So I'm in a urology room today. First case listed 25 y/o Female for L stone extraction.

Patient was seen in our Pre-Op Evaluation Clinic.
Wheel chair bound since age 5
Obese - 115kg, BMI 50
Type 2 DM
OSA - BiPap at home
Type 2 Muscular Dystrophy (Spinal Muscular atrophy) (H&P noted good neck muscle control)
Hx Difficult IV start
S/P Spinal surgery for scoliosis

Labs ok.
K 4.8, Hgb 15, Plat 250, Na 137, Creat 0.8, can't remember the rest...but nothing jumped out at me as grossly out of wack.

Plan? I'm just looking for what your initial thoughts are, you haven't seen the patient, but you've got to start formulating a plan. No real wrong answers here...we're just getting started.

I'll be back to check on the thread tomorrow and tell you what I saw during patient interview and how we handled the case.