CC
Jennifer is a 39-year-old female here today for followup regarding an episode of blurred vision, balance issues and slurred speech as well as her fatigue, insomnia as well as hair loss.
HPI
The patient tells me since I last saw her on July 28th that she has had no further episodes similar to what she experienced when she was flying. She is very pleased about that. She continues to stress over and ruminate over the cause of that, however, and it is really becoming an issue for her. She said that she had an appointment scheduled with Dr. Lauze, but had to cancel it because of a conflicting appointment and has not been able to reschedule that yet, however does plan on doing so. She is still interested in trying to get to the bottom of that. She did undergo the MRI …show more content…
Hair loss. With a normal TSH value, I am going to have her see dermatology. She was given a referral for Northeast Dermatology Associates. She will schedule that at her earliest convenience.
Neurologic episode while at work on an airplane. I still think this does need further evaluation with neurology and she is going to reschedule that appointment with Dr. Lauze. She declines assistance from us with getting that scheduled. Should she have another episode, she will let me know immediately, so we can discuss further with Dr. Lauze. Consideration for EEG may also need to be done. It is very reassuring that she has not had a further episode.
Anxiety and emotional lability. I am going to have her start Celexa 10 mg one p.o. daily #30 with no refills. I reviewed the use and side effects including the black box warning and she is aware of what to be monitoring for. The plan would be to recheck in approximately three weeks so she knows to contact me sooner if she has any problems or concerns. I reviewed the use and side effects and she felt comfortable with that. Any issues or concerns, she will stop it and update
Jennifer is a 39-year-old female here today for followup regarding an episode of blurred vision, balance issues and slurred speech as well as her fatigue, insomnia as well as hair loss.
HPI
The patient tells me since I last saw her on July 28th that she has had no further episodes similar to what she experienced when she was flying. She is very pleased about that. She continues to stress over and ruminate over the cause of that, however, and it is really becoming an issue for her. She said that she had an appointment scheduled with Dr. Lauze, but had to cancel it because of a conflicting appointment and has not been able to reschedule that yet, however does plan on doing so. She is still interested in trying to get to the bottom of that. She did undergo the MRI …show more content…
Hair loss. With a normal TSH value, I am going to have her see dermatology. She was given a referral for Northeast Dermatology Associates. She will schedule that at her earliest convenience.
Neurologic episode while at work on an airplane. I still think this does need further evaluation with neurology and she is going to reschedule that appointment with Dr. Lauze. She declines assistance from us with getting that scheduled. Should she have another episode, she will let me know immediately, so we can discuss further with Dr. Lauze. Consideration for EEG may also need to be done. It is very reassuring that she has not had a further episode.
Anxiety and emotional lability. I am going to have her start Celexa 10 mg one p.o. daily #30 with no refills. I reviewed the use and side effects including the black box warning and she is aware of what to be monitoring for. The plan would be to recheck in approximately three weeks so she knows to contact me sooner if she has any problems or concerns. I reviewed the use and side effects and she felt comfortable with that. Any issues or concerns, she will stop it and update