Progress Note
Good morning Ms. Ella Smith, I see that you are here about the diagnosis of your father’s condition. I am prepared to explain the condition of your father. Mr. Drake was admitted to the hospital by ambulance he was suffering from fever and confusion. Mr. Drake had a physical examination done and he is suffering (encephalitis) inflammation of the brain tissue. Mr. Drake was given fluids through the IV to treat the infection around the brain tissue. Mr. Drake was placed on medication through the IV. Because of the severeness of his illness, Mr. Drake went into a light comatose state which only allowed tactile and verbal stimuli (response), but was unconscious. So a tube was placed through the nostril for feeding purposes. After 14 days of fluid injection through the IV Mr. Drake was slowly back to normal.

PART 2.
1. Meningitis is swelling of the membranes around the brain and spinal cord. There are different types of meningitis, but most are caused by viruses or bacteria. Viral meningitis can make you very sick but it often doesn’t have lingering effects. Bacterial meningitis is more serious. It progresses rapidly and can cause permanent damage or even become life-threatening. CT scans of the head may reveal swelling or inflammation. These tests can also help your doctor look for infection in other areas of the body that may be associated with meningitis. Spinal tap (lumbar puncture). The definitive diagnosis of meningitis requires an analysis of your cerebrospinal fluid (CSF), which is collected during a procedure known as a spinal tap. In people with meningitis, the CSF fluid often shows a low sugar (glucose) level along with an increased white blood cell count and increased protein. CSF analysis may also help your doctor identify the exact bacterium that causing meningitis.
2. Memory: repeating statements and questions over and over, not realizing that they’ve asked the question before. Forget conversations, appointments or events, and not remember them later. Routinely misplace possessions, often putting them in illogical locations. Eventually forget the names of family members and everyday objects.
Disorientation: People with Alzheimer’s may lose their sense of what day it is, the season, where they are or even their current life circumstances. Alzheimer’s may also disrupt your brain’s ability to interpret what you see, making it difficult to understand your surroundings. Eventually, these problems may lead to getting lost in familiar places.
Speaking and writing: Those with Alzheimer’s may have trouble finding the right words to identify objects, express thoughts or take part in conversations. Over time, the ability to read and write also declines.
Change in personality and behavior: Brain changes that occur in Alzheimer’s disease can affect the way you act and how you feel. People with Alzheimer’s may experience:*Depression *Anxiety *Social withdrawal *Mood swings *Distrust in others* Irritability and aggressiveness. Many important skills are not lost until very late in the disease. These include the ability to read, dance, and sing, enjoy old music, engage in crafts, and hobbies, tell stories, and reminisce.
3. The effects of stroke (brain attack) vary from person to person based on the type, severity, location, and number of strokes. The brain is extremely complex and each area of the brain is responsible for a special function or ability. When an area of the brain is damaged, which typically occurs with a stroke, an impairment may result. The brain is divided into 3 main areas: * Cerebrum (consisting of the right and left sides or hemispheres) * Cerebellum *Brain stem. Depending on which of these regions of the brain the stroke occurs, the effects may be very different. No two people experience aphasia the same way, with varying symptoms and severity: Aphasia may make it difficult to: Speak, Understand spoken language, Read, Write, Use numbers and do calculations, Use non-verbal gesturing. There are four main types of aphasia: Nonfluent: describes a person who has a difficult time speaking, writing, or finding specific words. Fluent: The rate of speech may be normal but the person may not make sense. He or she has difficulty reading or comprehending what others say. Global: is the most severe type. Patients produce few recognizable words and understand little or no spoken language. Anomic aphasia: is the persistent inability to supply the words for the very image things patients want to talk about particularly the significant nouns and verbs.
4. A single-photon emission computerized tomography (SPECT) scan lets your doctor analyze the function of some of your internal organs, A SPECT scan is a type nuclear imaging test, which means it uses radioactive substance and a special camera to create 3D pictures. SPECT scan produces images that show how your organs work. For instance, a SPECT scan can show how blood flows to your heart or what areas of your brain are more active or less active. SPECT can be helpful in determining which parts of the brain are being affected by Epilepsy. A position emission tomography (PET) scan is an imaging test that helps reveal how your tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to show this activity. The tracer may be injected, swallowed or inhaled, depending on which organ or tissue is being studied by the PET scan. The tracer collects in areas of your body that have higher levels of chemical activity, which often correspond to areas of disease. On a PET scan, these areas show up as bright spots. A PET scan is useful in revealing or evaluating several conditions, including some cancers, heart disease and brain disorders.

Riggin EA. Decision Support System. Mayo Clinic, Rochester, Minn. Nov. 20, 2013.