MT Help

Original Text: MT Help

At this point, due to underlying cirrhosis from his hepatitis C with massive involvement of the hepatocellular carcinoma. The patient is not resectable. The possibility of palliative chemoembolization has been thoroughly discussed with the patient, in that it might not be possible with bilateral involvement. If the patient wishes to pursue that; we need to do a CT pyelogram before any referral can be made. At this point, the patient understands the seriousness of his diagnosis and wishes that no further procedures be done to him. He requests that only comfort measures be rendered to him. We have discussed the possibility of making a referral to Hospice. The patient wants to think about it and would like to defer this decision for the next week or so until he has a chance to return to his primary care. Due to significant ascites and peripheral edema, I have adjusted his Aldactone to 50 mg b.i.d., he is to continue on Lasix. Should there be no significant weight loss or no significant diuresis, I have advised the patient to increase his Aldactone to 50 mg t.i.d. and to have this further adjusted by his primary care. The patient is to keep his appointment with primary care on May 30, 2000. The patient appears to be comfortable. His pain is under control with four tablets of Tylenol with codeine daily. He claims that that has helped his diarrhea.

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Revised Text:

At this point, due to underlying cirrhosis from his hepatitis C with massive involvement of the hepatocellular carcinoma, the patient is not resectable.

The possibility of palliative chemo-embolization has been thoroughly discussed with the patient, in that it might not be possible with bilateral involvement. If the patient wishes to pursue that, we need to do a CT pyelogram before any referral can be made. At this point, the patient understands the seriousness of his diagnosis and wishes that no further procedures be done to him. He requests that only comfort measures be rendered.

We have discussed the possibility of making a referral to Hospice. The patient wants to think about it and would like to defer this decision for the next week or so until he has a chance to return to his primary care.

Due to significant ascites and peripheral edema, I have adjusted his Aldactone to 50 mg b.i.d. and he is to continue on Lasix. Should there be no significant weight loss or no significant diuresis, I have advised the patient to increase his Aldactone to 50 mg t.i.d. and to have this further adjusted by his primary care.

The patient is to keep his appointment with primary care on May 30, 2000. The patient appears to be comfortable. His pain is under control with four tablets of Tylenol with codeine daily and he claims that it has helped his diarrhea.

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