Rosemary taylor 654249 79 year old lady current repeat medications varice gluconate 300 mg once a day furosemide 40 mg once a day the I cal d 3 once a day pregabalin 75 mg twice a day laxido as required omeprazole 20 mg once a day senna 7.5 to 50 mg naproxen 250 mg 3 times a day primidone 375 twice per day lisinopril 10 mg once a day paracetamol 1 g as required 4 times a day past medical history osteoarthritis meniere's syndrome 2004 hypertension 20 12 subclinical hyperthyroidism I should say essential tremor gastroesophageal reflux disease and osteoarthritis right knee x-ray today comminuted a fracture of the patella with overlying soft tissue swelling and hematoma tsh 11.7 from previously 4.81 t 4 and t 3 awaited troponin t 16 previously 21 t 4 13.2 corrected calcium 2.62 remainder of bone profile normal magnesium normal creatinine 88 from 72 with normal sodium and potassium lfts alt of 38 but remainder of lfts normal crp 5 urea 10.8 full blood count hemoglobin 119 no no raised white cells venous blood gas ph 7.41 sodium a 133 base excess 1.7 number 8 ed sentral neutronabut slit walking to the car right knee swelling breezing from the proximal tibia and fibula to the lower femur squeezing developing a fusion on knee can straighten leg but unable to bend due to pain on meeting patient fainted in eg wheelchair not noted by husband or public staff put in knee brace whilst unconscious in recess yeah you raised me taylor yes hello I'm mom of the kids oh I don't know why well I'm not I'm rob I'm 1 of the medical residents hi pledge to meet I'm sorry to hear about your knee and swelling over and all that malarkey how is it painful painful yeah flummy bet and you know you've broken your kneecap your patella exactly I'd I didn't didn't even know you had 1 yeah I did because I know the top part of it is bone to bone the bottom bit's alright I've got arthritis and I know that unfortunately I've had this stupid incident yesterday and when the bone specialist came to talk to me and was not very gruesome right and I I have trouble I wear 2 hearing aids I have trouble with accents and the gentleman have an accent there was a lot of noise going on and I couldn't make enough sense of what he was saying to be able to make a proper judgment so at some stage we need to have a conversation with somebody from that yes to work out what the plan is to work out because he was saying we've all got advantages and disadvantages I know you have to tell us that an operation or something like that yeah he was talking about whether it needed operation not whether it was fun wouldn't it that would be fun wouldn't it yeah well yeah I mean I I but the trouble is barry's had a stroke the reason he's here in a bed he's had strokes and I'm his carer see last night he's 1 off that that's not good the whole taylor family sounds good and so if it means being in hospital for a couple of days there are plans to be made and presumed to be made about which is and why would we keep you in the hospital for a couple of days I understand that you had some funny turn when you were bit sleepy yeah yeah apparently I do remember my vision going a bit blurry right and then the next thing I knew I was looking up at the ceiling saying you are at the pillway hospital right in the lincoln hospital were you having any of those pain no no I I I mean my knees didn't come a lot nothing when I when I woke up I woke up just the way I was before I went to sleep was totally lucy wasn't I yeah alright we're just texting a message to someone who's delivering some stuff to us here looking like an order coming in oh my brother has been seen but I didn't know very well I felt perfectly okay when I woke up and not but then this morning we got told that I wouldn't be able to go home and I'd need to stay here for a few days yeah it's all a bit unclear to me because obviously I wasn't there so it's difficult from my perspective there's nothing on your blood test that's concerning as a cause for why you might have had a history of anything right obviously have this broken bone in your knee which is annoying I need to work out what your routine actually does to be that's perfect I don't if you've got anything have you had a good observation you know I've done it for like 12 hours yeah and I think about it yeah which is a kinda like a have you been feeling well in yourself lately before you had this fine and and what led to you falling over and hurting your knee well I think that really shows believe it or not I was actually having an appointment at the eye department here right right and we had to go right out through the women's department to the fire car park beautiful to see I managed to tread on something that was slippery and that whole shoe was covered in mud and I think I landed on here it would make sense yeah because there's a different cut right across the sky so I think I chose the worst place to land I'm usually better at that than choosing my latently for safety is fun so having a look at your hands and listen to your chest is that alright yeah thank you you've got to see your hands please yeah we've all got arthritis everywhere and I've got an essential tremor which is being investigated by my gp because it's got worse but that was priest coming in here and what did you for a living in canada and done some work what did you do for a living what did I do for a living how long was that basic training was expensive competition but I've traveled a lot and done all sorts things right you know so nice and whereabouts are you living now any of those bishop stanton in and my brother came okay because we both lived on boats we had a motor home so we've traveled a lot around europe and that and awesome the best place you went in your motor home where's the best place you went in your motor home in europe think there was that little place do you know where you come across a place it wasn't part that far from benadryl but it was towards valencia and it just was a little a little beautiful village and that day was that that and esper esperimantico was was that yeah I played it too probably you got to gibraltar didn't you mhmm you got to gibraltar yeah oh great yeah we went on a nice big trip in our camper van a couple of years ago me and my wife we loved to scandinavian and out of turkey we love turkey we'll recommend next trip yeah go east it's lovely everyone's so friendly yeah yeah we've we've we've actually got a friend who's not much younger than me whose husband died about 18 months ago absolutely and she was always the driver because she had medical issues and she and her friend were actually heading inland in her motor home up to the arctic circle and again good on the girls enjoying it as long as you can that's a gorgeous drive as well yeah does your wife drive as well yeah we both drive yeah we did it was an argument as to who drove was my turn I was my turn my last trip was to holland and we managed to bring we managed to bring I lose the beds this happened a a throwaway home with this oh really yeah the french customs check the things these are lovely small boats are are little smuggler we said did you stop we stopped to go up to your room and we stopped and had a we're going to have a cup of tea that's right and I had jackie on his own monostatic seats in savilion and loads of me on to put it in the back of the wardrobe and his foot came out oh my god so she smelled a little quickly and there were 2 doors in the wardrobe 1 into the galley and 1 into the bathroom okay so what does it mean to get to the galley ward what does mean to get to the bathroom on the on the boat no this is you've got the other side is other we were just outside frightened by then called the police the guy said to him he said don't call the police don't call the police tonight and the police arrived in figueroa and it awful yeah but we just checked into the nearest hand side you're actually david's free knife so it's if that's been tested yeah so tell me why that that people want to take me here is because there's something because you had this funny turn okay and we didn't know what was going on we haven't found anything to explain the funny thing yeah and we worry about sometimes there's problems in people's hearts what's going on in their brain as a cause for the funny turn I mean obviously you were in a lot of pain with your legs and things like that and you've a few tests there to reassure you we hadn't gone up we hadn't eaten nothing moved out and you're in shock all of it think I'd be able to go back I just wanna have a quick look at your gut mhmm so things flat there yeah you should work out isn't it yeah and that's the only part of the I'm gonna put a little of a normal pelvic tilt back to the chest and the other teeth are you really okay so you're not using that test no okay okay you're comfortable with your son you're comfortable ish no I'm not good any pain in your tummy at all no I'm not okay can I just touch your legs okay it's good I'm not I'm worried any chest pain or shortness of breath no no anything like that no symptoms at all before or before no good we've had a really close look at you haven't you given you've a cardiac monitor all this time you've been here for like 12 hours or something like that I've been here since longer + on on the monitor so so I'll see how long you've been on the monitor for I think that's quite reassuring sometimes we scan people's heads to make sure there's nothing there that causes funny turns it may be worth doing that yeah I'd do that here and waiting around we could just get that done if you want yeah and then I'll speak to your pt team and work out what's going on with this and whether they want anything with it yeah as while you're here or whether they're happy to get you out of here yeah and we'll come up with another 1 okay so that I'd be well from my perspective I think I'm quite happy I think you put this funny turn I didn't know what happened yeah from what they've documented it said you were quite you fainted I did I was sitting in a wheelchair and I that you've not eaten anything and not drunk anything you're allowed to have a faint and you're in pain I think you've already allowed to faint yeah we haven't found anything worrying on our test which is good if I just need to find out what's going on with it if I I take naproxen and paracetamol for the arthritis mhmm is there anything else you can take for this pain from me yeah mean we could get you some codeine or something like that codeine I don't have the codeine to make the codeine so I don't have it yeah fine I I will see what the orthopedic team recommends they'll tell you if you use lots of these deoxygenase things then get a space there I don't any chance to see them today well that would be nice wouldn't it yeah and they go down and saw me they came down and see you today or I don't know yesterday or whatever yeah but I I just I think they've written it right now yeah I'll come back for a while okay alright see you guys in the next 1 bye and noted for an orthopedic note for fracture clinic follow-up don't plan observe for a few more hours if no concerns then could go home later today once observed for 24 hours or so please add to the tasks or to write a note on the computer system and to update the patient with a plan