713. Mr James Warden - Nurse - - -

Mr James Warden - Case Notes - Nursing - Writing

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abcdefghijklmnopqrstuvwyzDr Glynn Howard

Surgeon

249 Wickam Tee

Brisbane,4001

25 August 2012

Dear Dr Howard,

Re: Mr. James Warden, aged 70

I am referring Mr. James Warden, whose features are suggestive of bilateral inguinal hernia for further surgical management.

On 9 July 2012,Mr Warden came for a routine checkup during which, a small swelling was noticed in the right groin. His blood pressure was high and other systems were unremarkable. Following the groin examination, right inguinal hernia was suspected and was advised to avoid lifting heavy weight and reduce alcohol intake. Treatment options such as surgical repair was mentioned but seemed unconvinced.

Mr. Warden is a widower. With regard to risk factors ,he is allergic to penicillin, known hypertensive for the last five years and consumes alcohol regularly. His current medications include noten(50mg), aspirin(half daily dose), normison(10mg) and fifty plus multivitamins daily.

Today Mr. Warden presented with an increased swelling and dull aching pain in the right groin due to lifting a heavy wheelbarrow while gardening. However, a small swelling in the left groin was also noted. Based on the diagnosis of bilateral inguinal hernia the need for surgery was discussed.

In light of the above circumstances, your expert review and further management including surgery would be highly beneficial. Please note that he wishes to have surgery under local anesthesia.

In case you require any additional information kindly contact me.

Yours sincerely,

Doctor.

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1. ....Mr Warden reported for a routine check-up...

2. Remove "the"

3. ...and he was advised to...

4. ...but he seemed unconvinced.

5. ....allergic to penicillin, has been hypertensive for the last five years, and...

6. and Fifty Plus multivitamins

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8. In addition, (not "however")

9. In view of the above, kindly provide further assessment and management for Mr Warden including possible surgery.1. ....Mr Warden reported for a routine check-up...