Compulsive Disorders Case Summary

A review of her medical records indicates that she suffers from chronic back pain due to compression fractures. She is followed by Dr.Allan vrable at the spine institute for pain management. She suffers from chronic advanced COPD and is oxygen dependent at 2L/min continuously. She is followed by Dr. Pandya for pulmonary. She suffers from Atrial Fib for which she takes Coumadin. She is follow by Dr. Chalassani for cardiology. He also monitors her Coumadin level monthly. She suffers from co-morbidities of chronic shortness of breath related to her COPD, chronic anxiety as a result of her shortness of breath and GERD which is stable with medication. She has a history of HTN-stable and hyperlipidemia which is stable.

At today's visit she is home alone. Her daughter is on speaker phone. The daughter
The daughter states that she wants palliative care to follow the patient because the patient has been declining. Her appetite is poor but no weight loss. She has had increased forgetfulness and increased shortness of breath. The daughter states that with the patient continue decline she might soon not be able to make it to her pain management appointments. The patient reports that she has had frequent and increase episodes of anxiety because at times she feels like she cannot catch her breath. She states that her lorazepam was recently adjusted to 0.5 mg 4 times daily for her anxiety and 1 mg at night to help her sleep. The patient reports increased feeling of fullness in her stomach which she contributes to her GERD. She also states that she was diagnosed with a colon mass but has refused further diagnostic work up because of her advanced COPD. She states “even if it is cancerous, I would not want it operated on because I know I would not make it off the table due to my breathing issues". She