Mar 12, 2026 11:58 To: +16042339777 Page: 21/46 From: Foremed Medical Clinic Fax: 16043985614

Documentation for MARK THOMAS HOLAND

P:

- Recommend Coenzyme Q10 and Riboflavin as alternative supplements for migraine prevention.
- Prescribed sumatriptan.

-t/v prn

[Faxed to Guardian Kent Pharmacy Fax#: 604-522-3402, 18-Aug-2025 02:22 PM]
TEVA-SUMATRIPTAN DF 25 MG 25mg once for migraine. If initial dose was partially effective or headache recurs, may
repeat dose after >2 hours. Maximum dose: 100 mg per dose 200 mg per 24 hours Refill Qty:16 TABLET Repeats:0

BP: 108/70 sitting position
Weight: 77.1

Height: 175

BMI: 25.2

[Signed on 18-Aug-2025 14:26 by Gbogboade Ademiluyi (68199)]

-(30-Jan-2026 .:]

Seen in person. Seen with wife

WCB ‘acoustic injury' 19Jan2026. Control operator training. No previous hearing issues

Reports noise exposure from servers located behind his desk which he moved to one week prior.

Developed headaches , bilateral earache, irritability and joss of appetite. He filed a safety concern

His employer assessed nose at 56- 63db. File was closed. He also attended ER- no evidence of infection

He remains at work but has been moved to another work station. Had a normal hearing test today. o/e normal ear exam.
imp ?migraine secondary to noise exposure Plan c/w migraine prevention with coenzyme q10

Known migraine

8:

Migraine:

+ History of migraines, previously managed with Sumatriptan.

- Sumatriptan was effective in reducing migraine frequency, allowing for a one-third reduction in use.
- Currently experiencing a "bump" in migraine frequency and severity.

- Previous trial of Propranolol was not tolerated.

- Expresses interest in monthly injactions for migraine prevention.

General:

- Currently taking Wellbutrin, out of refills.

- Wellbutrin is effective, with no full breakouts and ability to go several days without it.
- Experiences occasional itchy speils.

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