{"text":"NHS Confidential: Personal data about a patient \nAcute Services Division N HS \nEmergency Care and Greater Glasgow \nMedical Services Directorate and Clyde \nGlasgow Royal Infirmary \n84 Castle Street Oesophageal Clinic \nGLASGOW Consultant: ~ . l \nG4 OSF Dr R Gillespie \nSwitchboard:0141~211~4000 Consultant Physician & Gastroenterologist \nDirect Dial: 0141~211~45t9 Dr J Winter \nFax: 0141~211~5659 Consultant Gastroenterologist \neamail: mary.doherty@northglasgow scot.nhs.uk \nJW\/PK\/20107395R \nDict: 07\/10\/2010 \nTyped: 13\/10\/2010 i \nDr Stephen MacPherson \nBridgeton Health Centre \n201 Abercromby Street ! \nGlasgow \nG40 2DA \nDear Dr MacPherson } \n\" Henry Norwood ~ 01\/01\/1950 ~ CHI: 0101506015 \n248 Millroad Drive, Glasgow, G40 2NS \nDiagnosis: Weight Loss \nIntermittent Vomiting \nNormal Endoscopy & CT Scan \nEmphysema \nChronic Back Pain Secondary to Vertebral Fracture \nCigarette Smoker \nI reviewed Henry Norwood, 60-ycars, this afternoon. He describes a 6-month history of anorexia, nausea and weight loss. He will \nvomit once or twice a weck, usually approximately an hour after food. Upper Gl endoscopy was unremarkable and CT scan of \nchest and abdomen revealed only emphysematous changes in his lungs and the previously recognised fracture of L1. \nHe is on no regular medication but uses Tramadol a few times a week. He is a cigarette smoker but drinks fittle aicohol. He works \nin the building trade and is very active. Hc has significant ongoing stress in his life. Last year he and his partner lost an infant to \\ \ncot death and his partner is now pregnant again. ' \n1 performed a contrast swallow this afternoon which showed no hold up in the ocesophageal emptying of the liquid. \nHe has been well investigated and no significant abnormality identified. | am inclined to feel that his symptoms arc duc to a \ncombination of reduced calorific intake secondary to anxicty and increased cxpenditure due to his active lifestyle and incrcased \nwork of breathing due to his incipient emphysema. \n1 have suggested that he try a low dose of Imipramine which may help his back pain and also his appetite. I have suggested 10mg \nat night, increasing to 25mg afier 2-weeks if tolerated. | \n1 think it would be very helpful is he could be reviewed by the community dietictan via your health centre, and provided with \nnutritional supplements if felt to be necessary. Otherwise he is likely to continue to lose weight unless his appetite improves. \n1 have checked his routine bloods, including thyroid function and coeliac serology. He will be reviewed again in 3-months. \nYours sincerely \netter health \noiisy t Gastroenterologist \nwww.nhsggc.org.uk 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