This is a 51 year-old M w/ a h/o MS, quadraparesis, HTN, restrictive
   lung disease, chronic constipation and SBOs s/p ileostomy, multiple
   UTIs (also s/p suprapubic tube) presents with SBO and UTI.  Of note he
   was just recently discharged from the [**Hospital1 52**] on [**10-2**] for an admission
   for a UTI (negative cultures) treated with cipro, shingles treated w/
   acyclovir and SBO evaluated by surgery but managed conservatively.  He
   returns today as his home health aide had noticed his Urine output was
   low, 75cc overnight when he usually has about 1 liter of UOP
   overnight.  His ostomy output has been high.  He has not noticed any
   symptoms.  Over the past two weeks he has had mild earaches, a
   sorethroat as well as some rhinorrhea.  He has not noticed any watery /
   itchy eyes.  He has not sure if he has had a change in his ostomy
   output or suprapubic output.  He has not noticed any visual changes, he
   has not noticed any new neurologic si/sx.  He denies any abdominal
   pain, has not sujectively noticed any change in abdominal distention.
   He denies any pain in regards to his zoster (now or when diagnosed).
   Denies CP, has an occasional cough that is not worsening.
   .
   In the ED, he was noted to be severely dehydrated on exam.   His BP
   nadir was 79/43 and HR peak was 97.  T 99 (he usually "runs low"), new
   ARF 1.4 up from 0.6.