Mary is a 70-year-old female here today with her friend Barbara, after receiving Phytel call regarding follow up of her diabetes and hyperlipidemia.
HPI
The patient tells me that she is doing reasonably well, since I have last seen her. She has been to see several specialists, including Dr. Kunz and Dr. Meattey. Dr. Kunz, rheumatology Dr. Meattey for endocrinology. She reports that there was some discussion as to a diagnoses, but she was finally diagnosed with PMR and was placed on steroids. She, however is somewhat frustrated with Dr. Kunz's office as she feels she is unaware of how she is supposed to taper her prednisone and reportedly has a couple of calls into his office and has not had a return call back. She is not sure how she should proceed regarding that, at this time.
The patient has also been to see Dr. Catcher, a hematologist because of a monoclonal …show more content…
Type 2 diabetes. Her A1C is better. I have encouraged her to really try to eat those regular meals, monitor her glucose values and we did discuss the possibility of decreasing or stopping the metformin at this time. She does understand that with the prednisone, that her glucose values would likely increase. It is something she is not willing to do at this point, but would consider for the future, depending on how her stomach is feeling. We will check an A1C in approximately six months.
Hyperlipidemia. She seems to be tolerating the Crestor. She will continue with that for now and I will update labs again with the next blood draw.
Recent diagnoses of polymyalgia rheumatica. I discussed with her that I would be happy to speak with the office manager at Dr. Kunz's office to see about the messages that she has left. She is considering whether to see a new rheumatologist down in Boston anyway. For now, she will continue with her current dosing of prednisone until I am able to speak with Dr. Kunz's office