C09976243 / invoice 20000

Reason: DischargeAppointment Notes: mmr 2/3Prescription printed. MEDICATION: Codeine Phosphate STRENGTH/VOLUME/FORM: 30mg tablets x 20DOSE: Give A HALF tablet Twice to THREE times a dayREPEATS: 3DURATION MEDICATION SHOULD LAST: approx 3 months    Vital Signs    

Reason: No Better ? POSS Need XR??Appointment Notes: eed 26.2  ------- Sms reply: YesHappens at night, every night has some soft coughs then gags. Unchanging, no response to doxy - present about a month or two, no previous hx. Bright, eating fine, does not happen after food, not very active due to arthritis. Hear sound fine, ? Harsh lung sounds but nothing dramatic, has increased tracheal sensitivity with deep palpation near thoracic inlet. LN normal, mouth clearVets online to rule out DAD etc. Heart normalBloods all normal. Mild lymnphopaenia likely stressRadiologist confirms DAD with tracheal instability and bronchiectasis exaccerbad by weight - potential future co morbidities of laryngeal dysfunction and thickened soft palate wil exacerbateStart codeine - start 1/2mg/kg bid to tid 15mg bid- wrote script for tablets ( hand written but recorded as document). Does may increase if needed    Vital Signs    Weight: 27.9;       MMColour: Pink;       Temperature: 38.75;       HeartRate: 132;       BodyScore: 2.8/5;       RespirationRate: Pantng;       CRT: <2;