To make it easier to read this document is typed from the handwritten notes of the PROGRESS RECORD of ELVINA M. ROLOFF while she was in the SOUTHWEST WASHINGTON MEDICAL CENTER hospital.
Question marks "?" indicate undecipherable letters or words.
Editorial notes by this author are indicated by bold type.
1/31 Neurology
Pt. seen + examinded, history reviewed.
She certainly has an encephalopathy, whether
due to vicodin, ????? vs remote effect
of adenocarcinoma ? limbic encepheloathy)
Is not possible to tell by exam
CT brain inconsistent with Ca mets.
P(1) Brain MRI (likely ? for malignancy)
(2) Hu antibody (this indicates a neurological problem).
(3) Keep off pain meds if possible. 
(Pain meds are not good.
Roxanol, a form of morphine is a pain med.
Approximately seven days after she was advised,
MARIE A. CHEATHAM increased the dosage of Roxanol the same day that ALVINA M. ROLOFF 'stopped breathing'.
Roxanol suppresses the body's ability to breath.)

Thank you  will dictate (signature)

Discussed with daughter who understands. (signature)
(Daughter understands. MARIE ANN CHEATHAM understands.)

2/1/01 S. NO complaints.
D??? pa??/?OB
O. 113/58 20 73 A??? 93? 1.5 L (blood pressure, respiration, pulse rate)
NA?
Oriented to 'hospital','2000', 'February' 'Tues'
(This is a mental status test of 'Where are you?', 'What is the year?'
'What is the month?' and 'What is the day?'. The year and day are wrong. It is 2001 and Thursday.)
(The rest of the notes are undecipherable.)
(signature)