Audio_Postop_Fp_8

BARIATRIC FOLLOWUP

SUBJECTIVE: The patient returns in followup from his recent operation for adhesive small bowel obstruction complicated by an artichoke bezoar on May 19, 2006. He previously had a jejunoileal bypass that was reversed. Since the operation, he has actually done very well and is having bowel function with the aid of stool softeners and is tolerating a diet. His energy level is slowly returning but he still has pain. Of note, he has chronic pain and has been on narcotics for this in the past. He has an appointment with the pain specialist on August 5, 2007.

OBJECTIVE: Patient appears well, is in good spirits and has his grandkids with him. Temperature is 98.8. Pulse 80. Respirations 20. BP 118/72. Abdomen: Incision is clean, dry, intact and healing well and no sign of infection or recurrence of the hernia. The abdomen is soft and nontender.

ASSESSMENT: Status post relief of bowel obstruction and repair of ventral hernia. Patient is recovering well with no sign of postoperative complication.

PLAN: The patient at this point can be dismissed to followup on an as-needed basis. He asks that I refill his pain medicines 1 additional time until he has a chance to meet with the pain doctors in the next couple of weeks. He said he has an appointment on May 5; therefore, I will give him 1 last refill on the pain medicine until then. He requested Tylenol with codeine for breakthrough which is the regimen I had given him after the hernia repair.