[doctor] patient is pamela cook . medical record number is 123546 . she's a 36-year-old female post bilateral reduction mammoplasty on 10-10 20-20 .
[doctor] hey , how are you ?
[patient] good . how are you ?
[doctor] i'm doing well . it's good to see you . how have you been ?
[patient] i've been doing good .
[doctor] great . how about your breasts , are they doing all right ?
[patient] great .
[doctor] are you having any chills , fever , nausea , or vomiting ?
[patient] no .
[doctor] good . all right . let's take a peek real quick .
[patient] sure .
[doctor] how's life otherwise ? pretty good ? nothing new ?
[patient] no , just enjoying summertime .
[doctor] okay . how's your family ?
[patient] they're good .
[doctor] good . all right . i'm going to take a look at your breast now . if you would just open up your gown for me .
[doctor] everything looks good .
[patient] yeah .
[doctor] how's your back pain ?
[patient] i'm not really having any more .
[doctor] any hard spots , lumps , or bumps that you've noticed ?
[patient] i did when i came in last time when i saw your pa , ruth sanchez in march . she said i , she said she found a lump right here under my left breast , but i have n't felt it since then . but i did the massages .
[doctor] okay , well . that that's good . uh , it's probably just the scar tissue , but everything looks good and you're healing wonderful , so .
[patient] i told her that the scars here was kind of bothering me and i got scar gel . i was using it everyday , but i do n't think i need it now .
[doctor] yeah , that scar did widen a little bit . let me take a closer look , hang on . this one widened a little too , ? the incisions are well healed though with no signs of infection or any redness on either breast , so i'm not concerned .
[patient] yeah , but this one just bothered me a little bit more .
[doctor] i understand . um , you can close your gown now .
[doctor] the only thing that is really going to help out that is to uh , to cut it out and re-close it .
[patient]
[doctor] and you do n't want that , ?
[patient] i mean , not right now .
[doctor] um , you want to come back and revisit um , maybe six months ?
[patient] yeah , i will do that . i still have n't , i still have some more of the gel and i can try using that again .
[doctor] okay . keep doing that twice a day . the gel is going to lighten the color a little bit , which is already pretty light . um , but , just in that area , and it's high tension , so it's going to rub a little bit .
[patient] yeah , but it kind of bothers me a little bit .
[doctor] uh , i do see that . like i said , the only way to really fix that is to cut it out .
[patient] uh- .
[doctor] um , let's take a look in six months and then we'll go from there . sound like a plan ?
[patient] but we have n't hit a full year yet .
[doctor] i know . um , i would n't do any revisions anyway for scar tissue until we're at least a year out anyway .
[patient] okay .
[doctor] so let's wait those six months . you can keep using uh , the mederma scar gel twice a day . massage and scar gel will help for the scars . um , you can put it on other scars too , if you need .
[patient] okay .
[doctor] um , so that's what i would do . let's just get some pictures today so we can keep up um , with them . and keep an eye on these scars and then we'll go from there .
[patient] sounds good .
[doctor] all right , well it's good to see you . i'm glad you're doing well .
[patient] yeah , same here .
[doctor] all right . well , i'm going to tell the front desk six months and we'll revisit those scars .
[patient] all right .
[doctor] thank you . they're gon na come get your photos now , okay ?
[patient] okay .

Medical orders:
description: come back six months
order_type: followup
reason: scar