DCH Healthcare Authority 809 University Boulevard East Tuscaloosa, AL 35403 Patient Health Summary

Date Printed 09/07/12 Patient Name: PEARSON,ADAM Address: 50147 GREENBRIAR RD ABERDEEN, MS 39730 Home Phone: 662 369-8753 Other Phone: 662 436-7144 Med Rec #: M002872400 Date of Birth: 08/22/1973 Sex: M Language Spoken:

Next of Kin
Next of Kin PEARSON,DONNA B Relationship SPOUSE (01) Phone Number 662 369-8753

Healthcare Providers For your Outpatient visit 09/06/12

Attending Mckenzie,Rick L., M.d.

Insurance Providers
Payer Name OTHER 1 Subscriber Name PEARSON,DONNA B Relationship SPOUSE (01)

Allergies, Adverse Reactions, Alerts

Allergen IV Dye, Iodine Containing Contrast Iodine Type Allergy Severity Unknown Reaction Last Updated 09/05/12

Allergy

Unknown

09/05/12

Active Problems
[no ACTIVE PROBLEMS recorded]

Medications
Medication VENLAFAXINE HCL (EFFEXOR XR ) 150 MG CAP.ER.24H MIRTAZAPINE 15 MG TABLET CLONAZEPAM 1 MG TABLET MORPHINE SULFATE (MS CON TIN) 100 MG TABLET.ER TIZANIDINE HCL (ZANAFLEX) 4 MG TABLET HYDROCODONE/IBUP ROFEN (VICOPROFEN 200 -7.5 MG TAB) 7.5 MG/200 MG T ABLET ARMODAFINIL (NUVIGIL) 250 M G TABLET HYDROCODONE BIT/ACETAMINOPH EN (LORTAB 5-500 TABLET) 1 TAB TABLET METHOCARBAMOL (ROBAXIN) 500 M G TABLET Dose 150 milligrams Route by mouth Frequency two (2) times per day Days Qty

15 milligrams 1 milligrams 100 milligrams

by mouth by mouth by mouth

at bedtime one (1) time per day every eight (8) hours

4 milligrams 1 tablet

by mouth by mouth

every eight (8) hours as ne ede every eight (8) hours

250 milligrams

by mouth

one (1) time per day

1 tablet

by mouth

every four (4) hours as needed

500 milligrams

by mouth

every eight (8) hours as ne ede

Advance Directives
[no ADVANCE DIRECTIVES recorded]

Immunizations
[no IMMUNIZATIONS recorded]

Vital Signs For your Outpatient visit 09/06/12

Vital Reading Temperature: Blood Pressure: Respirations: Pulse: O2SAT%: How Taken O NIBP Value 98.1 130/82 20 M 80 97 Recorded Date/Time 09/06/12 6:45pm 09/06/12 6:45pm 09/06/12 6:45pm 09/06/12 6:45pm 09/06/12 6:45pm

Body Measurements Height Weight

Value 6 ft 0.047244 in 227 lbs 1.218048 oz

Recorded Date/Time 09/06/12 6:15am 09/06/12 6:15am

Encounters
Encounter Registered Clinical Departed Surgical Day Care Location Regional Medical Center Regional Medical Center Date/Time 08/20/12 9:13am 09/06/12 8:59pm

Procedures
Procedure CONTRAST MYELOGRAM LUMBAR AND LUMBOSACRAL FUSION ANTERIOR TECHNIQUE LUMBAR AND LUMBOSACRAL FUSION POSTERIOR TECHNIQUE EXCISION INTERVERT Date 05/05/08 05/13/08 05/15/08 05/13/08

DISC EXCISE BONE FOR GRFT NOS FUSION/REFUS OF 2-3 VERTEBRAE FUSION/REFUS OF 2-3 VERTEBRAE CONTRAST MYELOGRAM INJECT STEROID ANESTH INJEC PERIPH NERV PERIPH NERVE INJECT NEC INJECT STEROID

05/15/08 05/13/08 05/15/08 09/10/10 12/06/10

Diagnostic Lab Results

Test Name Hematocrit Hemoglobin Mean Corpuscular Hemoglobin Mean Corpuscular Hemoglobin Concent Mean Corpuscular Volume Mean Platelet Volume Platelet Count RDW Coefficient of Variation Red Blood Count White Blood Count Anion Gap Blood Urea Nitrogen Calcium Level Carbon Dioxide Level Chloride Level Result 42.3 14.6 31.0 34.5 89.8 8.9 158 13.1 4.71 3.5 8 7 9.2 30 100 mg/dL mg/dL mmol/L mmol/L Unit % g/dL pg % fl fl X10^3/uL % X10^6/uL x10^3/uL Reference 42.0 52.0 14.0 18.0 27 31 32 36.5 82 99 6.8 10.8 150 430 11 16 5.00 6.00 4.8 10.8 513 718 8.4 10.2 22 32 101 111 Date/Time 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am 09/05/12 12:40pm 09/05/12 12:40pm 09/05/12 12:40pm 09/05/12 12:40pm 09/05/12 12:40pm

Creatinine Estimat Glomerular Filtration Rate Glucose Level Potassium Level Sodium Level Activated Partial Thromboplast Time INR International Normalized Ratio Prothrombin Time

0.86 >60 104 4.5 138 24.0 1.0 12.9

mg/dL ml/min mg/dL mmol/L mmol/L SEC

0.6 1.3 >60 70 110 3.5 5.1 135 145 22.4 35.5

SEC

11.8 14.3

09/05/12 12:40pm 09/05/12 12:40pm 09/05/12 12:40pm 09/05/12 12:40pm 09/05/12 12:40pm 09/05/12 11:40am 09/05/12 11:40am 09/05/12 11:40am

Microbiology Results
[no MICROBIOLOGY RESULTS recorded]

Social History
[no SOCIAL HISTORY recorded]

Family History
[no FAMILY HISTORY recorded]

Discharge Summary
[no DISCHARGE SUMMARY available]