The patient is 69-year-old female who is in mid-December sustained a fall and sustained a fracture of the left tibial pylon and left tibial shaft. She was admitted to St. Joseph's Wayne and she underwent external fixation of the fracture to allow for swelling to receive before definitive procedure was done. She is now electively admitted and prepare her for more definitive surgery. Her medical history is very complex. She has had an aortic valve replacement, hypertension mitral valve replacement with mechanical valve, she has known prolonged QT interval, anxiety, depression, and atherosclerotic heart disease. On presentation she is noted to have a white count of 13.8 with a left shift, an MCV 106.5 and some mild electrolyte imbalance.
