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POSTOPERATIVE VISIT=
HISTORY: This is a 54-year-old woman who had
gastric bypass surgery for the treatment of her extreme obesity. Her operation was complicated by a
staple line disruption due to a misfiring of the linear stapler, which was
repaired by hand and further stapling without subsequent problem. She spent 5 days in the hospital
postoperatively, had bleeding postoperatively that required a transfusion, =
and
resulted in some bruising of her flank.&nb=
sp;
In the last 3 weeks, she has felt better and is now feeling well.
PHYSICAL EXAMINATIO=
N: Her weight is 185 pounds. She has lost 13 pounds since
surgery. Temperature 36.5, pu=
lse
84, respirations 16, blood pressure 120/78. BMI 37.3. She appears absolutely well. The abdomen is soft, flat and
nontender. There is some brui=
sing
of the left flank that is persistent, although much of her bruising that I =
saw
2 weeks ago has gone away.
I removed her stapl=
es
today.
PLAN: The patient can now go to a stage 3
diet, and I instructed her how to do this.=
She already has good early satiety.=
She is taking her vitamins.
I instructed her to increase her exercise. She is already driving, and she sh=
ould
come back and see us in 3 months.