Yesterday was day 1 of a 17 day stretch. I will miss only one day – this coming Wednesday. Readers know that I love making rounds. This time I plan to write each day about the previous day.
Yesterday was not difficult. I rounded on only 3 patients. Today I will round later – my team is on call.
The big discussion yesterday revolved around increasing the ACE inhibitor dose in a patient with left ventricular ejection fraction of 20%, BP of 110/70, creatinine of 2.2, and urine protein/creatinine ratio of ~3.
We examined his meds and found a low dose of ACE inhibitor but he was talking amlodipine. So we decided to d/c the amlodipine and increase the ACE inhibitor. Over the next 2 days we will see if this strategy can work.
