|^~\&EQUATORDXTRAYEQUATORDXTRAY:0.12.8 (Build 310)LDemo Server1FFA8984-7166-4655-B195-7B4FFFD2F136GUID20050417213103+1000ORUR01ORU_R0120050417.736385P2.3.1AUSISO0.9LALAUS12345756Medical-Objects7C3E3682-91F6-11D2-8F2C-444553540000GUIDSRBuderim GE Centre7C3E3681-91F6-11D2-8F2C-444553540000GUID4024728674AUSHICMC12345Rx MedicalSRBuderim GE Centre7C3E3681-91F6-11D2-8F2C-444553540000GUID100004Medical-Objects7C3E3682-91F6-11D2-8F2C-444553540000GUIDSRDemo Server1FFA8984-7166-4655-B195-7B4FFFD2F136GUIDJONESJuneL19760108F24 Sutherland StreetBUDERIMQLD4556AUSC54455531PRNPH544555311O0341616XWHITEWILSONDRAUSHICPRLUPIN0191322WANDERSONTHOMASKDRAUSHICPRLUPINNRED61D86F3-5A52-4B7E-9FCC-4D8EA7F08F60Surgeons432A9380-B4B5-4371-86C8-AFC48E0D4738GUIDCM0341616XWHITEWILSONDRAUSHICPRLUPIN1D61D86F3-5A52-4B7E-9FCC-4D8EA7F08F60Surgeons432A9380-B4B5-4371-86C8-AFC48E0D4738GUID11488-4Surgeons Consultation NoteLN20050412+10000341616XWHITEWILSONDRAUSHICPRLUPINFrom Buderim GE Centre in File dated 16.04.2005LN=D61D86F3-5A52-4B7E-9FCC-4D8EA7F08F6020050413120301+1000PHYF20050413+10000191322WANDERSONTHOMASKDRAUSHICPRLUPIN0341616XWHITEWILSONDRAUSHICPRLUPIN0341615JANDREWSJOHN1FT11488-4LN12th April 2005Dr Wilson WhiteNambour Medical CentrePO Box 746NAMBOUR QLD 4560Dear Wilson,Re: Mrs June Jones D.O.B 08/01/1976 Phone: Thank you for asking me to see June again regarding her gallstones. As you know she had an episode of cholangitis around the time of her recent delivery and caesarean section in December. Ultrasound suggested dilated biliary tree and Thomas Anderson was kind enough to perform an ERCP and release several stones from the distal common bile duct. Since this time June has been generally well. She has had one episode last week where she had a similar episode of back pain which lasted 24 hours but has subsequently resolved. This was not associated with dark urine and not associated with fevers. I have had long discussions with June and her husband Cipher today. I have explained to her that she does have approximately 1% per annum of having further serious problems associated with her gallstones. Whilst these risks are small per annum, at her age there is a highly likelihood that she will have problems at some point. I have also explained that long term there is a small risk of carcinoma of the gallbladder associated with the presence of stones in the longer term. It is a difficult decision for June to commit to surgery for her gallbladder and I have not forced her hand at this point. I am however optimistic that she will agree to cholecystectomy eventually. Kind regardsYours sincerely,Dr. J Andrews MBBS, FRACSCc Dr Thomas AndersonF2FTHTMLAUSPDI<html><head></head><body><div> </div><div><font face="Arial">12th April 2005</font></div><div> </div><div><font face="Arial">Dr Wilson White</font></div><div><font face="Arial">Nambour Medical Centre</font></div><div><font face="Arial">PO Box 746</font></div><div><font face="Arial">NAMBOUR QLD 4560</font></div><div> </div><div><font face="Arial">Dear Wilson,</font></div><div> </div><div> </div><div><B><font face="Arial">Re: Mrs June Jones </font></B></div><div><font face="Arial"> D.O.B 08/01/1976 </font></div><div> </div><div><font face="Arial">Thank you for asking me to see June again regarding her gallstones. As you know she had an episode of cholangitis around the time of her recent delivery and caesarean section in December. Ultrasound suggested dilated biliary tree and Thomas Anderson was kind enough to perform an ERCP and release several stones from the distal common bile duct. </font></div><div> </div><div><font face="Arial">Since this time June has been generally well. She has had one episode last week where she had a similar episode of back pain which lasted 24 hours but has subsequently resolved. This was not associated with dark urine and not associated with fevers. </font></div><div> </div><div><font face="Arial">I have had long discussions with June and her husband Cipher today. I have explained to her that she does have approximately 1% per annum of having further serious problems associated with her gallstones. Whilst these risks are small per annum, at her age there is a highly likelihood that she will have problems at some point. I have also explained that long term there is a small risk of carcinoma of the gallbladder associated with the presence of stones in the longer term. </font></div><div> </div><div><font face="Arial">It is a difficult decision for June to commit to surgery for her gallbladder and I have not forced her hand at this point. I am however optimistic that she will agree to cholecystectomy eventually. Kind regards</font></div><div> </div><div><font face="Arial">Yours sincerely,</font></div><div> </div><div> </div><div> </div><div><font face="Arial">Dr. J Andrews MBBS, FRACS</font></div><div> </div><div> </div><div><font face="Arial">Cc Dr Thomas Anderson</font></div></body></html>F