Sturm und Drang

Cloudy Tuesday – very steady morning, then spotty afternoon – none after 4:30 PM as a very heavy Rain finally broke with Sturm und Drang. 24 Patients. No influenza. One Strep. Sinusitis with Bronchospasm reigned. Followed by Gastroenteritis (Noro-virus?). Another Pneumonia. Speaking of Pneumonia & Stormy weather : The purported Pneumonia in a 144 pack year smoker sent to Hospital for CT was admitted – 1.5 Liters of Transudative fluid were then drained off of his R lung. Sent to pathology. Looks ominous. The 112 pack year smoker with pneumonia will be back in later this week. If the re-X-ray is no better and continues to show Left basilar exudate, then he will be sent for CT as well (this has already been discussed with the patient). Rounding out the day were a Disability and two DOT PE’s one with uncontrolled Diabetes who walked out when told he would not be getting a 2 year certificate. Abdominal pain with bilious urine, treated for UTI, Nephrolith, and Pyelo, being tested for ARF, close follow-up in AM. Judo tonight with Ari ‘man’.