Clinical Notes

Author Pei ChungAnderson HealthcareJuly 1st, 2024 11:33am

Note Date/Time July 1st, 2024 11:33am

Anderson Hospital 6800 State Route 162 Maryville, IL 62062 History & Physical Update SignedPatient: Towell,Alexnder R MR#: M000499848 DOB: 08/04/1975 Acct:V00003676858Age: 48 ADM Date: 07/01/24 Loc: ANHSURGERY Attending Dr: Pei Chang Chung M.D.cc: ~History and Physical UpdateUpdateDate/Time: 07/01/24 11:33History and Physical has been reviewed, including an updated exam of the patient. There are NO changes in the patient’s condition.Risks, benefits, and alternatives have been discussed and questions answered. Patient agrees to proceed with procedure.This report may have been done utilizing a voice recognition system. Attempts have been made to correct errors. However, there may be uncorrected grammatical,spelling, and recognition errors present.Report Initialized date/time: Chung, Pei Chang MD 07/01/24 / 1133Electronically signed by: Chung, Pei Chang MD 07/01/24 1133

Author Pei ChungAnderson HealthcareJuly 22nd, 2024 12:21pm

Note Date/Time July 22nd, 2024 12:21pm

Anderson Hospital 6800 State Route 162 Maryville, IL 62062 History & Physical Update SignedPatient: Towell,Alexander R MR#: M000499848 DOB: 08/04/1975 Acct:V00003688837Age: 48 ADM Date: 07/22/24 Loc: ANHSURGERY Attending Dr: Pei Chang Chung M.D.cc: ~History and Physical UpdateUpdateDate/Time: 07/22/24 12:21History and Physical has been reviewed, including an updated exam of the patient. There are NO changes in the patient’s condition.Risks, benefits, and alternatives have been discussed and questions answered. Patient agrees to proceed with procedure.This report may have been done utilizing a voice recognition system. Attempts have been made to correct errors. However, there may be uncorrected grammatical,spelling, and recognition errors present.Report Initialized date/time: Chung, Pei Chang MD 07/22/24 / 1221Electronically signed by: Chung, Pei Chang MD 07/22/24 1221

Additional Discharge Instructions DISCHARGE INSTRUCTION SHEET FOR LAPAROSCOPIC SURGERIES DR. JOHNSON/CHUNG

PATIENT TO TAKE HOME

1. May shower the day after surgery over incisions. Do not submerge in water x 2weeks.

2. Call office for: Wound increasingly painful or bleeding Vomiting Fever of greater than 101 degrees

3. Expect some blood on dressing and old blood on skin.

4. If no bowel movement for two days, take 1 oz. (30 ml) Milk of Magnesia, if no results, take Fleets enema. May take an over the counter stool softener daily.

5. No heavy lifting > 20-25 pounds x 6 weeks for Hand-assisted laparoscopic colectomy.

6. No driving for 3 days or while taking narcotic pain medications.

7. Up walking 10-30 minutes three times per day.

8. Call the office to schedule a follow-up appointment for 2 weeks after your OR.

9. Oral pain medications prescription to be sent to pharmacy. May transition to Tylenol 500mg by mouth every 6 hours as needed for pain once your pain becomes mild and is not requiring the narcotics.

10. NUTRITION: Start out by drinking fluids and increase your diet as tolerated. If you experience nausea, try dry toast, crackers, and 7-UP. If nausea or vomiting persists, contact your surgeon�s office.

Instruction/Education Provided Antibiotic Form Hydrocodone/Acetaminophen (By mouth) Colectomy (DC)

Additional Instructions Discharge Instruction Sheet for Portacath Placement Dr. Lane, Dr. Wikiera, Dr. Johnson, Dr. Chung General and Laparoscopic Surgical Associates 6812 State Route 162 Suite 121 Maryville, IL. 62062 618-288-3616 1.) May shower in 24 hours. 2.) Rest today, then may resume normal light activity tomorrow. 3.) No strenuous activity with upper extremity on the side of the port for 1 week. 4.) Tylenol or ibuprofen over the counter as needed for pain. 5.) Call office for any wound concerns or increasing pain. 6.) Follow up with oncologist as scheduled. You were given TORADOL 15MG (IBUPROFEN) today at 1:00 PM. Do not repeat this medication for 3 hours from time given.

Additional Instructions DISCHARGE INSTRUCTION SHEET FOR DR. CHUNG

1. May shower in 24 hours, no soaking in bath x 2weeks.
2. Call office for: Wound increasingly painful or bleeding Vomiting Fever of greater than 101 degrees
3. No heavy lifting > 10-15 pounds x 6 weeks
4. No driving for 1 week
5. Up walking 10-30 minutes three times per day.
6. Follow-up 10-14 days in office for wound check or as previously scheduled. (288-3616)
7. Oral pain medications prescription has been sent electronically to the pharmacy. Take Tylenol 500mg every 6 hours and Ibuprofen 600mg every 6 hours for the first 2 days, then as needed.

Additional Instructions Discharge Instruction Sheet for Portacath Placement Dr. Lane, Dr. Wikiera, Dr. Johnson, Dr. Chung General and Laparoscopic Surgical Associates 6812 State Route 162 Suite 121 Maryville, IL. 62062 618-288-3616 1.) May shower in 24 hours. 2.) Rest today, then may resume normal light activity tomorrow. 3.) No strenuous activity with upper extremity on the side of the port for 1 week. 4.) Tylenol or ibuprofen over the counter as needed for pain. 5.) Call office for any wound concerns or increasing pain. 6.) Follow up with oncologist as scheduled.

Telephone Encounter - Brittni C - 08/09/2023 10:49 AM CDTFormatting of this note might be different from the original.Received a referral for patient to be seen for right wrist, I tried to call both numbers and left a voicemail for her to give us a call back and schedule.Electronically signed by Brittni C at 08/09/2023 10:50 AM CDTdocumented in this encounter

Telephone Encounter - Nurse Kimberly B - 08/12/2024 4:17 PM CDTFormatting of this note might be different from the original.Called pt about amb referral placed on 8/1. No appt has been scheduled with mws onx. Gave phone number to department and asked pt to call at convenient time.Electronically signed by Nurse Kimberly B at 08/12/2024 4:22 PM CDTdocumented in this encounter

Telephone Encounter - Benjamin Tan, MD - 09/06/2024 11:35 AM CDTFormatting of this note might be different from the original.Left Vm for him to call back to discuss tumor board consensus.Left VM also with Dr. Arshad, pt’s local oncologist.and left VM about possible candidacy for resection. Electronically signed by Benjamin Tan, MD at 09/06/2024 11:45 AM CDTdocumented in this encounter

Telephone Encounter - Ciaran M - 09/11/2024 2:53 PM CDTFormatting of this note is different from the original.Patient Query:Was an attempt to transfer to the assigned clinical staff or backline? “Yes”, Reason for call?: Ellen Sweatt is calling from Dr.Tan’s office requesting scheduling for patient. The referral has not been fully reviewed yet and informed Ellen of this and informed her that I would notify Dr. Field’s office.Who is the caller: Ellen SweattWhat is the best number for them to contact for a call back: 3143624113 Electronically signed by Ciaran M at 09/11/2024 2:59 PM CDTdocumented in this encounter

Telephone Encounter - Benjamin Tan, MD - 09/17/2024 11:58 AM CDTFormatting of this note might be different from the original.Called paeint about his scan results as well as tumor board recommendations. Will need a sooner appt than what was given for the patient to discuss suitability of resection vs transplnation vs systemic therapy alone vs HAIP. As such will refer the patient to see Dr. Chapman/Doyle/Khan for discussion.Electronically signed by Benjamin Tan, MD at 09/17/2024 12:00 PM CDTdocumented in this encounter

Telephone Encounter - Matthew H - 10/03/2024 11:24 AM CDTFormatting of this note might be different from the original.Called to schedule. Pt will need to callback to set up visit d/t infusion conflict. Electronically signed by Matthew H at 10/03/2024 11:25 AM CDTdocumented in this encounter

Telephone Encounter - Matthew H - 11/01/2024 1:23 PM CDTFormatting of this note might be different from the original.Images from the original note were not included.Pt girlfriend called to inquire about treatment process. She stated that MRI that was scheduled by Dr. Fields office was canceled, then rescheudled; however, she is unsure if this MRI is valid. MA is going to place new orders for MRI and schedule. Pt girlfriend would like to know what the plan is for after MRI if any. Electronically signed by Matthew H at 11/01/2024 1:25 PM CDTdocumented in this encounter

Telephone Encounter - Matthew H - 11/14/2024 8:30 AM CSTFormatting of this note might be different from the original.—– Message from Stephanie S sent at 11/13/2024 3:29 PM CST —–Hi,This has been approved by insurance. The referral has been updated to reflect this. They should be good to go.Thanks!Stephanie S—– Message —–From: Hunter, Matthew, EMTSent: 11/12/2024 2:34 PM CSTTo: Wu Su Abd Transplant Precert PoolI am not sure if I have requested a Pre-Auth for this patient or not. If not can we start one.Electronically signed by Matthew H at 11/14/2024 8:30 AM CSTdocumented in this encounter

Telephone Encounter - Elizabeth N - 01/06/2025 2:11 PM CSTFormatting of this note might be different from the original.Patient’s wife, Kim, called. She said Dr. Chapman Jr called them recently and they have not been able to connect with him. They are aware that Dr. Chapman Sr will be reaching out to them with regards to further treatment for Mr. Towell. They would like a general idea of what the test results ordered by Dr Chapman Jr indicated. I gave the message to Dr Chapman Jr and he reached out to the patient.Electronically signed by Elizabeth N at 01/06/2025 2:14 PM CSTdocumented in this encounter