chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chest discomfort, Dyspnoea, Electrocardiogram normal, Glucose urine present
Clinical narrative: DISCHARGE SUMMARY --                                    Account Number: Admitted: 11/28/2023 Discharge Date: 11/29/23    PCP    Recommended Outpatient Testing o Follow up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 73 y.o. male patient of CNP with history of Hypothydroidism, CHF, T2DM, Hyperlipidemia, HTN, presented with chest tightness and sob    Acute respiratory failure w/ hypoxia Covid-19 Virus Pneumonia Multifocal pneumonia Date of onset of symptoms: 11/23 Symptoms present on admission: Chest tightness, SOB, hypoxia, coughing Date of covid positive test: 11/28 Vaccination status: vaccinated Oxygen requirements on admission: 1 L Currently off O2 Cough productive of green sputum since 11/23 Influenza antigen test negative CXR showed patchy L basilar opacities Fever and leukocytosis absent at this time WBC count 6.62 Sputum culture negative MRSA probe, Strep pneumonia and legionella antigen negative Mycoplasma IgM antibody negative Received levaquin in ED due to allergies Procalitonin .7 has significant allergies, started on Levaquin for bacterial coverage  Hospital course remdesivir and steroids, but has been discontinued continue Levofloxacin 750 mg orally x 5days   Elevated Troponin CAD s/p CABG 2009 PAD CHF Reported history of cardiac cath w/ stent placement Hx of triple bypass BNP mildly elevated at 331 Troponin of 31 & Delta of 9 secondary due to hypoxia EKG was unremarkable for ischemic changes     Hypothyroidism On synthroid 125 mcg TSH of 0.97   Normocytic anemia Hgb 12.5; MCV 93.6   Type 2 DM w hyperglycemia Morbid obesity: BMI 37.94 Metformin 1000 mg; tresiba 20 units; jardiance 25 mg Pending A1C Glucosuria on UA   Mixed HLD On crestor 20 mg HTN On lisinopril-hydrochlorothiazide 20-12.5 On metoprolol 25 mg bid
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Glycosuria, Haemoglobin decreased, Hypersensitivity, Hypoxia, Influenza virus test negative
Clinical narrative: DISCHARGE SUMMARY --                                    Account Number: Admitted: 11/28/2023 Discharge Date: 11/29/23    PCP    Recommended Outpatient Testing o Follow up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 73 y.o. male patient of CNP with history of Hypothydroidism, CHF, T2DM, Hyperlipidemia, HTN, presented with chest tightness and sob    Acute respiratory failure w/ hypoxia Covid-19 Virus Pneumonia Multifocal pneumonia Date of onset of symptoms: 11/23 Symptoms present on admission: Chest tightness, SOB, hypoxia, coughing Date of covid positive test: 11/28 Vaccination status: vaccinated Oxygen requirements on admission: 1 L Currently off O2 Cough productive of green sputum since 11/23 Influenza antigen test negative CXR showed patchy L basilar opacities Fever and leukocytosis absent at this time WBC count 6.62 Sputum culture negative MRSA probe, Strep pneumonia and legionella antigen negative Mycoplasma IgM antibody negative Received levaquin in ED due to allergies Procalitonin .7 has significant allergies, started on Levaquin for bacterial coverage  Hospital course remdesivir and steroids, but has been discontinued continue Levofloxacin 750 mg orally x 5days   Elevated Troponin CAD s/p CABG 2009 PAD CHF Reported history of cardiac cath w/ stent placement Hx of triple bypass BNP mildly elevated at 331 Troponin of 31 & Delta of 9 secondary due to hypoxia EKG was unremarkable for ischemic changes     Hypothyroidism On synthroid 125 mcg TSH of 0.97   Normocytic anemia Hgb 12.5; MCV 93.6   Type 2 DM w hyperglycemia Morbid obesity: BMI 37.94 Metformin 1000 mg; tresiba 20 units; jardiance 25 mg Pending A1C Glucosuria on UA   Mixed HLD On crestor 20 mg HTN On lisinopril-hydrochlorothiazide 20-12.5 On metoprolol 25 mg bid
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Legionella test, Lung opacity, Mean cell volume normal, Mycoplasma test, Procalcitonin
Clinical narrative: DISCHARGE SUMMARY --                                    Account Number: Admitted: 11/28/2023 Discharge Date: 11/29/23    PCP    Recommended Outpatient Testing o Follow up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 73 y.o. male patient of CNP with history of Hypothydroidism, CHF, T2DM, Hyperlipidemia, HTN, presented with chest tightness and sob    Acute respiratory failure w/ hypoxia Covid-19 Virus Pneumonia Multifocal pneumonia Date of onset of symptoms: 11/23 Symptoms present on admission: Chest tightness, SOB, hypoxia, coughing Date of covid positive test: 11/28 Vaccination status: vaccinated Oxygen requirements on admission: 1 L Currently off O2 Cough productive of green sputum since 11/23 Influenza antigen test negative CXR showed patchy L basilar opacities Fever and leukocytosis absent at this time WBC count 6.62 Sputum culture negative MRSA probe, Strep pneumonia and legionella antigen negative Mycoplasma IgM antibody negative Received levaquin in ED due to allergies Procalitonin .7 has significant allergies, started on Levaquin for bacterial coverage  Hospital course remdesivir and steroids, but has been discontinued continue Levofloxacin 750 mg orally x 5days   Elevated Troponin CAD s/p CABG 2009 PAD CHF Reported history of cardiac cath w/ stent placement Hx of triple bypass BNP mildly elevated at 331 Troponin of 31 & Delta of 9 secondary due to hypoxia EKG was unremarkable for ischemic changes     Hypothyroidism On synthroid 125 mcg TSH of 0.97   Normocytic anemia Hgb 12.5; MCV 93.6   Type 2 DM w hyperglycemia Morbid obesity: BMI 37.94 Metformin 1000 mg; tresiba 20 units; jardiance 25 mg Pending A1C Glucosuria on UA   Mixed HLD On crestor 20 mg HTN On lisinopril-hydrochlorothiazide 20-12.5 On metoprolol 25 mg bid
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Productive cough, SARS-CoV-2 test positive, Sputum culture, Sputum discoloured, Staphylococcus test negative
Clinical narrative: DISCHARGE SUMMARY --                                    Account Number: Admitted: 11/28/2023 Discharge Date: 11/29/23    PCP    Recommended Outpatient Testing o Follow up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 73 y.o. male patient of CNP with history of Hypothydroidism, CHF, T2DM, Hyperlipidemia, HTN, presented with chest tightness and sob    Acute respiratory failure w/ hypoxia Covid-19 Virus Pneumonia Multifocal pneumonia Date of onset of symptoms: 11/23 Symptoms present on admission: Chest tightness, SOB, hypoxia, coughing Date of covid positive test: 11/28 Vaccination status: vaccinated Oxygen requirements on admission: 1 L Currently off O2 Cough productive of green sputum since 11/23 Influenza antigen test negative CXR showed patchy L basilar opacities Fever and leukocytosis absent at this time WBC count 6.62 Sputum culture negative MRSA probe, Strep pneumonia and legionella antigen negative Mycoplasma IgM antibody negative Received levaquin in ED due to allergies Procalitonin .7 has significant allergies, started on Levaquin for bacterial coverage  Hospital course remdesivir and steroids, but has been discontinued continue Levofloxacin 750 mg orally x 5days   Elevated Troponin CAD s/p CABG 2009 PAD CHF Reported history of cardiac cath w/ stent placement Hx of triple bypass BNP mildly elevated at 331 Troponin of 31 & Delta of 9 secondary due to hypoxia EKG was unremarkable for ischemic changes     Hypothyroidism On synthroid 125 mcg TSH of 0.97   Normocytic anemia Hgb 12.5; MCV 93.6   Type 2 DM w hyperglycemia Morbid obesity: BMI 37.94 Metformin 1000 mg; tresiba 20 units; jardiance 25 mg Pending A1C Glucosuria on UA   Mixed HLD On crestor 20 mg HTN On lisinopril-hydrochlorothiazide 20-12.5 On metoprolol 25 mg bid
Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Streptococcus test negative, Troponin increased, White blood cell count normal
Clinical narrative: DISCHARGE SUMMARY --                                    Account Number: Admitted: 11/28/2023 Discharge Date: 11/29/23    PCP    Recommended Outpatient Testing o Follow up with PCP   Results Pending At Discharge o None       Clinical Summary   Patient is a 73 y.o. male patient of CNP with history of Hypothydroidism, CHF, T2DM, Hyperlipidemia, HTN, presented with chest tightness and sob    Acute respiratory failure w/ hypoxia Covid-19 Virus Pneumonia Multifocal pneumonia Date of onset of symptoms: 11/23 Symptoms present on admission: Chest tightness, SOB, hypoxia, coughing Date of covid positive test: 11/28 Vaccination status: vaccinated Oxygen requirements on admission: 1 L Currently off O2 Cough productive of green sputum since 11/23 Influenza antigen test negative CXR showed patchy L basilar opacities Fever and leukocytosis absent at this time WBC count 6.62 Sputum culture negative MRSA probe, Strep pneumonia and legionella antigen negative Mycoplasma IgM antibody negative Received levaquin in ED due to allergies Procalitonin .7 has significant allergies, started on Levaquin for bacterial coverage  Hospital course remdesivir and steroids, but has been discontinued continue Levofloxacin 750 mg orally x 5days   Elevated Troponin CAD s/p CABG 2009 PAD CHF Reported history of cardiac cath w/ stent placement Hx of triple bypass BNP mildly elevated at 331 Troponin of 31 & Delta of 9 secondary due to hypoxia EKG was unremarkable for ischemic changes     Hypothyroidism On synthroid 125 mcg TSH of 0.97   Normocytic anemia Hgb 12.5; MCV 93.6   Type 2 DM w hyperglycemia Morbid obesity: BMI 37.94 Metformin 1000 mg; tresiba 20 units; jardiance 25 mg Pending A1C Glucosuria on UA   Mixed HLD On crestor 20 mg HTN On lisinopril-hydrochlorothiazide 20-12.5 On metoprolol 25 mg bid
Age: 66.0
Sex: F
Vaccine: PNC20
Symptoms: Erythema, Headache, Nodule, Pain in extremity, Peripheral swelling
Clinical narrative: Patient called the pharmacy 12/29/23 stating her right arm was red, swollen with a knot and hurts since receiving Prevnar 20 on 12/27/23. She has been taking Tylenol since then to aid with the pain. She has had prolonged headaches since the administration. She stated her arm has swollen more since the initial swelling.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Alanine aminotransferase increased, Anaemia, Aspartate aminotransferase increased, Asthenia, Blood alkaline phosphatase increased
Clinical narrative: Patient is a 64 y.o. female with a history of metastatic breast cancer on chemo, recent ED visit 11/25/23 for fever, discharged with empiric abx for UTI. She re-presented to Hospital 11/26/2023 with few days of fevers and found to have COVID-19. ID followed. Patient was discharged home with HHC in stable condition 11/29/23.    1. COVID-19 Infection: reported dry cough, congestion on admission. Respiratory PCR 11/27/23 positive for COVID-19. CXR 11/27/23 non-acute. Not on O2 so no indication for Decadron. Paxlovid started 11/27/23 per ID. Hold statin until 3 days post therapy, resume 12/6/23 if repeat LFTs stable.  2. Fever: suspect due to COVID-19, less likely UTI. UA 11/25/23 with 8 WBCs. Admit Tmax 101.6, WBC 7.4, neutrophils 76.2, ESR 98, CRP 101, procal 0.2. Urine cx with no growth, Blood cultures 11/27/23 negative to date. Initiated cefepime on admission. Oncology recommended continuing cefepime until blood cultures negative x 48 hours, discontinued 11/29/23. ID followed.  3. Metastatic Breast Cancer: per history with known mets to bone, recent progression of mets in liver. Follows with Dr. (medical oncology) and Dr. (radiation oncology). S/p bilateral mastectomy in 2014. S/p palliative radiation to bone mets. Disease progressed on hormonal therapy and xeloda, paclitaxel, and most recently Enhertu. Last chemo session ~3 weeks PTA. Plan to start gemcitabine 12/4/23. Hem/Onc followed.  4. Mechanical Fall: Reportedly fell due to generalized weakness. Patient hit head, no LOC. Admit CT head non-acute. Supportive care continued; PT/OT followed. 5. Transaminitis: admit ALP 586, AST 114, ALT 105. Likely due to known metastatic disease to liver. RUQ US 11/27/23 with hepatomegaly, numerous hepatic mets. Stable per trend. Recommend repeat labs with PCP/Oncology in 5-7 days. Has scheduled labs 12/1/23.  6. Chronic Anemia: baseline Hgb ~10-11; stable on admit. Likely secondary to metastatic disease. Monitored.  7. Cancer Related Pain: per history. Continued home gabapentin, Narx reviewed on admit. 8. Obesity: Body mass index is 38.62 kg/m². Recommended diet/lifestyle modifications.   9. Code status: Full code
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Blood culture negative, C-reactive protein increased, COVID-19, Cancer pain, Chemotherapy
Clinical narrative: Patient is a 64 y.o. female with a history of metastatic breast cancer on chemo, recent ED visit 11/25/23 for fever, discharged with empiric abx for UTI. She re-presented to Hospital 11/26/2023 with few days of fevers and found to have COVID-19. ID followed. Patient was discharged home with HHC in stable condition 11/29/23.    1. COVID-19 Infection: reported dry cough, congestion on admission. Respiratory PCR 11/27/23 positive for COVID-19. CXR 11/27/23 non-acute. Not on O2 so no indication for Decadron. Paxlovid started 11/27/23 per ID. Hold statin until 3 days post therapy, resume 12/6/23 if repeat LFTs stable.  2. Fever: suspect due to COVID-19, less likely UTI. UA 11/25/23 with 8 WBCs. Admit Tmax 101.6, WBC 7.4, neutrophils 76.2, ESR 98, CRP 101, procal 0.2. Urine cx with no growth, Blood cultures 11/27/23 negative to date. Initiated cefepime on admission. Oncology recommended continuing cefepime until blood cultures negative x 48 hours, discontinued 11/29/23. ID followed.  3. Metastatic Breast Cancer: per history with known mets to bone, recent progression of mets in liver. Follows with Dr. (medical oncology) and Dr. (radiation oncology). S/p bilateral mastectomy in 2014. S/p palliative radiation to bone mets. Disease progressed on hormonal therapy and xeloda, paclitaxel, and most recently Enhertu. Last chemo session ~3 weeks PTA. Plan to start gemcitabine 12/4/23. Hem/Onc followed.  4. Mechanical Fall: Reportedly fell due to generalized weakness. Patient hit head, no LOC. Admit CT head non-acute. Supportive care continued; PT/OT followed. 5. Transaminitis: admit ALP 586, AST 114, ALT 105. Likely due to known metastatic disease to liver. RUQ US 11/27/23 with hepatomegaly, numerous hepatic mets. Stable per trend. Recommend repeat labs with PCP/Oncology in 5-7 days. Has scheduled labs 12/1/23.  6. Chronic Anemia: baseline Hgb ~10-11; stable on admit. Likely secondary to metastatic disease. Monitored.  7. Cancer Related Pain: per history. Continued home gabapentin, Narx reviewed on admit. 8. Obesity: Body mass index is 38.62 kg/m². Recommended diet/lifestyle modifications.   9. Code status: Full code
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Computerised tomogram head normal, Cough, Culture urine negative, Fall
Clinical narrative: Patient is a 64 y.o. female with a history of metastatic breast cancer on chemo, recent ED visit 11/25/23 for fever, discharged with empiric abx for UTI. She re-presented to Hospital 11/26/2023 with few days of fevers and found to have COVID-19. ID followed. Patient was discharged home with HHC in stable condition 11/29/23.    1. COVID-19 Infection: reported dry cough, congestion on admission. Respiratory PCR 11/27/23 positive for COVID-19. CXR 11/27/23 non-acute. Not on O2 so no indication for Decadron. Paxlovid started 11/27/23 per ID. Hold statin until 3 days post therapy, resume 12/6/23 if repeat LFTs stable.  2. Fever: suspect due to COVID-19, less likely UTI. UA 11/25/23 with 8 WBCs. Admit Tmax 101.6, WBC 7.4, neutrophils 76.2, ESR 98, CRP 101, procal 0.2. Urine cx with no growth, Blood cultures 11/27/23 negative to date. Initiated cefepime on admission. Oncology recommended continuing cefepime until blood cultures negative x 48 hours, discontinued 11/29/23. ID followed.  3. Metastatic Breast Cancer: per history with known mets to bone, recent progression of mets in liver. Follows with Dr. (medical oncology) and Dr. (radiation oncology). S/p bilateral mastectomy in 2014. S/p palliative radiation to bone mets. Disease progressed on hormonal therapy and xeloda, paclitaxel, and most recently Enhertu. Last chemo session ~3 weeks PTA. Plan to start gemcitabine 12/4/23. Hem/Onc followed.  4. Mechanical Fall: Reportedly fell due to generalized weakness. Patient hit head, no LOC. Admit CT head non-acute. Supportive care continued; PT/OT followed. 5. Transaminitis: admit ALP 586, AST 114, ALT 105. Likely due to known metastatic disease to liver. RUQ US 11/27/23 with hepatomegaly, numerous hepatic mets. Stable per trend. Recommend repeat labs with PCP/Oncology in 5-7 days. Has scheduled labs 12/1/23.  6. Chronic Anemia: baseline Hgb ~10-11; stable on admit. Likely secondary to metastatic disease. Monitored.  7. Cancer Related Pain: per history. Continued home gabapentin, Narx reviewed on admit. 8. Obesity: Body mass index is 38.62 kg/m². Recommended diet/lifestyle modifications.   9. Code status: Full code
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Head injury, Hepatomegaly, Hypertransaminasaemia, Metastases to liver, Neutrophil count increased
Clinical narrative: Patient is a 64 y.o. female with a history of metastatic breast cancer on chemo, recent ED visit 11/25/23 for fever, discharged with empiric abx for UTI. She re-presented to Hospital 11/26/2023 with few days of fevers and found to have COVID-19. ID followed. Patient was discharged home with HHC in stable condition 11/29/23.    1. COVID-19 Infection: reported dry cough, congestion on admission. Respiratory PCR 11/27/23 positive for COVID-19. CXR 11/27/23 non-acute. Not on O2 so no indication for Decadron. Paxlovid started 11/27/23 per ID. Hold statin until 3 days post therapy, resume 12/6/23 if repeat LFTs stable.  2. Fever: suspect due to COVID-19, less likely UTI. UA 11/25/23 with 8 WBCs. Admit Tmax 101.6, WBC 7.4, neutrophils 76.2, ESR 98, CRP 101, procal 0.2. Urine cx with no growth, Blood cultures 11/27/23 negative to date. Initiated cefepime on admission. Oncology recommended continuing cefepime until blood cultures negative x 48 hours, discontinued 11/29/23. ID followed.  3. Metastatic Breast Cancer: per history with known mets to bone, recent progression of mets in liver. Follows with Dr. (medical oncology) and Dr. (radiation oncology). S/p bilateral mastectomy in 2014. S/p palliative radiation to bone mets. Disease progressed on hormonal therapy and xeloda, paclitaxel, and most recently Enhertu. Last chemo session ~3 weeks PTA. Plan to start gemcitabine 12/4/23. Hem/Onc followed.  4. Mechanical Fall: Reportedly fell due to generalized weakness. Patient hit head, no LOC. Admit CT head non-acute. Supportive care continued; PT/OT followed. 5. Transaminitis: admit ALP 586, AST 114, ALT 105. Likely due to known metastatic disease to liver. RUQ US 11/27/23 with hepatomegaly, numerous hepatic mets. Stable per trend. Recommend repeat labs with PCP/Oncology in 5-7 days. Has scheduled labs 12/1/23.  6. Chronic Anemia: baseline Hgb ~10-11; stable on admit. Likely secondary to metastatic disease. Monitored.  7. Cancer Related Pain: per history. Continued home gabapentin, Narx reviewed on admit. 8. Obesity: Body mass index is 38.62 kg/m². Recommended diet/lifestyle modifications.   9. Code status: Full code
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Obesity, Procalcitonin, Pyrexia, Red blood cell sedimentation rate increased, Respiratory tract congestion
Clinical narrative: Patient is a 64 y.o. female with a history of metastatic breast cancer on chemo, recent ED visit 11/25/23 for fever, discharged with empiric abx for UTI. She re-presented to Hospital 11/26/2023 with few days of fevers and found to have COVID-19. ID followed. Patient was discharged home with HHC in stable condition 11/29/23.    1. COVID-19 Infection: reported dry cough, congestion on admission. Respiratory PCR 11/27/23 positive for COVID-19. CXR 11/27/23 non-acute. Not on O2 so no indication for Decadron. Paxlovid started 11/27/23 per ID. Hold statin until 3 days post therapy, resume 12/6/23 if repeat LFTs stable.  2. Fever: suspect due to COVID-19, less likely UTI. UA 11/25/23 with 8 WBCs. Admit Tmax 101.6, WBC 7.4, neutrophils 76.2, ESR 98, CRP 101, procal 0.2. Urine cx with no growth, Blood cultures 11/27/23 negative to date. Initiated cefepime on admission. Oncology recommended continuing cefepime until blood cultures negative x 48 hours, discontinued 11/29/23. ID followed.  3. Metastatic Breast Cancer: per history with known mets to bone, recent progression of mets in liver. Follows with Dr. (medical oncology) and Dr. (radiation oncology). S/p bilateral mastectomy in 2014. S/p palliative radiation to bone mets. Disease progressed on hormonal therapy and xeloda, paclitaxel, and most recently Enhertu. Last chemo session ~3 weeks PTA. Plan to start gemcitabine 12/4/23. Hem/Onc followed.  4. Mechanical Fall: Reportedly fell due to generalized weakness. Patient hit head, no LOC. Admit CT head non-acute. Supportive care continued; PT/OT followed. 5. Transaminitis: admit ALP 586, AST 114, ALT 105. Likely due to known metastatic disease to liver. RUQ US 11/27/23 with hepatomegaly, numerous hepatic mets. Stable per trend. Recommend repeat labs with PCP/Oncology in 5-7 days. Has scheduled labs 12/1/23.  6. Chronic Anemia: baseline Hgb ~10-11; stable on admit. Likely secondary to metastatic disease. Monitored.  7. Cancer Related Pain: per history. Continued home gabapentin, Narx reviewed on admit. 8. Obesity: Body mass index is 38.62 kg/m². Recommended diet/lifestyle modifications.   9. Code status: Full code
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Ultrasound abdomen abnormal, Urinary tract infection, White blood cell count normal, White blood cells urine positive
Clinical narrative: Patient is a 64 y.o. female with a history of metastatic breast cancer on chemo, recent ED visit 11/25/23 for fever, discharged with empiric abx for UTI. She re-presented to Hospital 11/26/2023 with few days of fevers and found to have COVID-19. ID followed. Patient was discharged home with HHC in stable condition 11/29/23.    1. COVID-19 Infection: reported dry cough, congestion on admission. Respiratory PCR 11/27/23 positive for COVID-19. CXR 11/27/23 non-acute. Not on O2 so no indication for Decadron. Paxlovid started 11/27/23 per ID. Hold statin until 3 days post therapy, resume 12/6/23 if repeat LFTs stable.  2. Fever: suspect due to COVID-19, less likely UTI. UA 11/25/23 with 8 WBCs. Admit Tmax 101.6, WBC 7.4, neutrophils 76.2, ESR 98, CRP 101, procal 0.2. Urine cx with no growth, Blood cultures 11/27/23 negative to date. Initiated cefepime on admission. Oncology recommended continuing cefepime until blood cultures negative x 48 hours, discontinued 11/29/23. ID followed.  3. Metastatic Breast Cancer: per history with known mets to bone, recent progression of mets in liver. Follows with Dr. (medical oncology) and Dr. (radiation oncology). S/p bilateral mastectomy in 2014. S/p palliative radiation to bone mets. Disease progressed on hormonal therapy and xeloda, paclitaxel, and most recently Enhertu. Last chemo session ~3 weeks PTA. Plan to start gemcitabine 12/4/23. Hem/Onc followed.  4. Mechanical Fall: Reportedly fell due to generalized weakness. Patient hit head, no LOC. Admit CT head non-acute. Supportive care continued; PT/OT followed. 5. Transaminitis: admit ALP 586, AST 114, ALT 105. Likely due to known metastatic disease to liver. RUQ US 11/27/23 with hepatomegaly, numerous hepatic mets. Stable per trend. Recommend repeat labs with PCP/Oncology in 5-7 days. Has scheduled labs 12/1/23.  6. Chronic Anemia: baseline Hgb ~10-11; stable on admit. Likely secondary to metastatic disease. Monitored.  7. Cancer Related Pain: per history. Continued home gabapentin, Narx reviewed on admit. 8. Obesity: Body mass index is 38.62 kg/m². Recommended diet/lifestyle modifications.   9. Code status: Full code
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Acute pulmonary oedema, Acute respiratory failure, Asthenia, Atrial fibrillation, Blood lactic acid
Clinical narrative: Patient is a 97 y.o. female who presented on 11/20/2023 with hypoxia from COVID-19 pneumonitis.     COVID-19 pneumonia Acute Hypoxemic Respiratory Failure Acute pulmonary edema  - Patient endorses approximately 3 days worth of symptoms PTA, however unclear if she is a fully reliable historian. Initially arrived on room air, satting in the low 90s.  Placed on oxygen with improvement in O2 to the mid to high 90s. She states that she has been vaccinated. - Admitting provider discussed plan with daughter (she is from out of state) over the phone, agree to continue to use steroids and to avoid remdesivir for now - CXR (11/20/23) with new pulmonary edema - likely due to Covid 19 infection  - Continue Decadron for 10 days total - Continue home Lasix  - Weaned off of supplemental oxygen. Continue to monitor   Viral sepsis due to COVID-19, present on admission; resolved - On admission patient tachycardic, tachypneic, LA 3.7, WBC 13.8 - Was given 1L fluid and broad spectrum abx in ED   Generalized weakness - Likely due to above, at baseline lives at AL and is wheelchair bound - Continue supportive care  - PT/OT/ CM consulted, recommending 5 days of therapy - Plan for return to AL with home health care    Permanent Atrial fibrillation Sinus node dysfunction status post dual-lead pacemaker placement - Initial tachycardia likely due to acute illness as described above - Follows with Dr. Per Cardiology notes patient was previously on Coumadin but stopped due to fall risk. In June she was placed on beta-blocker and taken off of sotalol as she continued to be in a-fib and was asymptomatic  - Continue metoprolol    Hypertension - Patient is on amlodipine, metoprolol, lasix   GERD - Continue pantoprazole Hypertension - Patient is on amlodipine, metoprolol, lasix   GERD - Continue pantoprazole   Urinary retention  - S/p bladder pacemaker
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, COVID-19 pneumonia, Chest X-ray abnormal, Condition aggravated, Hypoxia
Clinical narrative: Patient is a 97 y.o. female who presented on 11/20/2023 with hypoxia from COVID-19 pneumonitis.     COVID-19 pneumonia Acute Hypoxemic Respiratory Failure Acute pulmonary edema  - Patient endorses approximately 3 days worth of symptoms PTA, however unclear if she is a fully reliable historian. Initially arrived on room air, satting in the low 90s.  Placed on oxygen with improvement in O2 to the mid to high 90s. She states that she has been vaccinated. - Admitting provider discussed plan with daughter (she is from out of state) over the phone, agree to continue to use steroids and to avoid remdesivir for now - CXR (11/20/23) with new pulmonary edema - likely due to Covid 19 infection  - Continue Decadron for 10 days total - Continue home Lasix  - Weaned off of supplemental oxygen. Continue to monitor   Viral sepsis due to COVID-19, present on admission; resolved - On admission patient tachycardic, tachypneic, LA 3.7, WBC 13.8 - Was given 1L fluid and broad spectrum abx in ED   Generalized weakness - Likely due to above, at baseline lives at AL and is wheelchair bound - Continue supportive care  - PT/OT/ CM consulted, recommending 5 days of therapy - Plan for return to AL with home health care    Permanent Atrial fibrillation Sinus node dysfunction status post dual-lead pacemaker placement - Initial tachycardia likely due to acute illness as described above - Follows with Dr. Per Cardiology notes patient was previously on Coumadin but stopped due to fall risk. In June she was placed on beta-blocker and taken off of sotalol as she continued to be in a-fib and was asymptomatic  - Continue metoprolol    Hypertension - Patient is on amlodipine, metoprolol, lasix   GERD - Continue pantoprazole Hypertension - Patient is on amlodipine, metoprolol, lasix   GERD - Continue pantoprazole   Urinary retention  - S/p bladder pacemaker
Age: 95.0
Sex: F
Vaccine: COVID19
Symptoms: Tachycardia, Tachypnoea, Viral sepsis, White blood cell count increased
Clinical narrative: Patient is a 97 y.o. female who presented on 11/20/2023 with hypoxia from COVID-19 pneumonitis.     COVID-19 pneumonia Acute Hypoxemic Respiratory Failure Acute pulmonary edema  - Patient endorses approximately 3 days worth of symptoms PTA, however unclear if she is a fully reliable historian. Initially arrived on room air, satting in the low 90s.  Placed on oxygen with improvement in O2 to the mid to high 90s. She states that she has been vaccinated. - Admitting provider discussed plan with daughter (she is from out of state) over the phone, agree to continue to use steroids and to avoid remdesivir for now - CXR (11/20/23) with new pulmonary edema - likely due to Covid 19 infection  - Continue Decadron for 10 days total - Continue home Lasix  - Weaned off of supplemental oxygen. Continue to monitor   Viral sepsis due to COVID-19, present on admission; resolved - On admission patient tachycardic, tachypneic, LA 3.7, WBC 13.8 - Was given 1L fluid and broad spectrum abx in ED   Generalized weakness - Likely due to above, at baseline lives at AL and is wheelchair bound - Continue supportive care  - PT/OT/ CM consulted, recommending 5 days of therapy - Plan for return to AL with home health care    Permanent Atrial fibrillation Sinus node dysfunction status post dual-lead pacemaker placement - Initial tachycardia likely due to acute illness as described above - Follows with Dr. Per Cardiology notes patient was previously on Coumadin but stopped due to fall risk. In June she was placed on beta-blocker and taken off of sotalol as she continued to be in a-fib and was asymptomatic  - Continue metoprolol    Hypertension - Patient is on amlodipine, metoprolol, lasix   GERD - Continue pantoprazole Hypertension - Patient is on amlodipine, metoprolol, lasix   GERD - Continue pantoprazole   Urinary retention  - S/p bladder pacemaker
Age: 40.0
Sex: F
Vaccine: FLU4
Symptoms: Mobility decreased, Pain in extremity, Tenderness
Clinical narrative: initial burst of pain and sore arm for 2 days.  2 weeks later severe arm pain, sensitive to touch, and hard to lift arm.
Age: 71.0
Sex: F
Vaccine: COVID19
Symptoms: Acoustic stimulation tests abnormal, Deafness, Tinnitus
Clinical narrative: I began to hear a rushing sound in my ears, predominantly the left ear, in early 2022.  By  then I had received  3 COVID vaccines- Feb 3, 2021; March 3, 2021; and Oct 22, 2021.  Dr said there was no fluid in my ears. He sent me for a hearing test, which revealed age related hearing loss. He also recommended I get an MRI. I have not done that.  Dr  did not prescribe any medication?s.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Acute respiratory failure, Atelectasis, Blood creatinine increased, Blood lactic acid
Clinical narrative: Patient is a 80 y.o. male patient of MD with history of HFrEF, HTN, HLD, T2DM, BPH, anxiety, and depression Patient presented to with shortness of breath and mild changes mental status.    Acute on chronic hypoxic respiratory failure Mild metabolic encephalopathy, resolved COVID-19 infection Sepsis, POA Patient presented with preceding history of upper respiratory tract infection symptoms since 2-3 days back.  He was sent from assisted living with mild change in his mental status and shortness of breath, tested positive for COVID-19 11/18 Patient is vaccinated for COVID-19 infection.  He is also up to date with his booster.   He had  temperature of 100.3 with pulse rate of 107 respirations of 22.  VBG done in ER showed pH of 7.39 with PCO2 42.7  WBC was 14.34 with lactic acid of 2.7 BNP of 6001  CXR: Moderate cardiomegaly with slight to mild bibasilar atelectasis.   CT chest without contrast: Bibasilar atelectasis Empirically started on antibiotics, switched to ceftriaxone and azithromycin Procalcitonin normal, suspect symptoms more due to COVID-19 infection as opposed to bacterial pneumonia Stopped antibiotics and monitor off of them, patient improving Continue decadron, for total of 10 days, LDT 12/3 On RA as 11/24 with sats between 88-91%  Discharge home with remainder of decadron RX, IS/flutter.    AKI on CKD stage 3 baseline creatinine is between 1.56?1.8, worsened up to 2.8 Home torsemide held on admission Cr was back to baseline and torsemide resumed 11/22 Continue to monitor renal function   Chronic HFrEF Ischemic cardiomyopathy s/p ICD HTN and HLD Does not appear to be in acute exacerbation at this time 2D echo done on 9/13/2023 showed EF of 30% with moderate hypokinesis of the apex, interventricular septum and anterior wall of the left ventricle Continue home Plavix, isosorbide, metoprolol and pravachol Resume torsemide but at half dose 11/22, and full dose 11/23 Continue to hold entresto, BP well within normal range, will need to address resumption in the outpatient setting once acute illness has resolved.    Paroxysmal atrial fibrillation  Continue Eliquis and metoprolol Hypothyroidism Continue Synthroid.   Diabetes mellitus type 2 A1c of 7.6  Can resume metformin on discharge however will need to monitor renal function closely as he is at the lower limit of creatinine clearance cutoff.   May benefit from changing to alternative agent however will defer this to PCP    BPH Continue home flomax   Anxiety and depression Continue home Effexor. Obesity  BMI >41 kg/m2 Dietary and lifestyle modifications
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Blood pH normal, Brain natriuretic peptide increased, COVID-19, Cardiomegaly, Chest X-ray abnormal
Clinical narrative: Patient is a 80 y.o. male patient of MD with history of HFrEF, HTN, HLD, T2DM, BPH, anxiety, and depression Patient presented to with shortness of breath and mild changes mental status.    Acute on chronic hypoxic respiratory failure Mild metabolic encephalopathy, resolved COVID-19 infection Sepsis, POA Patient presented with preceding history of upper respiratory tract infection symptoms since 2-3 days back.  He was sent from assisted living with mild change in his mental status and shortness of breath, tested positive for COVID-19 11/18 Patient is vaccinated for COVID-19 infection.  He is also up to date with his booster.   He had  temperature of 100.3 with pulse rate of 107 respirations of 22.  VBG done in ER showed pH of 7.39 with PCO2 42.7  WBC was 14.34 with lactic acid of 2.7 BNP of 6001  CXR: Moderate cardiomegaly with slight to mild bibasilar atelectasis.   CT chest without contrast: Bibasilar atelectasis Empirically started on antibiotics, switched to ceftriaxone and azithromycin Procalcitonin normal, suspect symptoms more due to COVID-19 infection as opposed to bacterial pneumonia Stopped antibiotics and monitor off of them, patient improving Continue decadron, for total of 10 days, LDT 12/3 On RA as 11/24 with sats between 88-91%  Discharge home with remainder of decadron RX, IS/flutter.    AKI on CKD stage 3 baseline creatinine is between 1.56?1.8, worsened up to 2.8 Home torsemide held on admission Cr was back to baseline and torsemide resumed 11/22 Continue to monitor renal function   Chronic HFrEF Ischemic cardiomyopathy s/p ICD HTN and HLD Does not appear to be in acute exacerbation at this time 2D echo done on 9/13/2023 showed EF of 30% with moderate hypokinesis of the apex, interventricular septum and anterior wall of the left ventricle Continue home Plavix, isosorbide, metoprolol and pravachol Resume torsemide but at half dose 11/22, and full dose 11/23 Continue to hold entresto, BP well within normal range, will need to address resumption in the outpatient setting once acute illness has resolved.    Paroxysmal atrial fibrillation  Continue Eliquis and metoprolol Hypothyroidism Continue Synthroid.   Diabetes mellitus type 2 A1c of 7.6  Can resume metformin on discharge however will need to monitor renal function closely as he is at the lower limit of creatinine clearance cutoff.   May benefit from changing to alternative agent however will defer this to PCP    BPH Continue home flomax   Anxiety and depression Continue home Effexor. Obesity  BMI >41 kg/m2 Dietary and lifestyle modifications
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Chronic kidney disease, Computerised tomogram thorax abnormal, Condition aggravated, Dyspnoea, Echocardiogram abnormal
Clinical narrative: Patient is a 80 y.o. male patient of MD with history of HFrEF, HTN, HLD, T2DM, BPH, anxiety, and depression Patient presented to with shortness of breath and mild changes mental status.    Acute on chronic hypoxic respiratory failure Mild metabolic encephalopathy, resolved COVID-19 infection Sepsis, POA Patient presented with preceding history of upper respiratory tract infection symptoms since 2-3 days back.  He was sent from assisted living with mild change in his mental status and shortness of breath, tested positive for COVID-19 11/18 Patient is vaccinated for COVID-19 infection.  He is also up to date with his booster.   He had  temperature of 100.3 with pulse rate of 107 respirations of 22.  VBG done in ER showed pH of 7.39 with PCO2 42.7  WBC was 14.34 with lactic acid of 2.7 BNP of 6001  CXR: Moderate cardiomegaly with slight to mild bibasilar atelectasis.   CT chest without contrast: Bibasilar atelectasis Empirically started on antibiotics, switched to ceftriaxone and azithromycin Procalcitonin normal, suspect symptoms more due to COVID-19 infection as opposed to bacterial pneumonia Stopped antibiotics and monitor off of them, patient improving Continue decadron, for total of 10 days, LDT 12/3 On RA as 11/24 with sats between 88-91%  Discharge home with remainder of decadron RX, IS/flutter.    AKI on CKD stage 3 baseline creatinine is between 1.56?1.8, worsened up to 2.8 Home torsemide held on admission Cr was back to baseline and torsemide resumed 11/22 Continue to monitor renal function   Chronic HFrEF Ischemic cardiomyopathy s/p ICD HTN and HLD Does not appear to be in acute exacerbation at this time 2D echo done on 9/13/2023 showed EF of 30% with moderate hypokinesis of the apex, interventricular septum and anterior wall of the left ventricle Continue home Plavix, isosorbide, metoprolol and pravachol Resume torsemide but at half dose 11/22, and full dose 11/23 Continue to hold entresto, BP well within normal range, will need to address resumption in the outpatient setting once acute illness has resolved.    Paroxysmal atrial fibrillation  Continue Eliquis and metoprolol Hypothyroidism Continue Synthroid.   Diabetes mellitus type 2 A1c of 7.6  Can resume metformin on discharge however will need to monitor renal function closely as he is at the lower limit of creatinine clearance cutoff.   May benefit from changing to alternative agent however will defer this to PCP    BPH Continue home flomax   Anxiety and depression Continue home Effexor. Obesity  BMI >41 kg/m2 Dietary and lifestyle modifications
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Ejection fraction decreased, Glycosylated haemoglobin increased, Hypokinesia, Ischaemic cardiomyopathy, Left ventricular failure
Clinical narrative: Patient is a 80 y.o. male patient of MD with history of HFrEF, HTN, HLD, T2DM, BPH, anxiety, and depression Patient presented to with shortness of breath and mild changes mental status.    Acute on chronic hypoxic respiratory failure Mild metabolic encephalopathy, resolved COVID-19 infection Sepsis, POA Patient presented with preceding history of upper respiratory tract infection symptoms since 2-3 days back.  He was sent from assisted living with mild change in his mental status and shortness of breath, tested positive for COVID-19 11/18 Patient is vaccinated for COVID-19 infection.  He is also up to date with his booster.   He had  temperature of 100.3 with pulse rate of 107 respirations of 22.  VBG done in ER showed pH of 7.39 with PCO2 42.7  WBC was 14.34 with lactic acid of 2.7 BNP of 6001  CXR: Moderate cardiomegaly with slight to mild bibasilar atelectasis.   CT chest without contrast: Bibasilar atelectasis Empirically started on antibiotics, switched to ceftriaxone and azithromycin Procalcitonin normal, suspect symptoms more due to COVID-19 infection as opposed to bacterial pneumonia Stopped antibiotics and monitor off of them, patient improving Continue decadron, for total of 10 days, LDT 12/3 On RA as 11/24 with sats between 88-91%  Discharge home with remainder of decadron RX, IS/flutter.    AKI on CKD stage 3 baseline creatinine is between 1.56?1.8, worsened up to 2.8 Home torsemide held on admission Cr was back to baseline and torsemide resumed 11/22 Continue to monitor renal function   Chronic HFrEF Ischemic cardiomyopathy s/p ICD HTN and HLD Does not appear to be in acute exacerbation at this time 2D echo done on 9/13/2023 showed EF of 30% with moderate hypokinesis of the apex, interventricular septum and anterior wall of the left ventricle Continue home Plavix, isosorbide, metoprolol and pravachol Resume torsemide but at half dose 11/22, and full dose 11/23 Continue to hold entresto, BP well within normal range, will need to address resumption in the outpatient setting once acute illness has resolved.    Paroxysmal atrial fibrillation  Continue Eliquis and metoprolol Hypothyroidism Continue Synthroid.   Diabetes mellitus type 2 A1c of 7.6  Can resume metformin on discharge however will need to monitor renal function closely as he is at the lower limit of creatinine clearance cutoff.   May benefit from changing to alternative agent however will defer this to PCP    BPH Continue home flomax   Anxiety and depression Continue home Effexor. Obesity  BMI >41 kg/m2 Dietary and lifestyle modifications
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Mental status changes, Metabolic encephalopathy, PCO2 normal, Procalcitonin normal, Respiratory failure
Clinical narrative: Patient is a 80 y.o. male patient of MD with history of HFrEF, HTN, HLD, T2DM, BPH, anxiety, and depression Patient presented to with shortness of breath and mild changes mental status.    Acute on chronic hypoxic respiratory failure Mild metabolic encephalopathy, resolved COVID-19 infection Sepsis, POA Patient presented with preceding history of upper respiratory tract infection symptoms since 2-3 days back.  He was sent from assisted living with mild change in his mental status and shortness of breath, tested positive for COVID-19 11/18 Patient is vaccinated for COVID-19 infection.  He is also up to date with his booster.   He had  temperature of 100.3 with pulse rate of 107 respirations of 22.  VBG done in ER showed pH of 7.39 with PCO2 42.7  WBC was 14.34 with lactic acid of 2.7 BNP of 6001  CXR: Moderate cardiomegaly with slight to mild bibasilar atelectasis.   CT chest without contrast: Bibasilar atelectasis Empirically started on antibiotics, switched to ceftriaxone and azithromycin Procalcitonin normal, suspect symptoms more due to COVID-19 infection as opposed to bacterial pneumonia Stopped antibiotics and monitor off of them, patient improving Continue decadron, for total of 10 days, LDT 12/3 On RA as 11/24 with sats between 88-91%  Discharge home with remainder of decadron RX, IS/flutter.    AKI on CKD stage 3 baseline creatinine is between 1.56?1.8, worsened up to 2.8 Home torsemide held on admission Cr was back to baseline and torsemide resumed 11/22 Continue to monitor renal function   Chronic HFrEF Ischemic cardiomyopathy s/p ICD HTN and HLD Does not appear to be in acute exacerbation at this time 2D echo done on 9/13/2023 showed EF of 30% with moderate hypokinesis of the apex, interventricular septum and anterior wall of the left ventricle Continue home Plavix, isosorbide, metoprolol and pravachol Resume torsemide but at half dose 11/22, and full dose 11/23 Continue to hold entresto, BP well within normal range, will need to address resumption in the outpatient setting once acute illness has resolved.    Paroxysmal atrial fibrillation  Continue Eliquis and metoprolol Hypothyroidism Continue Synthroid.   Diabetes mellitus type 2 A1c of 7.6  Can resume metformin on discharge however will need to monitor renal function closely as he is at the lower limit of creatinine clearance cutoff.   May benefit from changing to alternative agent however will defer this to PCP    BPH Continue home flomax   Anxiety and depression Continue home Effexor. Obesity  BMI >41 kg/m2 Dietary and lifestyle modifications
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Respiratory symptom, SARS-CoV-2 test positive, Sepsis, White blood cell count increased
Clinical narrative: Patient is a 80 y.o. male patient of MD with history of HFrEF, HTN, HLD, T2DM, BPH, anxiety, and depression Patient presented to with shortness of breath and mild changes mental status.    Acute on chronic hypoxic respiratory failure Mild metabolic encephalopathy, resolved COVID-19 infection Sepsis, POA Patient presented with preceding history of upper respiratory tract infection symptoms since 2-3 days back.  He was sent from assisted living with mild change in his mental status and shortness of breath, tested positive for COVID-19 11/18 Patient is vaccinated for COVID-19 infection.  He is also up to date with his booster.   He had  temperature of 100.3 with pulse rate of 107 respirations of 22.  VBG done in ER showed pH of 7.39 with PCO2 42.7  WBC was 14.34 with lactic acid of 2.7 BNP of 6001  CXR: Moderate cardiomegaly with slight to mild bibasilar atelectasis.   CT chest without contrast: Bibasilar atelectasis Empirically started on antibiotics, switched to ceftriaxone and azithromycin Procalcitonin normal, suspect symptoms more due to COVID-19 infection as opposed to bacterial pneumonia Stopped antibiotics and monitor off of them, patient improving Continue decadron, for total of 10 days, LDT 12/3 On RA as 11/24 with sats between 88-91%  Discharge home with remainder of decadron RX, IS/flutter.    AKI on CKD stage 3 baseline creatinine is between 1.56?1.8, worsened up to 2.8 Home torsemide held on admission Cr was back to baseline and torsemide resumed 11/22 Continue to monitor renal function   Chronic HFrEF Ischemic cardiomyopathy s/p ICD HTN and HLD Does not appear to be in acute exacerbation at this time 2D echo done on 9/13/2023 showed EF of 30% with moderate hypokinesis of the apex, interventricular septum and anterior wall of the left ventricle Continue home Plavix, isosorbide, metoprolol and pravachol Resume torsemide but at half dose 11/22, and full dose 11/23 Continue to hold entresto, BP well within normal range, will need to address resumption in the outpatient setting once acute illness has resolved.    Paroxysmal atrial fibrillation  Continue Eliquis and metoprolol Hypothyroidism Continue Synthroid.   Diabetes mellitus type 2 A1c of 7.6  Can resume metformin on discharge however will need to monitor renal function closely as he is at the lower limit of creatinine clearance cutoff.   May benefit from changing to alternative agent however will defer this to PCP    BPH Continue home flomax   Anxiety and depression Continue home Effexor. Obesity  BMI >41 kg/m2 Dietary and lifestyle modifications
Age: 37.0
Sex: F
Vaccine: FLU4
Symptoms: Pain
Clinical narrative: initial pain went away after a few days but came back in 1 week and pain persisted for 1-2 weeks, then went away mostly, but still not fully healed.
Age: 77.0
Sex: M
Vaccine: RSV
Symptoms: Pruritus, Rash
Clinical narrative: Pt broke out in a rash beginning about 10 days after receiving RSV vaccine. Rash started on upper back and spread to most of the trunk. Was prescribed prednisone (but cannot take due to hyperglycemia), and hydroxyzine for itching and rash and Triamcinolone cream.  The rash is not getting better, but also has not gotten worse over the last few days.
Age: 48.0
Sex: F
Vaccine: COVID19, FLU4
Symptoms: Injection site pain, Pain
Clinical narrative: pain still when lifting arm, putting seat belt on across body, and injection spot is still sore.
Age: 59.0
Sex: F
Vaccine: FLU4
Symptoms: Mobility decreased, Pain, Pain in extremity, Sleep disorder
Clinical narrative: At first could barely move arm above chest level, painful/sore when stretching, having trouble sleeping on it and can't stretch it out.  Patient trying own PT and using biofreeze to help.