Subject: Fwd: History
From: "Brian McGlinchey" <[email-masked]>
To: "R. Hunter Biden" <[email-masked]>
Date: Sun, 8 Nov 2015 16:29:23 -0500

Hunter --- this is my complete medical history for your review.  Let me if it needs edits.  Best ---
Brian 

Sent from my iPhone

Begin forwarded message:

> From: Megan McGlinchey <[email-masked]>
> Date: November 8, 2015 at 4:08:00 PM EST
> To: "[email-masked]" <[email-masked]>
> Cc: Megan McGlinchey <[email-masked]>
> Subject: History
> 
> Brian's illness began in September 2014, with a pain in his left side. Initially it felt like a pulled muscle. He had a cat scan of his abdomen in October of 2014, but it showed nothing. Blood tests were done, and it showed that his hemoglobin was a 10. His doctor prescribed calcium and scheduled a colonoscopy for November 2014.
> 
> Throughout October and November Brian remained very lethargic and still had the pain in his left side. He was too weak to go through with the colonoscopy in November. He began seeing a new primary care doctor in December and the colonoscopy, along with a ERG was rescheduled for December. The colonoscopy showed diverticulosis and the ERG showed gastritis and a possible ulcer. His gastroenterologist prescribed iron pills and Prilosec. He found some relief into January 2015 with this treatment. 
> 
> Towards the end of January, he still did not feel well. He had periodic blood tests which showed that his hemoglobin was getting lower, a 7. By the middle of February, he was really feeling bad. He had another blood test, which showed, for the first time, that his white blood count was "slightly elevated". It was because of these results that his primary doctor recommended going to the emergency room on February 13.
> 
> Upon being admitted to the ER, Brian had blood tests and a cat scan. The blood test revealed that his hemoglobin was now a 6 and his white blood count was 40,000. The cat scan, which was conducted without contrast because he had very poor kidney function, showed a large mass in his liver. Doctor's initially thought that it was a tumor, but after further review, they theorized that it was actually a large abscess, caused by an infection. They began treatment for the infection, IV antibiotics, and scheduled a procedure to drain the liver and confirm their diagnosis. This was scheduled for Monday, February 16. Over the weekend, Brian's condition worsened and he went into full blown "septic shock."  His organ function started systematically shutting down. Doctors immediately scheduled the liver procedure for February 15, and an Interventional Radiologist inserted a needle into his liver to drain the fluid, which he confirmed was pus. They determined that Brian has one large abscess and two smaller abscesses in his liver. A drain was inserted into the largest abscess.
> 
> He continued with the IV antibiotics for his entire stay in the hospital, and he was discharged on February 23, with the drain and on the IV antibiotics. The IV antibiotics were administered through a PICC line in his left arm. His appetite was very poor, and since the illness began in September, 2014, he had lost a significant amount of weight.
> 
> Around February 29/March 1, Brian began to exhibit some confusion and weakness, and also began vomiting. On March 3, he had an episode of confusion and almost passed out. He was taken back to the ER, and it was determined that he had a clot in his portal vein, along with a diagnosis of "altered mental state", which doctors thought was caused by an antibiotic he was taking, Flagyl. (As we later learned from another hematologist, the altered mental state was caused by the clot.) To combat the clot, he was put on Lovenox, which was injected into his abdomen twice a day. While in the hospital for the clot, he developed C-Diff. He spent three days in the hospital and was sent home on the Lovenox, and a new antibiotic (because of the initial thought that he was allergic to Flagyl).
> 
> On March 14, he began feeling sick again, with episodes of vomiting, which doctors thought might be a reaction to the new antibiotic. He also had severe pains on his right side, near the top of his thigh. He had an episode where he almost passed again, so he was rushed to the ER for a third time on March 15. He was found to be bleeding internally, from the Lovenox, and had 2 large hematoma on his right side. (The drain in his liver was still in place.) He underwent surgery to cauterize the artery and stop the bleeding. His hemoglobin was still very low and his platelet count was also very low. Over the course of his treatment, he was given several blood transfusions, as well as plasma and platelets.
> 
> After this third episode, he remained in the ICU for 17 days, and then spent an additional 2 days in the regular hospital. He was very weak after his ordeal, and it was determined that he was not strong enough to return home, so he went to an inpatient rehabilitation facility for 6 days. Prior to leaving the hospital, his liver drain was removed, as was his PICC line. He was discharged on oral antibiotics (Augmentin), which he took for an additional month. He had a fair amount of abdominal fluid was built up as part of his illness, so he was also put on Lasik. Since blood thinners were not an option to help with the clot, he was put on Nadolol. The clot in his portal vein remains, but scans have shown that his liver has found another pathway around the clot, and his liver function is normal. Scans have also shown that the abscesses and the hematoma have resolved. He continues to be on the following medicines: Nadolol, Lasik, and Spirnolactone.
> 
> He continues to have numbness and pain in his hands and feet, which have not gotten better with time. Doctors tell him it is a side effect of the sepsis. Just within the last few weeks, he has started to experience a pain/sensation in his left side, similar to the original pain from September 2014. 
> 
> It was never determined in any of the tests he received, what the original pain was caused by.
> 
> 
> 
> 
>   =2