting
Clinical narrative: Chest pressure, intermittent tachycardia, cough, SOB, fever, nausea, vomiting, diarrhea and altered mental status. Cough and SOB remain persistent. Trial of carvedilol for 2 weeks to improve palpitations with no improvement.
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Anaemia of chronic disease, Asthenia, COVID-19, Chest X-ray abnormal
Clinical narrative: Patient is a 62 y.o. female patient of MD with history of ESRD on hemodialysis, hypertension, diabetes mellitus on insulin presented to Mansfield Hospital with 3 days of generalized weakness, muscle ache, fatigue, vomiting, nausea, shortness of breath, found to have COVID infection.   Acute hypoxemic respiratory failure COPD not on home oxygen Chest xray Mild interstitial prominence cannot exclude mild edema.  No focal pneumonia.  Management for COVID as below Wean off oxygen slowly Incentive spirometry, Mucinex Albuterol as needed   Covid-19 Virus Infection Date of onset of symptoms: 11/9/23 Symptoms present on admission: Muscle ache, generalized weakness, shortness of breath Date of covid positive test: 11/11/23 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: 2 L Current oxygen requirements:room air  Medical therapy: steroids, patient not on remdesivir due to kidney failure Consultants following: Infectious disease Anticipated special isolation end date: 11/21/23     Nausea vomiting Dehydration Received 500 cc of fluids in the emergency room Reglan before meals for 4 doses Liquid diet, advance as tolerated Daily labs No more nausea or vomiting, start the patient on renal diet on 11/12 Hypertension, currently soft blood pressure due to dehydration Reschedule Coreg, Entresto spironolactone, Bumex, hydralazine start from tomorrow Hold nifedipine  Minoxidil nightly Continue clonidine patch   Diabetes mellitus, with hyperglycemia, Uncontrolled diabetes with A1c 7.8 on 10/38/2023  increase Lantus dose to 19 units twice daily while on steroids, lispro 4 units with meals Resume home dose after discharge    ESRD on hemodialysis, consult nephrology Hemodialysis MWF    Anemia likely anemia of chronic disease Hemoglobin 7.9 Order occult blood in stool Order vitamin B12, folate and iron CBC daily Consider blood transfusion if hemoglobin drops below 7   Chronic systolic heart failure with ejection fraction 35% CAD Continue aspirin, statin, Bumex, Aldactone, minoxidil, hydralazine and clonidine and carvedilol
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Chronic obstructive pulmonary disease, Condition aggravated, Dehydration, Diabetes mellitus inadequate control, Dyspnoea
Clinical narrative: Patient is a 62 y.o. female patient of MD with history of ESRD on hemodialysis, hypertension, diabetes mellitus on insulin presented to Mansfield Hospital with 3 days of generalized weakness, muscle ache, fatigue, vomiting, nausea, shortness of breath, found to have COVID infection.   Acute hypoxemic respiratory failure COPD not on home oxygen Chest xray Mild interstitial prominence cannot exclude mild edema.  No focal pneumonia.  Management for COVID as below Wean off oxygen slowly Incentive spirometry, Mucinex Albuterol as needed   Covid-19 Virus Infection Date of onset of symptoms: 11/9/23 Symptoms present on admission: Muscle ache, generalized weakness, shortness of breath Date of covid positive test: 11/11/23 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: 2 L Current oxygen requirements:room air  Medical therapy: steroids, patient not on remdesivir due to kidney failure Consultants following: Infectious disease Anticipated special isolation end date: 11/21/23     Nausea vomiting Dehydration Received 500 cc of fluids in the emergency room Reglan before meals for 4 doses Liquid diet, advance as tolerated Daily labs No more nausea or vomiting, start the patient on renal diet on 11/12 Hypertension, currently soft blood pressure due to dehydration Reschedule Coreg, Entresto spironolactone, Bumex, hydralazine start from tomorrow Hold nifedipine  Minoxidil nightly Continue clonidine patch   Diabetes mellitus, with hyperglycemia, Uncontrolled diabetes with A1c 7.8 on 10/38/2023  increase Lantus dose to 19 units twice daily while on steroids, lispro 4 units with meals Resume home dose after discharge    ESRD on hemodialysis, consult nephrology Hemodialysis MWF    Anemia likely anemia of chronic disease Hemoglobin 7.9 Order occult blood in stool Order vitamin B12, folate and iron CBC daily Consider blood transfusion if hemoglobin drops below 7   Chronic systolic heart failure with ejection fraction 35% CAD Continue aspirin, statin, Bumex, Aldactone, minoxidil, hydralazine and clonidine and carvedilol
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Glycosylated haemoglobin increased, Haemoglobin decreased, Hyperglycaemia, Lung disorder
Clinical narrative: Patient is a 62 y.o. female patient of MD with history of ESRD on hemodialysis, hypertension, diabetes mellitus on insulin presented to Mansfield Hospital with 3 days of generalized weakness, muscle ache, fatigue, vomiting, nausea, shortness of breath, found to have COVID infection.   Acute hypoxemic respiratory failure COPD not on home oxygen Chest xray Mild interstitial prominence cannot exclude mild edema.  No focal pneumonia.  Management for COVID as below Wean off oxygen slowly Incentive spirometry, Mucinex Albuterol as needed   Covid-19 Virus Infection Date of onset of symptoms: 11/9/23 Symptoms present on admission: Muscle ache, generalized weakness, shortness of breath Date of covid positive test: 11/11/23 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: 2 L Current oxygen requirements:room air  Medical therapy: steroids, patient not on remdesivir due to kidney failure Consultants following: Infectious disease Anticipated special isolation end date: 11/21/23     Nausea vomiting Dehydration Received 500 cc of fluids in the emergency room Reglan before meals for 4 doses Liquid diet, advance as tolerated Daily labs No more nausea or vomiting, start the patient on renal diet on 11/12 Hypertension, currently soft blood pressure due to dehydration Reschedule Coreg, Entresto spironolactone, Bumex, hydralazine start from tomorrow Hold nifedipine  Minoxidil nightly Continue clonidine patch   Diabetes mellitus, with hyperglycemia, Uncontrolled diabetes with A1c 7.8 on 10/38/2023  increase Lantus dose to 19 units twice daily while on steroids, lispro 4 units with meals Resume home dose after discharge    ESRD on hemodialysis, consult nephrology Hemodialysis MWF    Anemia likely anemia of chronic disease Hemoglobin 7.9 Order occult blood in stool Order vitamin B12, folate and iron CBC daily Consider blood transfusion if hemoglobin drops below 7   Chronic systolic heart failure with ejection fraction 35% CAD Continue aspirin, statin, Bumex, Aldactone, minoxidil, hydralazine and clonidine and carvedilol
Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Nausea, SARS-CoV-2 test positive, Vomiting
Clinical narrative: Patient is a 62 y.o. female patient of MD with history of ESRD on hemodialysis, hypertension, diabetes mellitus on insulin presented to Mansfield Hospital with 3 days of generalized weakness, muscle ache, fatigue, vomiting, nausea, shortness of breath, found to have COVID infection.   Acute hypoxemic respiratory failure COPD not on home oxygen Chest xray Mild interstitial prominence cannot exclude mild edema.  No focal pneumonia.  Management for COVID as below Wean off oxygen slowly Incentive spirometry, Mucinex Albuterol as needed   Covid-19 Virus Infection Date of onset of symptoms: 11/9/23 Symptoms present on admission: Muscle ache, generalized weakness, shortness of breath Date of covid positive test: 11/11/23 Vaccination status: vaccinated Imaging: Chest x-ray Oxygen requirements on admission: 2 L Current oxygen requirements:room air  Medical therapy: steroids, patient not on remdesivir due to kidney failure Consultants following: Infectious disease Anticipated special isolation end date: 11/21/23     Nausea vomiting Dehydration Received 500 cc of fluids in the emergency room Reglan before meals for 4 doses Liquid diet, advance as tolerated Daily labs No more nausea or vomiting, start the patient on renal diet on 11/12 Hypertension, currently soft blood pressure due to dehydration Reschedule Coreg, Entresto spironolactone, Bumex, hydralazine start from tomorrow Hold nifedipine  Minoxidil nightly Continue clonidine patch   Diabetes mellitus, with hyperglycemia, Uncontrolled diabetes with A1c 7.8 on 10/38/2023  increase Lantus dose to 19 units twice daily while on steroids, lispro 4 units with meals Resume home dose after discharge    ESRD on hemodialysis, consult nephrology Hemodialysis MWF    Anemia likely anemia of chronic disease Hemoglobin 7.9 Order occult blood in stool Order vitamin B12, folate and iron CBC daily Consider blood transfusion if hemoglobin drops below 7   Chronic systolic heart failure with ejection fraction 35% CAD Continue aspirin, statin, Bumex, Aldactone, minoxidil, hydralazine and clonidine and carvedilol
Age: 72.0
Sex: M
Vaccine: FLU4
Symptoms: Erythema, Pain in extremity, Pruritus
Clinical narrative: Patient was itchy and had a red sore arm for a day.
Age: 10.0
Sex: M
Vaccine: COVID19
Symptoms: Product administered to patient of inappropriate age
Clinical narrative: COVID vaccine for 12+ given to 10 year old.
Age: 69.0
Sex: M
Vaccine: VARZOS
Symptoms: Product storage error
Clinical narrative: VACCINE FROZEN INSTEAD OF REFRIGERATED
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Acute respiratory failure, Arrhythmia, Atrial fibrillation, Blood potassium increased, Blood sodium decreased
Clinical narrative: Patient is a 77 y.o. female patient of, DO with history of of COPD on 3 L home oxygen supplementation, hypertension, diabetes, end-stage renal disease dialysis Monday Wednesday Friday presented to Hospital ED with shortness of breath.   Acute on chronic hypoxic respiratory failure Multifactorial; uses 3 L NC ATC at home; needed 5 L on admission, now back to baseline Resolved; encourage IS, PEP, OOB   Covid 19 infection COPD exacerbation AF, WBC 11.8, symptoms started 11/5, tested positive 11/7 Has been vaccinated Continue dexamethasone started 11/8 for 10 days ID consulted; no indication for remdesivir, continue supportive care PT / OT recommended HH Continue home inhalers at discharge   Fluid overload ESRD needing HD Hyponatremia, Hyperkalemia-resolved CXR with vascular congestion; K 5.3, Na 134 Missed HD 11/8 due to SOB Nephrology consulted; HD 11/13, may return to her usual HD center on Wed with no special arrangement since she will be out of isolation, provided supply of masks Labs normalized   DM2, with long term insulin use, with hyperglycemia HgA1c 6.5 (11/10) home medication lantus 28 units at bedtime with SSI Needed IV insulin in ER; BS improved, BID lantus 20 units while inpatient Resume home Lantis, short acting insulin, linagliptin at discharge   Essential HTN Normotensive off meds; continued to monitor   Hx of CAD Continued home plavix   GERD Continued home PPI   Morbid obesity BMI 47; LSM   Cardiac arrhythmia Noted overnight 11/10; pt denies symptoms, VSS Outpatient echocardiogram as needed per PCP   Chronic anemia Hb stable at baseline of 8 Continued epo/iron with HD per nephrology
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Condition aggravated, Dyspnoea
Clinical narrative: Patient is a 77 y.o. female patient of, DO with history of of COPD on 3 L home oxygen supplementation, hypertension, diabetes, end-stage renal disease dialysis Monday Wednesday Friday presented to Hospital ED with shortness of breath.   Acute on chronic hypoxic respiratory failure Multifactorial; uses 3 L NC ATC at home; needed 5 L on admission, now back to baseline Resolved; encourage IS, PEP, OOB   Covid 19 infection COPD exacerbation AF, WBC 11.8, symptoms started 11/5, tested positive 11/7 Has been vaccinated Continue dexamethasone started 11/8 for 10 days ID consulted; no indication for remdesivir, continue supportive care PT / OT recommended HH Continue home inhalers at discharge   Fluid overload ESRD needing HD Hyponatremia, Hyperkalemia-resolved CXR with vascular congestion; K 5.3, Na 134 Missed HD 11/8 due to SOB Nephrology consulted; HD 11/13, may return to her usual HD center on Wed with no special arrangement since she will be out of isolation, provided supply of masks Labs normalized   DM2, with long term insulin use, with hyperglycemia HgA1c 6.5 (11/10) home medication lantus 28 units at bedtime with SSI Needed IV insulin in ER; BS improved, BID lantus 20 units while inpatient Resume home Lantis, short acting insulin, linagliptin at discharge   Essential HTN Normotensive off meds; continued to monitor   Hx of CAD Continued home plavix   GERD Continued home PPI   Morbid obesity BMI 47; LSM   Cardiac arrhythmia Noted overnight 11/10; pt denies symptoms, VSS Outpatient echocardiogram as needed per PCP   Chronic anemia Hb stable at baseline of 8 Continued epo/iron with HD per nephrology
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Glycosylated haemoglobin, Haemoglobin decreased, Hyperglycaemia, Hyperkalaemia, Hypervolaemia
Clinical narrative: Patient is a 77 y.o. female patient of, DO with history of of COPD on 3 L home oxygen supplementation, hypertension, diabetes, end-stage renal disease dialysis Monday Wednesday Friday presented to Hospital ED with shortness of breath.   Acute on chronic hypoxic respiratory failure Multifactorial; uses 3 L NC ATC at home; needed 5 L on admission, now back to baseline Resolved; encourage IS, PEP, OOB   Covid 19 infection COPD exacerbation AF, WBC 11.8, symptoms started 11/5, tested positive 11/7 Has been vaccinated Continue dexamethasone started 11/8 for 10 days ID consulted; no indication for remdesivir, continue supportive care PT / OT recommended HH Continue home inhalers at discharge   Fluid overload ESRD needing HD Hyponatremia, Hyperkalemia-resolved CXR with vascular congestion; K 5.3, Na 134 Missed HD 11/8 due to SOB Nephrology consulted; HD 11/13, may return to her usual HD center on Wed with no special arrangement since she will be out of isolation, provided supply of masks Labs normalized   DM2, with long term insulin use, with hyperglycemia HgA1c 6.5 (11/10) home medication lantus 28 units at bedtime with SSI Needed IV insulin in ER; BS improved, BID lantus 20 units while inpatient Resume home Lantis, short acting insulin, linagliptin at discharge   Essential HTN Normotensive off meds; continued to monitor   Hx of CAD Continued home plavix   GERD Continued home PPI   Morbid obesity BMI 47; LSM   Cardiac arrhythmia Noted overnight 11/10; pt denies symptoms, VSS Outpatient echocardiogram as needed per PCP   Chronic anemia Hb stable at baseline of 8 Continued epo/iron with HD per nephrology
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Hyponatraemia, Pulmonary congestion, Respiratory failure, SARS-CoV-2 test positive, White blood cell count increased
Clinical narrative: Patient is a 77 y.o. female patient of, DO with history of of COPD on 3 L home oxygen supplementation, hypertension, diabetes, end-stage renal disease dialysis Monday Wednesday Friday presented to Hospital ED with shortness of breath.   Acute on chronic hypoxic respiratory failure Multifactorial; uses 3 L NC ATC at home; needed 5 L on admission, now back to baseline Resolved; encourage IS, PEP, OOB   Covid 19 infection COPD exacerbation AF, WBC 11.8, symptoms started 11/5, tested positive 11/7 Has been vaccinated Continue dexamethasone started 11/8 for 10 days ID consulted; no indication for remdesivir, continue supportive care PT / OT recommended HH Continue home inhalers at discharge   Fluid overload ESRD needing HD Hyponatremia, Hyperkalemia-resolved CXR with vascular congestion; K 5.3, Na 134 Missed HD 11/8 due to SOB Nephrology consulted; HD 11/13, may return to her usual HD center on Wed with no special arrangement since she will be out of isolation, provided supply of masks Labs normalized   DM2, with long term insulin use, with hyperglycemia HgA1c 6.5 (11/10) home medication lantus 28 units at bedtime with SSI Needed IV insulin in ER; BS improved, BID lantus 20 units while inpatient Resume home Lantis, short acting insulin, linagliptin at discharge   Essential HTN Normotensive off meds; continued to monitor   Hx of CAD Continued home plavix   GERD Continued home PPI   Morbid obesity BMI 47; LSM   Cardiac arrhythmia Noted overnight 11/10; pt denies symptoms, VSS Outpatient echocardiogram as needed per PCP   Chronic anemia Hb stable at baseline of 8 Continued epo/iron with HD per nephrology
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Acute kidney injury, Acute respiratory failure, Anaemia, Angiogram pulmonary abnormal, Aspartate aminotransferase increased
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Asthenia, Bladder catheterisation, Blood alkaline phosphatase normal, Blood bilirubin increased, Blood creatinine increased
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Blood gases normal, Blood sodium decreased, COVID-19, COVID-19 pneumonia, Computerised tomogram head normal
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Computerised tomogram kidney abnormal, Computerised tomogram spine normal, Dehydration, Delirium, Drug screen negative
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fall, Hyponatraemia, Hypoxia, Lethargy, Liver function test increased
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Lung infiltration, Metabolic encephalopathy, Platelet count decreased, Pneumonia, Productive cough
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Renal mass, Sinus node dysfunction, Sleep disorder, Thrombocytopenia, Ultrasound bladder normal
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 84.0
Sex: M
Vaccine: COVID19-2
Symptoms: Ultrasound kidney normal, Urinary retention, Viral infection, Vomiting
Clinical narrative: Patient is a 85 y.o. male with a history of adrenal insufficiency, atrial fibrillation (on Pradaxa), polymyalgia rheumatica, syncopal events from orthostasis who presented to RMH 10/28/2023 after a fall at home and generalized weakness.Found to have COVID 19 pneumonia.     1. Acute metabolic encephalopathy: Noted on admission with lethargy.  CT head nonacute and VBG without hypercapnia. UDS negative. Likely with component of delirium. PRNs ordered Improving. 2. Fall: Reported falling out of his bed unknowingly overnight, waking up wedged between the frame of his bed and the wall.  No signs of external trauma, CT head and C-spine nonacute on admission.  3. Acute Hypoxic RF with Acute COVID-19 infection: 1-2-day onset of generalized weakness and productive cough. Wife recently tested positive for COVID-19. Mild cough with hypoxemia on admission. continued  remdesivir and dexamethasone. Oxygen titrated. Resolved. Dexamethasone stopped.  4. Community-acquired pneumonia: Mild productive cough with bibasilar infiltrates on admit  CTPA.  5. AKI: CR 1.68 on admission, baseline 0.8.  Suspect related to dehydration but also had urinary retention improved with fluids. PRN straight cath. Foley catheter placed. Renal bladder US w/o obstruction.  Resolved.  6. Urinary retention: Required straight cath. Foley cathter placed. Voiding trial 11/6 prior to dc.  7. Chronic hyponatremia: NA 133 on admission, intermittently 130?133 in the past.  Improved with IVF to 135 (10/29) 8. Elevated LFTs: admit labs AST 165, TB 2.2 with normal ALP.  He reported waking up with vomitus at home prior to arrival however  Potentially related to viral syndrome.   9. Incidental finding: Left renal mass seen on CT.  Will need MRI once Cr improves.  10. Chronic anemia: Baseline Hgb 12?13, stable on admission. 11. Thrombocytopenia: Plt 114 on admission, intermittently low in the past.  Suspect secondary to viral syndrome, monitored. 12. Tachybrady syndrome: felt to be likely iatrogenic associated with his medications at the time which have since been adjusted.  A 7-day MCT after that admission did not show any high risk blocks. 13. Atrial fibrillation: Follows with Dr. (cardio), diagnosed in 2004 and recently restarted on flecainide.  Continued home Pradaxa, Toprol and flecainide.  Follow-up as scheduled. 14. Polymyalgia rheumatica: Maintained on chronic prednisone at 7.5 mg daily.   15. Secondary adrenal insufficiency: Iatrogenic due to chronic systemic steroids s/p SDS Solu-Cortef 10/28/2023.  Continue with steroids per COVID-19 protocol, resume home doses when appropriate. 16. HTN: Continued home amlodipine.  Held losartan (AKI) and HCTZ (hyponatremia). Resumed on dc.  17. Code status: full code
Age: 64.0
Sex: F
Vaccine: COVID19-2, RSV
Symptoms: Visual impairment
Clinical narrative: On 12/21/23 woke up from sleep and experienced grey veil/loss of vision on right eye. 08/2023 dry needle therapy on right side of neck