🔗 Linked Evidence
ISCOPE_CLINIC_JUNE_30 — p.2
📄 ISCOPE CLINIC JUNE 30 | p.2
📄 ISCOPE CLINIC JUNE 30 | p.2
📝 Extracted Text (OCR)
RE: Mark Thomas Holand Page 2 of 3 - Surgical history includes embolization via bilateral femoral artery access with platinum coils for ulcer bleed. - Current medications include sumatriptan, sertraline, quetiapine at night, risperidone, and trazodone. Sleep medications were started due to sleep disruptions caused by pain. - Was working in rail maintenance, then transitioned to a training role at Skytrain. Was terminated from employment. Workers' compensation claim was denied by an audiologist who attributed the claim to migraines without reviewing the migraine reduction program or the timeline of the first emergency room visit on 01/30/2026. - Family doctor has been managing headaches. Did not see a specialist until 05/27/2026, by which time things had stabilized. Exam- neuro intact Assessment & Plan: 1. Migraines - Currently stabilized with migraine reduction program including triple progressive glasses, Coenzyme Q10, smoking cessation, alcohol cessation, and trigger elimination. - No new medications to be started at this time. - Riboflavin 400mg recommended as per handout provided. - Follow-up as needed if anything changes. 2. TMJ (per otolaryngology) - Daily heat application and massage recommended. - Mouth guard at night recommended but currently without insurance coverage. 3. Neck pain and tension - Currently 2/10, fluctuates. - Trigger point injections available through anesthesiologist if interested. Referral can be arranged now or at time of flare-up. - Continue current management with sauna, swimming pool, and massage. Follow-up as requested ASSESSMENT AND PLAN License Number: 47874 / Signed on 29th June 2026 Page 2 of 3