On the 11/8
Seen Dato YKT. History retaken, he ordered for Lung Function Test (LFT), MRI Abdo, and CXR.
-LFT shows spirometry is within normal limits
-MRI Abdo shows bilateral biliary and pancreatic ducts; likely ampulla lesion suggest further assessment with ERCP
-ECG shows sinus rhythm.
On the 12/8
Dato YKT suggest for Whipple's OP on the 21/8 admit on the 21/8. For group and cross match 2 unit of pack cell, anesthesia and cardiac assessment.
On the 21/8
Seen by Dato YKT for OP on Monday. To admit, for group and cross match 2 unit of pack cell (Done). For anesthesia and cardiac assessment.
Seen by Dr L ( Cardiac assessment) Echo done shows EF: 78% Then he ordered for EST. Done, and Dr L allowed to proceed for the OP.
On the 22/8
Seen by Dato YKT, for anesthesia assessment today, chest physiotherapy for diabetic management, Dr C.
Dr. C (diabetic management) seen the patient, for TDS HGT monitoring. Put on Daonil 1.5 tablet am and 1 tablet pm and continue own medication, Coversyl.
Dr. W (anesthesia assessment) viewed the patients to book ICU bed. To do PT, APTT and blood test.
PT and APTT shows normal and blood test shows normal too.
He also comment for Dr C to put regime for insulin.
On the 23/8
Dr C comments on S/C Insulated 10 unit BD and continue own medication at OP day, Monday.
Dato YKT on leave covered by Mr O, continue same treatment.
Dr L ask to discharge from his side.
On the 24/8
Dr W ordered for S/C Actrapid and withhold S/C Insulated including tablet Daoril.
Dato YKT ordered for 1L of D/Saline with 1.5 L of D5% plus 2gKCL and he also ordered for CBD insertion.
OP DONE...
In the ICU
Oxygen 5L via simple mask. On CVP monitoring.
Dato YKT order to maintain CVP reading between +10 to +12. If lower challenge plasma gel if higher give lasix 20mg. He also put on IV suprazon 1g, controloc and sandostatin.
(Over all, plasma gel 3.5L has been transfused to the patient in 3 days time. The CVP reading is around +4 to +6)
Seen by Dr W for 6 hourly HGT monitoring and 4 hourly CVP monitoring. He also ordered for FBC, BUSE, Urine for hemoglobin and blood transfusion report.
-FBC shows TWBC high, TRBC low, Hb low
-BUSE shows normal
-Blood transfusion report shows allergic reaction
-To off epidural after completion of 120 mls.
On the 25/8
Dr C ordered for S/C insulated and Coversyl for BP high and HGT reading is 20.1 mmol/L.
As for Dr W, ordered for Isoket infusion to lower down the BP.
Dato YKT ordered to transfused 1 unit of pack cell and allowed to transfer out to the ward. But, the daughter want to stay for another day. Granted.
On the 26/8
Dato YKT allowed patient to be transfered out to the ward, as Dr C continue his treatment and Dr W allow to be transfer out too.
The patient general condition during discharge conscious and alert.
as a result i dun understand wat u tryin to say n dunno y u wanna post this blog oso...
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