A community of 30,000 US Transcriptionist serving Medical Transcription Industry
The first headline on our AlphaStaff login thing was "What does fulfillment at work really look like?"
It lead to this article: http://management.fortune.cnn.com/2012/05/01/happiness-at-work-fulfillment/?section=money_pf&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fmoney_pf+%28Personal+Finance%29
The bigwigs at Nuance should really be more careful about *editing* the site that they force us to go to multiple times a day. Wouldn't want us to all start to get unhappy about our working conditions! :)
with careful inspection of the mucosa. The mucosa in the cecum, ascending, transverse, and descending colon was normal. Scattered diverticula were noted in the sigmoid colon. Retroflexion in the rectum revealed no abnormalities. The scope was withdrawn. The patient tolerated the procedure well.
DIAGNOSTIC IMPRESSION: @@
PLAN: @@The plan for this patient is to follow up with @@ primary care physician. GI followup as needed.
PREOPERATIVE DIAGNOSIS: Indications heme-positive stool. Requesting is Dr. Lucena indication.
HISTORY AND PHYSICAL: An 84-year-old man with a history of valve replacement for which she is on Coumadin noted to have heme-positive stool. Colonoscopy was requested for evaluation. On exam, vital signs were stable as noted in the chart. CVS: S1, S2 regular. LUNGS: Clear. ABDOMEN: Soft, nontender, nondistended.
DESCRIPTION OF.
PROCEDURE AND FINDINGS: After obtaining informed consent, during which the risks and benefits of the procedure were explained to the the patient was placed in lateral decubitus position where deep sedation was administered by Anesthesia. A rectal exam revealed no abnormalities, the colonoscope was introduced into the rectum and under direct vision was advanced to the cecum, which was identified by the appendiceal orifice and the ileocecal valve. Quality of the prep was fair. The scope was slowly withdrawn. In the proximal descending colon, 3 sessile file polyp measuring approximately 12/14/2011 mm in diameter was seen. This was removed in 2 pieces using a hot snare technique. The pieces were retrieved. Some mild oozing of blood was noted from the polypectomy. This was controlled by a cautery using the tip of the snare. Since the patient has to be on Coumadin because of his artificial valve. We proceeded to place 2 Hemoclips at the polypectomy site to help reduce the risk of post-polypectomy bleeding. No bleeding was noted following the cautery and deployment of the 2 Hemoclips. In the proximal transverse colon, another sessile polyp measuring 12 mm in diameter was seen. This was removed in its entirety with hot snare technique