Cardiologist doctor Kenneth Chew. 1st November 2023. - next appt - April 3rd
How is mri n blood level
Legs
..........
Hands when opening bottle
2. Physiotherapy- to walk etc same old?
How long walk. Mins?
Mims. Beach
Arms better?
3a
How long drive
Ppl renew membership lta
3. Dermasone - pls get pharmacy
Rash -
Potassium n water. ?
Heart medication?
3?
Warfarin?
Eyes
Dentals
Lungs breathing more
Resmed?
4. Cough evening March - middle
Finish
5.
22 or 234d feb
Faetus stains in panty. I pass gas - turn out stains.
What do I eat ?
Papaya banana apricots spinach?
Until today - 26feb.
27 n 28th - no more
29 -- little. In night.
13 March- Faetus stains in panty. In the night. 12?
Iron - to eat?
Other medicines- water n potassium?
Dietitian?
6
Vestibular doctor. Ent Vesticular. Crisyles
Mysthenia- 3 tablets - once a day
Photosynthesis. Medicine ok
Refractory eye - on top of the double vision.
Eye doctor.
Condition is little complicated.
Refractory error or not - eye doctor can see.
N doctor sees there is Condition. But eye doctor can tell more.
Lump - dermatology
General surgeon? Dermatology?
Kikimia? Amyloid doses?
Cardiologist doctor - physiotherapy etc
Move with words - left sided stroke . Speech impairment after stroke.
Online. Plateau little bit
Scar brain
Scar brain explain.
Do I use a walking stick?
Dr Kenneth Chew
Blood test to come out.
Blood test is - the treponin
Treponin - marker for inflammation of the heart muscles - it's come down. So, it's better. Than it was in the last admission.
The steroids seem to have done you some good. (Big reduction or?)
Steady reduction.
1st came to us 10th October, 800, this high.
Came down and came right up again. You went on the steroids,
It has come down.
Optimal level is as low as possible. Not become zero
It may never be complety normal.
We need to decide how long we need to give you the medication. Prednisone.
Some people may stay on it - long term.
5 milligrams.
Some people- we can completely take it off.
With you - I want to put you on 5 milligrams for a while.
I want to repeat your heart scan - to see how you are coming around.
If you don't mind.
10 mgs in hospital.
Now it's 5 MG one day.
How do you feel? Patient- moi.
Less Breathless.
Thymectomy. Now heart operation.
Inr - is too low. Some adjustments.
Warfarin dose is too little.
Increase the warfarin.
3mg warfarin. Increase?
Normally it's 2
Now she is 1.45
Warfarin increases the inr.
Inr monitoring.
Sister Patsy.
Stable first then put you on home monitoring. Kenneth will write a letter to sister patsy.
Allergy medicine no
Acc clinic in one week. (?)
8th Nov heart centre (?)(!)
Inr -- heart failure appt. Adjust the warfarin levels.
Neurology appt - there.
I'm going to give you the predisolane and the heart medications ok. Ans warfarin as well.
Jardin
Water retention medication, jardiance. Yes.
Thyroxine- the other doctors.
Warfarin - 3.mg.
Tomorrow Friday and Saturday - 4 MG. - the next 3 days.
Hfac clinic (?) Is on Wednesday??
Sunday Monday Tuesday - Wednesday - I want you to take 3.5 MG of warfarin.
We will do further adjustments after that.
Sunday. Monday - 3.5 MG
When to do the next heart scan. 5 months time. And which heart scan to do?
Ultra sound scan with jelly. And mri scan? And ct scan.
Mri scan - stop the steroids or resume the steroids. Shows a little bit swollen, that would make me decide whether to keep it on or off
If the mri scan - there is no more swelling, and that means your heart has no more swelling, your heart had recovered and improved , then we can take it off -
At the same time, I want to check the check the treponin. So we will have two things to guide my therapy.
4 months time? You see me in April.
March or April.
Heart valve replacement operation.
Mri.
Blood tests as well.
Treponin.
Medication.
Faromitidin in the afternoon. That is fine!
Any gastric?
Steroids can give a lot of gastric.
Let the heart recover. Let us wait - to travel.
It looks better in some ways but we have to see how it goes for the next couple of months.
Stable Inr - then home monitoring - inr?
Drive it would be. Me- then - I would tell you- not to.
Until. More stable.
Lta letter.
Nine. Months?
Complexities- heart inflammation - not so common.
35per cent before operation
25 per cent after operation
Control a d maintain it?
Slow down. Rare. Step by step.
Heart muscles
Treponion
