Mar 12, 2026 11:58 To: +16042339777 Page: 18/46 From: Foremed Medical Clinic Fax: 16043985614

Documentation for MARK THOMAS HOLAND

-(14-May-2025 : dizziness; lab req. Pls check BP]
Seen in person. Known migraine

Subjective:

- Dizziness and lightheadedness for past morth, occurring with moderate physical activity (Scooters, walking uphill)
- No loss of consciousness or fainting

- No chest pain or shortness of breath

- Occasional palpitations

- Tinnitus for past few years

- Currently taking antihistamine for urticaria {prescribed by allergist for 6 months)

- No known medication allergies

- Alcohol: 1-2 drinks once weekly

- No smoking or recreational drugs

- Works in rail maintenance for SkyTrain - physical work (lifting) but symptoms don't affect work

Objective:

- BP 104/68 {reports consistently low readings at home)
- Normal gait

- Negative Romberg test

- No pronator drift

- Good tandem gait and balance

- Heart sounds normal

- Respiratory examination normal

Assessment & Plan:

1. Dizziness and lightheadedness

- Possible cardiac cause

- Investigations: 24-hour Holter monitor with syrnptom diary to correlate symptoms with heart rhythm
- Advised to maintain adequate hydration (2L water daily)

[Signed on 14-May-2025 9:24 by Gbogboade Ademiluyi (68199)]

-(22-May-2025 : test results from holter]

Called patient .

Subjective:

- Holter monitor results discussed with Mark.

- Reports dizziness and lightheadedness, now improved with electrolytes.

- Recently presented to ER with reflux and gastritis, currently managed with pantoprazole with good effect.

- No identified triggers for gastritis - denies association with spicy foods, hot drinks, or caffeinated beverages.

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Created by: OSCAR The open-source EMR www.oscarcanada.org 2026-03-12

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