rH inted at 10/7/16 3:39 aw fe (CSN1487" fc} FAIRVIEW University of Minnesota Medical Center, Fairview - West Bank 2450 Riverside Ave - Minneapolis, MN 55454 After Visit Summary 10/3/2016 DS - - Thank you! Thank you for choosing Fairview for your care. Our goal is always to provide you with excellent care, Hearing back from our patients is one way we can continue to improve our services. Please take a few minutes to complete the written survey that you may receive in the mail after you visit wth us. Thank you! PM Safety We all care about your loved one’s safety. To reduce the risk of self-harm, remove access to all + Firearms + Medicines (both prescribed and over-the-counter) + Knives and other sharp objects. + Ropes and lke materials. + Alcohol + Carkeys Patient Information Date OF Birth 5/13/2000 About your hospital stay You were admitted on: October 3, 2016 ‘You last received care in the: Child Adolescent MH Inpatient Unit You were discharged on: October 7, 2016 Who to Call For medical emergencies, please call 911 For non-urgent questions about your medical care, please call your primary care provider or clinic, 612- 302-8200 Attending Provider Provider ‘Truong, Dung Hoang, MD Peterson, Richard Todd, MD Page 1 of 8Sama Pe «107116 3:30 Seep E OER Ea PM Attending Provider (continued) Primary Care Provider Office Phone # Fax# Helen eo Thomas. 612-302-8200 612-302-8277 UMP BROADWAY FAMILVMED 1020 WEST BROADWAY MINNEAPOLIS MN 55411 Your next 10 appointments already scheduled Nov 10, 2016 12:30 PM Discovery Clinic ‘New Patient Visit with Alyssa Lauren Halper, MD 2512 Building, 3rd Floor Peds Diabetes (UMP MSA Clinics) 2512 S 7th Street Minneapolis MN 55454-1404 612-365-6777 Further instructions from your care team Gorsanan | Discharge Planning and Instructions t was admitted to University of Minnesota Masonic Children’s Hospital Unit 7A for stabilization of suicidal ideation. While patient was in the hospital, patient participated in groups and met with the psychiatrist, nurses, and case manager. Medications were changed and instructions will be given on how to continue with these changes. Patient denies suicidal ideation, has been doing well on the unit, and is ready to discharge. Main Diagnosis Major Depressive Disorder severe-recurrent with anxious distress Posttraumatic Stress Disorder Major Treatments, Procedures and Findings: The patient participated in the therapeutic milieu and groups. The patient learned and practiced positive coping strategies. The patient was assessed for mental health and medication needs. Medications were adjusted based on the identified needs. ‘Symptoms to Report: feeling more aggressive, increased confusion, losing more sleep, mood getting worse or thoughts of suicide Lifestyle Adjustment: The patient should take medications as prescribed. Patient's caregivers are highly encouraged to supervise administering of medications, Patient's caregivers should ensure patient does not have access to weapons, sharps, or medications of any kind - these items should be locked away. Patient caregivers are highly encouraged to follow treatment recommendations. Follow Up Plan: Endocrinology: Alyssa Halper Discovery Clinic- University of Minnesota Masonic Children’s Hospital 2450 Riverside Ave, Minneapolis, MN 55454 612-365-6777 Next appointment: November 10th at 12:30pm. It has been recommended that patient be seen every three months for follow up. In Home CTSS: MN CarePartner 3405 Chicago Ave S, Minneapolis, MN 55407 612-289-5656 Page 2 of 8EE = 10/7/16 3:39 eaeeomiange ‘referral has been made to this service. Someone will be calling you to set up an intake appointment. Adolescent Partial Hospitalization Program: been referred to the Fairview Adolescent Partial Hospitalization Program, to assist in making an effective transition from hospitalization to living at home. The programs are a structured setting, with \dividual and family work, group therapy, skills groups, academics, and medication management. There is currently a short waiting list to start the program. A day treatment staff member will contact you to set up an intake appointment within a week of discharge from the inpatient unit. If you have not heard from intake staff in the next 3 - 5 business days, or you have questions about the program, please feel free to contact the program directly at 612-273-6055. Program is located at: U of MN/Fairview, 2450 Riverside Ave, West Building 48, Minneapolis, MN 55454 Transportation: If you live in the Mpls School District bussing will be arranged by the program, during the school year. If you live outside of the Mpls School District you will need to arrange bussing by calling your school contact at your child’s school, Bussing address for Fairview is: 525 23 Av. Mpls, MN 55454, During summer programming families are responsible for transporting their child to and from the program. Some insurance companies may be able to help with transportation so you may éall your insurance company to determine your benefits. Resources: Crisis Intervention: 800-784-2433 or 800-273-8255 (TTY: 800-799-4889). Call anytime for help. National Alliance on Mental Illness (www.mn.nami.org): 651-645-2948 or 800-950-6264. MN Association for Children's Mental Health (www.macmh.org): 800-528-4511 Alcoholics Anonymous (www.aleoholics-anonymous.org): Check your phone book for your local chapter. Suicide Awareness Voices of Education (SAVE) (www.save.org): 888-511-SAVE (7283) National Suicide Prevention Line (www.mentalhealthmn.org): 800-273-TALK (8265) Mental Health Consumer/Survivor Network of MN (www.mhesn.net): 651-637-2800 or 800-483-2007 Mental Health Association of MN (www.mentalhealth.org): 612-331-6840 or 800-862-1799 General Medication Instructions: See your medication sheet(s) for instructions. Take all medicines as directed. Make no changes unless your doctor suggests them. Go to all your doctor visits. Be sure to have all your required lab tests. This way, your medicines can be refilled on time. Do not use any drugs not prescribed by your doctor. Avoid alcohol Admission Information Provider Department Dept Phone 10/3/2016 Richard Todd Peterson, Ur Adol Mh Inpt Unit. 612-273-6062 MO Your Vitals Were Blood Pressure Pulse Temperature Respirations 108/66 mmHg 97 98.7 °F (37.1 °C) (Oral) 16 Height Weight BMl (Body Mass index) Pulse Oximetry 1.44 m (4'8.69") 82,328 kg (181 Ib 8 39.70 kgim2 98% oz) Last Period 09/03/2016 MyChart Information MyChart lets you send messages to your doctor, view your test results, renew your prescriptions, schedule Page 3 of 8spam Pies 10716 3:30 MyChart Information (continued) SARTORI Kale appointments and more. To sign up, go to www.fairview.org/MyChart, contact your Fairview clinic or call 855-513-5513 during business hours. Review of your medicines START taking glyBURIDE 2.5 MG tablet ‘Commonly known as: DIABETA / MICRONASE hydrOXYzine 25 MG tablet Commonly known as: ATARAX en eo ay Dose / Directions Dose: 2.5 mg Take 1 tablet (2.5 mg) by mouth 2 times daily (with meals) Quantity: 60 tablet Refills: 0 Dose: 25mg Take 1 tablet (25 mg) by mouth every 8 hours as needed for anxiety Quantity: 60 tablet Reflls: 0 CONTINUE these medicines which may have CHANGED, or have new prescriptions. If we are uncertain of the size of tablets/capsules you have at home, strength may be listed as something that might have changed. gabapentin 100 MG capsule Commonly known as: NEURONTIN This may have changed = how much to take - when to take this Used for: Depression with suicidal ideation Dose / Directions Dose: 100 mg ‘Take 1 capsule (100 mg) by mouth 2 times daily Quantity: 90 capsule Refills: 30 “insulin aspart 100 UNIT/ML soln Commonly known as: NevolOG PEN Dose: 30 Units Inject 30 Units Subcutaneous 3 times daily (before This may have changed: meals) how much to take Quantity: + Month how to take this Refills: 0 when to take this + additional instructions * insulin aspart 100 UNITIML soin Dose: 26 Unis Commonly known as: NoveLOG PEN This may nave changed: - how much to take - when to take this Inject 26 Units Subcutaneous At Bedtime Quantity: 1 Month Refills: 0 “insulin aspart 100 UNIT/ML soln Commonly known as; NovolOG PEN This may have changed: You were already taking a medication with the same name, and this prescription was added. Make sure you understand how and when to take each. Dose: 15 Units Inject 15 Units Subcutaneous Take with snacks or supplements for high blood sugar Quantity: 1 Month Refills: 0 Page 4 of 8TRL RG Tinted at 10/716 3:39 PM Review of your medicines (continued) CONTINUE these medicines which may have CHANGED, or have new prescriptions. If we are Uncertairi of the size of tablets/capsules you have at home, strength may be listed as something that might have changed. (continued) * insulin aspart 100 UNITML soin Commonly known as: NovoLOG PEN This may have changed: You were already taking a medication with the same name, and this prescription was added. Make sure you understand how and when to take each. Dose / Directions Dose: 1-25 Units Inject 1-28 Units Subcutaneous 3 times daily (before meals) Quantity: 1 Month Refills; 0 * insulin aspart 100 UNITIML soin Commonly known as: NoveLOG PEN This may have changed: You were already taking a medication with the same name, and this prescription was added. Make sure you understand how and when to take each. Dose: 1-25 Units Inject 1-25 Units Subcutaneous At Bedtime Quantity: 4 Month Refils: 0 insulin glargine 100 UNIT/ML PEN Commonly known as: LANTUS This may have changed: how much to take Dose: 60 Units Inject 60 Units Subcutaneous 2 times daily Quantity: 4 Month Refils: 0 CONTINUE these medicines which have NOT CHANGED Dose / Directions LEXAPRO PO Dose: 20 mg Take 20 mg by mouth Refills: 0 rosuvastatin 20 MG tablet Dose: 20mg Commonly known as: CRESTOR VITAMIN D (CHOLECALCIFEROL) PO Where to get your medicines These are the prescriptic Fairview Pharmacy Riverside - Minneapolis, MN - 606 24th Ave S = gIYBURIDE 2.5 MG tablet = hydrOXYzine 25 MG tablet sulin aspart 100 UNITIML soln ~ insulin aspart 100 UNIT/ML soln insulin aspart 100 UNITIML soln ~ insulin aspart 100 UNIT/ML soln insulin aspart 100 UNITIML soln Take 1 tablet (20 mg) by mouth At Bedtime Quantity: 30 tablet Refils: 0 Dose: 2000 Units Take 2,000 Units by mouth daily Refils: 0 ions that you need to pick up. We sent some of them to specific pharmacies. Go to these places to get your medicines. 606 24th Ave S Sto 202 Minneapolis MN 55454 Phone: 612-672-7500 Some of these will need a paper prescription and others can be bought over the counter. Ask your nurse if you have questions. - insulin glargine 100 UNIT/ML PEN Page 5 of 8— ETT, °ricted at 10/7/16 3:38 - ‘ = PM Protect others around you: Leam how to safely use, store and throw away your medicines at www.disposemymeds.org. Page 6 of 8