Patient: Jessica Simpson Title: Phone followup - RV
Provider: Vilayil, Ruth
Appointment Date: 2021-May-03
Referred By: Tancon, Scott
I had a phone vist with Jessica today at her request. Still struggling with hypergranulation tissue, saturating pads, etc. it seems it is not frank blood but brown and sticky mixed with transudate. She has seen Dr Genoway and I will request her notes from their interaction, Jessica is ok with that request.
She is requesting in person physical exam to see if anything can be done about the hypergranulation at the apex of the vagina. I am trying not to duplicate care as she is seeing three bridges and Dr Genoway, but I will request their notes and bring Jessica in to see me shortly.
Patient: Jessica Simpson
Title: Office followup - RV Provider: Vilayil, Ruth
Appointment Date: 2021-May-14
Referred By: Tancon, Scott
Jessica was seen in the office for followup today, by request. She is still diating daily basis with size #2. There is daily bleeding, BRB, not excessive amounts. Some clear discharge. She is worried about location of her clitoris. She has discussed this with her surgeon in Montreal. The vaginal band got incised by the dr in Vancouver.
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stil granulation tissue in the neovagina, less than previous, less bleeding.
?citors seen somewhat buried beneath the apex of the labia majora.
spec: able to advance fairly deep in to the full length, no granulation tissue seen deep within. AgNo3 to the superficial granulation tissue visualized.
P: reassurance, no fu here for now.
Patient: Jessica Simpson
Title: Office followup - RV
Provider: Vilayil, Ruth
Appointment Date: 2021-Jun-29
Referred By: Tancon, Scott
Jessica was seen in the office for followup today at her request. I spent 45 minutes with her and her mother today.
The hypergranulation complication of surgery is improving. Almost none externally. She has not been diting the neovagina due to pain, she didn't say how long she has stopped for. No more bleeding.
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vulva - well healed, mild scarring
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vagina - blateral labial hypergranulation tissue anteriorly, treated with AgNo3 with consent
spec: unable to advance the speculum beyond 4 cm internally.
single digit exam - the neovagina has narrowed deeper internally, not able to admit even 1 fingertip.
I had a difficut discussion with Jessica and her mother. She was visibly upset because of the apparent