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Mervyn BRADY
Discharged on March 24, 2025
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This personalised guide will help you track your appointments, medications, complete important tasks, and know when to seek help.
Your Current Medications
Important Tasks0/3 completed
When to Contact Your Doctor
If you experience any of these symptoms, call 000 immediately or go to the nearest emergency department.
Call 000 immediately if you develop severe headache, especially with nausea or vomiting.
Contact your doctor immediately if you notice new double vision, vision loss, or other eye problems.
Call 000 if you experience sudden weakness, difficulty walking, or coordination problems.
Contact your doctor if you notice confusion, memory problems, or personality changes.
Your Follow-up Appointments
For any emergency, please call Triple Zero 000.
TWEED VALLEY HOSPITAL
70 Rajah Road, Ocean Shores NSW 2483
Phone: 07 5506 7000
DISCHARGE SUMMARY
Patient Name: MB
Age: 70 years old
Admission Date: 01/05/2025
Medical Service: Physician
AMO: Dr. John Doe
Discharge Date: 24/03/2025
LMO: Dr. James Doe
LMO Address: Ocean Shores Medical Centre
Ward: TVH Surg 4A2
Language: English
PRINCIPAL DIAGNOSIS:
Pituitary apoplexy
INPATIENT MANAGEMENT SUMMARY:
Patient presented with headache and L CN6 palsy post leuprolide injection (for metastatic prostate cancer) in community. MRI Brain showing pituitary apoplexy. Discussed with GCUH Neurosurgery, not for surgical management. Endocrine consulted, patient was stress dosed for a few days, but repeat pituitary panel had stable hormones and no requirement for ongoing hormone replacement. Not for further leuprolide injections (Pituitary apoplexy is rare side effect of GnRH agonists).
KEY ISSUES THIS ADMISSION:
- Pituitary macroadenoma with associated apoplexy - Woke up on 08/03/25 with diplopia and headache. MRB showing pituitary macroadenoma 15x16x23mm with hemorrhage
- Acute onset Left CN6 palsy - Diplopia with L lateral gaze, likely due to irritation from apoplexy
- Metastatic prostate cancer - PSA 400 (Feb 2025), PSMA scan showing widespread osseous metastatic disease
- R femoral bony lesion - Prophylactic nail completed 14/03/2025
- New thrombocytopenia - Nadir 72, likely secondary to bone marrow suppression from skeletal mets
- Potential bladder malignancy - Incidental finding on CT, urology follow-up arranged
DISCHARGE MEDICATIONS:
- Felodipine (Felodil XR) 10mg oral daily in morning - for blood pressure
- Macrogol 3350 with electrolytes 2 sachets oral daily PRN - for constipation
- Pantoprazole 40mg oral daily PRN - for indigestion/heartburn
- Paracetamol (Panadol Osteo) 665mg oral TDS - for pain
- Rosuvastatin 40mg oral daily in morning - to lower cholesterol
MEDICATIONS CEASED:
- Bicalutamide 50mg oral tablet - CEASED
- Leuprorelin 22.5mg/3 months IM injection - CEASED
FOLLOW-UP ARRANGEMENTS:
- Endocrine OPD - 10 April 2025 (booked)
- GP to organise MRI pituitary + Pituitary panel 2 weeks before above appointment
- GCUH Ophthalmology OPD - referral sent, patient will be contacted
- Medical Oncology and Radiation Oncology OPD - referrals sent
- Urology - Bilateral orchidectomy + Rigid Cystoscopy +/- TURBT booked
ALLERGIES:
No Known Allergies
Attending Medical Officer:
Dr. John Doe
Respiratory Physician
Provider No: XXXXXXXX
Local Medical Officer:
Dr. James Doe
Provider No: XXXXXXXX
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