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beautiful pink lava erupting in this dreamstate horizon
2005-11-27 5:03 p.m.

I'm going to type in here what is in this document the hospital sent us earlier in the week. I know there are some friends in the medical professions that want specific info. Here I go:

REVIEW OF SYSTEMS: Significant for intermittent redness in face and raynaud hands at times, intrmittent numbness and tingling throughout body. No recent cough, shortness of breath or chest pain, no hemoptysis. No severe bouts of abdominal pain. Did have a rash once after she had swelling from blood pressure medicine. It may have been a drug reaction.

PHYSICAL EXAMINATION:

GENERAL: An anxious woman moving around in bed a lot, poor historian with poor concentration.

SKIN:She has some mild erthema on face and hands. No clear rash, no ischemia on fingertips, and no fissures.

HEENT: Is significant mainly for some dry mouth, perhaps, but no oral lesions.

CHEST: Clear

ABDOMEN: Nontender with no organomegaly

EXTREMITIES: no synovitis detectablt at fingers, wrists, elbows, or shoulders, all of which have reasonable range of motion. Knees cool without effusions. Anmlkes and toes nontender. She did not have a footdrop ans seemed to be 5/5 throughout.

LABORATORY DATA:
Essentially unremarkable chemistry
panel and CBC. ESR 16, ANA negative, TSH normal at 1.9 negative, negative Sjogren antibodies, negative lupus anticoagulent, Russell viper venom time, and anticardiolipin antibodies with a normal PT and PTT. Other serologies, including rheumatoid factor, are pending.
IMPRESSION:
CNS vasculitis. The patient does present with multiple abnormalities of the CNS in terms of small hemorrhages and a beaded appearance on angiogram, consistent with CNS vasculitis.

It could be some type of autoimmune or infllammatory condition. Although she has chronic Raynaud's and some redness on her hands and face, suggesting the possibility of connective tissue disease, her antinuclear antibody has been negative. This makes connective tissue disease much less likley, especially in the setting of having a low sedimentation rate, no internal organ inflammation, and negative Sjogren antibodies. I'll add more as I deal with typing it in.