Eastcote Health Centre | Abbotsbury Gardens | Eastcote | Pinner | Middlesex | HA5 1TG
Tel: 0208 866 0121 & 0208 866 8382 www.abbotsburypractice.nhs.uk E86022
4 June 2024
NHS Number: 706 691 3507
Dear ED/surgical team on call
Re: Mrs Fatima Jamal
13-Oct-1983 40y
6 The Close, Eastcote, Pinner, HA5 1PH, , 07526590202
I would be grateful if you could review this lady who has ongoing flank pain for the past week. She
was seen in ED on 30th May and was found to have a CRP of 150. She was given a course of co-amox
and sent home for ?pyelo. Urine cultures have come back negative.
She initially had fevers but these have settled. The main ongoing issue is constant dull ache in both
flanks which gets worse when she passes urine. She also reports dysuria for the past 2 days which is
new.
She feels very uncomfortable due to the pain. When seen in ED last week the doctor told her she
would have an OP scan within the next week but she hasn’t heard from the team.
I would be grateful if she can have a repeat set of bloods to check her inflammatory markers are
coming down but also consider a CT scan for ?stones given the nature of her pain.
She is travelling next week so wants to get to the bottom of her discomfort.
Yours sincerely
Dr Adam Pack
Dr Shalin Bhattessa | Dr Shireen Siddiqui
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Consultations
Date Consultation Text
04-Jun-2024 11:07 GP Surgery (ABBOTSBURY PRACTICE) PACK, Adam (Dr)
Problem Right flank pain (First)
History went to ED last week on 30/5
was discharged on PO co-amox and codeine
today is last day of abx
was told she has kidney infection
not taking the codeine due to risk of constipation.
reports she has discomfort on both her sides
constant dull pain, 3-4/10
pain is worse when she passes urine- feels its going from flank to groin
on both sides.
drinking lots of water
now getting dysuria when passing urine- new for her in past 2 days.
pain in sides remains- struggling to sleep due to the ache.
ED did want to scan her this week but not heard anything- she said it
was a CT scan but nothing arranged.
CRP was 150 on 30/5
urine culture done by us didn't show any growth
Document eMED3 (2010) new statement issued, not fit for work 2 Fit Note
Document (Diagnosis: Right flank pain; Duration 04-Jun-2024 - 18-Jun-
2024)
Examination Tympanic temperature 37.1 degrees C • Heart rate 80 beats/min
• Blood oxygen saturation - on room air 98 %
abdo soft
tender right and left flank but right worse than left
O/E - blood pressure reading 127/92 mmHg • Urine glucose test
negative • Urine nitrite negative • Urine leucocyte test = negative
• Urine ketone test negative • Urine protein test = + • Urine blood
test = negative
urine colour is like water.
Medication Cefalexin 500mg tablets One To Be Taken Twice A Day 14 tablet
Test Request Winpath - Blood Sciences - Unknown specimen
Test Request : Full blood count - FBC (g)
Test Request : C reactive protein (g)
Test Request : Liver Function Tests
Test Request : RENAL Profile
Ultrasound - Unknown specimen
Test Request : US Urinary tract
Comment discussed option of going back to ED due to ongoing pain as needs
bloods +- scan. Initially pt not keen to go and would rather OP
arrangements however decided if she goes to ED today they may well
scan her today- concerned as shes travellling next week.
paracetamol prn
urgent bloods at Mt vernon
US abdomen
for further week of PO cefalexin due to dysuria
ref for private to urology ?renal stones
30-May-2024 11:21 GP Surgery (ABBOTSBURY PRACTICE) TANNA, Anika (Dr)
Problem Lower abdominal pain (First)
History 40y
F2F consultation
2d hx fever, body aches - temps up to 39
Taking paracetamol, ibuprofen
Had paracetamol at 3am, 7am
Pain on R side
Has not been to A&E as felt in too much pain to wait to be seen, called
111 several times yesterday and overnight
No cough/cold/sore throat
No vomiting/diarrhoea
Currently on period
Examination Alert, appears to be uncomfortable
T 38.8
Chest clear, good air entry R+L, sats 99% in air
HR 105
O/E - blood pressure reading 105/74 mmHg
Abdomen soft, R iliac fossa and R flank tenderness on palpation, no
guarding/rebound tendenress, rosvings positive
Urine leucocyte test = + • Urine protein test = + • Urine blood test = +
• Urine glucose test negative • Urine ketone test negative
urine beta hcg negative
Comment Reluctant to attend A&E however in view of obs, examination findings
advised needs ot have surgical review to exclude appendicitis, ?
pyelonephritis, advised needs to have surgical review - will contact
surgical team to be reviewed, to attend A&E asap
Will send MSU
Attempted to call @ 1150 unable to get through, will keep trying
Problems
Active
Date Problem Associated Text Date Ended
04-Jun-2024 Right flank pain
30-May-2024 Lower abdominal pain
26-Feb-2024 Has a sore throat
12-Sep-2023 Bursitis left trochantedc bursitis.
21-Jun-2022 Sore throat symptom
12-Oct-2021 Gestational diabetes mellitus
01-Mar-2021 Failed encounter - message left on 11:15am
answer machine
07-Oct-2020 Pregnant
13-Dec-2018 Vitamin D deficiency see recent test
04-Sep-2013 Cervical neoplasia screening
11-Jan-2013 Referral to minor surgery special
interest GP
11-Jan-2013 Referral for further care
11-Jan-2013 In-house ophthalmology
19-Sep-2012 Cervical neoplasia screening
17-Aug-2012 [SO]Eyelid
Significant Past
Date Problem Associated Text Date Ended
24-Feb-2024 Conjunctivitis 19-May-2024
14-Sep-2022 COVID-19 13-Oct-2022
08-Dec-2020 Missed miscarriage 02-Mar-2021
07-Oct-2020 Recurrent miscarriage -3 and one TOP[spina 31-Dec-2020
bifida]
08-Jul-2019 Miscarriage at 11/40 02-Oct-2019
29-May-2019 Patient currently pregnant 25-Mar-2020
13-Dec-2018 Termination of pregnancy contemplated Spina Bifida 19-Apr-2019
08-Aug-2018 Endoscopic endometrial polypectomy and hysteroscopy 31-Oct-2018
16-Jul-2018 Fibroids 09-Oct-2018
25-Jan-2018 Miscarriage 15.1.18 20-Apr-2018
16-Jan-2018 Patient pregnant 01-Oct-2019
18-Oct-2016 Emergency caesarean section 11-Jan-2017
18-Oct-2016 Delivery by emergency caesarean 11-Jan-2017
section
18-Aug-2016 Gestational diabetes mellitus 11-Nov-2016
15-Mar-2016 Patient pregnant EDD 2.11.16 IVF 14-Apr-2017
22-Feb-2016 In vitro fertilisation (IVF) 17-May-2016
02-Jul-2014 Primary infertility unspecified 13-Jan-2015
09-Nov-2011 Disorder of menstruation 06-May-2022
Medication
Acute
Drug Dosage Quantity Last Issued On
Cefalexin 500mg tablets One To Be Taken 14 tablet 04-Jun-2024
Twice A Day
