History of shortness of breath, wheezing with exertion and/or sleep, rule out post inflammatory hypersensitivity and reactive airway disease secondary to chlorine gas exposure status post chlorine exposure on 07/06/98and cigarette smoking .
History of post traumatic stress, i.e., fear of recurrent chlorine gas exposure, status post chlorine exposure on 07/06/98.
History multiple rib fractures, early 1970’s, 1980’s.
History multiple fractures of the toes.
History multiple fractures of the nose.
History fracture right and left clavicle, early 1980’s.
History of laceration left wrist, 1965, with post surgical scarification.
In my opinion, by review of medical history and physical examination, this examinee’s history of shortness of breath and wheezing with exertion and/or sleep is, within reasonable medical certainty, consistent with the long term effects of chlorine gas exposure.
examinee has been advised of the nature of his injury and of the likelihood that chlorine gas exposure, in addition to cigarette smoking, has contributed to an increased sensitivity of the distal airways manifesting in symptoms of shortness of breath and periodic wheezing when sleeping and/or exercising.
To further elucidate the examinee’s underlying condition, the additional pertinent medical records from Medical Center and the Workers’ Compensation physicians would need to be reviewed, and the examinee should have a chest x-ray, pulmonary function test, treadmill stress test, functional capacity evaluation and evaluations by a pulmonologist and psychologist. Additional specialized evaluation of the airways may be recommended after pulmonary consultation.
The examinee is advised to avoid smoking, perfumes, colognes, hydrocarbons, paints, and any and all other respiratory allergens or irritants, and he should consider using an air filter at his home and office in conjunction with various inhalers including corticosteroids (Azmacort) and/or bronchodilators (Serevent).
Should the examinee experience more severe or disruptive symptoms, he should seek medical reevaluation and maintain a relationship with a family physician or pulmonary specialist.
After review of additional pertinent medical records, diagnostic studies, treatment course and upon attaining maximum medical improvement, the examinee’s condition may be reviewed with regard to any permanent effect as a consequence of the chlorine gas exposure on 07/06/98 and an impairment rating assessed.
Medical care was not provided by Dr. M.D. for this examinee who was seen one time for the sole purpose of this medical evaluation.
THE HEALTH PLACEA Private Medical Practice of David P. Kalin, M.D., M.P.H.Tel 813.966.1431 Fax 813.925.1932
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