OneStrangeLife – Personal Health Summary

Generated: 2025-04-23

1. Snapshot

Item Current Status
Pacemaker Implanted 11 Sep 2015 for symptomatic sinus bradycardia (HR 25–35 bpm). Device functioning; next battery‑life check needed.
Pulmonary Embolism Unprovoked PE on 02 Dec 2019 → lifelong anticoagulation (Apixaban 5 mg BID).
Blood Pressure / HR Typically ≈ 120–125/70–76 mmHg, HR ≈ 70 bpm on Metoprolol 100 mg BID + Lisinopril 10 mg QD.
Fasting Glucose 145–175 mg/dL despite Empagliflozin 25 mg QD (A1c 6.5–6.7 %).
Kidneys eGFR ~50–55; benign simple renal cysts (largest ~14 cm, Bosniak I).
Weight / BMI 317 lb (BMI ≈ 43).
Lipid Panel (Jan 2025) LDL 78 mg/dL, HDL 37, TG 91 (statin stopped; LDL still at goal).
Current Rx Apixaban, Metoprolol, Lisinopril, Empagliflozin, Quetiapine, Tamsulosin, supplements.
Key Symptoms Painful urination, right‑arm numbness (C6 pattern), leg edema, slow‑healing wounds, post‑meal fatigue.

2. Cardiovascular

  • Stress SPECT (09 Sep 2024): Normal perfusion, LVEF 73 %, no ischemia or scar.citeturn6file0
  • Left‑heart cath (20 Feb 2018): Normal coronaries.
  • No evidence of Wellens’ syndrome. Pacemaker pacing masks ST‑T; no biphasic T‑waves seen.
  • Actions
    1. Schedule pacemaker interrogation ➜ battery‑replacement timeline.
    2. Confirm pacemaker logs re: atrial fibrillation episodes (supports anticoagulation).
    3. Repeat echocardiogram (> 7 yrs since last) to reassess EF and valves.

3. Diabetes & Metabolism

Date A1c %
2017 5.3
2020–2021 6.3–6.4
Apr 2023 6.6
Dec 2023 6.7
Jul 2024 6.5
Feb 2025 6.6
  • Interpretation: Mild‑to‑moderate hyperglycaemia, trending upward; fasting 145–175 mg/dL.
  • Contributors: Weight, quetiapine, carb‑heavy breakfast.
  • Plan Ideas
    • Add Metformin or GLP‑1 RA.
    • Nutrition: protein‑rich or low‑GI breakfast; calorie deficit for 5‑10 % weight loss.
    • Check A1c + CMP in 3 mo.

4. Kidneys & Urology

  • Renal cysts: Stable Bosniak I – no intervention.
  • Creatinine: 1.3–1.5 mg/dL (CKD stage 2–3). Empagliflozin + ACE‑I protective.
  • Painful urination / micro‑hematuria: CT urogram negative for stones/tumor. Consider:
    • Repeat urinalysis + culture (UTI risk ↑ with SGLT2 inhibitor).
    • Cystoscopy if dysuria persists.
  • Trace protein: Order urine albumin/creatinine ratio.

5. Neurologic & Musculoskeletal

  • Right‑arm numbness: Distribution consistent with C6 radiculopathy → cervical MRI / EMG.
  • Leg edema: Multifactorial (obesity, venous insufficiency). Ensure compression, consider low‑dose diuretic if symptomatic.
  • Slow‑healing wounds: Likely from hyperglycaemia + edema + iron‑deficiency (ferritin 14 ng/mL).

6. Additional Findings

  • Iron deficiency: Start oral or IV iron; repeat ferritin/CBC.
  • Fatty liver / early cirrhotic morphology on CT: Order full liver panel, FibroScan.
  • Mental health: Quetiapine benefits vs metabolic side‑effects—discuss alternatives if feasible.

7. 10‑Point Checklist for Next Visit

  1. Pacemaker interrogation + battery forecast.
  2. Clarify AF burden; confirm need for ongoing apixaban.
  3. Repeat echocardiogram.
  4. Basic metabolic panel, A1c, fasting lipids, urine ACR.
  5. Iron studies follow‑up; commence supplementation.
  6. Evaluate persistent dysuria → UA, culture, possible cystoscopy.
  7. Cervical MRI/EMG for arm paraesthesia.
  8. Address leg edema: compression, weight loss, possible diuretic.
  9. Discuss metformin or GLP‑1 RA; nutrition referral.
  10. Liver work‑up given CT findings.