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AJ-18. - 1174. Smitha Kantha - Maria John


 

Dr. Patric Desouza

The Senior Endocrinologist

Blue Well Hospital

Australia, 468

St Kildare

Melbourne

VIC 3004


14 December 2014


Dear Dr. Desouza


Re: Mrs. Maria John, age 60


I am referring Mrs. Maria Jhon, who has been experiencing signs and symptoms of thyroiditis and diabetes, requires your expert advice and further management for hyperglycemia and hyperthyroidism


On 11 December, Mrs. Jhon was presented with constipation associated with severe abdominal pain. Also, excessive joint pain, slurred speech, and dry mouth were reported. As a result of exhaustion and increased thirst were observed. On examination blood pressure increased by 170/100mm of Hg and other vitals were remarkable


Subsequently, blood sugar level was increased up to 400 mg/ dl and T3 T4, TSH was deranged. Hemoglobin was 8gm /dl noted.MRI and CT scan revealed slight bleeding in the temporal lobe and bulging in the right upper quadrant of the abdomen. X-ray was showing an enlarged neck gland. Thyroidectomy was recommended.


In regards to past medical history, Mrs. John has had osteoporosis, hypertension in 2011,2014 respectively, and a hernia repair in 2010 is reported. The list of medications is attached with the letter for your kind perusal.


Based on the aforementioned circumstances, your treatment and management for glycemic control and hyperthyroidism would be profoundly beneficial for Mrs. John's health condition. In case you require any additional information please do not hesitate to contact me.


Yours Sincerely


Charge Nurse

Shelly Kate

Charge Nurse

Blue Well Hospital



 

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