Personal Genome Project

PAST MEDICAL HISTORY:
Reveals a basal cell cancer removed from the left paranasal area eight years ago. He has also been seen twice for chest pains and referred to the Mass General Hospital, both of which were described eventually as esophageal spasms; one in 1977 and one in 2002. The 2002 episode was postprandial chest pain associated with dizziness, sweating, and vomiting. He was referred to Mass General Hospital where he underwent tests which were negative including an exercise tolerance test. He also has lichen planus which comes and goes and for which he occasionally gets Westcort a low dose corticosteroid.

His blood pressure is 116/80, his height is 69", his weight is 162 pounds. His pulse is 52 and regular and his respirations are 12 and unlabored. He is in no acute distress and denies any pain. His HEENT examination reveals no evidence of any pallor or scleral icterus. His pupils are equal, react to light and accommodation. All extraocular movements are intact. His funduscopic examination reveals flat disks and no exudates or hemorrhages. Thyroid is not enlarged. His pharynx is clear without exudate. His tongue is in the midline. He has good dental care with several crowns. There is no significant adenopathy in the neck, axillary, groin areas. Carotids are equal without bruits. There is no increase in thyroid tissue. His lungs are clear to percussion and auscultation. Cardiac examination reveals a regular rate and rhythm without murmurs. His abdominal examination reveals no masses and no organomegaly. The skin is clear without any suspicious lesions at the present time. Extremities reveal no edema, no calf tenderness, no swollen joints, and no rashes. Rectal examination reveals no masses, a normal size prostate without nodules. Stool obtained at the time of examination was negative for occult blood. Neurological exam is grossly physiological. Testes normal without masses and there is no evidence of any hernias.

Mild Reynaud's syndrome resulting in occasional swelling and blistering of toes after winter walks.

Lower back pain when bending, resulting from:
1. transitional lumbosacral segmentation.
2. at the assigned L5-S1 level there is mild anterolisthesis as well as congenitally short ap dimension of the bony canal and broad-based left central, combination of disc and osteophyte without definite impingement on the neural structures.
3.L4-5 broad-based disc bulging which combines with facet arthropathy to create mild to moderate bilateral inferior foraminal encroachment.