AA.28. ANASUYA KANNAIYAN - MARIA JOHN

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Dr Patric D'Souza

The Senior

Endocrinologist

Blue Well Hospital Australia

468 st Kilda road

Melbourne vic3004

14 December,2014

Dear Dr D'Souza,

Re: Mrs Maria John,age : 60 years

I am writing to refer Mrs John,who has hyperthyroidism.she requires continuous assessment and treatment from your service.She is being discharged today.

Mrs John was admitted to hospital on 14/12/2015 with complaints of joint pain, abdominal pain, constipation, irritability,dry mouth, slurred speech, dizziness, fatigue and increased thirst.Her laboratory reports revealed decreased TSH, increased T3 T4, blood sugar more than 400 mg/dl and haemoglobin level of 8 mg/dl.In MRI, slight bleeding in temporal lobe and slight bulging in right upper quadrant of the abdomen evidenced by ultrasonography.Additionaly,her X- ray shows enlarged glands in neck.She had been planned for thyroidectomy however she has requested for medical management.

Mrs John has had hypertension, stroke with right sided paralysis,seizure disorder, irritable bowel syndrome, osteoarthritis and hyperthyroidism for 6 months.She lives with her husband in a rental flat and has two adult children.Her mother is a known case of diabetes mellitus.

Kindly educate her regarding dietary modification which include : high fibre,low salt and restricted dairy products.Please continue her medication regimen which has been enclosed.Make sure to encourage her to do exercises and walking after each meal.Please note that she had follow up visit after 2 week with TSH reports.

Please do not hesitate to contact me if you have any queries.

Your's sincerely

Shells Kate

Charge Nurse

Blue Well Hospital

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