{"text":"NHS ConRdential: Peraonal data shouta palient \nNHS Lanarkshire \nDepartment of Gastroenterology \nUniversity Hospital \nMonkiands \n\"Monkscourt Avenue \nNHS \ne i \nTEL: 01698-401431 Airdrie \u2019 . \n: ML6 0TS Lanarkshire \nPatricia Hunt Date Dictated: 09\/12\/2021 \n22 Cuilmuir View Date Typed: 11\/01\/2022 \nCroy Ref: 2682056 \nGlasgow Letter Rel: AW\/GT \nG6s oHH Clinic Date: 08\/12\/2021 \n\u2019 CHI Barcode: ! \ni \n* 12098203403\u00ab u \nConsultant: Doctor Jen Veryan [ \n- 1 \nDear Patricia Hunt | \nPatient Naue: Patricia Hunt i \nPatient date of birth: 12\/09\/1982 \u2018 . ! \nPatient Address: 22 Cuilmuir View, Croy, Glasgow, G65 $HH \u00a7 \nProblem: ) \u2018 i \n1. Recurrent iron deficiency anaemia i \na. haemoglobin of 39 with an MCV of 61.8 and ferritin of 2.9 in 2019 . . \n. b. most recent haemoglobin 85 . i \n\u00a2. QFit>400 in June 2021 \nd. Mild gastritis on upper endoscopy with normal D2 biopsies (Aprit 2021) \n2. Weight loss \u2014 most recent weight at clinic 36kgs (47kgs in 2019) with BMI of 13.3 \n3. .Upper abdominal pain (reason for initial referral to endoscopy) ~ resolved with discontinuing Ferrous Fumarate, \ncurrently on Ferrous Sulphate with no further symptoms \nMany thanks for coming up to the hospital for your Gastroenterology appointment, it was a pleasure meeting you. You \nhad initially been sent through for an upper endoscopy because you were experiencing some upper abdominal discomfort \nand your blood counts were noted to be low. This was carried out in April 2021 which showed some mild inflammation \nin the stomach, but was otherwise normal- there was no explanation for your low blood count. We discussed why we \nwere Jooking at carrying out further testing \u2014 you were signilicantly anaemic in 2019 (much more than I would expect to \noccur in pre-menopausal women) and your stool test from June came back as positive for microscopic amounts of blood \n(QFit >400). You had mentioned that you had cancelled your colonoscopy because you ivere unable to take manage \nMoviprep and you were still passing solid stools on the day of the test. I have prescribed you Picolax as an alternative ; \nand I have re-requelted the colonoscopy to be done as soon as possible. i I \nYour weight at the clinic today was 36kgs which is 11kgs less than the last weight I can see documented in 2020 (when i \n- you were dischatged from the Dietetic Service). [ have aiso asked for a CT chest, abdo pelvis to be carried out so you \nreceive correspondence from the radiology department as well. In the meantime, I will also re-refer you on to the \nDietetic Department because T wonder if they will be able to help you meet your nutritional requirements. \nYour urine sample at the clinic had microscopic haematuria (smatf amounts of bloods that you can't see with your naked \neye), and you may warrant further investigalion from that point of view. The CT will be helpful, but if there is no \nexplanation for your low blood count on your CT or colonoscopy, then we can recheck your urine at your next \nappointment (I will bring you back early this year) and I will ask my urology colleagues for advice if it remains positive \nfor blood, \u2018 \nYour blood tests at your clinic appointment showed a haemoglobin of 95 (better, but still low), with evidence of ongoing \niron deficiency and new folate deficiency \u2014 I would appreciate if you could continue your iron (please stop this a week \nbefore your colonescopy) and [ would be grateful if your GP could preseribe you folic acid Smg daily. Your kidney lests \nwere worse than I exp\u00e9cted (eGFR 49), so I have sent out another form to recheck these, as well as to do some further \ntests (glomerutonephritis screen) \u2014 I witl keep an eye out for the result but if you could phone the department on 01698 \n752 431 once you have had these taken, then I will know (o look for them. ) \nYours 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