text: As described above the patient was transfused an additional 2 units in the Intensive Care Unit and the patient also received an upper endoscopy study and her varices were banded .', 'On transfer to the Lemgarson Hospital service   her hematocrit was 31.2   white count 11.1 and a platelet count 80 . Her PT was 13.1   PTT 26.7 . The rest of her labs were unremarkable .', 'She was watched very closely while on the floor . She was on GI bleed precautions at all times   was too large for IV . She had a clot at the blood bank and she had BID hematocrits checked .', 'She was kept NPO until January 26 when she began to feel hungry . At that time clear liquids were started . All of her stools were guaiaced . She also began Nadolol 40 mg QD to reduce her portal', 'hypertension . The GI consult team continued to follow her . We also tried to contact her physician at Va Sit Namar Healthcare and was unsuccessful . Therefore we decided to work up her cirrhosis .', 'She was described as having cirrhosis and we decided that we wanted to try to figure out the etiology .', 'Her ferritin and iron studies did not reveal any evidence of hemochromatosis and her hep serologies were all negative . She also had negative antimitochondrial antibody and she also had no evidence', 'of ceruloplasmin . Over the course of her admission were also sent an alpha-1-antitrypsin   which was negative .', 'She did very well over the course of her admission with no evidence of further bleeding .', 'Her hematocrit stayed stable at approximately 32 . We also did an ultrasound guided paracentesis .', 'The peritoneal fluid showed a glucose of 244   total protein 0.8 and a albumin of 0.5   globulin 0.3   amylase 16   LDH of 51 . The serum albumin gradient was 1.8 consistent with portal hypertension .', 'The cell count showed a white blood cell count of 160 with 16 polys . She therefore criteria for a spontaneous bacterial peritonitis .', 'Her platelet count stayed persistently low and we decided that it might be due to Cimetidine . Therefore we switched her Cimetidine to Prilosec .', 'By the 2th the patient was feeling very well and desired to transfer or discharge to home . She wanted to be closer to North Dakota .', 'After discussion with her private physician   Dr. Joasscchird   tel. 090-249-6079   at Va Sit Namar Healthcare and Dr. Acrookesjo at Do Of Hospital', 'the patient was judged to be fit for discharge and she was sent home with AH and physical therapy . She was quite able to climb stairs on her own in the hospital .', 'She is to follow up with Dr. Acrookesjo in one week and Dr. Work the gastrointestinal fellow here at PUOMC in 2 weeks . She may require a repeat upper endoscopy study to see if she needs any rebanding .', 'The patient however complained of a persistent wheeze with beta blocker   therefore it was agreed that we would stop the beta blocker until the patient was followed up as an outpatient .