C09990560 / invoice 10000

Reason: Check Up With New Dosaging With MedsAppointment Notes: Overdue reminders  ------- Sms reply: Y.History: Full of energyEating a lotDrinking a lot and urinating a lotTrilostane given at 8am this morningExamination: Mental State: normalEyes: symmetrical, no redness, nuclear sclerosisEars: normalTeeth: Level 0Mucous membranes: pink External Lymph nodes: normalHeart sounds: normal, no murmurs or arrhythmias auscultatedLung sounds: normal BV sounds both sidesAbdominal palpation: comfortable, no abnormalities palpatedSkin: normal, has a soft mobile SQ mass RHS chest near axilla approx 2cm diameterGenitals: normal, full GU exam not performedMusculoskeletal: ambulatory x4, no deficits noted in consult, full MSK exam not performedNeurological: BAR, no deficits noted, full neuro exam not performedLaboratory: Assessment: Recheck ACTH stim testConsent has been given by the client to proceed with this treatment  -  YesPlan:Bloods taken at 0h (4 hours after trilostane dose)0.17ml synacthen given IVBloods then taken 1 h Will call O with results    Vital Signs    Weight: 8.6;