Re: surgery and replacement; related?

[Guest guest]

,

Wow, that was quick. Thank you for clarifying that for me, it was driving

me " bonkers " .

Lori : )

Re: surgery and replacement; related?

> Lori,

>

> deviated septum surgery is a nasal surgery and

> mechanical aortic valve replacemen is heart surgery. You

> were right.

>

>

> > The patient has a history of mechanical aortic valve replacement in 1998

for

> > aortic stenosis. He also has a history of hypercholesterolemia. He had

an

> > echocardiogram last month that was within normal limits. He has been on

HMG-CoA

> > reductase inhibitors, however, could not tolerate it due to high CPKs.

The

> > patient presents for evaluation of his current medical status. He denies

any

> > chest pain, shortness of breath, orthopnea, paroxysmal nocturnal

dyspnea,

> > dyspnea on exertion, headaches, light-headedness, bright red blood per

rectum,

> > melena, urinary symptoms, abdominal pains, fevers, chills, arthralgias,

or

> > myalgias. He denies any weight loss. Further review of systems is within

normal

> > limits.

> >

> > PAST MEDICAL HISTORY: As above. A colonoscopy was performed 2 years;

within

> > normal limits.

> >

> > PAST SURGICAL HISTORY: Mechanical aortic valve replacement**, deviated

septum

> > surgery, tonsillectomy, and right knee arthroscopic surgery.

> >

> >

> >

> > **In PSH is the deviated septum surgery related to the mechanical aortic

valve

> > replacement or is it a separate surgery for the nose. I have a feeling

it is

> > related to the replacement but cannot not absolutely be positive. I

have

> > transcribed otolaryngology before and maybe this is what is confusing

me, or

> > maybe it is because it is past surgical history and that it could be

related to

> > a nasal septal surgery (or would " nasal " septal surgery have been

specified).

> > This may be a dumb question but I would rather know then look dumber

typing the

> > wrong thing.

> >

> > The reason I am having this problem is, you can usually figure out what

is going

> > on just by what is in the patien'ts dictation, correct? Should I assume

(which

> > I really hate to use the word " assume " here) that since nothing related

to the

> > " nose/nasal " was mentioned/dictated that it would have to to with the

septum of

> > the heart? I did look up everything I could possibly think of to try to

relate

> > the two and just became more confused. ; o

> >

> > I hope this makes sense, since it sure does not make sense to me. : )

I

> > apologize if this seems like nothing but rambling or if I have made it

more

> > confusing for myself. ONE OF THOSE DAYS I GUESS.

> >

> > There are so many wise participants in this newsgroup and I value you

input.

> >

> > Thank you,

> >

> > Lori

> >

> >

> >

> >

> >

> >

[Guest guest]

Hi Margaret,

Thank you for explaining that to me. I know I should have known that the

PSH and PMH is the place where they would talk of other things that are no

where else in the dication. I really think the word " septum " threw me way

off and I was just making it harder on myself, as I usually do. The part

you mentioned about the only time " there would a septal problem in the heart

is usually something like a defect " really made this subject more clear.

Like I said before, I value the input of the participants on this board as

it has helped my knowledge of MT immensly.

Thank you all,

Lori

> Lori, I have typed a lot of different surgeries as I work for a hospital.

When I see deviated septum surgery, I immediately think of the nasal

surgery; as a matter of fact, I had never thought to relate it to aortic

valve surgery. Seems to me when there is a septal problem in the heart, it

is usually something like a defect (atrial septal defect, ventricular septal

defect), rather than a deviation. I just can't figure out how it can be a

part of the heart surgery. Also, there are many times when docs will

discuss things in both the PMH and the PSH that have not been mentioned

anywhere else in the report. Hope this helps, MG

>