C10001306 / invoice 10000

Appointment Reason: Diarrhoea, Appointment Notes: She was discharged on Thursday evening after her dental scaling and CT scan. Initially, she seemed a bit drowsy but otherwise fine. She slept well, took her steroids as prescribed, and ate a small amount of boiled beef tenderloin. Yesterday morning, she had a bowel movement: half of it was normal, but the other half was black watery liquid. Since her overall energy seemed okay, I assumed it might subside and, following Animalius's previous advice, I administered her Toceranib (Palladia) and 0.6ml of children’s Paracetamol in the evening. She still had a decent appetite and ate boiled beef tenderloin (cut into small pieces) over three feedings. She appeared a little tired but was even able to go for a short 2-minute walk. However, about 3 hours after the evening meal and Toceranib dose, she began having diarrhea again. It started as black stool and was followed by three episodes of watery diarrhea. She seemed gassy, and while the volume decreased over time, it remained completely formless and watery. Shortly after taking the Paracetamol, she vomited her entire dinner. Surprisingly, the beef was almost entirely undigested despite being in her stomach for 3 hours. The color of the diarrhea was not pitch black but very close to a dark soy-sauce color.First dose of treatment in DecemberRadiation therapy in NovemberThyroid Cancer - Grade 3Gums Pink & tachyBAR in waiting roomO advised does want to eat - but stopped giving food from 9PM last night, stopped water from 10PM. gave water in waiting room-Oct 2025. lump in the neck . noted gurgling sound and found a lump. -c+ chronic . exercise induced c+. -blood and hormone-diet: R/C hypoA . (allergic to poultry / fish - ok with white fish ) ; ok with beef -cyopotintADC and referred to Animalius (partial glossectomy), FNA of palatial salivary  result pending.changed to smalll amount of beef 3d ago.ate well. started d+ yesterday morning. dark brown . no blood. mucous. paracetamol 0.6ml and steroid 1.25mg -wants to eat and drink. supplement; Omega-3, liver supportant ; probiotic (from Korea)  -c+ with no production -d+ x7 - v+ x1 -recomm radiation first and then consider sx. no distant MZ. -lethargic. -pneumonia- possible side effects from radiation dx  thyroid carcinomatceranib 5m,g MWFriday pred 1.25mg . no improvmeent inhaler so put it back on 1.25mg OU corneal deposit - 3-4 yrs bilateral MPL G3/4 wheezing Rt side150RR 40 T  39.1advocate Assessment1) v+2) diarrhoeaddx: GE, recent diet change .P:1 )  R/C hypo 2) prokolin3) ondansetron4) maropitant     Vital Signs    Weight: 3.1;       MMColour: Pink;       CRT: 1-2;