May 1, 2014

Ian R. Wing, MD
2261 Arizona Avenue, Suite B
Madison, WI 53207
RE:

Elvira Martinson

Dear Dr. Wing:

I saw your patient, Ms. Elvira Martinson, in consultation in my office today.
She brought the x-rays from your office with her. She was afebrile today
but on questioning admitted a low grade fever over the past few days. I
removed the fluid as seen on your film of April 30 from the right lower lung field,
and she felt considerably more comfortable. On thoracentesis, there was 50 mL
of straw colored fluid. Her history is well known to you, so I will not repeat it.
On physical examination I found a well-developed, well-nourished, white
female with minimal dyspnea. There was no lymphadenopathy. Breath sounds
were diminished somewhat on the right; there was dullness at the right base.
The left lung was clear to percussion and auscultation. The remainder of the
examination was negative.
Because of her history of chronic asthma, I suggested she might consider
bronchoscopy if this fluid reaccumulates. Because she is a heavy smoker, I
insisted she stop smoking completely. If she does not, she will not enjoy
continuing good health; though I have no idea of the actual prognosis.
Your patient has been returned to you to for her continuing care. I will be
glad to see her again at any time you think is necessary. I am enclosing a copy
of the pathology report on the fluid. As you can see, it is negative. Thank you
for letting me see this pleasant lady.
Sincerely yours,
Jon L. Mikosan, MD
drt

Enc: Pathology report