Medical Documentation Proofreading Example 11

Proofreading

This patient present two the office today dew to some problems with her right hand. It had been tingling  and getting numb periodicaly over the past several weeks. She is worried about carpel tunnel. She does  lot of repetitive type activities. It is worse at night. It involve mostly the middle finger, although she says it  also involves the first and second digit on the right hand. She has some pain on her thumb as well. She  thinks that could be arthritis. The patient is going to use Anaprox double strength one pills every 12 hours  with food as well as a cock-up Wrist splint. We are going to try this for two weeks, and if condition is still  present then we are going to proceed with EMG test at that time. He is working on diet and exercise and  she is doing a great job. Right now, for the blood pressure we are going to continue to observe as she  carries forward addition measures in her diet or exercise for lose more weight, and I expect the  bloodpressure will continue to improve.

carpal tunnel syndrome


Answer

This patient presents to the office today due to some problems with her right hand. It has been tingling and getting numb periodically over the past several weeks. She is worried about carpal tunnel. She does a lot of repetitive type activities. It is worse at night. It involves mostly the middle finger, although she says it  also involves the first and second digits on the right hand. She has some pain in her thumb as well. She  thinks that could be arthritis. The patient is going to use Anaprox double strength one pill every 12 hours  with food as well as a cock-up wrist splint. We are going to try this for two weeks, and if the condition is still  present, then we are going to proceed with EMG test at that time. She is working on diet and exercise, and  she is doing a great job. Right now, for the blood pressure, we are going to continue to observe as she carries forward additional measures in her diet and exercise to lose more weight, and I expect the  blood pressure will continue to improve.



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