Patient’s name: Patrick O’Toole
Age: 73-year-old male
Past medical history
Drug history
Allergy
You are Patrick O’Toole ,73 years old male. You’ve noticed blood mixed with mucus when you spit. You get the feeling of mucus coming from the back of your nose / throat and then when you spit it out, its mucus mixed with blood (Dark red ) .
This has been ongoing for last 2-3 months but getting more frequent (2-3 times a week).
You’re always clearing your throat, and when you spit out the mucus, you notice small streaks of blood. You have never really suffered a sinus infection asides normal flu.
You’ve also had some weight loss recently. About 5kg in the last 6 months
You do NOT have any coughing, chest pain, or shortness of breath. You have been on Apixaban for 5 years and had no issues. You have been regular with all your medications.
SAY NO TO ANY OTHER SYMPTOMS ASKED
Social History: Smoker: 25 cigarettes a day for the past 50 years. Lives alone. Wife passed away 10 years ago. Retired postman.
ICE (Ideas, Concerns, Expectations):
Ideas: You think the apixaban may be thinning your blood too much or you may be suffering from a sinus infection.
Concerns: You’re worried about the blood, especially since you were told apixaban increases bleeding risk.
Expectations: You want the doctor to figure out what’s causing the blood and tell you what to do next.
Questions for the doctor?
Should I stop my Apixaban?