C09973138 / invoice 10000

02/03/2026 Diagnosis: Lymphoma (cytological diagnosis), intermediate to large cell. ICC inconclusive. Flow cytometry non definitive, suspect B or null cell. CHOP 19 week 1

History: Chuck has been well at home. Alicia noted from Wednesday following his last appointment that he had markedly improved. His lymph nodes have also markedly improved. Alicia administered trazodone and gabapentin prior to today's appointment. 

Physical Examination findings: Bright, alert and responsive. Oral examination not performed (muzzled). Peripheral lymph nodes palpating normally! Heart and lungs unremarkable. Abdominal palpation soft and comfortable. Mm pink, crt < 2 secs, HR 84 RR pant Temp 38.9  Wt: 41.7 kg. 

Laboratory results: CBC performed prior and adequate for today's treatment. 

Treatment: 0.85mg vincristine was administered IV via a 22g catheter in the right cephalic vein using the closed injection Equashield system.
Dispensed cyclophosphamide 275 mg (225 mg/m2) to be given on the 9th March with frusemide 60 mg. 
Reduce prednisolone to 30 mg PO SID
Trazodone 300 mg prior to appointment, gabapentin prior to appointment. 

Comments: It was a pleasure to see Chuck today, we are pleased that he has obtained a clinical remission from his lymphoma, well done Chuck. We have commenced the CHOP 19 protocol today. We will see Mr Chuck Norris again in 2 weeks time.  Please feel free to call or email if you have any further queries regarding Mr Chuck Norris.