Hot Keys

ASSESSMENT

Stressed the importance of 10% weight loss through dietary control and increasing frequency of aerobic exercise to reduce the risk of developing type 2 diabetes mellitus.

Patient educated to stay well hydrated and to problem-shoot potential ketone production at a lower blood sugar value than normal to reduce the risk of DKA.

Patient educated to stay well hydrated.

Patient instructed to scan Libre sensor at least every 6-8 hours for full data collection.

The patient was advised to test four times a day for 30 days to meet Medicare criteria to acquire a *** CGM system.

FNA was performed using US guidance with 4 passes using a 25 gauge needle. There were no complications. Will await pathology results before further recommendations are made.

Last TRIG: ***. Will recheck the level today and will continue to monitor.

See NP Zuberi in 3 months.

See NP Murdoch in 3 months.

See NP Carter in 3 months.

She will see NP Carter in 3 months.

He will see Karen Jacobson, PA-C in 3 months.

She will see Kelsey Perfect, PA-C in 3 months.

INSTRUCTIONS

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Please ask your opthalmologist to send the results of your next eye exam to PDEC. PDEC Fax : 503-297-3338

Register with Synthroid Direct. After you register with Synthroid Direct, call PDEC and request to have your prescription transferred. To register, go to https://www.synthroid.com/ and scroll down until you see the 'Save on Synthroid' savings card.

Please call Legacy in 1-2 days to schedule your next DEXA scan at ***. Phone : 503-413-7800

Please call Providence St. Vincent in 1-2 days to schedule your next DEXA scan. Phone :503-216-2167

Please call Providence Portland in 1-2 days to schedule your next DEXA scan. Phone : 503-215-6079

Please call Providence Bridgeport in 1-2 days to schedule your next DEXA scan. Phone : 503-216-0665

Please call Providence Milwaukie in 1-2 days to schedule your next DEXA scan. Phone : 503-513-8350

Please call Providence Newberg in 1-2 days to schedule your next DEXA scan. Phone : 503-537-1780

Please call Epic Imaging in 1-2 days to schedule your next DEXA scan at the ***(Gateway/Hall/Nimbus/Bethany) facility. Phone : 503-253-1105

Contact Faye Sono, PT. for to follow up regarding establishing an osteoporotic exercise regimen. Phone: 503-413-3707.

Begin taking metformin 1 tablet (500 mg) at dinner daily for 1 week. At week 2, increase to 2 tablets (1,000 mg) at dinner daily for 1 week. At week 3, increase to 3 tablets (1,500 mg) at dinner daily, on going. A prescription will be called in for you today.

Please call OHSU in 1-2 days to schedule your CT Coronary Artery Calcium Score. An order will be sent today. Phone : 503-418-0990.

To use your phone as a Libre receiver, download the Freestyle Libre application from either your Apple App Store (iPhones) or from Google Play (Androids). Create a Libre account if you do not have one already using your **full and legal name and accurate date of birth.** To share your data with PDEC, allow data sharing by inputting the share code for PDEC. From the Libre app home screen, select the top left hand button with 3 horizontal lines, then select 'Share', followed by 'LibreView Connect', 'Connect to Practice' and then enter the following share code followed by continue: 08659644.

Keep feet well moisturized.

Please consult podiatrist Dr. Clifford Mah for further evaluation. Phone : 503-643-1737

Please consult Dr. Samuel Shiley for further evaluation. Phone : 503-229-8455

Continue your excellent effort and improved dietary and exercise regimens to achieve additional weight loss.

Continue your excellent effort and improved dietary and exercise regimens to achieve additional weight loss to reduce your risk of developing type 2 diabetes.

Aim for 10% weight loss through dietary control and increasing frequency of aerobic exericse.

Aim for 10% weight loss through dietary control and increasing frequency of aerobic exercise to reduce risk of developing Type 2 Diabetes.

Stay well hydrated and problem-shoot potential ketone production at a lower blood sugar value than normal to reduce your risk of DKA. Your medication (***) will not allow your blood sugars to reach extremely elevated values as they normally would without your medication.

Stay well hydrated.

Test blood sugar four times a day for 30 days on one meter to meet Medicare criteria in order to acquire a *** CGM system. To meet overall average, it is recommended you check your blood sugar 5 times a day at least twice a week. You may also submit a written log showing that you are testing 4 times a day for 30 days.

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The patient was last seen on ***. He is currently taking *** daily. No significant hypoglycemic episodes in the interim. Weight has *** lbs since last appointment. Exercise regimen consists of ***. Diet has been ***. The last hemoglobin A1c was ***, and last LDL was ***. Last eye exam *** Last urine microalbumin ***

The patient was last seen on ***. She is currently taking *** daily. No significant hypoglycemic episodes in the interim. Weight has *** lbs since last appointment. Exercise regimen consists of ***. Diet has been ***. The last hemoglobin A1c was ***, and last LDL was ***. Last eye exam *** Last urine microalbumin ***

Blood glucose average of *** with ***% in target range, ***% high and ***% low Checking an average of *** times per day Morning: Afternoon: Evening: Night:

Libre CGM reviewed with a blood glucose average of *** with ***% in target range, ***% high, and ***% low GMI: ***% Glucose Variability: ***% Scanning Frequency:

Dexcom CGM reviewed with a blood glucose average of *** with ***% in target range, ***% high, and ***% low SD: GMI:

Medtronic CGM reviewed with a blood glucose average of *** with ***% in target range, ***% high, and ***% low SD: Time in Automode: ***%

Dexcom CGM reviewed with a blood glucose average of *** with ***% in target range, ***% high, and ***% low Total range: Time in Control-IQ:

Tandem t:slim X2 with Control-IQ Technology

Current basal rates:2400 -- Carbohydrate ratio:2400 --Insulin sensitivity:2400 -- Blood glucose target

No meter available for review today considering the patient does not check his blood sugars at home.

No meter available for review today considering the patient does not check her blood sugars at home.

No diabetic eye exam on file

No eye exam or urine microalbumin on file

Urine microalbumin due. Last ***:

No urine microalbumin on file

increased

decreased

In regards to her impaired fasting glucose, she is currently taking *** mg daily. *** . Diet has been reportedly ***. Her exercise regimen consists of ***. Weight has *** lbs since her last appointment. Her last A1c was *** with an LDL of ***.

In regards to his impaired fasting glucose, he is currently taking *** mg daily. *** . Diet has been reportedly ***. His exercise regimen consists of ***. Weight has *** lbs since his last appointment. His last A1c was *** with an LDL of ***.

The patient was last seen on ***. In the interim, there have been no signs or symptoms of hyper or hypothyroidism including nervousness, palpitations, significant weight change, diaphoresis, or tremors. She also denies dysphagia, odynophagia, eye pain, or eye dryness. Her weight has *** lbs since the last appointment. Energy level has been at baseline. She is currently taking *** mcg daily.

The patient was last seen on ***. In the interim, there have been no signs or symptoms of hyper or hypothyroidism including nervousness, palpitations, significant weight change, diaphoresis, or tremors. He also denies dysphagia, odynophagia, eye pain, or eye dryness. His weight has *** lbs since the last appointment. Energy level has been at baseline. He is currently taking *** mcg daily.

She is also seen for hypothyroidism. In the interim, there have been no signs or symptoms of hyper or hypothyroidism including nervousness, palpitations, significant weight change, diaphoresis, or tremors. She also denies dysphagia, odynophagia, eye pain, or eye dryness. Energy level has been at baseline. She is currently taking *** mcg daily.

He is also seen for hypothyroidism. In the interim, there have been no signs or symptoms of hyper or hypothyroidism including nervousness, palpitations, significant weight change, diaphoresis, or tremors. He also denies dysphagia, odynophagia, eye pain, or eye dryness. Energy level has been at baseline. He is currently taking *** mcg daily.

The patient was last seen on ***. She ** a personal history of fracture and ** a family history of parental hip fracture. She is currently taking *** mg calcium and *** IU of Vitamin D daily. Appetite has been normal. No fractures in the interim. Her weight has *** lbs since the last appointment. Exercise regimen consists of ***. Diet has been ***.

The patient was last seen on ***. He ** a personal history of fracture and ** a family history of parental hip fracture. He is currently taking *** mg calcium and *** IU of Vitamin D daily. Appetite has been normal. No fractures in the interim. His weight has *** lbs since the last appointment. Exercise regimen consists of ***. Diet has been ***.

She is also seen for osteoporosis. She ** a personal history of fracture and ** a family history of parental hip fracture. She is currently taking *** mg calcium and *** IU Vitamin D daily. Appetite has been normal. No fractures in the interim.

He is also seen for osteoporosis. He ** a personal history of fracture and ** a family history of parental hip fracture. He is currently taking *** mg calcium and *** IU Vitamin D daily. Appetite has been normal. No fractures in the interim.

DEXA *** Lumbar Spine: Hip: Femoral Neck: FRAX: 10-Year -- ***%, Hip -- ***%

DEXA *** Lumbar Spine: Hip (L): Hip (R): Femoral Neck (L): Femoral Neck (R): FRAX: 10-Year -- ***%, Hip -- ***%

Patient was last seen ***. He is currently taking ***. Last injection was ***. His energy level is at baseline. Strength and endurance at baseline. Weight has *** since last appointment.

testosterone cypionate 200 mg/mL *** mL IM every two weeks.

This video visit is being done using a HIPAA compliant service due to social distancing requirements for COVID-19. The patient verbally consents to this telemedicine visit.

not currently on a thyroid medication regimen.

not currently on a osteoporotic medication regimen.

not currently on a prediabetic medication regimen.

In regards to their vitamin D deficiency, the patient is currently taking ** IU daily.

showed no evidence of diabetic retinopathy bilaterally

showed evidence of mild diabetic retinopathy bilaterally

showed evidence of moderate diabetic retinopathy bilaterally

In regards to their vitamin D deficiency, the patient is currently taking ** IU daily.

Vitals

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Unable to obtain vitals via TMV appointment.

Medications

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Humalog U-100 *** units with meals

Novolog U-100 *** units with meals

Humalog U-100 on a sliding scale with meals daily.

Novolog U-100 on a sliding scale with meals daily.

Humalog U-100 via *** pump.

Novolog U-100 via *** pump.

Begin taking 1 tablet (500 mg) per oral route once daily at dinner. Starting on week 2, increase dose to 2 tablets (1,000 mg) once daily at dinner. Starting on week 3, increase dose to 3 tablets (1,500 mg) per oral route once daily, ongoing.

Begin taking 0.25 mg once weekly for 4 weeks. On week 5, increase dose to 0.5 mg once weekly for 4 weeks.

Starting on week 9, increase dose to 1.0 mg once weekly, ongoing.