1. Recurrent PE.
Youung lady was incidentally found with pulmonary embolism from a ct thorax. She presented with very minimal symptom, with very mild sob only. She is a known paraplegic from a suicidal jump when she was younger and found #C6, and subsequently put on wheelchair. Another episode of PE was detected last year during the workup of a small pleural effusion and a paraspinal mass, likely pleural fibroma. She completed course of pradaxa for 6 months and followup ct showed resolution of embolism.
Highly uncooperative and requested homeleave in between the treatment. Very nasty face.
Its very easy to DAMA a patient, but seriously this is no less different from allowing a timebomb to wheelchair around in the street. But she simply just didn’t care about the risks and believed in her own invincibility. I’m so stressed and depressed.
2. Popo with poor intake x2
3. Acute on CKF.