Patient: Last visit to Dr. Song Zhigang or discharge time: Hello Professor Song: I am Changzhou Zhu*lan 11 I checked PT at you: PT: 16.9 seconds, INR: 1.4 seconds you told me to take warfarin a piece, I returned to Changzhou in the second hospital 17 checked PT: 18.4 seconds, INR: 1.52 seconds and cardiac ultrasound, the doctor here told me to add a quarter to eat four to five days The last time I visited the hospital, I had the following tests, results and treatment plan: According to your guidance, everything is fine. Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: Ultrasound results are basically normal, the left ventricle size has returned to normal, the left atrium is slightly large, there is no major problem, we recommend regular review, pay attention to PT changes. Patient: Thank you for today’s PT report came out, high I regulate today to eat a piece to eat four days and then check the results and then send you to help me see Thank you! Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: Okay. Patient: Hello Professor Song: I thank you very much for taking time out of your busy schedule to solve my problem, thank you! Today’s prothrombin report came out also high point get your guidance today to start eating three-quarters, eat after five days want to check again to see if you look good? And Professor Song, these highs could be related to taking digoxin! The last time I didn’t eat digoxin, I started to eat digoxin after the last review at your hospital, and I’ve been high for several times. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: It’s not related to digoxin, think back to the last few days what is the difference between diet and before. Patient: Hello Professor Song: recently ate a diet similar to the previous, either ate some green fava beans, which had not been eaten before. Patient: Hello Professor Song forgot to also eat brain platinum and Fuyuan Amino Acid Oral Liquid Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: It may be the effect of fava beans. Patient: Thank you Professor Song, oh I know these days did not eat fava beans on Monday, but also to check the time to see. Patient: Thank you Professor Song! Today’s PT report came out, the PT is: PT: 19.4 seconds, INR: 1.65 seconds these five days have been eating three-quarters of the tablets, do you see the need to add, or eat three-quarters as usual to eat after ten days to see. Thank you. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: This value is still acceptable, take this amount of medication for a few days and check again. Patient: Yes, thank you, Professor Song. Patient: Hello Professor Song: The PT report is out, the PT is 21 seconds, INR is 1.78 seconds, and I have been taking three quarters of the tablets recently, is this number acceptable? How long will it take to check again? Thank you, Professor Song. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: This value is OK, we can still eat according to the original dose, and we can extend the interval of rechecking appropriately. Patient: Yes, thank you Professor Song. Patient: Hello Professor Song: The PT report is out, the PT is: PT: 27.3 seconds, INR: 2.29 seconds, recently been eating three quarters of a tablet, this number is high again, recently the diet and the usual did not eat anything, this number should not stop, or reduce a quarter to eat half a tablet after five days to check again to see, thank you Professor Song. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: No need to stop the medication, just reduce the dosage by a quarter of a tablet. Patient: Okay, thank you, Professor Song. Patient: Hello, Professor Song: I have a question about whether I can check PT during my menstrual period. Is it accurate if I do? Thank you Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: You can check it after your period. Patient: Yes, thank you, Professor Song. Patient: Hello Professor Song: The PT report is out, the PT is: PT: 16.8 seconds, INR: 1.47 seconds, recently been eating half a tablet, this number is low again, recently the diet is the same as usual, recently how not flat horizontal ah! It’s high and low at one time. Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: PT fluctuations are very common, as long as it is in a range interval, you can add a quarter tablet, the problem is not big. Patient: Hello Professor Song: Today’s PT report came out, the PT is: PT: 24.2 seconds, INR: 2.04 seconds than July 3 up now is eating three-quarters of a tablet, this number need to reduce the drug? Or should I take three-quarters as usual? Hello Professor Song, I have a thought I don’t know if it’s right or not you help me analyze it. This is my idea, I am based on the above several times to eat half a tablet will be low, eat three-quarters and will be high, there may be a size on the tablets also have a relationship between the half tablet basically no size, is a quarter on the quarter, the quarter and then a little less point, so that the PT indicators will probably be a little more normal, Professor Song, do you think it is possible? I have been controlling my diet well, basically every day is different, and my body is also very good. I hope Professor Song will give me more guidance. The patient’s PT report came out today, and the PT was 15.9 seconds, and the INR was 1.36 seconds. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: It is recommended to continue to take ¾ tablets Patient: Hello, Professor Song: The PT report came out today, and the PT is: PT: 21.6 seconds, INR: 1.83 seconds. This time up, and please teach Professor Song, these days sleep at night to sit or pillow to sleep higher to be comfortable, and stomach hunger fast please teach Professor Song what is the cause of this, what is the solution formula Thank you Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: from your last follow-up, her heart function has no problem, pillow to sleep higher should be a habit problem, used to sit and sleep should not be Should not (should not be sitting breathing it). In addition, she should see the endocrinology department to check her hormone level if she is hungry. The patient: Professor Song hello: to pillow cushion high sleep, is likely to be a habit problem, sitting sleep is only these days probably hot days sometimes rest sleep in the bamboo rattan chair above the reason, and then see a few days to see, thank you Professor Song, this report is okay, right, recently has been eating three quarters of a tablet or keep this can be next time can extend a little time to check, okay, thank you! Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: The anticoagulation index is well maintained, continue to take this amount of medication. Patient: Hello Professor Song: The PT report came out today, and the PT is: PT: 24.9 seconds, INR: 2.10 seconds. This time it went up a bit, do I need to reduce the medication or keep taking three-quarters of a tablet Thank you Patient: Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: Still taking three-quarters of a tablet Patient: Okay thank you for sending Professor Patient: Hello Professor Song: I haven’t contacted you for a long time, today’s PT report came out, the PT was: PT: 25.6 seconds, INR: 2.16 seconds . This time, after a month, the PT has gone up a little, do you need to reduce the medication or keep taking three-quarters of a tablet? Patient: Yes, thank you, Professor Song. Patient: Hello, Professor Song: I haven’t contacted you for a long time, but the PT report came out today. The PT report came out today, and the PT was: PT: 21.5 seconds, INR: 1.82 seconds. This time, after more than a month, it went down a little bit, but I still keep taking three-quarters of a tablet. I would also like to ask you, the indexes of the previous checkups were more or less the same a month ago, can this be extended in time? Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: If you feel that the anticoagulation index is stable, you can extend the interval of PT check, but at least 2 times a year, if it is convenient, it is better to check once every 1 to 3 months, after all, anticoagulation is very important for patients with valve replacement. Patient: Yes, thank you, Prof. Song. As long as the PT check index is maintained at the above three times, I will keep checking it once a month, so that I will know whether the PT check index is high or low in time, and I can adjust the medication in time. I would like to thank you, Professor Song, for taking care of us. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: You’re welcome, and we’ll be in touch if there’s anything. Patient: Hello Professor Song: I would like to consult you, now the weather is cold, feet have been cold, I want to buy an electric footbath soak feet, like I had an incision can use the footbath soak feet? Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: You can use it, there is no effect Patient: Okay thank you Professor Song Patient: Hello Professor Song: It’s been a long time since I contacted you, the PT report came out today, the PT is: PT: 18.3 seconds, INR: 1.56 seconds . This time, after more than a month, the PT has gone down a little bit, still keep taking ¾ tablets? What do I need to pay attention to Thank you. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: Eat according to the original dose. Patient: Okay thank you Professor Song Patient: Hello Professor Song: something to consult you my wife yesterday started a little stomach pain and then went to the bathroom fainted I picked her up and put her flat in the chest up and down wipe about a couple of minutes woke up, such a phenomenon before the open surgery also had, after the open surgery has never been, originally this few days to check PT menstrual period and bad to do PT, I want to accompany her to the hospital to check, you see what needs I would like to accompany her to the hospital to check which aspects you see need to check Thank you Patient: Also last night measured the blood pressure high pressure 145 low pressure 71 pulse 85 this morning is high pressure 119 low pressure 61 pulse 76 Patient: Also last night I measured her blood pressure high pressure 145 low pressure 71 pulse 85 this morning is high pressure 119 low pressure 61 pulse 76 Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: need to do a cranial CT Patient: Okay Thank you, Professor Song. Shanghai Changhai Hospital, Department of Thoracic Surgery, Song Zhigang: You need to go to the Department of Neurology to see what is wrong with the skull? Then have a cardiologist or cardiac surgeon listen to how her prosthetic valve sounds. Patient: Okay, thanks, I came back from your place and did the ultrasound this is now eight months I’ll do the cardiac ultrasound again by the way to see thank you Professor Song. Patient: Hello Professor Song: Today I had a cranial CT scan, cardiac ultrasound, blood count, ECG, and PT routine done at Changzhou Hospital, and the doctor here said there was nothing and no medication was prescribed. I’m not sure if I’ll be able to take a picture of it, but I’m taking three quarters of a tablet of warfarin and half a tablet of digoxin. Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: There is nothing abnormal in the heart examination, and the medication will maintain the status quo. I would like to ask your neurologist to take a look at the cranial CT problem and see if there is a need to use some nutritional drugs for the nervous system. Patient: Yes, thank you, Professor Song. Patient: Hello, Professor Song: I haven’t contacted you for a long time. This time, after more than a month, the PT has gone down a little bit, still keep taking ¾ tablets? What do I need to pay attention to Thank you. Patient: Hello Professor Song: It’s been a long time since I contacted you, but the PT report came out today. This time, after more than a month, the PT has gone down a little bit, still keep taking ¾ tablets? What do I need to pay attention to Thank you. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: This result is fine, still eat according to the original dose. Patient: Yes, thank you, Professor Song. Patient: Hello, Professor Song: I haven’t contacted you for a long time, but the PT report came out today. This time, after more than a month, the PT has gone down a little bit, still keep taking ¾ tablets? What do I need to pay attention to Thank you. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: Still taking the same dose. Patient: Yes, thank you, Professor Song. Patient: Hello, Professor Song: I haven’t contacted you for a long time, but the PT report came out today. This time, after more than a month, the PT has gone up a little. What do I need to pay attention to Thank you. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: This result is OK, still eat according to the original dose. Patient: Yes, thank you, Professor Song. Patient: Hello, Professor Song: I haven’t contacted you for a long time, but the PT report came out today. The PT report came out today. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: This result is fine, still eat according to the original dose Patient: Hello Professor Song: I haven’t contacted you for a long time, the PT report came out today, and the PT was: PT: 26.2 seconds, INR: 2.20 seconds. This time, after more than a month and almost February. Do I need to lose a quarter of the high? Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: No need to reduce it, it will probably come down again after a while. Patient: Yes, thank you, Professor Song. Patient: Hello, Professor Song: I haven’t contacted you for a long time, but the PT report came out today. This time, after a month, this value is okay, right? Thank you. Patient: How is it bad to send photos now? The PT report came out today, and the PT value is: PT: 23.7 seconds, INR: 2.00 seconds. This time, after two months, this value is okay, do not be higher than 2.0, thank you Happy New Year Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: This result is very good, very stable, eat according to the original dose. Patient: Yes, thank you. Happy New Year. Patient: Hello Professor Song: I haven’t contacted you for a long time, the PT is fine for the last few months. Patient: Okay, I’ll go to do a checkup in a few days, and then I’ll have to work hard to help you look at it. Patient: Hello Professor Song: I’ve had a cold for many days, and today I went to check my blood clotting and blood count. Changhai Hospital Thoracic Surgery Department Song Zhigang: Blood count is normal. There is no doctor’s prescription, only the application form for cardiac ultrasound and electrocardiogram prescribed by the doctor. Patient: Hello Professor Song: The doctor said it was anemia to take blood supplements after not prescribing it and brought back the slip for you to see and said that the cold was well and the cold was caused by anemia can be seen on the blood routine? The PT report today also came out PT23.5 seconds, INR: 1.99 Please take a look at it Thank you, and now the network how I published after the reduction of points is not good to publish again how to do ah Patients: Professor Song Hello: the doctor said anemia to take blood supplementation drugs after not prescribed to take the bill back to let you see also said that the cold is well and cold is caused by anemia on the blood routine can be seen? Today’s PT report also came out PT23.5 seconds, INR: 1.99 Please take a look at it Thank you, Shanghai Changhai Hospital Thoracic Heart Surgery Department Song Zhigang: Anticoagulation index is good, the routine blood results are anemia, she is not caused by excessive menstruation, eat some blood tonic medicine to observe and see, not to go to the Department of Hematology to let them treat it. Patient: Okay, thank you for the blood medicine to replace the valve which class can eat ah Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: all can eat, eat a few days to check the PT results. Patient: Okay thank you Professor Song Patient: Hello Professor Song: I haven’t contacted you for a long time, I haven’t checked my PT for 2 months today, and the PT report came out with PT 18.2 seconds, INR: 1.55 seems to be a bit low, right? I can take a little bit bigger pills, right? Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: The result is fine, and the medication can be eaten according to the original dose. Patient: Yes, thank you, Professor Song. Patient: Hello, Professor Song: I’m coming to Shanghai next Tuesday for something, so I’ll come to do a review. Are you working? Are we going to register with you for the review or are we going to go to the outpatient clinic and what do we need to do? Can you help me arrange it? Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: Outpatient, cardiac ultrasound and PT Patient: Okay, thank you, just do these two items and then contact you when you get the bill Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: Okay. Patient: Hello Professor Song, are you here today? I’ll come to your office at 1:00 on the 8th floor to get the cardiac ultrasound report and send it to you, thank you for your help. Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: after 3 pm in the patient: Professor Song, hello: today’s PT report came out, the PT is: PT: 29.4 seconds, INR: 2.60 seconds Last time at the end of September in your place is 19.2 seconds INR: 1.7 seconds, the original is to eat three-quarters of the tablets, in your place after the investigation you warfarin told to eat a piece, aminoglutethimide to eat half a tablet, double grams to eat Half a tablet, today to check the number of this high? Shanghai Changhai Hospital Thoracic Surgery Department Song Zhigang: The value is high, you can take three quarters of a tablet every single day and one tablet every double day. Patient: Hello Professor Song: Today’s PT report came out, the PT is: PT: 17.6 seconds, INR: 1.54 seconds. Last month was 29.4 seconds INR: 2.6 seconds, in your instructions warfarin single day to eat a double day to eat three quarters of a tablet, ammonia body to eat half a tablet, double grams to eat half a tablet so can two days to eat a piece of every other day to eat three quarters can? Eat a month and then check. Song Zhigang, Department of Thoracic Surgery, Shanghai Changhai Hospital: The result may be the effect of the recent change in diet, you can still eat the original dose, wait a week and then recheck again. Patient: Take three quarters of a tablet on every single day and one tablet on every double day, and then check again after a week.