[Expert Solution]: The patient is doing better

The patient is doing better. She was up and around yesterday and she felt much better. Her shortness of breath has improved. She has no orthopnea but some apparent dyspnea. REVIEW OF SYSTEMS: Constitutional, ophthalmologic, otolaryngologic, cardiovascular, respiratory, GI, GU, musculoskeletal, integumentary, neurologic, psychiatric, endocrine, hematologic, immunologic negative other than what I have mentioned. OBJECTIVE: The patient looks good, and is in no acute distress. VITALS are stable. She is afebrile. HEAD, EYES, EARS, NOSE, and THROAT were examined and found to be negative. NECK supple, no JVD. The ABDOMEN is benign. EXTREMITIES: The swelling has gone down but she still has some swelling on the feet. NEUROLOGIC examination is grossly intact and nonfocal. Her WEIGHT today is 154 pounds. LABORATORY: Basic metabolic panel: BUN 43, creatinine 1.8, glucose 122. During the day her glucose has come up to around 200. Platelet count today is 128. ASSESSMENT: 1. Decompensated acute on chronic diastolic heart failure, improving 2. Diabetes mellitus, type II. 3. End-stage renal failure secondary to DM, currently on hemodialysis. 4. Fluid overload state, improving. RECOMMENDATIONS: 1. We will resume Amaryl 2mg p.o. qd, watch her Accu-Cheks. 2. Follow up kidney function. 3. Increase activity and discharge when able to ambulate without SOB.