tag:blogger.com,1999:blog-80330486685370774282024-03-19T15:04:38.625-07:00Welcome To My BlogMy Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.comBlogger657125tag:blogger.com,1999:blog-8033048668537077428.post-69557935313368354682021-11-25T06:58:00.001-08:002021-11-25T20:29:25.389-08:00Merry Christmas 2021 from the Hendricks<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/N7VQ5Qr0Ncs" width="320" youtube-src-id="N7VQ5Qr0Ncs"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: justify;"><span style="font-size: x-large;">I am so thankful God has allowed me to send out our Christmas Letter/Video. <span style="color: black; font-variant-east-asian: normal; font-variant-numeric: normal;">In 1986 we started our first Christmas Letter as hobby and tradition. In 2005 we created our first Christmas video along with the letter. Only four times have I used same song for those years. (you guess what songs) This is 9th time I have used Silent night for music. I started this tradition to look back at the year, count my blessings and share equally with our friends/family our yearly news. (I love getting news in Christmas cards from others). </span><span style="color: black; font-variant-east-asian: normal; font-variant-numeric: normal;">Each Christmas video is also posted on YouTube with Christmas at Grandma's House in 07 the most viewed with 1572 views. The first you tube Christmas video in 95 only has 91 views. Silent Night in 2011 is most viewed blog video with 1395 views.</span></span></div><p style="text-align: left;"> </p></div><div class="separator" style="clear: both; text-align: center;"><br /></div><p></p><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span style="font-size: large;">We</span></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Wish you<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">A Merry Christmas<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Our favorite time of year<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">A season of hope & good cheer<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Counting our blessings from this year<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Waiting to hear from friends far and near<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Jan bought a green Inflatable Kayak this year<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Dennis Passed out, while buying a car this year<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">His Checkup test showed blood counts way too low<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">March 11<sup>th</sup> Dennis admitted to hospital for heart attack<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">April 8<sup>th</sup> saw Dennis in hospital for Leukemia and chemo,<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">May 6<sup>th</sup> Dennis put on hospice and sent home on his back<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">In June, Dennis could finally walk, and normal clothes wear,<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">We Camped in a tent with family near Portland in September<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">We Attended a wedding, and Cindy Best’s funeral in October<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Doing lots of Puzzles, many walks and enjoying time together<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Dennis on face book, makes videos, hot tubing, and a blogger<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Janice busy at Quilting, Spinning, Knitting, & Painting a Picture<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Hi from Mouse our cat, and Barney & Squeaky our bird conure<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="font-size: large; line-height: 20.7px;">Grateful for those who helped us, cards, visits and each prayer<o:p></o:p></span></p><p align="center" class="MsoNoSpacing" style="line-height: 17.0775px;"><span style="line-height: 17.0775px;"><span style="font-size: large;">God Bless You this on 2021 Christmas and a Happy New Year</span><o:p style="font-size: 18pt;"></o:p></span></p><p align="center" class="MsoNoSpacing" style="font-size: 14.85px; line-height: 22.275px;">Dennis & Janice Hendricks</p><a href="https://www.youtube.com/watch?v=N7VQ5Qr0Ncs" style="color: #336699; text-decoration-line: none;"><span style="font-size: x-small;">Merry Christmas 2021 - YouTube</span></a></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><br /></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: justify;"><br /></div>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com1tag:blogger.com,1999:blog-8033048668537077428.post-55831890499120400412021-10-30T06:34:00.000-07:002021-10-30T06:34:21.678-07:00Imagine Life Without You<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/cHJm3rJhjqo" width="320" youtube-src-id="cHJm3rJhjqo"></iframe></div><p style="text-align: justify;"><span style="font-size: x-large;">50 years ago I first met Jan when our family moved to Coulee Dam in my Junior year of high school 47 years ago we were married. 14 years ago I made this video about Jan. I do not know when the song actually came out- finding the right song is the hardest part of making my videos. Jan and I in our early days of marriage would joke about who would go first when our time to go, came. We would also joke about who loves the other the most. I am so thankful for Janice and the memories we share. I am also thankful for you who is reading this today- God has you here for a purpose- Do not give up- Keep Pressing on. Some of us disagree on issues- but I still cannot imagine life without you. Today we say goodbye to my sister in Law- she knew the Lord- but it will still be hard to imagine Life without Her.</span></p><p><span style="font-size: x-large;"></span></p><div class="separator" style="clear: both; text-align: center;"><span style="font-size: x-large;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhXXdifkfzvjn4tB-eqCjCds7kHfhY9VKG7bxCgn-tgbv6eFISXyEMDO9Azl8SnDCM1e2en-UkAsGriVO0BKYCmSkwgYmXz7VafaWVzC0YfcNKGmS6j5sHZ-XQlh2lJAnwMMIjZ54M1XQpx/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="180" data-original-width="210" height="393" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhXXdifkfzvjn4tB-eqCjCds7kHfhY9VKG7bxCgn-tgbv6eFISXyEMDO9Azl8SnDCM1e2en-UkAsGriVO0BKYCmSkwgYmXz7VafaWVzC0YfcNKGmS6j5sHZ-XQlh2lJAnwMMIjZ54M1XQpx/w458-h393/image.png" width="458" /></a></span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><span style="font-size: x-large;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqW51MrgPc7wsHxeRcr13pgcIzrdTUP7QO2tAay7FfOAyR8ImtphSIo0O419EoV-WarRdKTS708joY8Hn28fJBjXQYUezywVWRx7FD5YgwYFy60wcYdW56FQH_fixZOaHTWBDlyjohsmOh/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="206" data-original-width="206" height="452" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjqW51MrgPc7wsHxeRcr13pgcIzrdTUP7QO2tAay7FfOAyR8ImtphSIo0O419EoV-WarRdKTS708joY8Hn28fJBjXQYUezywVWRx7FD5YgwYFy60wcYdW56FQH_fixZOaHTWBDlyjohsmOh/w452-h452/image.png" width="452" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=cHJm3rJhjqo">Imagine Life Without You (Jan) - YouTube</a></div><br /><br /><br /></span><p></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-8868127759853593752021-10-06T07:37:00.017-07:002021-11-07T08:53:52.036-08:00Home Free<p style="text-align: center;"> <iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/nMKEgJtcn2s" width="320" youtube-src-id="nMKEgJtcn2s"></iframe></p><p style="text-align: justify;"><span face="Roboto, Noto, sans-serif" style="background-color: white; color: #0d0d0d; white-space: pre-wrap;"><span style="font-size: x-large;">Perhaps the nicest words one can receive are; “I’m praying for You”. Thank you to those who have reached out with prayers and love. One lady prayed and sent me a card and is now with Jesus-before I even got home from hospital. Since retirement, February 28th, 2020-not knowing what laid ahead is "normal". </span></span><span style="background-color: white; color: #0d0d0d; font-size: x-large; white-space: pre-wrap;">This last April, 2021 I was admitted to hospital with Acute Myeloid Leukemia just 18 days after being admitted for Heart Attack. I came home from hospital under Hospice on May 6th, 2021. I have seen miracles from God and enjoyed the last 5 months. This is my 4th video made this year, from an 1990 song by Wayne Watson called "Home Free". I do not know how long I have down here- none of us know that. I am just passing thru down here and Heaven is my home. God has you here for a purpose as well- it may not be for you, but for someone else who needs you in their life. I have so experienced that in so many lives God has placed in my life.</span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=nMKEgJtcn2s&t=34s">Home Free - YouTube</a></div><p></p><div class="separator" style="clear: both; text-align: center;"><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUeQx_EZ6uR1V_a2bvxJ04sKtMFWmfa7IgGyqpu8l36ZX4x9kGcw5RbetnlAj8EIn8DJnnpACtlr8Xzr5I30bdESNhvarQp3aL89ZM1eNv5pqSKKlg-dcCs1Rzw6mXh7xGPiIoxxyLKNCD/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="701" data-original-width="526" height="597" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUeQx_EZ6uR1V_a2bvxJ04sKtMFWmfa7IgGyqpu8l36ZX4x9kGcw5RbetnlAj8EIn8DJnnpACtlr8Xzr5I30bdESNhvarQp3aL89ZM1eNv5pqSKKlg-dcCs1Rzw6mXh7xGPiIoxxyLKNCD/w446-h597/image.png" width="446" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEnZSZX-kyCtLgpi4f59QgLA3ZpYYKlMLvRXoZlAZ16uEEXEqXG9ey_DYzWNMQtxj1pibQJJSoZjPVf-ZjjTPsp8fHqVZAxb2Ku2ZtQo6pZBmMg-K_Mqc_iCSKxEwXycsuqvr9GCfUsVuN/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="206" data-original-width="206" height="397" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEnZSZX-kyCtLgpi4f59QgLA3ZpYYKlMLvRXoZlAZ16uEEXEqXG9ey_DYzWNMQtxj1pibQJJSoZjPVf-ZjjTPsp8fHqVZAxb2Ku2ZtQo6pZBmMg-K_Mqc_iCSKxEwXycsuqvr9GCfUsVuN/w397-h397/image.png" width="397" /></a></div><span style="font-size: large;">Taken June 12th, 2021</span></div></div><span style="background-color: white; white-space: pre-wrap;"><div style="color: #0d0d0d;"><div class="separator" style="clear: both; font-size: xxx-large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjrTtgh_cZNSSF35tcdEJtAKrpZHg6Y8jXc8o1jp1pKX1OjLqreIchdTk2GqNmUNoU2gUinY1SOSC2e1itWTa0g4-WEZQjxg8_R03ZqwB4dmPl9qXDFw2EhmkB9Nsbr9YP3e3ymDNfZWNTu/s600/200504992_10225545662053175_3295758655920999942_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="600" data-original-width="600" height="439" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjrTtgh_cZNSSF35tcdEJtAKrpZHg6Y8jXc8o1jp1pKX1OjLqreIchdTk2GqNmUNoU2gUinY1SOSC2e1itWTa0g4-WEZQjxg8_R03ZqwB4dmPl9qXDFw2EhmkB9Nsbr9YP3e3ymDNfZWNTu/w439-h439/200504992_10225545662053175_3295758655920999942_n.jpg" width="439" /></a></div><span style="background-color: white; color: #0d0d0d; font-size: large; white-space: pre-wrap;">This was taken In August, when Darcie brought us donuts</span></div><div style="color: #0d0d0d;"><div class="separator" style="clear: both; font-size: xxx-large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgABY0zWDFZEAU9tVmwecRhBmAHuD9AVefV-Oiba6K7rYVG0TWSK5jaDy_bHbeWHoOIlU9JB4IxkSszF4upYalQT4fDz31FOSpJsO1Pwv23_llawHgpMbknAv7lgyAG2eoKHxYmhYoLytl8/s1440/thumbnail1.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1440" data-original-width="1080" height="579" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgABY0zWDFZEAU9tVmwecRhBmAHuD9AVefV-Oiba6K7rYVG0TWSK5jaDy_bHbeWHoOIlU9JB4IxkSszF4upYalQT4fDz31FOSpJsO1Pwv23_llawHgpMbknAv7lgyAG2eoKHxYmhYoLytl8/w433-h579/thumbnail1.jpg" width="433" /></a></div><span style="font-size: large;">This photo was taken 9/13/21 near Chelan on hwy 971. That week I had my first haircut since February. we had hoped to travel on Lady of the Lake but it was broken down and other boat was full.</span></div><div style="color: #0d0d0d; font-size: xxx-large;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3us3WDxJuYBUUfCKto35r3xSj0q9VLko2UqrlFGhE86H4tcavr1XsBor0jSmVmBypDji1b-Ny44CFeU4oCXIDmNrXLIpwNBv7zzCxV-c2JAGat8YVdHmQHQoPZLqNIS7HsV7TxWBPL085/" style="margin-left: 1em; margin-right: 1em; text-align: center;"><img alt="" data-original-height="206" data-original-width="206" height="568" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg3us3WDxJuYBUUfCKto35r3xSj0q9VLko2UqrlFGhE86H4tcavr1XsBor0jSmVmBypDji1b-Ny44CFeU4oCXIDmNrXLIpwNBv7zzCxV-c2JAGat8YVdHmQHQoPZLqNIS7HsV7TxWBPL085/w568-h568/image.png" width="568" /></a></div><div><div style="color: #0d0d0d; text-align: center;"><span style="font-size: large;">Photo taken 9/22/21 <span style="text-align: left;">while camping at Milo McGiver State Park- </span></span></div><div style="color: #0d0d0d; text-align: center;"><span style="font-size: large;"><span style="text-align: left;">Our first camping trip this summer.</span></span></div></div><div style="color: #0d0d0d;"><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; font-size: xxx-large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWGYvkNx9e7l3SvvVFtEcZshfD6YKi_yuQHmD4D1n3rNijw9zpV5naGkwtgRcGoz78rEn13fq-JaJNG_2f0wf7kTMsMG9LBPh8BljiYZNRmBAEYnTmoK0ppsmMx3ZJJsJ3Kg_UdKJzX4-g/s540/116214611_3235234926536156_9181692095868645516_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="540" data-original-width="522" height="491" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiWGYvkNx9e7l3SvvVFtEcZshfD6YKi_yuQHmD4D1n3rNijw9zpV5naGkwtgRcGoz78rEn13fq-JaJNG_2f0wf7kTMsMG9LBPh8BljiYZNRmBAEYnTmoK0ppsmMx3ZJJsJ3Kg_UdKJzX4-g/w474-h491/116214611_3235234926536156_9181692095868645516_n.jpg" width="474" /></a></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;">Update: <span style="color: black; font-family: arial; text-align: start; white-space: normal;">I actually made this video 3 weeks ago and posted this blog this morning even though I wrote most of it last week. This morning at 9am Hospice took my blood sample for testing. Lisa called tonight and said my blood count is normal!!! I praise God and give him glory. </span></span></div><div class="separator" style="clear: both; text-align: justify;"><span><span style="color: black; font-family: arial; font-size: x-large; text-align: start; white-space: normal;">Some have asked if I am healed? I am reminded of the man in John 9- a whole chapter is spent talking about his healing and he basically says " I don't know, I just know I was blind but now I can see". Did he give God credit for the miracles in his life properly, and was eyesight the only miracle in his life from God? I can ask the same of myself?<div>I do know- I wondered If I would make it to fathers Day- now I am thanking God every day and counting my blessings- Maybe Thanksgiving?</div><div>I do know I told a nurse not to leave the hospital room as I did not want to die alone- and last week I was in church or with church family almost every day. (Sunday 10am, Tuesday 7am, Wednesday 7pm, Thursday 7am, Thursday 5pm, and Saturday 5pm) I have missed very few Sunday mornings</div><div>I do know I came home on a stretcher 5 months ago- was carried into the house with help of firemen called to help, could not walk or even turn over in bed and used a bed pan and now I can walk and drive car.</div><div>I do know my blood count was off in 5 areas several months ago and off in 6 areas last April and last week I received a normal blood count reading for those areas now.</div><div>I hear many have died from covid, many have died from getting the covid shot and I am writing this thanking God for each day I have- over 5 months at home now from a disease the doctor told me I had weeks or maybe months but not years. Do we put time frames on miracles from God- it would still be a miracle if it was 5 days, 5 months or 5 years.</div><div>I do know the medical bills have totaled over $600,000.00 for me and my share has been less than one monthly tithe total. </div><div>I do know since retiring- the years have been uncertain- but also so blessed. I have enjoyed some of the best times in our marriage. So enjoyed the daily bible reading this year with Jan. I have enjoyed the things that have not changed- no pain during this year It was a year ago I attended the funeral of a former dot supervisor who died from cancer.</div><div>So- no- I have not asked if I still have Leukemia- does it matter? I have seen so many miracles he has done for me and each day I wake up is a miracle. People have been so good to us- brought us meals, cards, and visited us when I could have no visitors while in hospital. No- I do not know how long I have down here- but I had to share my thanks before Thanksgiving day</div></span></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;"><span style="color: black; font-family: arial; text-align: start; white-space: normal;">Thank you for your prayers. Just to let you know how far I have come- let me post some past blood counts.</span></span></div><div style="color: black; font-family: arial; text-align: justify; white-space: normal;"><span style="font-size: x-large;">God is in control and I am in his hands. thanks for your prayers. </span></div><div style="color: black; font-family: arial; text-align: justify; white-space: normal;"><span style="font-size: large;"><br /></span></div><div style="color: black; font-family: arial; text-align: justify; white-space: normal;">October 6th, 2021</div><div style="color: black; font-family: arial; text-align: justify; white-space: normal;"><table class="components" id="components2" style="background-color: rgba(255, 255, 255, 0.88); border-spacing: 0px; border: none; color: #363636; font-family: "Source Sans Pro", Calibri, Arial, sans-serif; font-size: 17.3333px; margin: 0px; max-width: 100%; padding: 0px; width: 897.375px;" summary="Table of test result components"><colgroup style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col></colgroup><thead style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><tr style="background-color: rgba(0, 61, 121, 0.05); box-sizing: border-box; color: #003d77; margin: 0px; max-width: 100%; overflow-wrap: break-word; padding: 0px; position: relative;"><th id="components2_col0" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Result Component">Component</th><th id="components2_col1" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Value of Component Result">Your Value</th><th id="components2_col2" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Range of Normal Values">Standard Range</th><th id="components2_col3" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Special Conditions">Flag</th></tr></thead><tbody style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">WBC</td><td class="valueCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">4.7<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*3/uL</span></td><td class="rangeCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">2.9 - 10.9 10*3/uL</span></td><td class="flagCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">RBC</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">4.58<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*6/uL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">3.72 - 5.69 10*6/uL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">HGB</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">14.3<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> g/dL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">11.5 - 17.3 g/dL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">HCT</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">40.9<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> %</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">34.3 - 50.6 %</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">MCV</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">89.2<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> fL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">81.5 - 98.9 fL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">MCH</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">31.2<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> pg</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">27.1 - 33.6 pg</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">MCHC</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">34.9<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> g/dL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">32 - 35 g/dL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">RDW</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">14.5<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> %</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">11.8 - 15.8 %</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">Platelet Count</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">140<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*3/uL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">130 - 360 10*3/uL</span></td></tr></tbody></table></div><div style="color: black; font-family: arial; text-align: justify; white-space: normal;"><span style="font-size: large;"><br /></span></div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;"><br /></div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;">June 223rd, 2021</div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;"><table class="components" id="components3" style="background-color: rgba(255, 255, 255, 0.88); border-spacing: 0px; border: none; color: #363636; font-family: "Source Sans Pro", Calibri, Arial, sans-serif; font-size: 17.3333px; margin: 0px; max-width: 100%; padding: 0px; width: 897.375px;" summary="Table of test result components"><colgroup style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col></colgroup><thead style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><tr style="background-color: rgba(0, 61, 121, 0.05); box-sizing: border-box; color: #003d77; margin: 0px; max-width: 100%; overflow-wrap: break-word; padding: 0px; position: relative;"><th id="components3_col0" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Result Component">Component</th><th id="components3_col1" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Value of Component Result">Your Value</th><th id="components3_col2" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Range of Normal Values">Standard Range</th><th id="components3_col3" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Special Conditions">Flag</th></tr></thead><tbody style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">WBC</td><td class="valueCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">5.9<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*3/uL</span></td><td class="rangeCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">2.9 - 10.9 10*3/uL</span></td><td class="flagCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">RBC</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">3.10<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*6/uL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">3.72 - 5.69 10*6/uL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">L</td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">HGB</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">9.9<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> g/dL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">11.5 - 17.3 g/dL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">L</td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">HCT</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">29.9<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> %</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">34.3 - 50.6 %</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">L</td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">MCV</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">96.3<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> fL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">80.4 - 100.9 fL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">MCH</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">31.8<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> pg</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">27.1 - 33.6 pg</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"></td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">MCHC</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">33.0<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> g/dL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">32 - 35 g/dL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">RDW</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">17.7<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> %</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">11.8 - 15.8 %</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; outline: none; padding: 0.5rem; vertical-align: top;">H</td></tr></tbody></table></div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;"><br /></div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;"><br /></div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;">april 22nd, 2021</div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;"><br /></div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;"><br /></div><div style="color: black; font-family: arial; font-size: 13.3333px; text-align: start; white-space: normal;"><table class="components" id="components46" style="background-color: rgba(255, 255, 255, 0.88); border-spacing: 0px; border: none; color: #363636; font-family: "Source Sans Pro", Calibri, Arial, sans-serif; font-size: 17.3333px; margin: 0px; max-width: 100%; padding: 0px; width: 897.375px;" summary="Table of test result components"><colgroup style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col><col style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"></col></colgroup><thead style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><tr style="background-color: rgba(0, 61, 121, 0.05); box-sizing: border-box; color: #003d77; margin: 0px; max-width: 100%; overflow-wrap: break-word; padding: 0px; position: relative;"><th id="components46_col0" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Result Component">Component</th><th id="components46_col1" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Value of Component Result">Your Value</th><th id="components46_col2" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Range of Normal Values">Standard Range</th><th id="components46_col3" scope="col" style="border: none; box-sizing: border-box; font-weight: normal; margin: 0px; max-width: 100%; padding: 0.5rem; text-align: left;" title="Special Conditions">Flag</th></tr></thead><tbody style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">WBC</td><td class="valueCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">0.1<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*3/uL</span></td><td class="rangeCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">2.9 - 10.9 10*3/uL</span></td><td class="flagCol" style="border: 0px solid rgb(234, 234, 234); box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">LL</td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">RBC</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">2.45<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*6/uL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">3.72 - 5.69 10*6/uL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">L</td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">HGB</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">7.9<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> g/dL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">11.5 - 17.3 g/dL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">L</td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">HCT</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">23.0<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> %</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">34.3 - 50.6 %</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">L</td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">MCV</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">93.8<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> fL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">81.5 - 98.9 fL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">MCH</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">32.4<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> pg</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">27.1 - 33.6 pg</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">MCHC</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">34.5<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> g/dL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">32.3 - 35.0 g/dL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">RDW</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">15.4<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> %</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">11.8 - 15.8 %</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"></td></tr><tr class="odd" style="background-color: white; box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;"><td class="nameCol srchbl" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">Platelet Count</td><td class="valueCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">7<span class="unit" style="box-sizing: border-box; font-size: 0.909em; font-weight: normal; margin: 0px; max-width: 100%; padding: 0px;"> 10*3/uL</span></td><td class="rangeCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-style: italic; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;"><span class="clearlabel" color="transparent !important" style="box-sizing: border-box; display: block; height: 0px; line-height: 0; margin: 0px; max-width: 100%; opacity: 0; overflow-wrap: normal; overflow: hidden; padding: 0px; position: relative; width: 0px; word-break: normal;"></span><span aria-hidden="true" style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px;">130 - 360 10*3/uL</span></td><td class="flagCol" style="border-color: rgb(234, 234, 234); border-image: initial; border-style: solid; border-width: 1px 0px 0px; box-sizing: border-box; font-size: 1.1em; font-weight: bold; margin: 0px; max-width: 100%; padding: 0.5rem; vertical-align: top;">LL</td></tr></tbody></table></div></div></div></span>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com1tag:blogger.com,1999:blog-8033048668537077428.post-60685154676780054992021-09-03T07:20:00.008-07:002021-10-27T17:31:24.226-07:00I'm A State Worker<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/-u9bFOffgPg" width="320" youtube-src-id="-u9bFOffgPg"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: left;"><span _msthash="46540" _msttexthash="576436029"><span _istranslated="1" style="font-size: x-large;">On September 3rd, 1985 I started working for state of Washington in Pasco, for WUTC; working port of entry scales. They moved us to Marysville two years later under a promotion. It was so expensive there, that I requested a transfer to an opening in Wenatchee and moved on Christmas Day 1987. In 1993 I was to transfer to Kent or be laid off due to lack of funding. I commuted for one month until I could start with WSDOT on Oct. 4th, 1993, with no break in service. My first winter was staying at Stevens pass to plow snow, nights, and in 2003 I transferred to Striping from maintenance where we would stripe from Canadian border to below Othello in summers. Winter months I go back to maintenance to plow snow and work with maintenance. It was a good 35 years and I made a lot of friends, they gave me some good equipment to work with, and I enjoyed the medical insurance and leave benefits. I also am glad safety was such a concern for them and I have seen some beautiful areas of the state as well. So here is a short video called "I'm A State Worker" that I put together a few years ago.</span></span></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHOFAmuf03q3f764TpMw3vwJlLv5CaJkY0Y5tMa76A9KnTquKYM6KJMv_Ceme-r3i3zRS5fGF0thykDmke2rBmNOQNL5U9jBzbxM5JYb94j43vlm-EfH9orpkfGj8O-uKQKj3vHT4H76_B/s1600/10246409_10154094302915010_7377133186931291043_n.jpg" style="color: #33aaff; margin-left: 1em; margin-right: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhHOFAmuf03q3f764TpMw3vwJlLv5CaJkY0Y5tMa76A9KnTquKYM6KJMv_Ceme-r3i3zRS5fGF0thykDmke2rBmNOQNL5U9jBzbxM5JYb94j43vlm-EfH9orpkfGj8O-uKQKj3vHT4H76_B/s320/10246409_10154094302915010_7377133186931291043_n.jpg" style="border: none; position: relative;" width="320" /></a></div></div><br /><span style="font-size: large;"> </span><span face=""Open Sans", sans-serif" style="font-size: x-large;">What is the best American state to go sunbathing?</span><div class="body" style="box-sizing: border-box; font-family: "Open Sans", sans-serif; max-height: max(45rem, 105vh); overflow: hidden; padding: 0px 1rem; position: relative;"><p style="box-sizing: border-box;"><span style="font-size: x-large;">MonTANa</span></p><div class="title" style="box-sizing: border-box; padding: 1rem;"><span style="font-size: x-large;">What state is famously known for selling small soft drinks?</span></div><div class="body" style="box-sizing: border-box; max-height: max(45rem, 105vh); overflow: hidden; padding: 0px 1rem; position: relative;"><p style="box-sizing: border-box;"><span style="font-size: x-large;">Minnesota</span></p><div class="title" style="box-sizing: border-box; padding: 1rem;"><span style="font-size: x-large;">Which US state does all the horse hair come from?</span></div><div class="body" style="box-sizing: border-box; max-height: max(45rem, 105vh); overflow: hidden; padding: 0px 1rem; position: relative;"><p style="box-sizing: border-box;"><span style="font-size: x-large;">Maine.</span></p><p style="box-sizing: border-box;"><span style="font-size: x-large;"><span style="background-color: white;">He pokes through the contents and comes across an old brass lamp. "This would look nice on my mantelpiece," he thinks, so he takes it home with him. While polishing the lamp, a genie appears and grants him three wishes. "I wish for an ice-cold diet Pepsi right now!" POOF! A Pepsi appears before him </span><span class="read-more-text" style="background-color: white;">on his desk, so he picks it up and guzzles it all at once. Now that he can think more clearly, he states his second wish. "I wish to be on an island where women reside." POOF! Suddenly he is on an island with gorgeous females. He then tells the genie his third and last wish: "I wish I'd never have to work ever again." POOF! He's back in his government office.</span></span></p><p style="box-sizing: border-box;"><span style="font-size: x-large;"></span></p><div class="separator" style="clear: both; text-align: center;"><br /></div><span style="font-size: x-large;"><a href="https://www.youtube.com/watch?v=-u9bFOffgPg">I'm A State Worker - YouTube</a><br /><span class="read-more-text" style="background-color: white;"><br /></span></span><p></p></div></div></div><p></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-67462386216112593342021-08-14T06:49:00.004-07:002021-10-13T16:44:34.884-07:00Memories You Gave To Me<p></p><div style="text-align: center;"><br /></div><div style="text-align: justify;"> <iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dwqPUi534kBtLeCASdrX32w6iOR7Y41dkw3SLWaYdmeJHPC4UTO0R9qt1v-8lbpmCYbU5ZZMaD0Vwr2U_IaFQ' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div><div style="text-align: justify;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span style="background-color: white; color: #333333; font-size: xx-large; text-align: justify;">My memories are locked in my mind- and they don't age. I enjoy looking at old photo albums & videos. Aren't memories great. I am also thankful for Janice- we have only been married 47 years, but they are so full of good memories as well. I am so blessed. I am thankful for the memories she has given to me. Someone said, "Life brings tears, smiles and memories. The tears dry, the smiles fade but the memories last forever."</span></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdXGqgSQ3GTEetsPT-TY9obqCmJSsXZ2qZGNjxTjWyy1MwuqW2ETW36srxiSZKs987fVogzPNE3gldznlOhRt9yHcjHyPBeCzII_BXDBboB4CvPVlJVQabdZO030YA9a95Dx-GHPZWgf3t/s1600/546547_277799075643312_221433617946525_598222_509960127_n.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" kda="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdXGqgSQ3GTEetsPT-TY9obqCmJSsXZ2qZGNjxTjWyy1MwuqW2ETW36srxiSZKs987fVogzPNE3gldznlOhRt9yHcjHyPBeCzII_BXDBboB4CvPVlJVQabdZO030YA9a95Dx-GHPZWgf3t/s1600/546547_277799075643312_221433617946525_598222_509960127_n.jpg" style="border: none; position: relative;" /></a></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: center;"><span _msthash="412659" _msttexthash="5897229" style="font-size: large;">Memory is a way of holding on to the things you love, the things you are, the things you never want to lose.</span></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj49RSbyLOX43yfRqEXkyMz_oF2RQEkkjIcMV-OB0ZJS3-IZ4bhs4OIwva72IfmatxibWlFxlLpyXmsWet4sRPK-8UNUssLVAhp1TU2bZJoMcEUNiC_N3flMHBQ_yr71tDgMpwaLYvz7rnV/s1600/scan0001.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj49RSbyLOX43yfRqEXkyMz_oF2RQEkkjIcMV-OB0ZJS3-IZ4bhs4OIwva72IfmatxibWlFxlLpyXmsWet4sRPK-8UNUssLVAhp1TU2bZJoMcEUNiC_N3flMHBQ_yr71tDgMpwaLYvz7rnV/s1600/scan0001.jpg" style="border: none; position: relative;" width="245" /></a></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span _msthash="412660" _msttexthash="846651" style="font-size: large;">Memories may fade as the years go by </span></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span _msthash="412661" _msttexthash="2215642" style="font-size: large;">but they won’t age a day</span></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjD82JwNDNSU9grcARYqOWMOtZH15DvxpXBGxoi9Q6XK7viIf3yd1FWiTuDUI6hgOWgXrkj_ca1edgXiS4RS7dUB-ctTlE-EGaeDmZ2ddu6CGuvuICr3-tVl5zRwaR-M5m6cwcaT1-wqqlo/s1600/scan0043.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjD82JwNDNSU9grcARYqOWMOtZH15DvxpXBGxoi9Q6XK7viIf3yd1FWiTuDUI6hgOWgXrkj_ca1edgXiS4RS7dUB-ctTlE-EGaeDmZ2ddu6CGuvuICr3-tVl5zRwaR-M5m6cwcaT1-wqqlo/s1600/scan0043.jpg" style="border: none; position: relative;" width="255" /></a></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span _msthash="412662" _msttexthash="956514" style="font-size: large;"> Each day of our lives we make deposits </span></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span _msthash="412663" _msttexthash="873223" style="font-size: large;">in the memory banks of our children.</span></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhluIDmUK3d-xBSB0eHhtau_sqluaUTnRMGOwljMzQOyQ5mhyphenhyphenfxKUSfp2dQk_9IF4SJsSHuU5RyT5osn_rE55alzr34l7wG53Nt2m8yjRCAXH83x0iTwNbh3Oenrv0dcln1dyaGJAdLfATp/s1600/scan0002.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" bua="true" closure_lm_834647="null" height="246" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhluIDmUK3d-xBSB0eHhtau_sqluaUTnRMGOwljMzQOyQ5mhyphenhyphenfxKUSfp2dQk_9IF4SJsSHuU5RyT5osn_rE55alzr34l7wG53Nt2m8yjRCAXH83x0iTwNbh3Oenrv0dcln1dyaGJAdLfATp/s1600/scan0002.jpg" style="border: none; position: relative;" width="320" /></a></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span _msthash="412664" _msttexthash="1224210" style="font-size: large;"> Happiness is nothing more than good health </span></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span _msthash="412665" _msttexthash="245882" style="font-size: large;">and a bad memory.</span></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><span _msthash="412665" _msttexthash="245882" style="font-size: large;"><br /></span></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dxOy0HYpcbImECK6kdcik4-v4dqCetxahmAClZgA_WVt2-V5wynt5cluBdcvNuYTRq41di6UhI-nSmPcHxCvA' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;">same video as above; only downloaded for phones that do not play youtube</div><div class="separator" style="clear: both; text-align: center;"><br /></div><br /><span _msthash="412665" _msttexthash="245882" style="font-size: large;"><br /></span></div>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-51641021107501990222021-07-12T07:06:00.005-07:002021-10-04T12:59:49.088-07:00Stroll over Heaven With You<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/kpgZXo8lUJk" width="320" youtube-src-id="kpgZXo8lUJk"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;">April 13th, 2021 was our 47th Anniversary and I failed to acknowledge or celebrate it because I was under Chemo in the Hospital. I added some photos of those years to an Allen Jackson song called <br />"I want to Stroll Over Heaven With You". Even if the photo memories do not mean anything to you-I hope the words minister to you and you enjoy his voice. Janice has made this year one of the best the way she has helped me under hospice care and I want to wish her a Happy 47th Anniversary Today.</span></div><div class="separator" style="clear: both; text-align: center;"><br /></div><p style="text-align: center;"> <iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dzBD4o5CfITos1LMnhJhAL_bbcU_w_hFzCRJvTvP7H6p7eYr5BzOIKJGXRIiOFGcrvW3AwOLDOtBxrPNrKWrA' class='b-hbp-video b-uploaded' frameborder='0'></iframe>oi</p><p style="text-align: center;"><br /></p><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;">Sometimes the you tube video will not play - so this is a downloaded version that should play if that happens- just click on the arrow button</span></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC2AJOJhwxwRU-EL2Mi8pACrrgYWqavccgP3y_QRkYFmIgV3yp7U-Qsa6WQtoSXMtr7nSoy8P5R-AHQ1pj9EnWAGiBTf3gzibtO9MZXbJ6pMRpMWbNRn8SZkKFMxhMZ98ZVS6xAY7eSntX/s2048/SCAN0229.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2048" data-original-width="1455" height="557" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiC2AJOJhwxwRU-EL2Mi8pACrrgYWqavccgP3y_QRkYFmIgV3yp7U-Qsa6WQtoSXMtr7nSoy8P5R-AHQ1pj9EnWAGiBTf3gzibtO9MZXbJ6pMRpMWbNRn8SZkKFMxhMZ98ZVS6xAY7eSntX/w394-h557/SCAN0229.JPG" width="394" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: x-large;">Jan painted this 8x10 picture for me and had it delivered to my room on our Anniversary Day.</span></div></div><p style="text-align: center;"><br /></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-75360886941336745182021-07-06T19:39:00.011-07:002021-11-06T18:28:29.235-07:00Start With Well Done<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/CYOoEqOPR-o" width="320" youtube-src-id="CYOoEqOPR-o"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;">Greater Vision wrote/sing "Start With Well Done"- a favorite of mine. I took time to add photos of the first 6 months of 2021. This includes the surprise time spent in hospital for heart and A M Leukemia as well as my recovery up to July. I give God credit for answering prayer. Janice has done a super job to take care of me under Hospice. I would like to thank those who pray for me, those who shared meals, sent cards, mowed our lawn, visited us, as well as the hospital and hospice staff who have been wonderful. </span></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;"><br /></span></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJfe32KOgU_i07q-QjRdejzvd5omkltbmlFBrE9h_GBKUB7DRzNCMM_7D_G3lA205uTkJAkNXjdxg2vpUyfEkpmHJK83-Ttgb2hODWurcSkoi5PL1E7HVmzEadHTgL3gUmSzDSSPiIs6mk/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="206" data-original-width="206" height="403" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJfe32KOgU_i07q-QjRdejzvd5omkltbmlFBrE9h_GBKUB7DRzNCMM_7D_G3lA205uTkJAkNXjdxg2vpUyfEkpmHJK83-Ttgb2hODWurcSkoi5PL1E7HVmzEadHTgL3gUmSzDSSPiIs6mk/w403-h403/image.png" width="403" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div></span></div><p></p><div style="background-color: white; font-family: arial, helvetica;"><p><span style="font-size: medium;">Dr. Julie Smith from last months visit to Dr. </span></p><blockquote style="border-left: 2px solid blue; padding-left: 3px;"><div style="margin: 0px; max-width: 100%; padding: 0px; text-align: justify; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Assessment/Recommendations:</span><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a rel="nofollow noopener noreferrer" shape="rect" style="color: #0044ff; cursor: pointer; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;"></a><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px;">66 y.o.</span><a rel="nofollow noopener noreferrer" shape="rect" style="color: #0044ff; cursor: pointer; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;"></a><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px;"></span><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> male with AML Monoblastic subtype, with critically illness at presentation and initiation of induction chemotherapy. </span><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">He was discharged eventually the first week of May h<span>as been home with hospice since it in many regards has had substantial improvement in his quality of life and symptom management. He has now eating better, and has at this point a temporary hematologic improvement and stabilization of his white count and platelet count, his anemia is also improved from 3 weeks ago likely due to his improvement in nutrition.</span></span></span></div><div style="margin: 0px; max-width: 100%; padding: 0px; text-align: justify; width: auto;"><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="margin: 0px; max-width: 100%; padding: 0px; text-align: justify; width: auto;"><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">However his exam findings are fairly classic today for leukemia cutis. This is not surprising given monoblastic acute leukemia subtype, as monoblastic leukemia has a predilection for soft tissues including soft tissues of the skin, kidneys, other organs, gums, and in patients who develop leukemia cutis this is considered ominous, with impending hematologic relapse. <span>I discussed that this is not a curable condition and treatment with aggressive chemotherapy would be extremely difficult if not harder than he had before. His goals are to not have treatment that would make him weaker or take away from his current quality of life even knowing that his leukemia is terminal.</span></span></span></div><div style="margin: 0px; max-width: 100%; padding: 0px; text-align: justify; width: auto;"><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="margin: 0px; max-width: 100%; padding: 0px; text-align: justify; width: auto;"><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Regarding prognosis it may be that during the next several weeks to 1 or 2 months he would have other signs and symptoms of progressive leukemia such as symptomatic anemia, development of purpura and petechiae, bone pain, etc. Also gum swelling and bleeding from his gums would be something to watch for.</span></span></div><div style="margin: 0px; max-width: 100%; padding: 0px; text-align: justify; width: auto;"><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="margin: 0px; max-width: 100%; padding: 0px; text-align: justify; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px;">He would like to stay on hospice and given his subtype of leukemia, its aggressiveness, and the findings on exam today in addition to noncurative treatment </span><span face="Arial, sans-serif" style="margin: 0px; max-width: none; padding: 0px;">I also recommend that he continue on hospice treatment.</span></span></div></blockquote><p><span style="font-size: medium;"> </span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=CYOoEqOPR-o&t=17s">Start With Well Done - YouTube</a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><br /></div></div><div class="separator" style="clear: both; text-align: justify;"><span><div class="separator" style="clear: both; font-size: xx-large; text-align: center;"><span style="background-color: white; color: crimson; font-family: arial; text-align: start;"></span></div><div class="separator" style="clear: both; font-size: xx-large; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKoKipi2IoPZwbnuAzmOqRUU4tBaA4j8Kt2d97Getj0_Y06LlnYmCvb8UziG0Po8eLykEJah9HVo0oaO3thVRcBOIejGi4GodXu_NXo_sdmmW5CngeY4x5cEv1mo1dRwAvLZugrtY9zxxE/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="846" data-original-width="564" height="527" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKoKipi2IoPZwbnuAzmOqRUU4tBaA4j8Kt2d97Getj0_Y06LlnYmCvb8UziG0Po8eLykEJah9HVo0oaO3thVRcBOIejGi4GodXu_NXo_sdmmW5CngeY4x5cEv1mo1dRwAvLZugrtY9zxxE/w351-h527/image.png" width="351" /></a></div><div class="separator" style="clear: both; font-size: xx-large; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: left;"><span style="font-size: large;">Here are some of the Dr. reports from while I was in hospital;</span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: left;"><span style="font-size: large;"><br /></span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: left;"><div class="title" style="box-sizing: border-box; color: #363636; font-family: "Source Sans Pro", Calibri, Arial, sans-serif; height: 3.5rem; margin: 0px; max-width: 100%; padding: 0px; position: relative; vertical-align: bottom; width: 916.688px;"><span style="font-size: medium;"><h1 class="header" style="box-sizing: border-box; color: #003d77; display: inline-block; font-weight: normal; line-height: 1.5rem; margin: 0px; max-width: 100%; overflow: hidden; padding: 0.7rem 0px 0.5rem; position: relative; text-overflow: ellipsis; vertical-align: bottom; white-space: nowrap; width: calc(100% - 5rem);"><span>Note From Your Admission on 04/08/21</span><span style="margin-left: 0.5rem;"><span class="subjectIndicator" style="box-sizing: border-box; margin: 0px 0px 0px 0.5rem; max-width: 100%; padding: 0px;"></span></span></h1><div id="assistiveicons" style="box-sizing: border-box; display: inline-block; margin: 0px; max-width: 100%; padding: 0.7rem 0.5rem 0px; text-align: right; vertical-align: bottom; width: 5rem;"><div class="assistiveicon" style="box-sizing: border-box; display: inline-block; margin: 0px; max-width: 100%; padding: 0px; width: 2rem;"><a href="https://mychart.confluencehealth.org/MyChart/inside.asp?mode=admissions&showNote=1&lrpid=1&hnoid=7&hnodat=WP%2D24VzTvx2Rte4ZPufH0Kqjqfg%2D3D%2D3D%2D24Uww4HtT07M7QCoe%2D2BOd160gcHSlspgtxxez4FQfMbOVA%2D3D&printmode=true" id="printerfriendlylink" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: 100%; padding: 0px; text-decoration-line: none;" target="_blank"><img alt="Printer friendly page--New window will open" class="assistiveicon qnrPrintIcon" src="https://mychart.confluencehealth.org/MyChart/en-US/Images/print.png" style="border: 0px; box-sizing: border-box; display: inline-block; float: right; margin: 0px; max-width: 100%; padding: 0px 0px 0px 0.125rem; position: relative; width: 2rem;" title="Printer friendly page" /></a></div></div></span></div><div class="section" style="box-sizing: border-box; color: #363636; font-family: "Source Sans Pro", Calibri, Arial, sans-serif; margin: 0px; max-width: 100%; padding: 0px; width: 916.688px;"><div class="report" style="background-color: transparent; background-image: none; box-sizing: border-box; line-height: normal; margin: 0px; max-width: 100%; padding: 0px; width: 916.688px;"><div data-context="READONLY0PATDATPATID Z109408" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: 916.688px;"><div class="rpt StandardII" style="background-color: white; box-shadow: rgba(0, 0, 0, 0.25) 0px 1px 4px; box-sizing: border-box; font-family: "Segoe UI", sans-serif; margin: 0px; max-width: none; padding: 0px; width: 916.688px;"><div class="pgHeaderFooter" style="box-sizing: border-box; margin: 0px; max-width: none; overflow: auto; padding: 0px 23px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="LPG" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"></div></div></div><div class="bothColumns fs10 singleColumn" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="mainColumn singleColWide" style="box-shadow: none; box-sizing: border-box; height: auto; margin: 0px; max-width: none; padding: 14px 23px 16px; vertical-align: top; width: auto;"><div class="pgSection" data-sectdepth="1" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px 0px 16px; width: auto;"><div class="sectionHeaderLine" style="border-top: 1px dotted rgb(200, 200, 200); box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; position: relative; top: 0.85em; width: auto; z-index: 0;"><span style="color: #0a649c; font-size: medium;"><br /></span></div><div class="sectionHeaderLine" style="border-top: 1px dotted rgb(200, 200, 200); box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; position: relative; top: 0.85em; width: auto; z-index: 0;"><span style="color: #0a649c; font-size: medium;">Progress Notes by GENEVIEVE O'SULLIVAN, MD at 05/05/21 1034</span></div><div class="sectionHeaderLine" style="border-top: 1px dotted rgb(200, 200, 200); box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; position: relative; top: 0.85em; width: auto; z-index: 0;"><span style="color: #0a649c; font-size: medium;"><br /></span></div><div class="pgContent" style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 2px 0px 0px 16px; width: auto;"><table class="rz_30_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 854.688px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_30_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_30_4 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;"><div class="pgSection sectHlt12 pgNoSectHeader" data-sectdepth="2" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="pgContent" style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 0px; width: auto;"><table class="rz_30_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_30_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_30_5 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><div class="fmtConv" style="box-sizing: border-box; font-family: Arial; line-height: normal; margin: 0px; max-width: none; padding: 0px; width: auto;"><div data-copy-context="NOTE|553596930|55662|537992540|Z109408|55688.99|152285434" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Palliative Care Progress Note</span><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><a name="LINKBEGIN|700|5|SUBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span id="MR_COMSUM^``^#`BEGIN^``^#`Subjective^``^#`0^``^#`1924162.91804^``^#`0^``^#`1^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Subjective<span id="SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Subjective^``^#`0^``^#`1924162.91804^``^#`0^``^#`1^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a name="LINKEND|700|5|SUBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"></span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><br /></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Hospital Course / Interval History: </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Nursing, hospitalist,</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">notes reviewed. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Discussed with chaplain who visited yesterday. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Per nursing, taking medications with applesauce in the evening was difficult. Concern for possible aspiration. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">O2 requirement has remained stable. Afebrile. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Dennis tells me his appetite is improved. He is wanting more smoothie or juice this morning. No abdominal pain, nausea. His abdomen continues to be distended. No fevers. He feels like it's difficult to swallow, and that he is noticing a bit of a cough. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Looking forward to going home. Discussed hospice again which he voices he still would like to do. He remains hopeful that he will feel better but tells me he knows he will die. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Called Janis and updated her about possible aspiration and consideration of abx. She has questions regarding hospice. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">I called Lynn at hospice and discussed discharging tomorrow with open on Satuday</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><br /></span></div></div></div></td></tr></tbody></table></div></div></td></tr></tbody></table></div></div></div></div></div></div></div></div></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: left;"><span style="font-size: medium;"><br /></span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: left;"><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Palliative Care Assessment/ Recommendations</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;">Mr. Hendricks is a 66 yo gentleman with AML, with a prolonged and complicated hospital course since admission on 4/8.</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">We have had several goals of care discussions throughout his course, the most recent yesterday. He has communicated with this family, and they are supportive, that he wants to go home, and be on hospice. He holds on to hope that he may get better, though does not desire ongoing medical intervention in the hospital setting. He has made it clear that he knows he will die, and he is comfortable with this. </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">He is currently stable and able to be cared for at home by his family. Hospice open date is Saturday.</span></span></div><div><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"><br /></span></span></div><div><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: large;"><br /></span></span></div></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: center;"><span style="font-size: large;">5-4-21</span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: center;"><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">IMPRESSION</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;">:</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;">6</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;">6-year-old man with:</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">1. AML, status post induction with idarubicin and cytarabine, initial oncologist Dr. Buckley, transitioning to Dr. Smith. His neutropenia has resolved. Platelets have normalized. Hemoglobin is stable from yesterday at 8, although down from 2 days prior 10. He has had a very rough time with this 26-day hospitalization, including extensive time in ICU on the ventilator, as outlined separately, with subsequent intermittent periods of acute hypoxic respiratory failure requiring high flow oxygen. I speak with him briefly about how all this has been for him, he is quite clear that he would not want reintubation in the event of progressive respiratory failure,, but I really have not taken the discussion any further, as there is palliative care meeting with the patient is best previously scheduled for today, see above, with patient expressing wish to transition to comfort measures only after that discussion per Dr. O'Sullivan, who has written those orders for comfort measures and DNR status. Dr. Sullivan will communicate directly Dr. Smith regarding this.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">2. Acute hypoxic respiratory failure. Etiology is not entirely clear with persistent hypoxemia. I have personally reviewed his chest x-ray from yesterday, with mild pulmonary vascular congestion with stable mild basilar opacities. He did respond to a dose of furosemide at the time of his high flow requirement, now on 5 L. He had a CT angiogram which was negative for pulmonary embolism on April 10, has not had interval imaging in that regard. His renal function did worsen following that study, and currently his creatinine is 1.62. His LV systolic function was normal on echocardiogram in 4/28. In any event, he does want to focus on comfort only as of the palliative care discussion today, although if in the hospital was more comfortable on high flow he would be okay with that for a short period. He is afebrile, has resolved neutropenia, antibiotics discontinued today, as well as prophylaxis in the setting of wish for DNR only and enrolling in hospice.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">3. Ogilvie syndrome. This developed in the setting of a fentanyl infusion in the ICU. He was treated with neostigmine on 4/23 and colonoscopy for decompression on 4/24. Eric continues to have bowel movements, scheduled senna is continued.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">4. Cardiac tamponade with cardiogenic shock. About 6 and 50 cc of amber-colored fluid was removed by pericardiocentesis and ultimately he went for a pericardial window and drain placement, drain removed on 4/20, and repeat limited echo on 4/28 with resolution of effusion. He is tachycardic but needs of his overall goals of care have not repeated an echo.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">5. Troponin bump up to 2.1 to peak in setting of his critical illness, not further assessed currently. No chest pain today. He was hospitalized in March 2021 with angina symptoms and surprisingly normal coronaries on angiographic evaluation, and was subsequent to that that his AML was diagnosed.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">6. Acute kidney injury. Peak creatinine was 3.07. Nephrology followed, signed off on 4/18. Creatinine started rising again on 5/3, lisinopril was discontinued, but he is also diuresed for worsening respiratory flora at the time but creatinine is not coming down, we will not continue to monitor, continue off lisinopril.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">7. Severe protein calorie malnutrition. He has been on TPN. He is increasing oral intake of milk shakes today. TPN is discontinued following completion of today's bag as noted above.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">8. Subdural hematoma. The timing of onset this is unclear, it was an incidental finding on his CNS imaging, with no progression on follow-up CT on 4/29, Dr. Whitson consulted, no neurosurgical intervention recommended at that time.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">9. Possible nephrogenic diabetes insipidus. Fluid management has been difficult, balancing tendency toward volume overload and respiratory failure with renal function, see off service note from Chad McBride from yesterday. In transitioning care with comfort the only goal, not desiring prolongation of life, not following further labs.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">10. Melena noted earlier in his stay. Was not on PPI prior to pressure, has been on Protonix during the admission. Platelets have risen, stable H&H from yesterday to today, focusing on comfort, stop surveillance labs.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">11. Delirium with critical illness. Although is quite fatigued, appears resolved, able to coherently tell me details about his life, children, etc.</span></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: center;"><span style="font-size: medium;"><br /></span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: center;"><div class="sectionHeader" style="background-color: white; box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; margin: 0px; max-width: none; padding: 0px; position: relative; text-align: start; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;"><span style="font-size: medium;">Progress Notes by MORGANNE MCCANN, OT at 05/03/21 0857</span></h1></div><div class="pgContent" style="background-color: white; box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; margin: -1px 0px 0px; max-width: none; padding: 2px 0px 0px 16px; text-align: start; width: auto;"><table class="rz_14_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 854.688px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_14_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_14_4 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;"><div class="pgSection sectHlt12 pgNoSectHeader" data-sectdepth="2" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="pgContent" style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 0px; width: auto;"><table class="rz_14_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_14_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_14_5 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><div class="fmtConv" style="box-sizing: border-box; font-family: Arial; line-height: normal; margin: 0px; max-width: none; padding: 0px; width: auto;"><div data-copy-context="NOTE|551871905|55664|536258830|Z109408|55688.99|152285434" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Pt initially agreeable to therapy this morning, however, OT attempted to facilitate supine to sit EOB, pt states " I don't want to do this I am ready to go to heaven". OT offered to assist with feeding to increase caloric intake, but pt continued to state " I am not afraid to die" and "I just want to be in heaven". Pt refused his breakfast and politely declined therapy. Rn notified of pt's comment and behavior.</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;"><br /></span></span></div><div><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;"><br /></span></span></div></div></div></td></tr></tbody></table></div></div></td></tr></tbody></table></div></div></span></div><div style="text-align: justify;"><span style="font-size: medium;"> <span face=""Segoe UI", sans-serif" style="background-color: white; color: #0a649c; text-align: left;">Progress Notes by GENEVIEVE O'SULLIVAN, MD at 04/27/21 1314</span></span></div><div class="pgContent" style="background-color: white; box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; margin: -1px 0px 0px; max-width: none; padding: 2px 0px 0px 16px; width: auto;"><table class="rz_43_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 854.688px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_43_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_43_4 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;"><div class="pgSection sectHlt12 pgNoSectHeader" data-sectdepth="2" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="pgContent" style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 0px; width: auto;"><table class="rz_43_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_43_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_43_5 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><div class="fmtConv" style="box-sizing: border-box; font-family: Arial; line-height: normal; margin: 0px; max-width: none; padding: 0px; width: auto;"><div data-copy-context="NOTE|548959853|55670|533331116|Z109408|55688.99|152285434" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Palliative Care Progress Note</span><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><br /></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Hospital Course / Interval History: </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Nursing, hospitalist, and therapy notes reviewed.</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Transfusions today.</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Palliative Care Discussion</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">I reached out to Janis today. She feels like we should keep moving ahead with everything. She feels like we are slowly moving in the direction we should be. She doesn't feel that we need to make any other decisions right now unless his status changes, or if he is not improving (referring to his blood counts) over the next two weeks when they are suppose to. She is planning on calling Dennis later today. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">I provided her a medical update and an update about my conversation with Dennis. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">When I visited with Dennis this morning he told me several times "I am so confused." He is able to tell me that he has leukemia. When I talked about chemotherapy he told me, "I didn't even know I got any. I am so confused." He does state he wants to go home but that he wants to go because he doesn't understand why we can't do what we are doing in the hospital at home. I explained how sick he is and that if he wants further treatment for his cancer that he would need to continue to be int he hospital for now. I did offer the alternative - not having more treatment and going home, focusing on his comfort. I am not confident that he could completely grasp this as he still has acute delirium, though he did say that he is not what he meant (about going home). </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;">He has found religion a strength for him and voiced he was saved at age 9 at camp. He is not afraid to die.</span><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><br /></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><a name="LINKBEGIN|710|2|OBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span id="MR_COMSUM^``^#`BEGIN^``^#`Objective^``^#`0^``^#`1242530.502871^``^#`0^``^#`2^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Objective<span id="SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Objective^``^#`0^``^#`1242530.502871^``^#`0^``^#`2^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a name="LINKEND|710|2|OBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"></span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><br /></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Scheduled and PRN medications reviewed <br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />MAR Reviewed</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Vital signs:</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><a name="LINKBEGIN|30410007401|3|VSRANGESIPM|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Temp: [97.5 °F (36.4 °C)-98.4 °F (36.9 °C)] 98.3 °F (36.8 °C)</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Pulse: [94-138] 99</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">BP: (107-156)/(75-106) 155/92</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;">Resp: [19-50] 25</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">SpO2: [90 %-98 %] 98 %</span><a name="LINKEND|30410007401|3|VSRANGESIPM|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Physical Exam:</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Gen: Sitting up in bed, tearful. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">HEENT: NCAT, pupils are equal and anicteric. Dry lips. Poor dentition.</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Active bleeding from gums.</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">CV: RRR</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Pulm: Respirations are unlabored. Supplemental O2 via NC</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Abd: Soft. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">GU: Clear yellow urine </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />MSK/Ext: Thin </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">extremities. Sitting up in a chair.</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />Skin: Pale. Warm.</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Neuro: Alert, oriented, forgetful. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Psych</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">: poor attention, poor insight</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Last Bowel Movement:</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; font-style: italic; margin: 0px; max-width: none; padding: 0px;">4/27</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">I/Os reviewed</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Labs:</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Labs Reviewed</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;"><span style="font-size: medium;">Palliative Care Assessment and Recommendations</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">Mr. Hendricks is a 66 yo gentleman with AML, with a prolonged and complicated hospital course since admission on 4/8. He is expected to still need around 2 weeks for hematologic recovery after his induction, though he still has many hurdles to cross before he discharges from the hospital. He has acute delirium, progressively poor functional status, and has been NPO with swallow evaluation pending. He seems to be improving after complications from Ogilve's syndrome. His prognosis is very guarded. His wife Janis expressed surprise at the prognosisand needs time to process this as well as the myriad of other issues he is facing at this time. She is very supportive of him, and expressed wanting to honor his wishes, particularly hoping that he may be able to participate more in goals of care conversations in the days to come. </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Goals of Care: </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Continue current level of care. We made a plan to check in over the next several days to see how he is progressing clinically.</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Code Status: </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Changed to DNR today with wife as surrogate; This is in line with his previous expressed wishes</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">POLST: </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Will complete if/when he discharges from the hospital</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Advance Directive / DPOAHC: </span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">Wife Janis is surrogate</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><span style="font-size: medium;"> </span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">-Palliative care to continue to provide support to patient and family</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><span style="font-size: medium;">-Will continue to address goals during hospital journey</span></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="font-size: medium;"><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;">-Plan to reach out to Janis again on Friday, unless clinical status changes</span><span face="Arial, sans-serif" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></span></div></div></div></td></tr></tbody></table></div></div></td></tr></tbody></table></div><p></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-21404618630609877032021-06-08T13:50:00.024-07:002021-11-06T11:09:45.681-07:00Home<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/Mz0PwFxH5lo" width="320" youtube-src-id="Mz0PwFxH5lo"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;"><span face="Roboto, Arial, sans-serif" style="background-color: #f9f9f9; color: #030303; letter-spacing: 0.2px; text-align: start; white-space: pre-wrap;"><span>God has been so good to me. Several months ago I discovered I had </span></span><span face=""Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif" style="background-color: white; color: #050505; text-align: left; white-space: pre-wrap;"><span>Acute Myeloid Leukemia</span></span><span face=""Segoe UI Historic", "Segoe UI", Helvetica, Arial, sans-serif" style="background-color: white; color: #050505; text-align: left; white-space: pre-wrap;"> </span><span style="background-color: #f9f9f9; color: #030303; letter-spacing: 0.2px; text-align: start; white-space: pre-wrap;">cancer and after a month in the hospital- I came home. I gained strength enough to walk again this week. I was not recommended for post remission or consolidation in hospital. God has blessed me- so thankful for the prayers, cards, meals, visits and just being able to spend this time at home with Jan. My neighbors have been wonderful and I have seen what the news is truly like in those around me. It has been such a wonderful time. I made this video to share some of my blessings and remind you God hears our prayers, I have not given up- God is a good God. </span></span></div><div class="separator" style="clear: both; text-align: justify;"><span face="Roboto, Arial, sans-serif" style="text-align: start;"><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; letter-spacing: 0.2px; text-align: center; white-space: pre-wrap;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUL1Vd3DQQdzciG0Inz0YaFjd_isK-dB8vOHmQ4Ame_im21A4D9hC1BGGO5caOW-k7aaUpcYzPXfc5xhSK7XxAEefNUkuCDMpxWGqyNUb0j-Qxyhpdn40JVH-Su6wmdSNpKT5nJEtOKjn2/s727/167972395_10222606135975971_847246696487861110_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="476" data-original-width="727" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUL1Vd3DQQdzciG0Inz0YaFjd_isK-dB8vOHmQ4Ame_im21A4D9hC1BGGO5caOW-k7aaUpcYzPXfc5xhSK7XxAEefNUkuCDMpxWGqyNUb0j-Qxyhpdn40JVH-Su6wmdSNpKT5nJEtOKjn2/w612-h400/167972395_10222606135975971_847246696487861110_n.jpg" width="612" /></a></div><br /><div style="text-align: center;"><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3W0mi1dFYBHzVDCB7Sa39tim44lzEYaytPZ3IE-CNt30oSMkWipURMK10YFUURPcsmgKrRrkqgr-N03TJOYGTkxeYfW1rDSIe1Fe5GspCp4xkSGb6p-6ZNKFJ9v1H4yUC6sxadVAYTOS3/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="448" data-original-width="400" height="368" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi3W0mi1dFYBHzVDCB7Sa39tim44lzEYaytPZ3IE-CNt30oSMkWipURMK10YFUURPcsmgKrRrkqgr-N03TJOYGTkxeYfW1rDSIe1Fe5GspCp4xkSGb6p-6ZNKFJ9v1H4yUC6sxadVAYTOS3/w329-h368/image.png" width="329" /></a></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhY4lbldZTcA7gCEJ6ZgJsssj7IbgC99T6ycqWMyn87EnUami5jA1wkaN4M-DgSwKfRAELdlU-Jc40xICvdXXjhbxnuGItdtol88M_zV8YOPQSDkaNqpF7eaLeoz5s0e7tLnHIH_76g2Vfp/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="469" data-original-width="395" height="373" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhY4lbldZTcA7gCEJ6ZgJsssj7IbgC99T6ycqWMyn87EnUami5jA1wkaN4M-DgSwKfRAELdlU-Jc40xICvdXXjhbxnuGItdtol88M_zV8YOPQSDkaNqpF7eaLeoz5s0e7tLnHIH_76g2Vfp/w313-h373/image.png" width="313" /></a></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEQ58bW88OLCO91Iq7MCcTgJ5581vLdV5UDqpr4uh2HAdJSCdiW4-3_Bj5bxQWN66hpgnIPGd2I_CNWZD7f7znW_xMAECXpMZHFfTEI2-6HQQxeqijwOUH3_GW0W9nsj3_qa10tJdT8W1O/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="215" data-original-width="180" height="356" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiEQ58bW88OLCO91Iq7MCcTgJ5581vLdV5UDqpr4uh2HAdJSCdiW4-3_Bj5bxQWN66hpgnIPGd2I_CNWZD7f7znW_xMAECXpMZHFfTEI2-6HQQxeqijwOUH3_GW0W9nsj3_qa10tJdT8W1O/w298-h356/image.png" width="298" /></a></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><a href="https://www.youtube.com/watch?v=Mz0PwFxH5lo">"Home" Dennis - YouTube</a></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdB5-04dj5dRlK71Jee6m5CCMem0yfbwc83wPZObny8IbJxLO_pqJrKH5Iy9ALhnypw11xm00dkMOhVmdhFQ9e4o6jkXMzQIt8L8Hnh_lrTmNWft_szMjoMU9lvryHFznGQ6sMzhA0d9BW/s2016/250997184_435393751301653_3613372363709980658_n1.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2016" data-original-width="1512" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjdB5-04dj5dRlK71Jee6m5CCMem0yfbwc83wPZObny8IbJxLO_pqJrKH5Iy9ALhnypw11xm00dkMOhVmdhFQ9e4o6jkXMzQIt8L8Hnh_lrTmNWft_szMjoMU9lvryHFznGQ6sMzhA0d9BW/w300-h400/250997184_435393751301653_3613372363709980658_n1.jpg" width="300" /></a></div><span style="color: #030303;"><span style="background-color: #f9f9f9;">Here I am on 10-29-21</span></span><br /><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><span style="font-size: x-large;"><br /></span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: left;"><span style="font-size: x-large;">Here are some of the Dr. reports while I was in hospital;</span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: left;"><span style="font-size: x-large;"><br /></span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: left;"><span style="font-size: x-large;"><div class="title" style="box-sizing: border-box; color: #363636; font-family: "Source Sans Pro", Calibri, Arial, sans-serif; font-size: 17.3333px; height: 3.5rem; margin: 0px; max-width: 100%; padding: 0px; position: relative; vertical-align: bottom; width: 916.688px;"><h1 class="header" style="box-sizing: border-box; color: #003d77; display: inline-block; font-size: 1.5rem; font-weight: normal; line-height: 1.5rem; margin: 0px; max-width: 100%; overflow: hidden; padding: 0.7rem 0px 0.5rem; text-overflow: ellipsis; vertical-align: bottom; white-space: nowrap; width: calc(100% - 5rem);">Note From Your Admission on 04/08/21<span class="subjectIndicator" style="box-sizing: border-box; margin: 0px 0px 0px 0.5rem; max-width: 100%; padding: 0px;"></span></h1><div id="assistiveicons" style="box-sizing: border-box; display: inline-block; margin: 0px; max-width: 100%; padding: 0.7rem 0.5rem 0px; text-align: right; vertical-align: bottom; width: 5rem;"><div class="assistiveicon" style="box-sizing: border-box; display: inline-block; margin: 0px; max-width: 100%; padding: 0px; width: 2rem;"><a href="https://mychart.confluencehealth.org/MyChart/inside.asp?mode=admissions&showNote=1&lrpid=1&hnoid=7&hnodat=WP%2D24VzTvx2Rte4ZPufH0Kqjqfg%2D3D%2D3D%2D24Uww4HtT07M7QCoe%2D2BOd160gcHSlspgtxxez4FQfMbOVA%2D3D&printmode=true" id="printerfriendlylink" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: 100%; padding: 0px; text-decoration-line: none;" target="_blank"><img alt="Printer friendly page--New window will open" class="assistiveicon qnrPrintIcon" src="https://mychart.confluencehealth.org/MyChart/en-US/Images/print.png" style="border: 0px; box-sizing: border-box; display: inline-block; float: right; margin: 0px; max-width: 100%; padding: 0px 0px 0px 0.125rem; width: 2rem;" title="Printer friendly page" /></a></div></div></div><div class="section" style="box-sizing: border-box; color: #363636; font-family: "Source Sans Pro", Calibri, Arial, sans-serif; font-size: 17.3333px; margin: 0px; max-width: 100%; padding: 0px; width: 916.688px;"><div class="report" style="background-color: transparent; background-image: none; box-sizing: border-box; line-height: normal; margin: 0px; max-width: 100%; padding: 0px; width: 916.688px;"><div data-context="READONLY0PATDATPATID Z109408" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: 916.688px;"><div class="rpt StandardII" style="background-color: white; box-shadow: rgba(0, 0, 0, 0.25) 0px 1px 4px; box-sizing: border-box; font-family: "Segoe UI", sans-serif; margin: 0px; max-width: none; padding: 0px; width: 916.688px;"><div class="pgHeaderFooter" style="box-sizing: border-box; margin: 0px; max-width: none; overflow: auto; padding: 0px 23px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="LPG" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"></div></div></div><div class="bothColumns fs10 singleColumn" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="mainColumn singleColWide" style="box-shadow: none; box-sizing: border-box; height: auto; margin: 0px; max-width: none; padding: 14px 23px 16px; vertical-align: top; width: auto;"><div class="pgSection" data-sectdepth="1" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px 0px 16px; width: auto;"><div class="sectionHeaderLine" style="border-top: 1px dotted rgb(200, 200, 200); box-sizing: border-box; font-size: 1.27em; margin: 0px; max-width: none; padding: 0px; position: relative; top: 0.85em; width: auto; z-index: 0;"></div><div class="sectionHeader" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; position: relative; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; font-size: 1.27em; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;">Progress Notes by GENEVIEVE O'SULLIVAN, MD at 05/05/21 1034</h1></div><div class="pgContent" style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 2px 0px 0px 16px; width: auto;"><table class="rz_30_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 854.688px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_30_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_30_4 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;"><div class="pgSection sectHlt12 pgNoSectHeader" data-sectdepth="2" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="pgContent" style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 0px; width: auto;"><table class="rz_30_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_30_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_30_5 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><div class="fmtConv" style="box-sizing: border-box; font-family: Arial; line-height: normal; margin: 0px; max-width: none; padding: 0px; width: auto;"><div data-copy-context="NOTE|553596930|55662|537992540|Z109408|55688.99|152285434" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Palliative Care Progress Note</span><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><a name="LINKBEGIN|700|5|SUBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span id="MR_COMSUM^``^#`BEGIN^``^#`Subjective^``^#`0^``^#`1924162.91804^``^#`0^``^#`1^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Subjective<span id="SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Subjective^``^#`0^``^#`1924162.91804^``^#`0^``^#`1^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a name="LINKEND|700|5|SUBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Hospital Course / Interval History: </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Nursing, hospitalist,</span><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">notes reviewed. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Discussed with chaplain who visited yesterday. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Per nursing, taking medications with applesauce in the evening was difficult. Concern for possible aspiration. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">O2 requirement has remained stable. Afebrile. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Dennis tells me his appetite is improved. He is wanting more smoothie or juice this morning. No abdominal pain, nausea. His abdomen continues to be distended. No fevers. He feels like it's difficult to swallow, and that he is noticing a bit of a cough. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Looking forward to going home. Discussed hospice again which he voices he still would like to do. He remains hopeful that he will feel better but tells me he knows he will die. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Called Janis and updated her about possible aspiration and consideration of abx. She has questions regarding hospice. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">I called Lynn at hospice and discussed discharging tomorrow with open on Satuday</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><a name="LINKBEGIN|710|7|OBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"><span id="MR_COMSUM^``^#`BEGIN^``^#`Objective^``^#`0^``^#`1924162.923172^``^#`0^``^#`2^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Objective<span id="SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Objective^``^#`0^``^#`1924162.923172^``^#`0^``^#`2^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span face="Arial, sans-serif" style="box-sizing: border-box; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div></div></div></td></tr></tbody></table></div></div></td></tr></tbody></table></div></div></div></div></div></div></div></div></span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">IMPRESSION</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">:</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">6</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">6-year-old man with:</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">1. AML, status post induction with idarubicin and cytarabine, initial oncologist Dr. Buckley, transitioning to Dr. Smith. His neutropenia has resolved. Platelets have normalized. Hemoglobin is stable from yesterday at 8, although down from 2 days prior 10. He has had a very rough time with this 26-day hospitalization, including extensive time in ICU on the ventilator, as outlined separately, with subsequent intermittent periods of acute hypoxic respiratory failure requiring high flow oxygen. I speak with him briefly about how all this has been for him, he is quite clear that he would not want reintubation in the event of progressive respiratory failure,, but I really have not taken the discussion any further, as there is palliative care meeting with the patient is best previously scheduled for today, see above, with patient expressing wish to transition to comfort measures only after that discussion per Dr. O'Sullivan, who has written those orders for comfort measures and DNR status. Dr. Sullivan will communicate directly Dr. Smith regarding this.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">2. Acute hypoxic respiratory failure. Etiology is not entirely clear with persistent hypoxemia. I have personally reviewed his chest x-ray from yesterday, with mild pulmonary vascular congestion with stable mild basilar opacities. He did respond to a dose of furosemide at the time of his high flow requirement, now on 5 L. He had a CT angiogram which was negative for pulmonary embolism on April 10, has not had interval imaging in that regard. His renal function did worsen following that study, and currently his creatinine is 1.62. His LV systolic function was normal on echocardiogram in 4/28. In any event, he does want to focus on comfort only as of the palliative care discussion today, although if in the hospital was more comfortable on high flow he would be okay with that for a short period. He is afebrile, has resolved neutropenia, antibiotics discontinued today, as well as prophylaxis in the setting of wish for DNR only and enrolling in hospice.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">3. Ogilvie syndrome. This developed in the setting of a fentanyl infusion in the ICU. He was treated with neostigmine on 4/23 and colonoscopy for decompression on 4/24. Eric continues to have bowel movements, scheduled senna is continued.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">4. Cardiac tamponade with cardiogenic shock. About 6 and 50 cc of amber-colored fluid was removed by pericardiocentesis and ultimately he went for a pericardial window and drain placement, drain removed on 4/20, and repeat limited echo on 4/28 with resolution of effusion. He is tachycardic but needs of his overall goals of care have not repeated an echo.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">5. Troponin bump up to 2.1 to peak in setting of his critical illness, not further assessed currently. No chest pain today. He was hospitalized in March 2021 with angina symptoms and surprisingly normal coronaries on angiographic evaluation, and was subsequent to that that his AML was diagnosed.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">6. Acute kidney injury. Peak creatinine was 3.07. Nephrology followed, signed off on 4/18. Creatinine started rising again on 5/3, lisinopril was discontinued, but he is also diuresed for worsening respiratory flora at the time but creatinine is not coming down, we will not continue to monitor, continue off lisinopril.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">7. Severe protein calorie malnutrition. He has been on TPN. He is increasing oral intake of milk shakes today. TPN is discontinued following completion of today's bag as noted above.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">8. Subdural hematoma. The timing of onset this is unclear, it was an incidental finding on his CNS imaging, with no progression on follow-up CT on 4/29, Dr. Whitson consulted, no neurosurgical intervention recommended at that time.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">9. Possible nephrogenic diabetes insipidus. Fluid management has been difficult, balancing tendency toward volume overload and respiratory failure with renal function, see off service note from Chad McBride from yesterday. In transitioning care with comfort the only goal, not desiring prolongation of life, not following further labs.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">10. Melena noted earlier in his stay. Was not on PPI prior to pressure, has been on Protonix during the admission. Platelets have risen, stable H&H from yesterday to today, focusing on comfort, stop surveillance labs.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">11. Delirium with critical illness. Although is quite fatigued, appears resolved, able to coherently tell me details about his life, children, etc.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><div class="sectionHeader " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; position: relative; white-space: normal; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; font-size: 1.27em; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;"><br /></h1></div><div class="sectionHeader " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; position: relative; white-space: normal; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; font-size: 1.27em; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;"><br /></h1></div><div class="sectionHeader " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; position: relative; white-space: normal; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; font-size: 1.27em; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;"><br /></h1></div><div class="sectionHeader " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; position: relative; white-space: normal; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; font-size: 1.27em; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;"><br /></h1></div><div class="sectionHeader " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; position: relative; white-space: normal; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; font-size: 1.27em; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;">Progress Notes by GENEVIEVE O'SULLIVAN, MD at 04/28/21 0958</h1></div><div class="pgContent " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: -1px 0px 0px; max-width: none; padding: 2px 0px 0px 16px; white-space: normal; width: auto;"><table class="rz_2_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 854.688px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_2_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_2_4 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;"><div class="pgSection sectHlt12 pgNoSectHeader " data-sectdepth="2" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="pgContent " style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 0px; width: auto;"><table class="rz_2_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_2_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_2_5 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><div class="fmtConv" style="box-sizing: border-box; font-family: Arial; line-height: normal; margin: 0px; max-width: none; padding: 0px; width: auto;"><div data-copy-context="NOTE|549515045|55669|533889114|Z109408|55688.99|152285434" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Palliative Care Progress Note</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><a name="LINKBEGIN|700|14|SUBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"><span id="MR_COMSUM^``^#`BEGIN^``^#`Subjective^``^#`0^``^#`1317170.978515^``^#`0^``^#`1^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span>Subjective<span id="SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Subjective^``^#`0^``^#`1317170.978515^``^#`0^``^#`1^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a name="LINKEND|700|14|SUBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Hospital Course / Interval History: </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Nursing, hospitalist, and therapy notes reviewed.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">He was able to work with PT today and is currently sitting up in a chair. Swallow reassessed yesterday and was he demonstrated improved oropharyngeal swallow function and his diet was advanced to nectar thick liquids and dysphagia puree. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Palliative Care Discussion</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Dennis voices he feels much better today. He was very happy to have been able to work with PT, to get up to a chair. He feels like he has more energy. He has some yogurt in front of him as well as a juice, and he feels better now that he can eat and drink. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">He tells me he still feels a bit confused. He was talking about radiology calling him, and he doesn't understand why he can't get a call back from them. He is also wondering why Janis hasn't visited. I reviewed the visitor policy with him. He declined my offer to help him call this morning.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><a name="LINKBEGIN|710|12|OBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"><span id="MR_COMSUM^``^#`BEGIN^``^#`Objective^``^#`0^``^#`1317170.977099^``^#`0^``^#`2^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span>Objective<span id="SECTION_BOOKMARK_END^``^#`MR_COMSUM^``^#`BEGIN^``^#`Objective^``^#`0^``^#`1317170.977099^``^#`0^``^#`2^``^#`" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"></span></span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a name="LINKEND|710|12|OBJECTIVEBEGIN|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Scheduled and PRN medications reviewed <br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />MAR Reviewed</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Vital signs:</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><a name="LINKBEGIN|30410007401|11|VSRANGESIPM|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"></span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Temp: [97.5 °F (36.4 °C)-99.2 °F (37.3 °C)] 98.3 °F (36.8 °C)</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Pulse: [89-138] 126</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">BP: (107-169)/(65-109) 137/102</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Resp: [21-50] 30</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">SpO2: [92 %-98 %] 96 %</span><a name="LINKEND|30410007401|11|VSRANGESIPM|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Physical Exam:</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Gen: Sitting u</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">p in a chair, appears to be more awake and have more energy than yesterday.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">HEENT: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">NCAT, pupils are equal and anicteric. Dry lips. Poor dentition. Active bleeding from gums. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">CV: RRR</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Pulm: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Respirations are unlabored. Supplemental O2 via NC<br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />MSK/Ext: Thin extremities. Sitting up in a chair. <br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />Skin: Pale. Warm.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Neuro: Alert, oriented,</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">clear speech.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Psych:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">attention is improved.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Last Bowel Movement: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">4/2</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">8</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">I/Os reviewed</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Labs:</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Labs Reviewed</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">Palliative Care Assessment and Recommendations</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Mr. Hendricks is a 66 yo gentleman with AML, with a prolonged and complicated hospital course since admission on 4/8. He is expected to still need around 2 weeks for hematologic recovery after his induction, though he still has many hurdles to cross before he discharges from the hospital. He has acute delirium</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">which is improving. He also now able to eat and drink, and is staring to have some slight improvements in his functional status.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> He seems to be improving after complications from Ogilve's syndrome. His prognosis is very guarded. His wife Janis expressed surprise at the prognosis and needs time to process this as well as the myriad of other issues he is facing at this time. She is very supportive of him, and expressed wanting to honor his wishes, particularly hoping that he may be able to participate more in goals of care conversations in the days to come. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Goals of Care: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Continue current level of care. We made a plan to check in over the next several days to see how he is progressing clinically.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Code Status: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Changed to DNR</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">at initial consult</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> with wife as surrogate; This is in line with his previous expressed wishes</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">POLST: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Will complete if/when he discharges from the hospital</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Advance Directive / DPOAHC: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Wife Janis is surrogate</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Palliative care to continue to provide support to patient and family</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Will continue to address goals during hospital journey</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">-Plan to reach out to Janis again on Friday, unless clinical status changes </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: inherit; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div></div></div></td></tr></tbody></table></div></div></td></tr></tbody></table></div></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><div class="sectionHeader " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; position: relative; white-space: normal; width: auto;"><h1 class="title sectionTitle" style="box-sizing: border-box; color: #0a649c; display: inline; font-size: 1.27em; height: auto; margin: 0px 0px 0px -4px; max-width: none; padding: 0px 6px 0px 4px; position: relative; vertical-align: inherit; width: auto; z-index: 1;">Consults by GENEVIEVE O'SULLIVAN, MD at 04/26/21 1012</h1></div><div class="pgContent " style="box-sizing: border-box; color: #363636; font-family: "Segoe UI", sans-serif; font-size: 13.3333px; margin: -1px 0px 0px; max-width: none; padding: 2px 0px 0px 16px; white-space: normal; width: auto;"><div class="pgSection pgNoSectHeader " data-sectdepth="2" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="pgContent " style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 0px; width: auto;"><table class="rz_22_2 smartParaTable" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 854.688px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_22_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_22_4 hlt-1" colspan="12" style="box-sizing: border-box; color: #5e717a; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;">Consult Orders</td></tr><tr class="rz_22_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_22_4 hlt0" colspan="12" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;">1. Inpatient consult to Palliative Care [65148291] ordered by Simita Singh, MD at 04/25/21 0917</td></tr></tbody></table></div></div><table class="rz_22_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 854.688px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_22_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_22_4 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt 1pt; width: 854.688px;"><div class="pgSection sectHlt12 pgNoSectHeader " data-sectdepth="2" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div class="pgContent " style="box-sizing: border-box; margin: -1px 0px 0px; max-width: none; padding: 0px; width: auto;"><table class="rz_22_2" style="border-collapse: collapse; border-spacing: 0px; border: none; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><tbody style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;"><tr class="rz_22_3" style="background-color: inherit; box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; vertical-align: top;"><td class="rz_22_5 hlt0" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0pt; width: 852.031px;"><div class="fmtConv" style="box-sizing: border-box; font-family: Arial; line-height: normal; margin: 0px; max-width: none; padding: 0px; width: auto;"><div data-copy-context="NOTE|548031718|55671|532397233|Z109408|55688.99|152285434" style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px; width: auto;"><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; text-align: center; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">Palliative Care Consult</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">Reason for Consult</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">The Palliative Care service is consulted by</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Dr. Singh for goals of care.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">Outpatient Medical Team</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">:</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><a name="LINKBEGIN|84|0|PCP|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">CHRISTOPHER CAMPBELL, PA-C</span><a name="LINKEND|84|0|PCP|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">ID/CC/HPI:</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Mr. Hendricks is a 66 yo gentleman with AML. He has had a prolonged hospital course since admission on 4/8/21. He was admitted for management of presumed AML, with BM biopsy confirming it on 4/9. He started induction that was completed on 4/19. He had progressive respiratory decline between 4/10 - 4/12 and was intubated from 4/12 - 4/16. On 4/13 he was found to have cardiac tamponade he and he underwent a pericardiocentesis with drain placement. He required pressor support until 4/16, and then was transferred out of the ICU, only to return the next day for recurrence of severe colonic dilation due to Ogilvie syndrome. He had had issue with aspiration and ability to maintain nutrition and has been receiving TPN. He is pending reassessment of swallowing today, though assessment had previously been postponed due to his respiratory rate. On 4/19 he underwent a decompressive colonoscopy and and has required subsequent neostigmine which was successful.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">On 4/25 he expressed to the ICU physician that he wants to be made comfortable and a meeting with palliative care was discussed.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">I spoke with Dr. Smith today. She is taking over his oncologic care from Dr. Buckley and has reviewed his case and</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">she had</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> previously talked to his wife, Janis</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Palliative Care Discussion: </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Participants:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Mr. Hendricks, Mrs. Janis Hendricks</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">We met all together in Mr. Hendrick's room and it quickly became apparently that he was delirious and becoming distraught and paranoid while we were in the room. Janis and I made the decision to have the conversation out of his room. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">When I had initially seen him in the morning, he was less delirius. He told me, "If I'm going to die, I want to go home and be with family." This was an unprompted comment. He was tearful. I had asked him if I could invite Janis in so we could all meet together and he agreed. When we met with Janis he was much more confused, saying several times, "They are all lying to you." He warned me not to listen to "them" and that they are lying to me and to him. He voiced he was very confused and didn't know what was happening.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Background/social history</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Retired right before COVID. They had been planning a cruise that was cancelled</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Janis describes that Dennis was starting to become paranoid, though COVID was a conspiracy, and was having memory issues</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Understanding/perspective of illness</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Her understanding was that he had a very good chance at surviving and recovery / remission. She voiced that the prognosis is "good"</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-She allowed me to voice my understanding of his prognosis from Dr. Smith - 20-30% do not survive hospitalization, that if he survives and is discharged will need three more cycles of chemotherapy for a chance at remission; 30% obtain remission. This is all barring making it out of the hospital, maintains a functional status that allows for chemotherapy</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-We discussed how there are a lot of hurdles right now - currently NPO with swallow eval pending, delirium, neutropenia, etc and that he will be in the hospital at least about 2 more weeks as we are awaiting hematologic recovery</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Hopes</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Janis wants Dennis to be able to participate in these conversations</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-We discussed delirium, that he may take days to weeks to recover and that his mental status may wax and wane and that based on how he is today, he cannot make decisions for himself</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Acceptable quality of life</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">: </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Fears/concerns/worries</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-She has been concerned about communication, not being able to visit Dennis, and not knowing everyone involved in his care</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-I provided a list of consultants and recent physicians participating in his care</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Worried that he is not going to recover</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Communication preferences</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">-Directly with her and Dennis, and to include Dennis as we can in conversations </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-She has zoomed with him several times</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Past experience with serious illness/hospice</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-She was her mother's DPOAH and had to make decisions regarding EOL care for her</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; margin: 0px; max-width: none; padding: 0px;">Code Status</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">-She was not with Dennis when he changed his code status to DNR. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-She reversed this when he was in respiratory distress</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">-She believes he would want to be DNR/DNI if he had little to no chance of survival. </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-We discussed how CPR (chest compressions) is used when you heart stops, and this means you have died. If this were to be the case she believes he would not want resuscitation.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">Review of Systems</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">A 12 point review systems was performed and negative except per HPI and Symptom above </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">History</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Medical/Surgical History: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Reviewed in Epic Chart</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Social History: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Reviewed in Epic Chart, for additional details see background / social history above in HPI</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" /></span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Family History:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> Reviewed in Epic Chart</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Home Medications and MAR reviewed</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Allergies reviewed</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-style: italic; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">Physical Exam</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><a name="LINKBEGIN|114|1|VS|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;"></span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline; white-space: pre-wrap;">BP 112/75 | Pulse 103 | Temp 98.1 °F (36.7 °C) | Resp 24 | Ht 1.829 m (6' 0.01") | Wt 81.5 kg | SpO2 95% | BMI 24.36 kg/m² </span><a name="LINKEND|114|1|VS|800|||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;"></span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Gen:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Sitting up in bed, tearful.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">HEENT:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">NCAT, pupils are equal and anicteric. Dry lips. Poor dentition.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">CV:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">RRR</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Pulm:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Respirations are unlabored. Supplemental O2 via NC</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Abd:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Soft.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">GU:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Clear yellow urine</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />MSK/Ext: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Thin extremeties</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br style="box-sizing: border-box; margin: 0px; max-width: none; padding: 0px;" />Skin: </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Pale. Warm.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Neuro:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Alert, oriented, forgetful.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Psych:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Attentive to conversation. Good insight.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Labs -</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> Reviewed in Epic chart </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">WBC < 0.1, ANC 0. CMP from yesterday reviewed. Cr 1.23, Sodium 153 , Albumin 2</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Imaging -</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> I have reviewed the following imaging reports and the images when pertinent:</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Xray Abdomen from yesterday reviewed.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-decoration-line: underline;">Palliative Care Assessment and Recommendations</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Mr. Hendricks is a 66 yo gentleman with AML</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">, with a prolonged and complicated hospital course since admission on 4/8</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">He is expected to still need around 2 weeks for hematologic recovery after his induction, though he still has many hurdles to cross before he discharges from the hospital. He has acute delirium, progressively poor functional status, and has been NPO with swallow evaluation pending. He seems to be improving after complications from Ogilve's syndrome. His prognosis is very guarded. His wife Janis expressed surprise at the prognosis I expressed today and needs time to process this as well as the myriad of other issues he is facing at this time. She is very supportive of him, and expressed wanting to honor his wishes, particularly hoping that he may be able to participate more in goals of care conversations in the days to come.</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Goals of Care:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Continue current level of care. We made a plan to check in over the next several days to see how he is progressing clinically.</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Code Status:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Changed to DNR today with wife as surrogate; This is in line with his previous expressed wishes</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">POLST:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Will complete if/when he discharges from the hospital</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Advance Directive / DPOAHC:</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Wife Janis is surrogate</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Palliative care to continue to provide support to patient and family</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Will continue to address goals during hospital journey</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">-Changed code status today</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Discussed with</span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;">Dr. Singh and Dr. Smith today</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Thank you for this consult. Palliative Care Team will continue to follow the patient and provide support during this hospitalization</span></div><div style="box-sizing: border-box; margin: 0px; max-width: 100%; padding: 0px; width: auto;"><span style="box-sizing: border-box; font-family: Arial, sans-serif; font-size: 10pt; margin: 0px; max-width: none; padding: 0px;"> </span></div></div></div></td></tr></tbody></table></div></div></td></tr></tbody></table></div></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">4-18-21- Dr. Buckley;</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><div style="box-sizing: border-box; color: #363636; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; white-space: normal; width: auto;"><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Assessment/Recommendations:</span><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a name="LINKBEGIN|4|12|AGE||||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">66 y.o.</span><a name="LINKEND|4|12|AGE||||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"></span><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> male with AML Monoblastic subtype, with critically illness at presentation and initiation of induction chemotherapy. He will complete his civi ARA-C in </span><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">approximately 24 hours</span><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">. This will complete his induction chemotherapy, and treatment recommendations are to continue aggressive care, treat and prevent infections, transfuse prn. He will remain pancytopenic for 2-3 additional weeks, and is at risk of bleeding, and infection during that time.</span></div><div style="box-sizing: border-box; color: #363636; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; white-space: normal; width: auto;"><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; color: #363636; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; white-space: normal; width: auto;"><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">Tumor lysis labs are stable to improved.</span></div><div style="box-sizing: border-box; color: #363636; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; white-space: normal; width: auto;"><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; color: #363636; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; white-space: normal; width: auto;"><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Transfusion guidelines hgb 7.5 or less, platelets 10 or less. Irradiated, leukoreduced, pathogen free products.</span><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> Today he will receive platelets in addition to 2 units red blood cells.</span></div><div style="box-sizing: border-box; color: #363636; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; white-space: normal; width: auto;"><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="box-sizing: border-box; color: #363636; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; white-space: normal; width: auto;"><span style="box-sizing: border-box; color: black; font-family: Arial, sans-serif; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">I would continue aggressive transfusion support, IV antibiotics, avoid suppositories if possible, try to get bowel moving from above.</span></div></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"><br /></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;">4-15-21- Dr. Buckley;</div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px; text-align: left;">Assessment/Recommendations:</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; text-align: left; white-space: pre-wrap;"> </span><a name="LINKBEGIN|4|11|AGE||||1|" style="box-sizing: border-box; color: #0044ff; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; text-align: left;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; text-align: left;">66 y.o.</span><a name="LINKEND|4|11|AGE||||1|" style="box-sizing: border-box; color: #0044ff; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: none; padding: 0px; text-align: left;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; text-align: left;"></span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; text-align: left; white-space: pre-wrap;"> male with a recent history of a type II NSTEMI who had what appeared to be a transient bicytopenia with self resolving neutropenia and very mild thrombocytopenia that was followed by 2 to 3 weeks of progressive constitutional symptoms and an elevated white count above 30,000 blasts on the peripheral smear review concerning for AML. Bone marrow biopsy and flow cytometric analysis of peripheral blood returned positive for AML with </span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; text-align: left; white-space: pre-wrap;">monotypic differentiation. FISH for PML/RARA was negative.</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px; text-align: left; white-space: pre-wrap;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">Cytogenetics normal.</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">FLT3-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">. Genomics pending currently appears to be standard risk</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">#AML</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-Today is day</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">6</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> of 7+3</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">, day 3 of idarubicin held due to hemodynamic instability</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">,</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> cytarabine</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> held for 2 days during severe hemodynamic instability and need for pericardiocentesis now restarted and on fourth day of administration</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">.</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px;">He is still on 2 pressors he was able to come off of Levophed at some point today but after diuresis for volume management which he responded well to in regards to urine output he had worsening hypotension and is now back on both pressors with Levophed and vasopressin.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-Access is by PICC line</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-TTE showed a normal EF</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-His LDH is downtrending, his phosphorus is up trending secondary to lysis and acute renal failure</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">His renal failure secondary to leukemia and ATN, responded well to a diuretic challenge today. Currently not needing dialysis.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">-Plan to continue broad-spectrum antimicrobial coverage until he is no longer neutropenic. Currently on acyclovir, meropenem, and </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">posaconazole</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">His lack of improvement in mental status during sedation vacation today is somewhat concerning, does withdraw to noxious stimuli</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">Continue standard transfusion threshold with hemoglobin of 7.5 or less, platelets 10 or less spontaneously, 20 unless febrile, as needed if bleeding</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">He will need irradiated packed red blood cells due to his neutropenia</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">Prognosis continues to be guarded but his intent of treatment is definitive in nature with a prognosis measured in years if he is able to recover from acute events.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;"> </span></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="background-color: #f9f9f9; clear: both; color: #030303; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: start;"><span face="Segoe UI, sans-serif" style="background-color: white; color: #0a649c; font-size: 16.9333px;"><b>4-13-21- Dr. Buckley;</b></span></div><div class="separator" style="clear: both; text-align: start;"><span face="Segoe UI, sans-serif" style="background-color: white; color: #0a649c; font-size: 16.9333px;"><b><br /></b></span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; font-weight: bold; margin: 0px; max-width: none; padding: 0px;">Assessment/Recommendations:</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><a name="LINKBEGIN|4|11|AGE||||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">66 y.o.</span><a name="LINKEND|4|11|AGE||||1|" style="box-sizing: border-box; color: #0044ff; margin: 0px; max-width: none; padding: 0px;"></a><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"></span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> male with a recent history of a type II NSTEMI who had what appeared to be a transient bicytopenia with self resolving neutropenia and very mild thrombocytopenia that was followed by 2 to 3 weeks of progressive constitutional symptoms and an elevated white count above 30,000 blasts on the peripheral smear review concerning for AML. Bone marrow biopsy and flow cytometric analysis of peripheral blood returned positive for AML with monotypic differentiation. FISH for PML/RARA was negative.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">#AML</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-Today is day</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">4</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> of 7+3</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 12pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">, day 3 of idarubicin held due to hemodynamic instability cytarabine also held initially. His hemodynamics have improved with the interventions today including pressor support, intubation, pericardiocentesis. We will plan to continue continuous infusion cytarabine. If he is able to improve and come off of pressors we can consider adding in his last day of idarubicin.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">White blood cell count 4.5 he is now neutropenic with an ANC of 0.9 hemoglobin stable at 8.6 platelets low at 20</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-Access is by PICC line</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-TTE showed a normal EF</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-His LDH is downtrending, his phosphorus is up trending</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;"> </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">secondary to lysis and acute renal failure</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Urine output continues to worsen. Think there are certainly some contribution from infiltration from AML potentially also some ATN from his hemodynamic instability.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">-</span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Plan to continue broad-spectrum antimicrobial coverage until he is no longer neutropenic. Currently on acyclovir, meropenem, and planning to add posaconazole for prophylaxis due to his anticipated long-term neutropenia.</span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;"> </span></div><div style="background-color: white; box-sizing: border-box; color: #363636; font-family: Arial; font-size: 13.3333px; margin: 0px; max-width: 100%; padding: 0px; text-align: left; width: auto;"><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px; white-space: pre-wrap;">Prognosis continues to be guarded. His hemodynamics have improved throughout the day after his pericardiocentesis. His LDH continues to downtrend his overall burden of AML should be improving. Hopefully he is passed the initial severe inflammatory response from the degranulation process secondary to his aggressive leukemia and also the cytotoxic effects from his chemotherapy on his leukemia. Updated his wife today </span><span face="Arial, sans-serif" style="box-sizing: border-box; color: black; font-size: 11pt; margin: 0px; max-width: none; padding: 0px;">regarding the details and an additional 30-minute advanced care planning conversation.</span></div></div></div></div></span></div><p></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com1tag:blogger.com,1999:blog-8033048668537077428.post-66538242127049526902021-04-11T03:03:00.003-07:002021-10-27T17:32:44.982-07:00You Are So Beautiful<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/BYIofLMmkrQ" width="320" youtube-src-id="BYIofLMmkrQ"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333; font-size: xx-large; text-align: justify;">It seems only yesterday, Janice and I were married in Coulee Dam. We have so many good memories that are turning to Gold. I am so thankful for Janice putting up with me. I am so blessed having Janice as my best friend and helpmate. I am thankful for the many examples we had to follow, and the support, prayers and teaching we have had along the way. I am thankful that God ordained and created marriage between one man and one woman. This video was made a few years ago. No two people are truly compatible- It also takes committment. It takes work and I owe so much to Jan for this Day of Celebration. You Are So Beautiful and I Love You so Much. Happy Anniversary Janice.</span></div><p></p><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"><div class="separator" style="clear: both; text-align: center;"><span style="color: #336699; font-size: x-large; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfY9qIfc_gF0rn0GaLTXtBVRRzWPw6cOXC0cfH5QDBNDzKrw1xlbAf1gx4Ix_r-QXPRzbW-FQufPCekj1o46UfXh8r04HuJwg9mrrr_uiBEv9eFuFwbQXaoYezVaX4ScxoCnTl4QyES5oy/s1600/10322820_10152578566561735_6849487040235449310_n.png" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhfY9qIfc_gF0rn0GaLTXtBVRRzWPw6cOXC0cfH5QDBNDzKrw1xlbAf1gx4Ix_r-QXPRzbW-FQufPCekj1o46UfXh8r04HuJwg9mrrr_uiBEv9eFuFwbQXaoYezVaX4ScxoCnTl4QyES5oy/s1600/10322820_10152578566561735_6849487040235449310_n.png" style="border: none; position: relative;" width="320" /></a></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8Doc3ysZ5g4BOT5OLXmOYuskO3b9S4UDCDW31CUz7e4doDy3EDOIMGuFDW3ngZ4cHqNQEkkBQWcFNf0AouYBMU3rm0PfjBj_bWgFiqrbNsFrA4PHU5i0F4tE0_dePdmLAhChpAmuVqeP0/s2048/SCAN0222.png" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="2048" data-original-width="1256" height="859" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8Doc3ysZ5g4BOT5OLXmOYuskO3b9S4UDCDW31CUz7e4doDy3EDOIMGuFDW3ngZ4cHqNQEkkBQWcFNf0AouYBMU3rm0PfjBj_bWgFiqrbNsFrA4PHU5i0F4tE0_dePdmLAhChpAmuVqeP0/w526-h859/SCAN0222.png" width="526" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhS8q9biYhTAoZjXFB3Z6ijxi2if1DGfUwHYRqAvYdbgm6VlCV7cr1rO_cFg5tp4QYxAiQ8Pt6uh7Nr6AOppXbof9vTXoXDxlzxpRurx7_008walwqrVp-3Cr86OXPXILBL6s6loNI5F8AP/s2048/SCAN0227.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2048" data-original-width="1601" height="582" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhS8q9biYhTAoZjXFB3Z6ijxi2if1DGfUwHYRqAvYdbgm6VlCV7cr1rO_cFg5tp4QYxAiQ8Pt6uh7Nr6AOppXbof9vTXoXDxlzxpRurx7_008walwqrVp-3Cr86OXPXILBL6s6loNI5F8AP/w454-h582/SCAN0227.png" width="454" /></a></div><br /><br /><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjx06KTGU9s-EI8INO2Z5YLedlCYgTlglOBE2dsuI6rA2KDHim3eYMFpqNAb2n8e44sspruAQa2A2IS12wPwd4gfESX-K7NFkUxafweBdsTSZKpSUMiz8QCocJ6rzz4PBzjOiPzUE_budYE/s2048/SCAN0223.png" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2048" data-original-width="1533" height="569" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjx06KTGU9s-EI8INO2Z5YLedlCYgTlglOBE2dsuI6rA2KDHim3eYMFpqNAb2n8e44sspruAQa2A2IS12wPwd4gfESX-K7NFkUxafweBdsTSZKpSUMiz8QCocJ6rzz4PBzjOiPzUE_budYE/w427-h569/SCAN0223.png" width="427" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJHT1WD6kA5SvdKX4SepNYrRo1ZIvTIyI5ywb_wHJcp-SlIK6tpm8xmrgJ6DesgTVs2xY4fWRwArwsuzu3jxs-rCS3esTMi0nJlY53GAV9vtPruZSyKiNhx8pKdpGflg05Bn3tyrt8jCjK/s2048/SCAN0226.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2048" data-original-width="1521" height="600" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiJHT1WD6kA5SvdKX4SepNYrRo1ZIvTIyI5ywb_wHJcp-SlIK6tpm8xmrgJ6DesgTVs2xY4fWRwArwsuzu3jxs-rCS3esTMi0nJlY53GAV9vtPruZSyKiNhx8pKdpGflg05Bn3tyrt8jCjK/w446-h600/SCAN0226.JPG" width="446" /></a></div><br /><div class="separator" style="clear: both; text-align: center;"><br /></div><a href="https://www.youtube.com/watch?v=BYIofLMmkrQ">You Are So Beautiful (Jan) by Joe Cocker - YouTube</a><br /><div class="separator" style="clear: both; text-align: center;"><br /></div></div><div class="separator" style="clear: both; text-align: center;"><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"><br /></div></div>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-4058100629393026282021-03-06T06:34:00.001-08:002021-10-27T17:34:06.988-07:00God In This City<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/_cNbqxD6HGo" width="320" youtube-src-id="_cNbqxD6HGo"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-size: x-large;">32 years ago I heard on radio they had an opening on East Wenatchee City council- and I was one of two, to put in for it, and on todays date, March 6th, 1989, I was sworn in as councilmember. It has been 9 years since I served, but it was<span style="background-color: white; text-align: justify;"><span face="arial, helvetica, sans-serif" style="color: #333333;"> a fun 22.5 years. I did not know I would be paid for it, I just thought it could help on my job resume. Think my first controversial decision was to replace the finance directors elected position with a mayors appointee. Second decision was probably to build a new city hall- the converted gas station where Cedars now sits- had a dangerous entrance and was very crowded. I remember a split vote when some wanted to spend our funds on buying a modular for police dept. instead of waiting to push for new city hall. I won that vote and the city hall is one of the most proud items I was involved in. (and it is paid for) It was a controversial decision was who to take over as police chief. I lost in decision of tearing the Franklin House down to build the link transfer center. I consistently voted no on the sprint boat races and wish I would have voted no on allowing city to join PFD to build Wenatchee's arena- we were promised they would not come back to us asking for any funds if we simply joined so a portion of sales tax would come back to them. I was successful to repeal the utility tax- only to have it reinstalled. Most of the time I was successful in voting down the 1% property tax yearly increases- our city paid less in property taxes than county residents based on equal comparisons and greatly helped us annex years ago.</span></span></span></div><p></p><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"><div><br /></div><div><span style="font-size: x-large;"><span face="arial, helvetica, sans-serif" style="text-align: left;">We lost 4 to death while serving- I greatly miss Jan Nash and Ralph Aiken who were excellent council members that I leaned on greatly.</span><span face="arial, helvetica, sans-serif" style="text-align: left;"> </span><span face="arial, helvetica, sans-serif" style="text-align: left;"> </span><span face="arial, helvetica, sans-serif" style="text-align: left;">We also lost Randy Webly, a police officer, who I graduated with in Coulee Dam in 73 with my wife and I. And Peggy McArthur passed away, she served on city council with me, and also was elected as finance director before I came on. In the past 8 years, we also lost Mayor McGraw, Sandra McCourt, George Buckner, Virginia Oestreich, and Larry Frack, while Dawn Collings and Chuck Johnson have moved out of the area to be near family. </span></span></div><div><span style="font-size: x-large;"><br /></span></div><div><span face="arial, helvetica, sans-serif"><span style="font-size: x-large;">Some may ask why 22.5 years and an odd number of years? That is due to I changed my council seat in 90’s, and ran for a 2 year position instead of my 4 year position- and of coarse I had to run the following November that I was appointed. I regret running against a fellow council member, but wanted to know what people felt, as well as if you run un-opposed, no one will bring out the issues.</span></span></div></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"><div><span style="font-size: x-large;"><br /><span face="arial, helvetica, sans-serif">I served under 3 mayors- Mayor Lacy was patient with me and we knew where each of us stood, but I also remind you of his giving heart- when we had a fire in our house, he offered me use of one of his houses to stay in! We had a great council- Harry Raab is only council member still serving when I was there. There are only several employees still there that I worked with and the new mayor is doing a good job. I thank the citizens who attended city council meetings- that is so important and helpful. I need to thank my family and employer for allowing me the time to devote to city council. I had several good friends who I could bounce things off and I trusted. </span></span></div><div><span style="font-size: x-large;"><span style="font-family: arial;"></span><br /><span face="arial, helvetica, sans-serif">The city had less than 1,000 population when I took office, it now has over 15,000 I think. We had no unions, and think the police had 7 in police dept. and only five council members then instead of our seven we now have. I used to have minutes from 1989- but they were destroyed in our house fire several years ago. It would be interesting to compare wages and the number of employees comparing between 1989 and now.</span></span></div></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"><span style="font-size: x-large;"><br /></span><div><span style="font-size: x-large;"><span face="arial, helvetica, sans-serif">I am amazed how few people contact elected officials but will instead complain to paper or friends. City council is like raising </span><span face="arial, helvetica, sans-serif">teenagers- you need to look at all sides of the story,- and sometimes, the story you are given can be slanted to benefit the teenager. And you are a councilmember and not the friend who you wish you could be at times as well. </span></span></div></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"><span style="font-size: x-large;"><br /></span><div><span style="font-size: x-large;"><span style="font-family: arial;">I thank God- for his help and allowing me that opportunity to serve. I would pray silently before most meetings and never understood why I was placed in that position when there are so many more qualified people out there who he could have used and would have done a much better job. Remember, God used a mule in the Bible to get his message out.</span><br /><span style="font-family: arial;"><br /></span></span></div></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: justify;"><span style="font-size: x-large;"><span style="font-family: arial;"><span face="arial, helvetica, sans-serif">I thank the public for putting up with me- never sure if they voted for me, no one else wanted it, or voted against my challengers? It was a great time- thank you. And I have no plans to return nor do I really miss the stress. Many decisions were already made for you per federal laws and the title of politician keeps going down sadly- it got so I would seldom tell anyone what I did. </span></span></span><br /><div style="font-size: 14.85px; text-align: center;"><span style="font-family: arial;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF9TivoD8eiID3PP3-IeX9Ks3Mdja0E2WDEvHlFvHBQiQ_oiQElyhxHnTUGBIjPiL2jFLW5rrXbo1GUo4PFs6v9sB5m5zRjaklnRfbw40DJ-W6XUwNPcriCxwvFKNf6-Wpe_BGRPGrs_8K/s1600/301328_523054677732773_197610636_n.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjF9TivoD8eiID3PP3-IeX9Ks3Mdja0E2WDEvHlFvHBQiQ_oiQElyhxHnTUGBIjPiL2jFLW5rrXbo1GUo4PFs6v9sB5m5zRjaklnRfbw40DJ-W6XUwNPcriCxwvFKNf6-Wpe_BGRPGrs_8K/s400/301328_523054677732773_197610636_n.jpg" style="border: none; position: relative;" width="400" /></a></span></div><div style="font-size: 14.85px; text-align: center;"><br /></div><div class="separator" style="clear: both; font-size: 14.85px; text-align: center;"><span style="font-family: arial;"><span face="arial, helvetica, sans-serif"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGldhSXJI06J_nQ0V4ncx9WJp65T6AFhEsh7UOhl6qXjd7AkOT6Aho8wIUV1SlxGRyQXriFP4TdQzHqr5VeqYz0E4UuWmDcJyX-i-UPvIEzcki0aMvNFif5F5eG7eWPI3CYz9dmiJH0A2g/s1600/IMG_2625.JPG" style="color: #33aaff; margin-left: 1em; margin-right: 1em;"><img border="0" height="547" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgGldhSXJI06J_nQ0V4ncx9WJp65T6AFhEsh7UOhl6qXjd7AkOT6Aho8wIUV1SlxGRyQXriFP4TdQzHqr5VeqYz0E4UuWmDcJyX-i-UPvIEzcki0aMvNFif5F5eG7eWPI3CYz9dmiJH0A2g/w411-h547/IMG_2625.JPG" style="border: none; position: relative;" width="411" /></a></span></span></div></div><p> <a href="https://www.youtube.com/watch?v=_cNbqxD6HGo">God In This City by Chris Tomlin - YouTube</a></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-33414945127711891942021-02-21T09:28:00.005-08:002021-10-27T17:34:52.141-07:00I'm A Nut<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dwur2tkcxHSkKBH3jysfSREv7IsY_S787qLKEPzCJrcqEw_pJQ04_2P55oC9m48JK09sN_oXoqBs56AUNpCXw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span style="font-size: x-large;"><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333; text-align: justify;"><span>I am so blessed because of the lives of so many others. This past year as been so different than imagined- but again- God has been so good to me. I know you think I would place a favorite southern gospel song here today and perhaps this will be one of the songs played at my funeral?- This was a Leroy Mullins song from 1966- his only hit and a song often misattributed to Roger Miller (including me when I made it 10 years ago)- who never recorded this song. Leroy Mullins</span></span><span face="sans-serif" style="background-color: white; color: #202122; text-align: left;"> died of a </span><span style="color: black; text-align: left;">heart attack<span face="sans-serif" style="background-color: white;"> </span></span><span face="sans-serif" style="background-color: white; color: #202122; text-align: left;">at age 44 in May 1984</span></span></div><div class="separator" style="clear: both; text-align: left;"><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333; text-align: justify;"><span style="font-size: large;"><br /></span></span></div><p></p><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8Zb7oztJ8AXSUFaVTj6Wb1QiZGEyrtQ7gCrPoCA2MuaqMppDjAnr6Xhjp28w0lqTeDo7B80keslsiGlW9PcOmpi4aC_XEOjfDxOIyZiVBL8SpH4noLWIYm8oiTLeYDXyjUON_17wxYirj/s1600/1546300_763323693694935_771072878_n.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" closure_lm_375770="null" height="268" hta="true" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj8Zb7oztJ8AXSUFaVTj6Wb1QiZGEyrtQ7gCrPoCA2MuaqMppDjAnr6Xhjp28w0lqTeDo7B80keslsiGlW9PcOmpi4aC_XEOjfDxOIyZiVBL8SpH4noLWIYm8oiTLeYDXyjUON_17wxYirj/s1600/1546300_763323693694935_771072878_n.jpg" style="border: none; position: relative;" width="320" /></a></div><div style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; text-align: center;"><span style="font-size: large;">Today's mighty oak is just yesterday's nut, that held its ground.</span></div><div class="separator" style="background-color: white; clear: both; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif; font-size: 14.85px; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgO7liDpuidhPQhgccaAy-1vO-1ZtBsX-VjRQl_CYI08neUFhx9jJ-tNuSvhno-cFsj7LfqOzNaHr9hbrrSpHTnRXqc6nN4WcDbTUXx-gDNn5GcYvctOSsUWGYQWIu-JSzhcsVznU3TbkfL/s1600/1911955_599005713511125_1107687970_n.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration-line: none;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgO7liDpuidhPQhgccaAy-1vO-1ZtBsX-VjRQl_CYI08neUFhx9jJ-tNuSvhno-cFsj7LfqOzNaHr9hbrrSpHTnRXqc6nN4WcDbTUXx-gDNn5GcYvctOSsUWGYQWIu-JSzhcsVznU3TbkfL/s1600/1911955_599005713511125_1107687970_n.jpg" style="border: none; position: relative;" width="452" /></a></div><p><span><span style="font-size: large;"><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333;"><span class="firstword">What's</span> the difference between beer nuts and deer nuts?</span><br style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;" /><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333;">Beer nuts are $1.50 and deer nuts are under a buck.</span></span><br style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;" /><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333; font-size: x-large;"></span><br /><br style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;" /><span style="font-size: x-large;"><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333;">When you are sad,</span><br style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;" /><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333;">And feeling blue,</span><br style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;" /><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333;">Just Remember the Giant Oak Tree,</span><br style="background-color: white; color: #333333; font-family: Arial, Tahoma, Helvetica, FreeSans, sans-serif;" /><span face="Arial, Tahoma, Helvetica, FreeSans, sans-serif" style="background-color: white; color: #333333;">Was Once a nut like you.</span></span></span></p><p><span style="color: #333333; font-size: x-large;"><br /></span></p><p><a href="https://www.youtube.com/watch?v=c-rfh_M3llc">I'm a Nut (Dennis) by Leroy Pullins - YouTube</a><span style="color: #333333; font-size: x-large;"><br /></span><br /></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-77275479226300046972021-01-01T07:00:00.009-08:002021-10-27T17:35:47.422-07:00Moments To Remember- 2020 Review<p style="text-align: center;"></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/gQZvvRMKXUs" width="320" youtube-src-id="gQZvvRMKXUs"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: justify;"><span style="font-family: inherit; font-size: x-large; text-align: left;">In 2015 I created my first year end video reviewing photos I had taken and the date attached. Perhaps the hardest part is choosing the song, preferably about memories. This year I chose a 1955 song called Moments to Remember originally sang by the <span style="background-color: white; color: #444444;"> </span><span style="background-color: white; color: #444444;">Canadian quartet, The Four Lads.</span></span><span style="background-color: white; color: #444444; font-family: inherit; font-size: x-large; text-align: left;"><span> My favorite singers were The Statler Brothers and the Lettermen that are featured on this video.</span> I hope 2020 was a good year for you with lots of memories. I am grateful for those who made it so special for us. I have no idea what next year holds- but I know who holds the future. God may have you still here as someone needs you. He could also meet us in the air this year. Be ready.</span></div><p></p><p style="text-align: center;"><span style="font-family: inherit; font-size: x-large;"></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVqhugai3kXImyhdaCN7C-u4K4yi8NEe_P-mrOo2HMVCu30bEYDZGdNBoKE5R6Xw3zhmNKWkDDELAWD46Y9tPc5h166gQ0TPak5TvAsDHInJET96COikq2EPEqaaSHpu4aTmTDtdMhEOns/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="695" data-original-width="526" height="425" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVqhugai3kXImyhdaCN7C-u4K4yi8NEe_P-mrOo2HMVCu30bEYDZGdNBoKE5R6Xw3zhmNKWkDDELAWD46Y9tPc5h166gQ0TPak5TvAsDHInJET96COikq2EPEqaaSHpu4aTmTDtdMhEOns/w322-h425/image.png" width="322" /></a></div><div class="separator" style="clear: both; text-align: center;"><span style="background-color: white; font-family: inherit; font-size: x-large; text-align: left;">I must pause to thank those who made an impact on my life and went home during 2020. None of us know when our time is up down here.</span></div><p><span><span style="background-color: white; font-family: inherit; font-size: x-large;">I was able to attend service of Larry Weston, who died at age of 69 from cancer. He was my boss at wsdot and a role model for me. I also lost my longest neighbor, Mike Doherty, we would visit in backyard so often. Don Crowell was a former church board member, and Larry Trapp I knew from my WUTC days. None of these died from covid.</span></span></p><p><span><span style="background-color: white; font-family: inherit; font-size: x-large;">Here are some other people who I never met, but <span>impacted my life;</span></span></span></p><p><span style="background-color: white;"><span style="font-family: inherit; font-size: x-large;">George Alex Trebek, a Canadian-American game show host and television personality. He was the host of the syndicated game show Jeopardy! for 37 seasons from its revival in 1984 until his death in 2020. </span></span></p><p><span style="font-family: inherit; font-size: x-large;"><span style="background-color: white;">Christian singer, songwriter, and comedian, </span><span style="background-color: white; box-sizing: border-box;">Aaron Wilburn</span><span style="background-color: white;"> passed away November 27, 2020. </span><span style="background-color: #f8f8f8;">Born July 9, 1950, in Ardmore, AL, Wilburn began his career as a member of the Happy Goodman Family. </span><span style="background-color: white;">Throughout Aaron's five decades of songwriting, he either wrote or co-wrote many of Gospel music's most beloved songs, including "</span><span style="background-color: white;">Four Days Late</span><span style="background-color: white;">," "</span><span style="background-color: white;">Home</span><span style="background-color: white;">," "</span><span style="background-color: white;">It Won't Rain Always</span><span style="background-color: white;">," "</span><span style="background-color: white;">That Sounds Like Home To Me</span><span style="background-color: white;">," "</span><span style="background-color: white;">What A Beautiful Day (For The Lord To Come Again)</span><span style="background-color: white;">," and dozens more.</span></span></p><p><span style="font-family: inherit; font-size: x-large;"><span style="background-color: white;">Gary McSpadden was a renowned gospel singer and a member of the Gospel Music Association Hall of Fame. He was a member of the </span>Oak Ridge Boys<span style="background-color: white;"> from 1962-1963, and went on to a career with other top gospel groups of that era including the Bill Gaither Trio and the Gaither Vocal Band. McSpadden </span>died<span style="background-color: white;"> on April 15 at the age of 77 after a battle with cancer.</span></span></p><p><span style="background-color: white; font-family: inherit; font-size: x-large;"><span>Harold Reid shot to fame as a member of the Statler Brothers. The bass vocalist and comedian </span>died<span> on April 24,2020, after battling kidney failure. Reid was 80 years old at the time of his death.</span></span></p><p><span style="font-family: inherit; font-size: x-large;"><span><span style="background-color: white;"> </span></span><span style="background-color: white;">Kenny Rogers died on March 20 in Sandy Springs, GA. According to his family, </span><span style="background-color: white;"> "passed away peacefully at home from natural causes under the care of hospice and surrounded by his family." </span></span></p><h2 class="item-title" style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgba(0, 0, 0, 0); box-sizing: border-box;"><span style="font-family: inherit; font-size: x-large; font-weight: normal;"><span>Charley Pride the first Black singer to join the </span>Grand Ole Opry, died on Dec. 12, of COVID-19 complications. He was 86 years old.</span></h2><div><span style="font-family: inherit; font-size: x-large;"><span style="background-color: white;">Mac Davis, the writer of Elvis Presley's "In the Ghetto" died at the age of 78 on Sept. 29, just one day after news broke that he was critically ill after undergoing heart surgery in Nashville.</span><span style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgba(0, 0, 0, 0); box-sizing: border-box;"><br /></span></span></div><div><span style="background-color: white;"><span style="font-family: inherit; font-size: x-large;"><br /></span></span></div><div><span style="font-family: inherit;"><span style="background-color: white; font-family: inherit; font-size: x-large;">Charlie Daniels died on July 6 after suffering a hemorrhagic stroke. He was 83 years old.</span><span style="-webkit-font-smoothing: antialiased; -webkit-tap-highlight-color: rgba(0, 0, 0, 0); box-sizing: border-box; color: #45444a; font-size: x-large;"><br /></span></span></div><div style="text-align: center;"><span style="font-family: inherit; font-size: large;"><span style="background-color: white; color: #45444a;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhf71jJ1wnBezXSN3eEoQTbncOJ-msW85V_h10-BQDgQL3yTY1XjAK82GBbdFj4VdwlSbbk2O85dkNyvO8PYR_oCahq72nlhKqcX1KXokjLvVZ2inUh2ADl2GtJ6EVoVkDYEv0jfh6nJ_oi/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="205" data-original-width="206" height="439" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhf71jJ1wnBezXSN3eEoQTbncOJ-msW85V_h10-BQDgQL3yTY1XjAK82GBbdFj4VdwlSbbk2O85dkNyvO8PYR_oCahq72nlhKqcX1KXokjLvVZ2inUh2ADl2GtJ6EVoVkDYEv0jfh6nJ_oi/w440-h439/image.png" width="440" /></a></div><div class="separator" style="clear: both; text-align: center;"><span style="background-color: #0099cc; color: white; font-family: "Open Sans"; font-size: 0.875rem;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=gQZvvRMKXUs&t=38s">moments to remember -2020 Review - YouTube</a></div></span></span></div>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-84070517673087772332020-11-26T09:40:00.009-08:002021-10-27T17:36:38.958-07:00Merry Christmas 2020<p style="text-align: center;"> <iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/pd_4-uJ1jPU" width="320" youtube-src-id="pd_4-uJ1jPU"></iframe></p><p style="text-align: center;"><br /></p><p style="text-align: left;"><span style="font-size: xx-large; text-align: justify;">I Love Christmas and always look forward to hear from friends of their year- and this year will be enlightening. We have had lots of changes, but so many blessings and good memories as well. This is our 15th Christmas video and 25th Christmas letter. I hope you have a Merry Christmas and next year is even better for you. Normally we send this out the day after my birthday as tradition, but this year CNN reported Christmas may not happen this year- how wrong they are again- We celebrate Christ's birth all year long, and our Tree, lights, and even our Christmas letter is out, so we can celebrate Thanksgiving and now wish you a Merry Christmas and a Happy New Year.</span></p><p style="text-align: justify;"></p><table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiubw7bcvCUJnG96nAnAycaEHBoSCCQC2susf0kUSeLytzW4albZuFprdA_iX-mUgRxKhyBxbsZTtnkVSNn_yAaj6jNO9iAxMmbIYIloYEnqaLPQkxb6_V1L44OzYrzRb43_ozldhbpysTH/s600/125961534_2784532905167875_5144591969890519084_n.jpg" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="530" data-original-width="600" height="478" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiubw7bcvCUJnG96nAnAycaEHBoSCCQC2susf0kUSeLytzW4albZuFprdA_iX-mUgRxKhyBxbsZTtnkVSNn_yAaj6jNO9iAxMmbIYIloYEnqaLPQkxb6_V1L44OzYrzRb43_ozldhbpysTH/w541-h478/125961534_2784532905167875_5144591969890519084_n.jpg" width="541" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;"><br /></td></tr></tbody></table><div style="text-align: center;"><p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">We<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Wish you<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">A Merry Christmas<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Our favorite time of year<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">A season of hope & good cheer<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Counting our blessings from this year<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Waiting to hear from friends far and near,<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Jan had shoulder cup surgery early this year,<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Dennis after 35 years with state finally did retire<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Covid hit in March, and changed our plans for year<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">We Camped by Winthrop in our tent early this summer<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">We Visited Bodie State Park, Lake Tahoe with Jans sister<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Stehekin Trip and Several fun boating trips from Crescent Bar<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">We Hiked Saddle Rock, Silver Falls, Horselake and Lake Clara,<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Crater Lake Hike, Logging Museum, Collier State Park before fire<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Jan climbed Steamboat Rock, and we had our daily walks together<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Dennis has facebook, painting, videos, hot tub, and still a blogger<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Janice is busy with quilting, Spinning, Knitting, or Painting a Picture<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">Hello from Mouse our cat, and Barney & Squeaky our green Conure<o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial Narrow", sans-serif"><span style="font-size: large;">God Bless You, Have a Merry 2020 Christmas & Happy New Year</span><span style="font-size: 22pt;"><o:p></o:p></span></span></p>
<p align="center" class="MsoNormal"><span face=""Arial",sans-serif" style="font-size: 10pt;">Dennis & Janice
Hendricks</span></p><p align="center" class="MsoNormal"><a href="http://dennishendricks.blogspot.com/" style="font-size: 10pt;">dennishendricks.blogspot.com</a></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFJtz2nn42G_ElszXM9bgj-qV4E9wWFGfs3me8-RaFbp41Jgrebiyjp7OZbmP9M55RL-yLMQDeB2_B5A252yxuX6WZ3rAMw9RR_mzfciP7Ql8pgvfOy2j5KmewJL3zW2UpMO5FtDnqcoZs/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="781" data-original-width="526" height="542" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjFJtz2nn42G_ElszXM9bgj-qV4E9wWFGfs3me8-RaFbp41Jgrebiyjp7OZbmP9M55RL-yLMQDeB2_B5A252yxuX6WZ3rAMw9RR_mzfciP7Ql8pgvfOy2j5KmewJL3zW2UpMO5FtDnqcoZs/w366-h542/image.png" width="366" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=pd_4-uJ1jPU&t=2s">Merry Christmas 2020 - YouTube</a></div><p></p></div><p></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-39444838548805353402020-10-19T20:28:00.010-07:002021-10-26T10:12:38.543-07:00Remember When<p></p><div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen="" class="BLOG_video_class" height="266" src="https://www.youtube.com/embed/5UW3QyHzUBU" width="320" youtube-src-id="5UW3QyHzUBU"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: left;"><span style="font-size: x-large; text-align: justify; white-space: pre-wrap;">I first met Janice in my Jr. year of high school when we moved to Coulee Dam. We were married in 1974 and blessed with 3 wonderful children and 6 wonderful grandkids. Time has gone too fast. I feel so blessed and have so many good memories. Not knowing how many more years we have, I added a few photos to the Allen Jackson song "Remember When". Thanks to all those who have helped make our marriage so special and memorable.</span></div><p><span color="rgba(0, 0, 0, 0.87)" face="Roboto, Noto, sans-serif" style="white-space: pre-wrap;"></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmAyNnmeefONFN44ohuQBNaeGXvSJF-V7xdCIimaNwdITSG5ewJ6q3WdzYw5YETn4lUDxTf0000yk5iKn3wZy-FePToSfyutDyV_fz7PFi7ILn-821kIC9aV-oPhCxg_ioZoAfqZAYfW6D/s564/One-day-you-are-going-to-hug.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="564" data-original-width="564" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhmAyNnmeefONFN44ohuQBNaeGXvSJF-V7xdCIimaNwdITSG5ewJ6q3WdzYw5YETn4lUDxTf0000yk5iKn3wZy-FePToSfyutDyV_fz7PFi7ILn-821kIC9aV-oPhCxg_ioZoAfqZAYfW6D/s320/One-day-you-are-going-to-hug.jpg" /></a></div><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=5UW3QyHzUBU">Remember When - YouTube</a></div><p></p>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-10228694508503140582020-08-31T09:35:00.006-07:002021-10-27T17:38:25.644-07:00I've Been Everywhere- Crater Lake & Collier State Park<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: x-large;"><span face=""roboto" , "noto" , sans-serif" style="background-color: white; white-space: pre-wrap;">Hank Snow and Johnny Cash were some of the artists who recorded </span><span face=""roboto" , "noto" , sans-serif" style="background-color: white; white-space: pre-wrap;">"I've been Everywhere". I added some photos of our trip to Oregon last week where we hiked Crater Crater Lake, camped at Collier Memorial State Park and visited a logging museum. Most of you have been more places than we have- but I hope this video brings back memories of places you have been. This is only song I could find that was about Crater Lake- listen for it. </span></span><br />
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<img alt="Image result for collier memorial state park jokes" height="233" src="https://th.bing.com/th/id/OIP.FNRkpVoftB00OJ0tpY0-XwHaEK?w=309&h=180&c=7&o=5&pid=1.7" width="400" /></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=UZgZssq23HM&t=54s">I've Been Every Where - YouTube</a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><br /></div></div>
My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-32865184705419817492020-08-20T19:48:00.008-07:002021-10-27T17:23:24.699-07:00My Anchor Holds- Tribute to Larry Weston<div class="separator" style="clear: both; text-align: center;">
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<span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span style="font-size: x-large;">Larry Weston was a special friend. He was my boss, he was my facebook friend, and I looked up to him as a hero and example. This week he passed on to Heaven- I know he was ready and I will see him again. I made this video of some old photos I had of him and a song that he posted 11 weeks ago as one of his favorite songs. This is in honor of Larry Weston- see you on the other side Larry.</span></span><br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfz4N8dLp1B3mfi7yG2gGXLEQ4IjUylI6hB21uq19kAZSrvG4tJgRsrGpquZ0ZPKCUqdn22Kc8KxeWQeScHuq2fI-VDUJbqgxjVaMXr-yKky1XffnbWeAUNeh6ute52ooBywMDuxNTmIm5/s2048/SCAN0091.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1456" data-original-width="2048" height="389" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfz4N8dLp1B3mfi7yG2gGXLEQ4IjUylI6hB21uq19kAZSrvG4tJgRsrGpquZ0ZPKCUqdn22Kc8KxeWQeScHuq2fI-VDUJbqgxjVaMXr-yKky1XffnbWeAUNeh6ute52ooBywMDuxNTmIm5/w547-h389/SCAN0091.JPG" width="547" /></a></div><div class="separator" style="clear: both; text-align: center;"><span style="background-color: #f9f9f9; color: #030303; font-size: x-large; text-align: justify; white-space: pre-wrap;">I was wanting to post his obituary here and will when I find it. </span></div></div><div style="text-align: justify;"><span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span style="font-size: large;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsrRQnSL8KvuXXI6-ZUoS6xxmQD7lbPWO4O4py54VsTYnGzaAoodM2RChKhYkf3ZGZzOfIZ1tvAWfP4uRW0pupzQbq4HJ7zgoErHm-TUDVNFA0eE5GWk2LWJE33G-blnpgiqrMXPrZA9_I/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="960" data-original-width="715" height="728" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjsrRQnSL8KvuXXI6-ZUoS6xxmQD7lbPWO4O4py54VsTYnGzaAoodM2RChKhYkf3ZGZzOfIZ1tvAWfP4uRW0pupzQbq4HJ7zgoErHm-TUDVNFA0eE5GWk2LWJE33G-blnpgiqrMXPrZA9_I/w546-h728/image.png" width="546" /></a></div></span></span></div><div style="text-align: justify;"><span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span style="font-size: large;"><br /></span></span></div><div style="text-align: justify;"><span style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span style="font-size: x-large;">I also would like to share several posts I received honoring him as well as some from facebook; (I left names off as I did not ask permission to share them on my blog)</span></span></div><div style="text-align: justify;">
<span><span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; font-size: x-large; white-space: pre-wrap;"><span style="font-size: medium;"><br /></span></span>
<span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span><span face=""calibri" , "helvetica" , sans-serif" style="background-color: white; color: black; font-size: x-large; white-space: normal;">truly sorry to hear it. I first worked with Larry when I was a temp and he was the winter Tech 3 at Leavenworth. Later, when he was the Lead on the striping crew, before his promotion to Wenatchee Supv. Truly and honorable man and I regarded him highly.</span></span></span></span><span style="font-size: x-large;"><br />
<span><span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span><span face=""calibri" , "helvetica" , sans-serif" style="background-color: white; color: black; white-space: normal;"><br /></span></span></span>
<span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span><span face=""helvetica" , "arial" , sans-serif" style="background-color: white; color: #1c1e21; white-space: normal;">Love you Larry and we already miss you. Please give God a hug for us.</span></span></span></span><br />
<span><span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span><span face=""helvetica" , "arial" , sans-serif" style="background-color: white; color: #1c1e21; white-space: normal;"><br /></span></span></span>
<span face=""roboto" , "arial" , sans-serif" style="background-color: #f9f9f9; color: #030303; white-space: pre-wrap;"><span><span face=""helvetica" , "arial" , sans-serif" style="background-color: #f2f3f5; color: #1c1e21; text-align: left; white-space: normal;">My heart goes out to all of </span>Larry Weston<span face=""helvetica" , "arial" , sans-serif" style="background-color: #f2f3f5; color: #1c1e21; text-align: left; white-space: normal;"> family. He was such a riot when he worked at the WSDOT in Wenatchee. Great GREAT guy! He's the lucky on</span></span></span></span></span><span style="background-color: #f2f3f5; color: #1c1e21; font-family: inherit; font-size: xx-large; text-align: left;">❤</span></div><div style="text-align: justify;"><span style="background-color: #f2f3f5; color: #1c1e21; font-family: inherit; font-size: xx-large; text-align: left;"><br /></span></div><div style="text-align: justify;"><a href="https://www.youtube.com/watch?v=4MHpSoDYWoE&t=33s">My Anchor Holds - YouTube</a></div><div style="text-align: justify;"><br /></div>
My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-81865697465538722522020-06-13T21:22:00.004-07:002021-10-27T17:39:33.308-07:00This Old House- Bodie State Historic Park<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: x-large;">On June 9th, 2020 we visited Bodie State Historic Park in California. I added some photos to the song written by Stewart Hamblin in 1954 and sung here by Jimmy Dean. Bodie was a gold rush ghost town and what remains is about 5% of the buildings from the towns heyday of 1877-1881. It became a state park in 1962 and is preserved in a state of arrested decay. Bodies peak population probably ranged from 7 to 8,000. I think the song written by Stewart Hamblin reminds me how short our life is down here and our impact can live on but I am getting ready to meet the saints...</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKREfi6llK1X9NHIABlF4QxSWQaoo-xTEGM5IAsH0kvuIT12QLxm0iLVX6icDFwDYeC1MkTV0FceOU4GhDzyTIbZiHTHGZntXpZHlh9pf0davEuAcXYFZd0EQ_BoUjDUDeqDHDXKhj_yUH/s1600/20200610_132241.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjKREfi6llK1X9NHIABlF4QxSWQaoo-xTEGM5IAsH0kvuIT12QLxm0iLVX6icDFwDYeC1MkTV0FceOU4GhDzyTIbZiHTHGZntXpZHlh9pf0davEuAcXYFZd0EQ_BoUjDUDeqDHDXKhj_yUH/s400/20200610_132241.jpg" width="300" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2LL59IPTtDfsX9ZkVVzcOiuRhBX9g6VKhtqcgUt-uz25N09x0d0GhH3KdkIc1qvhN-GpobtbeMKD_PG5bpFvZ9v7ThOu4dCFNXXMwv8PfHx14fy3WR-prHcJn5t_n5-aADJJoy8bfpz4L/s1600/20200610_171442.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg2LL59IPTtDfsX9ZkVVzcOiuRhBX9g6VKhtqcgUt-uz25N09x0d0GhH3KdkIc1qvhN-GpobtbeMKD_PG5bpFvZ9v7ThOu4dCFNXXMwv8PfHx14fy3WR-prHcJn5t_n5-aADJJoy8bfpz4L/s400/20200610_171442.jpg" width="300" /></a></div>
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<span style="font-size: large;">Wednesday we hiked to several waterfalls on Lake Tahoe. </span></div>
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<span style="font-size: large;">Got 1600 steps in that day, almost sunburned, and lots of fun.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDzGfRNF6PMNgIbTsas-41s0bnaCivT-x46BrFUaq8_HhQbbLme01HkRchX5_b_LpYpSfR_12jwnK2Ijx-eHFWo-bdIq-54snc8SFSO2KD7iPjpoGVeRm2DmTjrbjOISoVJk_25KhuL46g/s1600/20200611_124340.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgDzGfRNF6PMNgIbTsas-41s0bnaCivT-x46BrFUaq8_HhQbbLme01HkRchX5_b_LpYpSfR_12jwnK2Ijx-eHFWo-bdIq-54snc8SFSO2KD7iPjpoGVeRm2DmTjrbjOISoVJk_25KhuL46g/s400/20200611_124340.jpg" width="300" /></a></div>
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<span style="font-size: x-large;">Thursday headed home and ate at our </span></div>
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<span style="font-size: x-large;">first sit down restaurant in 4 months.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjasBLiLAecMdA06w7kNwRC5leRnsTQSMUbfpvzEOGb8uvvwb4KXgFo2azIrP6t32VzcXCjcHJbX7TfF99LNW5ynAv9hEPUN2robKz0odQTogBfbnhMpT2zkuXRaUNtxAy2mvjSGrxBAUKb/s1600/20200611_170115.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="1600" data-original-width="1200" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjasBLiLAecMdA06w7kNwRC5leRnsTQSMUbfpvzEOGb8uvvwb4KXgFo2azIrP6t32VzcXCjcHJbX7TfF99LNW5ynAv9hEPUN2robKz0odQTogBfbnhMpT2zkuXRaUNtxAy2mvjSGrxBAUKb/s400/20200611_170115.jpg" width="300" /></a></div>
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<span style="font-size: large;">Thursday night in Bend, Oregon with Chic Fil A carryout.</span></div>
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<span style="font-size: large;">Friday a slight detour to visit my sister and Home Friday night.</span></div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: large;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: large;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dzAyDe8dOmVqim-ZGeGX-Wz0R4siwYvUCGFn88kmeeOn5A9O1Bf7yEZ6o9bvk-Uy4MGeVcB7gjl95zCo9bZyQ' class='b-hbp-video b-uploaded' frameborder='0'></iframe></span></div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: large;"><br /></span></div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: x-large;">Here is photos added to another song called This Old House by Jimmy Dean- Hope you have time to click on the arrow and view our day to a different song. </span></div><div class="separator" style="clear: both; text-align: center;"><span style="font-size: x-large;"><a href="https://www.youtube.com/watch?v=q2uW_BhrbCE&t=29s">This Old House Bodie State Historic Park - YouTube</a></span></div>
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</span><b></b><i></i><u></u><sub></sub><sup></sup><strike></strike>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-8869220749340248912020-04-26T07:02:00.003-07:002021-10-27T17:40:28.376-07:00Happy 7th Birthday Billy<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: x-large;">7 years ago today Billy was born- our youngest grandchild. In talking to him, you would have think he turned 7 already- But what a joy and privilege to know him. I added some photos from one year ago to today to show how tall he has grown and how fast time goes. Sadly because of the virus fears- he cannot have a party or finish his first grade at school. It will be a drive by party, so since you or I cannot give him a hug- lets shout out together, 1,2,3,-"Happy Birthday Billy"</span></div>
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My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-83819585116946212582020-04-17T06:49:00.003-07:002021-10-27T17:41:21.909-07:00Corona Virus USA<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: x-large;">History is being made right now in our country with the corona virus and lives are being changed. Hopefully this will be over by end of month, but I felt we needed to have some humor as well as save some of the memes that brought a smile to our faces. I added a few to a song written and sang by Pati Gradi- please excuse some of the language but try to find the humor. I think this is my 4th or 5th video about covid-19.</span><span style="font-size: large;"><br /></span></div>
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<span style="font-size: x-large;">First Day after Quarentine</span><span style="font-size: large;"><br /></span></div>
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My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-33368064842415373922020-04-11T06:50:00.002-07:002021-10-27T17:42:10.243-07:00Quarentineville<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: x-large;">History is being made with the Covid19 Virus. This is my second video about the virus with the last one having over 7500 views In 2 weeks on Youtube. This time I added the top Memes from Facebook that describe this event, to a song parody by Robert Lund that uses humor to help record this history in the Making. Feel free to share this video, after you Wash your Hands and Had a good laugh with this song called "Quarentineville". As one presidential candidate said, "People will die who have never died before because of this virus."</span></div>
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<span style="font-size: large;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgI7ZxoJwpIzyB4FUkKNfHlM4_If9KS6LtN5a-tQX81qhgkCnb3cSGk7ieF5fiJoi7_0yCi_AmPF2ml-QxLNfqYHJm3epSoEb0mwF2ArRxU84k7tCX3F4tDrb3ZtxgkRlBbFysg8D6NRYm0/s1600/92175415_2520319438281825_1226949646820048896_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="960" data-original-width="778" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgI7ZxoJwpIzyB4FUkKNfHlM4_If9KS6LtN5a-tQX81qhgkCnb3cSGk7ieF5fiJoi7_0yCi_AmPF2ml-QxLNfqYHJm3epSoEb0mwF2ArRxU84k7tCX3F4tDrb3ZtxgkRlBbFysg8D6NRYm0/s320/92175415_2520319438281825_1226949646820048896_n.jpg" width="259" /></a></span><span style="font-size: large;"><br /></span></div>
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</span>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com2tag:blogger.com,1999:blog-8033048668537077428.post-39900226890819134002020-04-05T07:14:00.003-07:002021-10-27T17:43:00.570-07:00Because He Lives<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: x-large;"><span face=""arial" , "helvetica" , sans-serif">It was 12 years ago today we experienced a house fire. It was around 1;15pm, I was in rear bedroom playing games (Chutes and Ladders) and giving the grandkids a quiet time. Jan, Darcie and Caitlyn had gone shopping in Cashmere. There was a knock on the door- a couple teens asked “Mr., Did you know your house is on fire?” I am grateful for those teens- I got my two grandkids out- yelled for someone to call 911 and waited for firemen. Actually, I did try to save the computer, but quickly gave up as smoke and noise rose. I do regret not closing more doors as I exited. I tried to reach the fire with a hose, but it was too short and fire too hot. This reminds me of what is important in life, and also reminds me of the many good people who helped us and we met. Pemco Insurance and France and Company were so good to us- six months to the day we moved back in same house. My daughter and her husband let us stay in their camper which was not only close to the house, but allowed us to visit with grandkids which helped all of us. Our family at Wenatchee First Assembly of God bent over backwards to help, my co-workers were so understanding, and our faith in God gave us strength we needed. I certainly do not know what tomorrow holds for you or I. God has never failed me. 0ur pastor reminded us that Immanuel means, "God with us." If you are having a tough time, do not give up! Don't be Afraid! Luke 1:37 is underlined in my Bible and reads, "God Can Do Everything.</span><span face=""arial" , "helvetica" , sans-serif">"</span></span></div>
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<span style="font-size: x-large;">These Four students took time to stop and tell me our house was on fire.</span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-idV25FBHUfR7Sgb0g5HeJ6bynLqUbZT7uOamFJR6PlA5BHRlOoy-q7oQwdF9bEiW-DFisOFM4Bc2u5sII8lQ1g-45iNPDqEm8-E66_MQOHXWzQCSOG8jPX1_cWgjZUpMmFV_ZCXZZAAl/s1600/IMG_3350.JPG" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-idV25FBHUfR7Sgb0g5HeJ6bynLqUbZT7uOamFJR6PlA5BHRlOoy-q7oQwdF9bEiW-DFisOFM4Bc2u5sII8lQ1g-45iNPDqEm8-E66_MQOHXWzQCSOG8jPX1_cWgjZUpMmFV_ZCXZZAAl/s1600/IMG_3350.JPG" style="border-bottom-color: currentColor; border-bottom-style: none; border-bottom-width: medium; border-image-outset: 0; border-image-repeat: stretch; border-image-slice: 100%; border-image-source: none; border-image-width: 1; border-left-color: currentColor; border-left-style: none; border-left-width: medium; border-right-color: currentColor; border-right-style: none; border-right-width: medium; border-top-color: currentColor; border-top-style: none; border-top-width: medium; border: medium none currentcolor; position: relative;" width="400" /></a></div>
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<span style="font-size: large;">A few of the many cards from friends we received.</span></div>
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<span style="font-size: x-large;">So much help and encouragement!</span><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpcLqQNkdaF_w33_eGVmy1t_3hxa48D59OBDWxElSN0-5GYITvVWwTNqquTlR7fDs6CmEFr0rE0-FyydWOv6XP0bawFc6i8jiqNqCz-_GDXAMuy_2_Z9rz3xl7awWmeBz9YEveEWBso8Ec/s1600/IMG_0302.JPG" style="color: #336699; font-size: 14.86px; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjpcLqQNkdaF_w33_eGVmy1t_3hxa48D59OBDWxElSN0-5GYITvVWwTNqquTlR7fDs6CmEFr0rE0-FyydWOv6XP0bawFc6i8jiqNqCz-_GDXAMuy_2_Z9rz3xl7awWmeBz9YEveEWBso8Ec/s1600/IMG_0302.JPG" style="border-bottom-color: currentColor; border-bottom-style: none; border-bottom-width: medium; border-image-outset: 0; border-image-repeat: stretch; border-image-slice: 100%; border-image-source: none; border-image-width: 1; border-left-color: currentColor; border-left-style: none; border-left-width: medium; border-right-color: currentColor; border-right-style: none; border-right-width: medium; border-top-color: currentColor; border-top-style: none; border-top-width: medium; border: medium none currentcolor; position: relative;" width="400" /></a></div>
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<span style="font-size: x-large;"><span>Darcie let us stay in her camper for six months- </span><span>what a blessing!</span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVFIUvsaUvgrY5UGMnyxPxgGZLiRLWIUaZvPAvwRbPE_6ngvXeREs8IxGvu3lEBfayODVbePOrzDiU2vlyY7MPOviYETVNtMYIrcUqFETZR4QLBdkfDrb8khBKRwSxMrJc86pqkKhK4m6u/s1600/IMG_3159.jpg" style="color: #336699; margin-left: 1em; margin-right: 1em; text-decoration: none;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVFIUvsaUvgrY5UGMnyxPxgGZLiRLWIUaZvPAvwRbPE_6ngvXeREs8IxGvu3lEBfayODVbePOrzDiU2vlyY7MPOviYETVNtMYIrcUqFETZR4QLBdkfDrb8khBKRwSxMrJc86pqkKhK4m6u/s1600/IMG_3159.jpg" style="border-bottom-color: currentColor; border-bottom-style: none; border-bottom-width: medium; border-image-outset: 0; border-image-repeat: stretch; border-image-slice: 100%; border-image-source: none; border-image-width: 1; border-left-color: currentColor; border-left-style: none; border-left-width: medium; border-right-color: currentColor; border-right-style: none; border-right-width: medium; border-top-color: currentColor; border-top-style: none; border-top-width: medium; border: medium none currentcolor; position: relative;" width="400" /></a></div>
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<span style="font-size: x-large;">We had a memorial service for our bird "Tica" </span></div>
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<span style="font-size: x-large;">who died in the fire.</span></div>
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<span style="font-size: x-large;">The Cat was ok and had gone downstairs under the bed.</span></div><div class="separator" style="clear: both; color: #333333; font-family: arial, tahoma, helvetica, freesans, sans-serif; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; text-align: center; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><span style="font-size: x-large;"><br /></span></div><div class="separator" style="clear: both; color: #333333; font-family: arial, tahoma, helvetica, freesans, sans-serif; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; text-align: center; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><span style="font-size: x-large;"><a href="https://www.youtube.com/watch?v=-Qt5Kg3WHGc&t=15s">Because He Lives (fire) by the Gaithers - YouTube</a></span></div>
My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-32936381314445728612020-03-26T20:39:00.004-07:002021-10-27T17:44:32.590-07:00Covid-19 Funny Song<div class="separator" style="clear: both; text-align: center;">
<iframe allowfullscreen="" class="YOUTUBE-iframe-video" data-thumbnail-src="https://i.ytimg.com/vi/8s7xkT9uA54/0.jpg" frameborder="0" height="266" src="https://www.youtube.com/embed/8s7xkT9uA54?feature=player_embedded" width="320"></iframe></div><div class="separator" style="clear: both; text-align: center;"><br /></div>
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<span style="font-size: x-large;">Steve Stewart recently wrote/sang/published the song Corona Ville. I added some photos to make one smile even more and take your mind away from fear and negativity everyone is forced to watch. I hope it brings a smile to your face and this finds you healthy and with just washed hands. This is just a hobby of mine and not meant to make fun of anyone- but bring a smile to your face and make you young again. Any resemblance to the truth is purely by accident and unintentional. This is an remake with several photos that may have offended facebook removed- either copyrighted or of democrats. </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNluXZoSNllXSAksEnlmUDSAWTTnhkh199HZFqTI1G4f8S0VI4qEtWnkFtHHCF5Bey3Aws42zidoBG4Rx_gl3BcFMDIlnT4GTtxjAvP4gMH6yG3wdG0rIrCkWsgQOtItlHlUqwzrFXVCck/s1600/90890296_10163021352065398_3769216333502218240_n.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="636" data-original-width="719" height="283" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNluXZoSNllXSAksEnlmUDSAWTTnhkh199HZFqTI1G4f8S0VI4qEtWnkFtHHCF5Bey3Aws42zidoBG4Rx_gl3BcFMDIlnT4GTtxjAvP4gMH6yG3wdG0rIrCkWsgQOtItlHlUqwzrFXVCck/s320/90890296_10163021352065398_3769216333502218240_n.jpg" width="320" /></a></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSJUyX6A0uBpLeIT_o72Pe_70AO7RRCH38Hvkwg93oKMbBy_THAkGzsnOnMsdaXMTdRDR36eEER6dsJ1UuP-ZVNydFiJb32Aq9EtvGmLCSfgIvYbU42kQxCcx6lzV1T_WPoq9LqlGMFHBH/s1600/90084186_10158256587238432_5083248177415454720_o%255B1%255D.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="720" data-original-width="960" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgSJUyX6A0uBpLeIT_o72Pe_70AO7RRCH38Hvkwg93oKMbBy_THAkGzsnOnMsdaXMTdRDR36eEER6dsJ1UuP-ZVNydFiJb32Aq9EtvGmLCSfgIvYbU42kQxCcx6lzV1T_WPoq9LqlGMFHBH/s320/90084186_10158256587238432_5083248177415454720_o%255B1%255D.jpg" width="320" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=8s7xkT9uA54">Funny Corona Ville Song - YouTube</a></div>
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My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-12579083251114980762020-03-20T06:30:00.005-07:002021-10-27T17:45:58.916-07:00Wanted Man<div class="separator" style="clear: both; text-align: center;">
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<div style="text-align: center;"><div style="text-align: justify;"><span style="font-size: x-large;">Two weeks ago we were notified our 15 day cruise would be cancelled the following Saturday.(March 7th) They say vacations are full of surprises- I could never imagine all the surprises since that announcement that have happened- I am hoping they will be over by this Sunday, the day our cruise was to end. (22nd) Ironically I would not have had internet those 15 days- but staying home I was put in facebook Jail several times- and someone made me a shirt about that and several asked why I was in facebook Jail? I decided to make a video of an 1969 Johnny Cash song called "Wanted Man". Many photos are posts I may have posted- some, facebook may have removed without me knowing it? This song will have to replace our vacation Video for this year.</span></div>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicTG5mOv46sJQudNmConqh8grbOZlztqUUpKN0lF11eNR7YXHj3r4KyaaAxTkYJ0lJ5FpdjCzUIdmZ2Ln-v5-mKXqUjrxiUvj4B1aW-Q7qyzpyYpHR-i4ocPsfzYhta0Bg20gs-WPEFWJK/s1600/90420557_10216880191173981_6871431263912198144_n.jpg"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEicTG5mOv46sJQudNmConqh8grbOZlztqUUpKN0lF11eNR7YXHj3r4KyaaAxTkYJ0lJ5FpdjCzUIdmZ2Ln-v5-mKXqUjrxiUvj4B1aW-Q7qyzpyYpHR-i4ocPsfzYhta0Bg20gs-WPEFWJK/s320/90420557_10216880191173981_6871431263912198144_n.jpg" /></a><br />
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<span style="font-size: x-large;">Thank You Maureen Johnson who made this shirt- I had over 42 likes on facebook and over 16 comments in just one day. The song is a Johnny Cash song from 1969- a song he seldom sang in his later years. I do hope the song takes your mind away from fear and worry and these two weeks will soon be history.</span></div>
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbLCPPm5xJSkAo_J5-AsaQ6MUSspTVYpMf_raLlZPYBcwyUAQNXf8i7b16AxMEtDM44W-m6_9qmAVruRw6RkUCMUZ8s5t7Oz6HQuytkyFHdLe-oryWCAjml3fwnX59r0BioMnY_lQ5KiJA/s1600/20180513_151556.jpg"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbLCPPm5xJSkAo_J5-AsaQ6MUSspTVYpMf_raLlZPYBcwyUAQNXf8i7b16AxMEtDM44W-m6_9qmAVruRw6RkUCMUZ8s5t7Oz6HQuytkyFHdLe-oryWCAjml3fwnX59r0BioMnY_lQ5KiJA/s400/20180513_151556.jpg" /></a><br />
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</span><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEha8YDOYPwFWiSw5B0gOKDDgQujc0v2VJnzAgmFYLVcO35xlv-4xmdHMZCE8sQ6U6-t-lEHC-UHfAETBERvPs5pcNR-ZQ9ONgAPCC1ap6YFkBvzON6K5MPRaUCycqa0iFwwD_T8blBEGTa_/" style="margin-left: 1em; margin-right: 1em;"><img alt="" data-original-height="180" data-original-width="180" height="314" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEha8YDOYPwFWiSw5B0gOKDDgQujc0v2VJnzAgmFYLVcO35xlv-4xmdHMZCE8sQ6U6-t-lEHC-UHfAETBERvPs5pcNR-ZQ9ONgAPCC1ap6YFkBvzON6K5MPRaUCycqa0iFwwD_T8blBEGTa_/w314-h314/image.png" width="314" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="separator" style="clear: both; text-align: center;"><a href="https://www.youtube.com/watch?v=WzGFk9ABGkQ">Wanted Man - YouTube</a></div><br /><br /></div>
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My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com1tag:blogger.com,1999:blog-8033048668537077428.post-82946600033651454122020-03-15T06:04:00.004-07:002021-10-27T17:55:45.053-07:00"The moon belongs to everyone, the best things in life are free"<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: x-large;">Recently I was challenged to make a video to the song "The Moon belongs to Everyone, The Best Things In Life Are Free". The 1925 song took on new life during the depression. I chose the Ink Spots version that was in 1946 I believe. I hope you enjoy the video as much as I enjoyed making it. I also hope you will remember, "The Best Things in Life Are Free.</span></div>
<div><span><span style="font-size: x-large;">Did you hear about the restaurant on the moon?<br />Great food, horrible atmosphere.<br /><br /> Two blondes are walking and one asks, “which is closer, the moon or Florida?” The other responds, “duh......can you see Florida?<br /><br /> What did Neil Armstrong say when no one laughed at his moon jokes?<br />I guess you had to be there.</span></span><br />
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<b></b><i></i><u></u><sub></sub><sup></sup><strike></strike></div><div><span><span style="font-size: x-large;"><span id="alttext-container" style="border-color: silver; border-style: solid; border-width: 1px; box-sizing: border-box; display: inline-block; height: 600px; overflow: hidden; padding: 1px; pointer-events: none; vertical-align: baseline; width: 600px;"><br class="Apple-interchange-newline" /><img align="left" height="16" id="alttext-image" style="display: inline; float: left; margin: 0px;" width="16" /><span id="alttext">The reason that no one has returned to the moon for so long is that every time someone tries to book a hotel there, it's full...</span></span></span></span></div><div><span><span style="font-size: x-large;"><span style="border-color: silver; border-style: solid; border-width: 1px; box-sizing: border-box; display: inline-block; height: 600px; overflow: hidden; padding: 1px; pointer-events: none; vertical-align: baseline; width: 600px;"><span><a href="https://www.youtube.com/watch?v=MNejSkvWO0g">The Best Things In Life Are Free - YouTube</a></span></span></span></span></div>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0tag:blogger.com,1999:blog-8033048668537077428.post-7479020260439355252020-03-03T06:43:00.003-08:002021-10-27T17:56:43.724-07:00American Trilogy- New Orleans<div class="separator" style="clear: both; text-align: center;">
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<span face=""arial" , "helvetica" , sans-serif" style="font-size: x-large;">I am reminded of what a beautiful place we live, every time I take a Vacation! Seven years ago today we arrived home from a cruise. We flew into New Orleans and had 2 hours before we could board the ship and a 2 hour tour after the cruise of New Orleans, to visit that city. There is a lot of history and beauty there- and of coarse the tour guide was proud of his city, but I still prefer North Central Washington! I have always said I liked most about striping was the beautiful country we saw. In 1972 Elvis sang a song called American Trilogy. I added some photos of that New Orleans trip. We are blessed and I hope you include North Central Washington in your vacation plans this summer.</span></div>
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"<b>An American Trilogy</b>" is a song arranged by country songwriter Mickey Newbury and made popular by Elvis Presley, who began including the song as part of his regular concert routine in the 1970s, thereby making the song a showstopper. It is a medley of three 19th century songs—"Dixie", a blackface minstrel song that became the unofficial anthem of the Confederacy since the Civil War; "All My Trials", originally a Bahamian lullaby, but closely related to African American spirituals, and well-known through folk music revivalists; and "The Battle Hymn of the Republic", the marching song of the Union Army during the Civil War.<sup> </sup>Over 465 versions of "An American Trilogy" have been recorded by different artists.<br />
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<span style="background-color: transparent; color: #676767; display: inline; float: none; font-style: normal; font-variant: normal; font-weight: 300; letter-spacing: 0.5px; text-align: center; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;">Just found out that someone has accidentally given away all my Elvis records. I’m all shook up.</span><br />
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<span style="text-decoration-color: initial; text-decoration-style: initial; text-decoration-thickness: initial;"><a class="_6qw4" data-hovercard="/ajax/hovercard/user.php?id=1649229217" href="https://www.facebook.com/dennis.hendricks.961" style="-webkit-text-stroke-width: 0px; background-color: transparent; color: #365899; cursor: pointer; font-style: normal; font-variant: normal; font-weight: 600; letter-spacing: normal; orphans: 2; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"></a></span><span style="background-color: transparent; color: #1c1e21; display: inline; float: none; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"> </span><span dir="ltr" style="background-color: transparent; color: #1c1e21; font-style: normal; font-variant: normal; font-weight: 400; letter-spacing: normal; text-align: left; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><span class="_3l3x">I lost my pet mouse Elvis the other night. He was caught in a trap</span></span></span></span><br />
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Tried to book tickets for an Elvis tribute night over the phone. Had to press one for the money, two for the show…</span></div><div style="-webkit-text-stroke-width: 0px; background-color: transparent; box-sizing: border-box; color: #676767; font-style: normal; font-variant: normal; font-weight: 300; letter-spacing: 0.5px; margin-bottom: 21px; orphans: 2; text-align: justify; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><span face=""arial" , "helvetica" , sans-serif" style="font-size: x-large;"><br /></span></div><div style="-webkit-text-stroke-width: 0px; background-color: transparent; box-sizing: border-box; color: #676767; font-style: normal; font-variant: normal; font-weight: 300; letter-spacing: 0.5px; margin-bottom: 21px; orphans: 2; text-align: justify; text-decoration: none; text-indent: 0px; text-transform: none; white-space: normal; word-spacing: 0px;"><span face=""arial" , "helvetica" , sans-serif" style="font-size: x-large;"><a href="https://www.youtube.com/watch?v=me-kPoNwOlg">american triology - YouTube</a></span></div>My Bloghttp://www.blogger.com/profile/00863898607546565954noreply@blogger.com0