C09976605 / invoice 10000

WEIGHT: 11.00
SUBJECTIVE: O brought home new baby 
Inappetant since, not wanting to eat dinner (until the following night), still eating treats 
Generally fussy eater 
DDU well, no v+ or coughing or sneezing 
No other concerns
OBJECTIVE: BAR, nervous but ok to examine 
DS: 1-2
MM pink CRT <2s
Eyes, ears, nose: NAD 
CVS: NAD 
Resp: NAD 
Abdo palp: tense but otherwise NAD 
LN: NAD
Skin + coat: NAD 
Temp: 38.7*C
ASSESMENT: Inappetant - DDx: fussy behaviour vs stress vs acute GE vs others
PLAN: Discuss that can do TAHP to check overall health - O agreed 
While waiting for results, rec to trial boiled chicken for bland diet + his favourite meal
Advised that if bloods NAD, can continue monitor or can investigate with specialist US

WEIGHT: 10.70
HISTORY: Doing ok

BAR
MM=pink
DS=0
CV= NAD
Resp = NAD
BS = 4
Abdo = NAD
Umbilical hernia no change
Otherwise NAD

C5 vacc - Year 1 of triennial

WEIGHT: 9.90
SUBJECTIVE: Lump on abdomen bothering
OBJECTIVE: BAR
MM=pink
DS =0
CV= NAD
Resp = NAD
BS =4
Abdo = 1cm umbilical hernia, non-reducible
Skin  mildly irritated over hernia
ASSESMENT: Umbilical hernia
+/- skin irritation - allergies?
PLAN: Recommend if continues to bother repair hernia - est $600 for this
If skin continues to be irritated consider ongoing management - eg cytopoint