Document KRYD7kkzv5R1dpQXJnG3OBvb0

FILE NAME: Norfolk & Southern - WC Case - Ancel Wheeler (NS) DATE: 1951 Oct 1 DOC#: NS028 DOCUMENT DESCRIPTION: Medical Report with Cover Letter to Dr. Ralph Carothers V' .LIAM L. F R E Y H O F . M.D. 2 Qcm UNION CENTRAI. BUILDING C incinnati 2 ,O hio J . E . V E R B R Y K E , M. D. O ctob er 1, 1951 DR. RALPH CAROTHERS 409 Broadway Cincinnati, Ohio. Dear Doctor Carothers: I am reporting to you on the examination requested on your Client, M r. A n cil W heeler, N & W Railroad Shop w orker. I was asked to report on his cardiovascular status. It would be m y fe e lin g that M r. W heeler does have a m oderate degree of essen tial hypertension associated with left ventricular preponderance and beginning atherosclerotic changes in h is a o rta . The E le ctro ca rd io gra m revealed no evidence of gross M yocardial Damage nor heart strain. His present weight of 290 pounds is evidently on a glandular b asis and probably represents a pituitary difficulty. The Laboratory findings revealed moderate increase in his Blood C h em istry. The U rinalysis was essentially negative. Red blood ce lls 4,420,000; White blood ce lls 9,000; Hemoglobin 89%. It would be my feelin g that while his cardiovascular status is not p e rfe ct, it in no way totally disables him . W LF:m V ery truly yours, ANCIL WHEELER N & W R ailroad Shop Em ployee Referred by D r. Ralph Carothers HISTORY M r. A n cil W heeler stated that he was employed at the N &. W Shop and was running a grinder which was used to pulverize asbestos fo r insulation of b o ile rs. He further stated that he had been an employee in the shop for seven years on the same job and had asker for a re sp irator but none was supplied him ; that he inhaled quantities of dust with the result that his right upper chest became sore and painful, producing cough and right anterior chest pain and shortness of breath. He did not have hem optysis. His past history is not especially rem arkable. He had never been seriously ill and had had no operations. The Physical Exam ination reveals a rather obese adult - age 39 years - weighing 290 pounds. The pupils were equal and reacted to light and accom m odation. Ophthalmoscopic examination revealed no evidence of exudate or hem orrhage. The rem aining teeth were in fa ir condition; no evidence of marked alveolar infection was noted. The tonsils were large and soft but no pus was expressed. The trachea was in the m idline. Thyroid not irre g u la rly enlarged. There was no evidence of cervical adenopathy. The Chest was broad and deep~and expanded equally and w ell. The percussion note was resonant over the backs; the diaphragms were high in position but descended equally; a few ronchi heard at the b ase s; no m oisture over the a p ices. The percussion note was resonant an teriorly. The heart was of norm al size and configuration; sounds cle a r; no m urm urs present; P .M .I. not palpable; no abnormal th rills nor pulsations noted over the precordial area; A 2 slightly louder than P 2; rhythm regu lar; rate not in creased . The Blood P ressu re was 140 systolic; 100 d iasto lic. The peripheral v e sse ls were not unduly thickened. The abdomen was just above the level of the costal border; no m asses were noted within the abdomen; no areas of tenderness; live and spleen not palpable. The extrem ities demonstrated norm al neuro logical findings; no gross joint involvement; no oedema. The D orsalis pedis were of equal and moderate pulsation. LABORATORY WORK BLO O D CH EM ISTR Y M oderately increased U R IN A L Y S IS E ssentially negative BLOOD COUNT H em o glo b in Red blood cells White blood cells 89% 4,420,000 9,000 E L E C T R O C A R D IO G R A M Rate 88 per minute P . R . Interval 0.16 seconds Rhythm sinus P waves normal Q . R .S . - preponderant S 3 T waves inverted in lead 3 Interpretation Normal Electrocardiogram . No change from E le ctro ca rd io gra m taken 6/20/51 STEREO SCO PIC AND L A T E R A L VIEWS OF CH EST - Also Bucky F ilm s of Ch est - A P and L a te r a l P ro jectio n s - The rib s rev eal no destruction nor produci-i n. The tra ch e a and m ediastinal structures are in m idline. The heart is not enlarged. No areas of recent infiltration, consolidation or effusion noted. No evidence of pneum onoconiosis. There is again noted slight thickening of the pleura over the right lung. Impression - Slight thickening of the pleura over the right lung.