[doctor] kelly wood . date of birth , february 15th , 1979 . established patient here for renal ultrasound because of hematuria . urine dipstick today . negative for leukocytes , nitrates , protein , ketone , bilirubin and glucose . color yellow and clear , urobilinogen 0.2 , ph 5.5 and specific gravity 1.020 . there is a trace amount of blood in the urine and intact . renal ultrasound impression . right kidney is 10 cm in length by five centimeter wide . there are no stones , masses or hydronephrosis . the left kidney is 10.8 centimeters in length and five centimeters wide . there is a six millimeter left renal stone non-obstructing . 533 milliliters pre-void and 0 milliliters post-void . hi , mrs. wood . i see you're just finished your ultrasound .
[patient] yes , ma'am .
[doctor] well , it looks like you have one stone in the left kidney but it's not obstructing anything .
[patient] i knew it had to be a kidney stone . i passed what looked like two small stones last week after i scheduled this appointment . and then for the past six weeks , i've had a few episodes of bright red urine the color of , like , cherry kool-aid . and last week , i was constantly having to pee and it hurt something terrible .
[doctor] how bad was your pain on a scale of zero to 10 ? zero being no pain and 10 being worse , as you can imagine .
[patient] um , at the time , i'd say an eight .
[doctor] are you having any flank pain now or tenderness in your lower back ?
[patient] no , after passing those stones , things have felt a lot better .
[doctor] that's good to hear . now , it looks like you're only taking alavert 10 milligrams a day and have no drug allergies . is that correct ?
[patient] that's right .
[doctor] all right , let's take a look at you today . let's use my default pe . well , mrs. wood , we know that the blood in your urine was due to the kidney stones . fortunately , you passed two last week and the blood has nearly subsided . you do still have one stone in the left kidney . since it's not obstructing or causing pain , i do n't recommend any surgical intervention at this time .
[patient] i'd like to know what i can do to stop getting these stones .
[doctor] as we discussed last time , the formation of kidney stones can not be attributed to a particular cause . but several factors increase the risk , such as dehydration , family history , certain foods , digestive tract disease and certain medical conditions .
[patient] yeah , i know i do n't drink near the amount of water that i should . i drink more mountain dew than anything .
[doctor] you should drink about half of your body weight in ounces of water a day .
[patient] so , if i weight 250 pounds , i should drink ?
[doctor] that would be 125 ounces of water a day and you should avoid drinking sugary drinks like mountain dew .
[patient] okay . is there any food i should n't eat ?
[doctor] great question . you should avoid food rich in sodium oxalate and animal protein . so that would be salty , processed food because they're high in sodium . ideally , you should consume less than 1,000 milligrams of sodium a day and reduce the amount of beef , poultry , fish , and pork .
[patient] what's oxalate ?
[doctor] it's an organic acid found in plants , that when digested , it binds to minerals that stones are formed from . foods like spinach , chocolate , beets , rhubarb and soy products .
[patient] well , i'll do whatever it takes to try to avoid getting these stones again .
[doctor] great . and here's a handout that you can look over . it goes over the dietary recommendations and what to avoid .
[patient] okay , good . i like to have things in writing to help me remember .
[doctor] perfect . well , if you have any more questions . if you do n't have any more questions , you're all set . i wo n't need to see you back until next year , as long as you do n't have any more issues like bleeding or pain . if you do have any issues , you can always call the office sooner . and if you experience any severe pain or bright red blood in your urine , you should go to the emergency room .
[patient] all right . well , let's hope we do n't have to do either of those and i see you next year .
[doctor] yes , let's hope . come right this way and i'll walk you to check out . update pe abdomen . no flank pain . anti gu . normal vaginal exam . primary diagnosis is hematuria . secondary diagnosis is chronic urol ... urolithiasis . thank you . this completes mrs. wood encounter .

Medical orders:
description: see you back next year
order_type: followup