Lyle B. Amer, M.D. 2212 Brothers Road . ‘Santa Fe, New Mexico 87505 Office: 505-983-9490 Fax: 505-983-0568 September 15, 2016 RE: GARY JOHNSON DOB 01/01/1953 Gary Johnson is a 63-year-old male here for an annual physical exam. He feels well. He has no complaints of pain anywhere His appetite is good. He is following a gluten-free diet. He has done that for the last five years. He is exercising at least an hour a day and actually was exercising up to two hours a day until he started campaigning. He does not drink alcohol He has not had any alcohol since 1987. MEDICATIONS: He currently is taking no medications. CIGARETTES: No smoking. EXERCISE: Currently he is exercising approximately an hour a day while campaigning; however, before the campaign started, he was exercising approximately two hours a day. He has been doing high-level, endurance athletics for the last 30 years, including triathlons, bike races, running races, and ski races. He has an extraordinarily high-level of aerobic fitness. PHYSICAL EXAMINATION: Generally, he is a very healthy-appearing 63-year-old male. WEIGHT: 172. BLOOD PRESSURE: 100/70 PULSE: 60. Head, eyes, ears, nose, and throat are unremarkable. Lymph nodes are unremarkable. Lungs are clear Abdomen is soft, nontender, normal bowel sounds. Liver is normal. Rectal Exam: His prostate is smooth, nontender, normal for his age. His extremities are unremarkable. He has good (cont)September 15, 2016 RE: GARY JOHNSON Page 2 perfusion. He has no arthritis. His left big toe has scarring from a frostbite incident years ago. His neuro, exam is grossly intact. His deep tendon reflexes are normal LABORATORY: Labs are pending, carotid Doppler is pending stress echo is pending, and bone density is pending. VACCINES: Pneumovax. PCV13 was offered, and he is considering it, annual flu shot he is considering, and Zostavax he is considering. IMPRESSION: He is an extremely physically fit and healthy 63- year-old male. Obviously, his decades of dedication to physical fitness, diet, no drinking, and no smoking have paid dividends as far as his current extraordinarily good health at this time of his life. RECOMMENDATIONS: I am going to check blood work, including cholesterol, prostate, thyroid, blood sugar, liver, and kidneys He is going to get a carotid Doppler to get a baseline. He is going to see Dr. Laurie Good, a dermatologist, for screening of skin cancer. He is going to have a bone density just to have a baseline. We talked about maybe doing a stress echo again to get a baseline given his extreme fitness and high level aerobic exercise. He is going to start taking vitamin D 1000 units a day. We talked about maybe starting taking aspirin 81 mg once a day for prevention of cerebrovascular disease and coronary artery disease. ( ) Aw uw Lyle B. Amer, M.D. LBA/or