Patient is john james 882417 61 year old man presenting complaint chest pain past medical history frequent ed attender hypertension type 2 diabetes paracetamol overdose multiple attendances with assault or alleged assault I should say presented june 27 with chest pain and was discharged presented 05:00 this morning with chest pain investigations crp 1 using his normal troponin 3 hemoglobin 126 with platelets 106 cause of that is blood count venous blood gas normal background bipolar disorder taking lithium most recent hem a hematinx not done in the last year despite long standing anemia past medical history add low vitamin d and then in past medical history type 2 diabetes most recent h p a 1 c 50 medications list 0 base cream folic acid oxybutynin 5 mg at night priyadel lithium 600 mg at night marapril 1.25 mg once in the day gligliazide dosing unclear olanzapine 20 mg at night omeprazole 20 mg in the morning atorvastatin 20 mg at night levothyroxine 100 micrograms hundred 25 micrograms in the morning metformin 1 g twice a day aspirin 75 mg once a day promethazine 25 to 50 at night epilim 200 in the evening epilim 501 in the morning and 1 in the evening so total dose of 500 in the morning and 700 in the evening no known drug allergies so that's reassuring isn't it alright yeah what's brought in to hospital I'm gonna to get get to to get get to get a look okay been in the fight since I was barley I just buy a car in the neighborhood I've got a night jacket I work right I got a security jacket and so what's brought you to hospital which is fine pain where's the pain at derek lower chest can you describe the pain to me okay can you describe the pain to me sharp sharp and crushing when you breathe in all the time walk up a hill or I like exercise you don't like exercise I like exercise does it make your pen worse my mate I'm a does it make you pain a pressure chest player chest and I'm hoping something really really would take the while for him right does the pain get worse when you walk up here in south west championships right got a bike in melbourne for 02/2008 I'm I can't imagine it does it make your chest pain worse when you play chess no I love chess okay and how about walking up a hill not very good at it he's on fire at all how about walking up a hill was on a does it leak out I don't think I'm alright I wanna leak like okay you wanna go home yeah that's fine your blood tests are reassuring written up there's no sign of damage to the heart on any of your blood tests you're bit anemic has anyone told you you're anemic before what's wrong with you low blood counts no better than overworked well we've not really looked why yeah so for a while I don't drink alcohol yeah was gonna ask you don't drink alcohol at all right you're completely teetering I don't like do you follow accepted by gps yeah how much do you like they generalize weakness alright I think you should have an ultrasound of your tummy to look at your liver to make sure your liver is okay what can I I won't be able to arrange it today because it's sunday you'd have to come back for it say again I hear me loudly sometime in the future when they're able to arrange it I agree what I agree yeah sounds good yeah of course I'll write you a letter and things I'll get your notes on your tummy I'll add some blood tests on is this room 807 opal villas yeah on locke street 167 locke street 167 locke yep okay I've got my address I've your address yeah exactly I can write it down come to drive it or you come to derek if they have it done alright I'll add you a free blood test on if there's anything to worry about on them I'll let you know but for now everything's fine you can get out of here I can go yeah it's fine what about now if you want I can take that off yeah okay that's fine I think I can get you some pretty good thank you alright nice to meet you thank you mate thank you see you later hi adam hello hi how's it going what are you doing I'm sorry good you're fine no you've definitely heard it mhmm but it doesn't need to be picked up by any way it's not seen as a chest x-ray there's nothing requested he's he had 1 yesterday we'll get all available oh yeah sorry if you had 1 yesterday I'll have go ahead and say back did 1 yesterday you had 1 yesterday I didn't see that you had 1 yesterday all available