chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Blood sodium normal, Blood thyroid stimulating hormone increased, Blood urea normal, Blood urine present, Carbon dioxide normal
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Chest X-ray normal, Chest pain, Chromaturia, Computerised tomogram abdomen, Computerised tomogram spine
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Condition aggravated, Constipation, Diarrhoea, Dysuria, EGFR status assay
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Electrocardiogram, Facet joint syndrome, Feeling abnormal, Flank pain, Flatulence
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Gastrointestinal sounds abnormal, Glucose urine absent, Groin pain, Haematocrit decreased, Haemoglobin normal
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Hepatic lesion, Hepatic mass, Hydronephrosis, Hydroureter, Hysterectomy
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: International normalised ratio normal, Intra-abdominal fluid collection, Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Mean cell volume normal, Mean platelet volume normal, Monocyte count, Monocyte percentage, Muscle spasms
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Neutrophil count decreased, Nitrite urine present, Pain, Pancreatic mass
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Platelet count decreased, Pleural effusion, Protein total decreased, Protein urine, Prothrombin time prolonged
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Pulmonary granuloma, Pyrexia, Red blood cell count normal, Red blood cell nucleated morphology, Red blood cells urine positive
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Red cell distribution width increased, Specific gravity urine normal, Spinal flattening, Spinal stenosis, Spondylolisthesis
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Stomatocytes present, Thyroxine free increased, Troponin I normal, Urine abnormality, Urine ketone body absent
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: Urine leukocyte esterase positive, Urobilinogen urine, Vertebral foraminal stenosis, White blood cell count decreased, White blood cells urine positive
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 68.0
Sex: F
Vaccine: COVID19
Symptoms: pH urine normal
Clinical narrative: Sent: 3/4/2021   7:55 AM Subject: Non-Urgent Medical Question                    For a full week now, I have been battling diarrhea and a very hyperactive stomach and intestines. Provider prescribed some bentyl Sunday to ease my cramping. At early onset I had some nausea too. I'm wondering if I don't need some blood work, whatever you think and maybe recheck my TSH too. Dr. already ordered a UA with culture which were both negative. That was done because of back pain over left kidney a couple of weeks ago. Diagnosis: Theo. My intestines have never been right since my surgery, but this gassiness and hyperactivity is much more extreme. I tried Metamucil and it blew my guts up even worse. I know I'm due for a CT scan. I see Dr. March 22. I'm trying to hold off until then because I want to discuss with him why I prefer to have all scans at specific facility. I just wanted to get your advice since it's been a week now. I did get my second Moderna vaccine on February 15 and  Fulvestrant injections on Feb. 22. My issues started on Feb. 25. Oddly, right now as I'm typing this, my gut is much calmer. Yesterday was my worst day with diarrhea.  3/13/21 ER for back pain - transferred to second hospital - remains admitted there as of 3/16/21 History of Present Illness:  Patient is a 68-year-old female with known metastatic ovarian cancer under active treatment since 2004, currently on fulvestrant after a massive debulking surgery by Dr. last July (2020).  Patient presented to outlying emergency room with flank pain & transferred here with severe bilateral hydronephrosis on imaging.  Patient had severe left flank pain about 2 weeks ago. Treated with tylenol, motrin, and heat and pain eventually dissipated. Then Tuesday and Wednesday pt did a lot of yard work and lifting. Thursday patient woke up with excruciating right flank pain.  Nothing has made it better.  Patient has tried ice, heat, tramadol Tylenol, Motrin, steroids and pain persists.  Additionally patient having nausea and vomiting.  She has started to have burning with urination.  Pain is excruciating stabbing.  Radiates to the groin.  Patient has also started running fevers today.  She feels pretty miserable.   Also patient notes difficulty with her bowels since her last surgery.  Prior to surgery she took Linzess every day.  Since surgery it has been suggested she does not need this medication.  Patient does note little to no notice when her bowels decide to move.  Severe significant gas.  Other times patient feels quite constipated.   UA suggests possible infection with positive nitrites, 1+ leukocyte esterase and 3+ blood.  WBC 2.1, Cr 1.0, K 3.0 CT scan with multiple abnormalities, but most notably severe bilateral hydronephrosis without obvious obstructing lesion.  Multiple scattered nodular densities concerning for metastatic disease.    Patient transferred for higher level of care and urology consultation.
Age: 83.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: EXTREME ARM PAIN RESULTING IN PRESCRIPTION OF MEDROL DOSE PAK
Age: 88.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Rash, Rash erythematous
Clinical narrative: Rash injection arm for 2 days itchy and red and slightly raised
Age: 41.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Pain, Pyrexia
Clinical narrative: low grade fever, extreme body aches, fatigue
Age: 14.0
Sex: F
Vaccine: HEP
Symptoms: Pain
Clinical narrative: Pain with movement, ibuprofen prn, cold/heat compresses
Age: 58.0
Sex: M
Vaccine: COVID19
Symptoms: Burning sensation, Erythema, Swelling
Clinical narrative: Redness, swelling, slight burning lasting at 5 days.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Chills, Cough, Fatigue, Headache, Injection site pain
Clinical narrative: Fever of 102.6, body aches, chills, tiredness, headache, pain at injection site,  coughing.
Age: 44.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Pyrexia
Clinical narrative: Fever of 102.6, body aches, chills, tiredness, headache, pain at injection site,  coughing.
Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Bell's palsy, Magnetic resonance imaging head
Clinical narrative: Developed Bell's Palsy 3/5/21 and was hospitalized 3/7/21 for 2 days .
Age: 60.0
Sex: M
Vaccine: COVID19
Symptoms: Blood pressure increased, Dizziness, Heart rate increased, Hyperhidrosis, Loss of consciousness
Clinical narrative: Pt began to feel lightheaded and dizzy.  He did pass out while sitting in chair.  Quickly came back, woke back up and was able to answer orientation questions.  He did report that this always happens to him when he takes antihistamines.  Observed for a period of 5-7 minutes and felt / looked better.  Told him we would observe him for a period of 30 minutes.  Within 5 minutes, he had the exact same reaction.  Patient passed out, was pale and diaphoretic.  Blood pressure was 65/39 with HR 45 (3/16 @ 1430).  At that time, he was moved to a gurney and placed in Trendelenburg position.  Patient observed. repeat blood pressure at 1435 was 104/64 with HR 68.  Patient continued in Trendelenburg position.  Patient observed until 1455.  Repeat blood pressure at 1452 was 105/69 with HR 73.  Patient looked and felt better.  He refused to go to ED.  Wife to stay with patient and observe this evening and afternoon.