1. Epigastric pain- In the past, the patient has had several back surgeries, has had chronic pain syndrome, and for a period of time, the patient has consumed opiate. In the two physical exams conducted in the office, the patient did not experience any abdominal pain. The patient nearly constantly had these abdominal pain episodes.
a. Possibly the patient requires an increased level of pain control with increased opiate dose, which should be discussed with the patient’s primary care physician.
2. End-stage liver disease. - We need to discover the cause of the liver cirrhosis.
Waiting for the alpha-fetoprotein level and hepatitis panel. In addition, we need to obtain information about the ultrasound that was performed in Diego medical center,