Michael Bryant, NP - 12/19/2025 9:36 AM CSTFormatting of this note is different from the original.Inpatient Discharge SummaryBRIEF OVERVIEWAdmitting Provider: William Cavanaugh Chapman, MDDischarge Provider: No att. providers foundPrimary Care Physician at Discharge: Beard, Kelsey Michelle, NP 618-258-0485 Admission Date: 12/18/2025 Discharge Date: 12/19/2025Admission Location: Barnes Jewish HospitalHospital Problems/Diagnoses:Principal Problem: Metastatic colon cancer to liverResolved Problems:No resolved hospital problems.DETAILS OF HOSPITAL STAYPresenting Problem/History of Present Illness:Mr. Towell is a 50 y.o. male with a history of sigmoid adenocarcinoma, metastatic terminal ileum adenocarcinoma to the liver s/p segment 2 hepatic resection in 5/2025 with two new lesions concerning for metastasis in segment 8. He returns to discuss repeat hepatic resection. He recovered very well after XI hepatic resection without complications. He continues chemotherapy with Dr. Tan, with last treatment 3 weeks ago. Surveillance MRI 11/9 showed 2 new lesions, 1.2 and 0.6 cm, followed by PET scan with very slight uptake.He feels wells overall, good appetite, no weight loss. Hospital Course:The patient was taken to the OR for a Procedure(s) (LRB):XI LIVER RESECTION - LAPAROSCOPIC ROBOTIC ASSISTED SEGMENT 5 8 and 4B, INTRAOPERATIVE ULTRASOUND and TAP BLOCK (N/A) on 12/18/2025. For details of the operation, please see the OP note in Epic. * Chapman, William Cavanaugh - Primary * Godfrey, Caroline Marie - Fellow>Post operative pain controlled with PO pain mediations.>Foley catheter was removed without incident.>Patient diet was advanced as tolerated on POD 1 passing gas, no BM. >A post-operative visit with the office of Dr. Chapman has been scheduled for 12/29. The patient was discharged to home in stable condition on 12/19, no need for home health skilled services.Scripts: Oxycodone #10, Gabapentin for 14 days, Robaxin for 14 days, OTC; Acetaminophen, Lidocaine patches, senna-docusate, Follow-up:Future Appointments Date Time Provider Department Center 12/29/2025 9:30 AM Martens, Gregory, MD PhD TXP CAM 12B SU Test Results Pending at Discharge:Pending Labs Order Current Status Surgical pathology Collected (12/18/25 1454) Operative Procedures Performed:Procedure(s):XI LIVER RESECTION - LAPAROSCOPIC ROBOTIC ASSISTED SEGMENT 5 8 and 4B, INTRAOPERATIVE ULTRASOUND and TAP BLOCKDischarge DetailsPhysical Exam at Discharge:Discharge Condition: goodPulse: 50Resp: 18BP: 108/59Temp: 36.6 °C (97.8 °F)Weight: 102.1 kg (225 lb)Pertinent Exam Findings at Discharge: Patient discharged with robotic surgical sites approximated with derma bond C/D/I. Implanted Port de-accessed at Discharge. Discharge Disposition:Patient will be discharged to:home Code Status at Discharge: FULL CODEDischarge Instructions:Instructions For Hepatobiliary Surgery Patients: Call 911 or go to your local emergency room if: You have bleeding from your incision that worries you. You have chest pain. You feel like you can’t catch your breath. You faint or pass out. Call Your Doctor If: You have a fever of 101.5 F degrees or higher. It is hard for you to urinate. You have nausea, vomiting or diarrhea. If you have bright red blood or bad smelling drainage from your incision sites. You have any questions about your medications. You have belly pain that is getting worse. Your incision is red or swollen. Your eyes appear yellow; you have clay-colored stool, dark urine, and/or persistent itching. These can be a signs of a problem with your liver. If you are sent home with a drain, call if there is a sudden change in your abdominal drain output or color. If you need to talk with a doctor after regular hours or on weekends; please call your doctor’s office. The voicemail will give you directions on how to reach the on call doctor for an emergency. Do NOT leave a message on the voice mail. These messages will not be heard until the next business day. Office of Dr. Chapman: (314) 362-2538Diet:Regular Diet as toleratedActivity:You may perform activities as you feel up to it. Do NOT lift anything over 10 pounds for 6 weeks. This includes babies and pets.Do NOT drive while taking narcotic pain medicine. It is very important to stay active. Take several short walks each day.Care Instructions:You may take showers. Pat wounds dry. Do not rub.Keep your incision site dry and clean. Do NOT take tub baths, go swimming or use a hot tub until approved by your doctor. It is normal to feel very tired for several weeks after surgery. It’s ok to rest as needed.Follow Up:You will need to follow up with your Primary Care Doctor in 1-2 weeks. It is VERY important to let your doctor know if any changes were made to your medications while you were in the hospital.Discharge Medications:Current Medications PAUSE taking these medications loperamide 2 mg tabletWait to take this until your doctor or other care provider tells you to start again.Take 1 tablet (2 mg total) by mouth 4 (four) times a day as needed for diarrheaFor: diarrhea caused by chemotherapyCommonly known as: IMODIUM A-Dprochlorperazine 10 mg tabletWait to take this until your doctor or other care provider tells you to start again.Defer to prescriber. Take 1 tablet (10 mg total) by mouth 3 (three) times a day as needed for nauseaFor: nausea and vomiting caused by cancer drugsCommonly known as: COMPAZINEzolpidem 5 mg tabletWait to take this until your doctor or other care provider tells you to start again.Do not take while taking narcotic pain medication. Take 1 tablet (5 mg total) by mouth nightly as needed for sleepFor: difficulty falling asleepCommonly known as: AMBIENTAKE these medications acetaminophen 500 mg capsuleTake 2 capsules (1,000 mg total) by mouth every 6 (six) hoursFor: paincetirizine 10 mg tabletTake 1 tablet (10 mg total) by mouth daily as needed for allergies or rhinitisCommonly known as: ZyrTECdocusate sodium 100 mg capsuleTake 1 capsule (100 mg total) by mouth 2 (two) times a day as needed for constipationCommonly known as: COLACEgabapentin 100 mg capsuleTake 1 capsule (100 mg total) by mouth 2 (two) times a dayCommonly known as: NEURONTINlevothyroxine 125 mcg tabletTake 1 tablet (125 mcg total) by mouth early morning before breakfastFor: a condition with low thyroid hormone levelsCommonly known as: SYNTHROIDlidocaine 5 %Place 1 patch on the skin daily for 12 hours Remove & discard patch(es) within 12 hours or as directed by MDCommonly known as: LIDODERMLORazepam 0.5 mg tabletTake 1 tablet (0.5 mg total) by mouth every 8 (eight) hours as needed for anxietyCommonly known as: ATIVANmethocarbamoL 500 mg tabletTake 2 tablets (1,000 mg total) by mouth 3 (three) times a day for 14 daysCommonly known as: ROBAXINmultivitamin with minerals tabletTake 1 tablet by mouth early morning before breakfastoxyCODONE 5 mg immediate release tabletTake 1 tablet (5 mg total) by mouth every 6 (six) hours as needed for painFor: painCommonly known as: ROXICODONEpropranoloL 20 mg tabletTake 1 tablet (20 mg total) by mouth early morning before breakfastCommonly known as: INDERALsenna-docusate 8.6-50 mgTake 1 tablet by mouth daily as needed for constipationCommonly known as: PERICOLACEOutpatient Follow-Up:Future Appointments Date Time Provider Department Center 12/29/2025 9:30 AM Martens, Gregory, MD PhD TXP CAM 12B SU Cosigned by William Chapman, MD at 12/19/2025 3:55 PM CSTElectronically signed by Michael Bryant, NP at 12/19/2025 11:17 AM CSTElectronically signed by William Chapman, MD at 12/19/2025 3:55 PM CSTdocumented in this encounter