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Dr. Jeffrey Taylor Community Carclidogist

25 January 2020

Dear Dr Taylor

Ra: My Thomos Sheffield, aged 73

Mr Thomas Sheffield needs assessment and monitoring of medications as he is recovering from permanent pacemaker placement secondary to complete heart block , his heart rate was 30-40 Beats per minute However, he was inducement of medications to rule out the diagnosis. Therefore permanent pacemaker implantation done, all laboratory and chest x-ray result were unremarkable. Post operatively Ibuprofen 800mg 3 times a day when - ever necessary was commenced. susgery dressing was changed daily and instructed to avoid lifting ford foxtnight. Education regarding surgery site, activities and it is important to start physical therapy after 3 weeks.

My Sheffield have had hystory of hypertension, dislipidemia and myocardial infarction on 2015, then insert stents on left anterior descanding artery , on medication.

My Sheffield is a retixed accountant, lives with wife his hobby is fisting and golf.

It would be highly appreciated of you could provide on going care and assistance for mr she field.

It is important to monitor pacer spikes present with stable rhythm, please note, on assessment he is capable of mobility independantly . kindly note, wound site healing with steri strip intact and island dressing applied , he discharged with non narcotic pain nedications for mild pain ,based on the above mentioned circumstances , monitoring of pain level and follow up cardiologist after 7-10 days to inspect post operative site and his blood pressure monitoring is recommend.

Please don't hesitate to contact me for further queries.

Yours sincerely,

Registered Nurse

Cardiac unit.