Results in Hi

Assessment & Plan
Right lower quadrant abdominal swelling, mass and lump
A frank and thorough discussion was performed with K•••••
We discussed her clinical history to date and the results of her recent CT abd/pelvis which show a bilateral confluence multiseptated ovarian masses. Her CA125, which is a tumor marker, was drawn by the referring provider and was 23.3, which we discussed Is within the normal range. Both benign and malignant etiologies were discussed, and the recommendation is for surgical assessment. Upon exam, it was noted that her masses extend to above the umbilicus. Surgery would be an open hysterectomy due to this with removal of both tubes and ovaries, possible removal of the omentum, possible pelvic lymph node dissection, possible conversion to open, if indicated. Explained that she would spend about three nights in the hospital or until she passes gas and then be discharged to home with no pushing, pulling or lifting for 6-8 weeks.
K*verbalized understanding and is in agreement and would like to move forward with surgery. We will have her follow up next week for a pre and post op education appointment. She has advanced care planning in place