Henry Ford studies

MEDICATIONS:

1.  Prednisone 20 mg a day.

CHIEF COMPLAINT:  “I feel okay.”

HISTORY OF PRESENT ILLNESS:  Patient gave birth to two fraternal twin girls 10 days ago.  They weigh 3 pounds a piece.  They are currently in the hospital.  Patient tried breast-feeding for about 4 to 5 days, but found that it was too uncomfortable.  The delivery was vaginal.  No complications.  Minimal pain.

EXAMINATION:

VITAL SIGNS:  Weight 188 pounds, blood pressure 110/70, with a temp of 98.1.

SKIN:  No evidence of dermatitis involving the skin of the arms, legs, or face.

CHEST:  Clear.

HEART:  Heart tones were okay.  No pretibial edema.

MUSC/SK:  No evidence of arthritis involving the joints of the hands, wrists, elbows, knees, ankles, or feet.

LABORATORY STUDIES:  Hemoglobin 11.4 g/dL.  Normal platelet count.

IMPRESSION:  Successful carrying to term twins during which the patient has an exacerbation of lupus characterized by hemolytic anemia.

MEDICAL DECISION MAKING:  Prescribed prednisone to be taken <___> mg a day, continue with prednisone 15 mg daily.  Return in 8 weeks.