 As mentioned above, the patient was admitted on 08/24/2007 to the Transitional Care Unit at XYZ Services for evaluation and rehabilitation.  She was seen in consultation by Physical Therapy and Occupational Therapy and had begun her rehabilitation till recovery.  The patient had been properly instructed regarding using the CPM machine and she had been instructed as well to limit each CPM session to two hours.  Very early in her hospitalization, the patient enthusiastically used the CPM much longer than two hours and consequently had increased right knee pain.  She remarked that she had a better degree of flexibility, but she did report an increased need for pain management.  Additionally, she required Ativan and at one point scheduled the doses of Ativan to treat her known history of anxiety disorder.  On the fourth hospital day, she was noted to have some rashes about the right upper extremity and right side of her abdomen.  The patient reported that this rash was itchy.  She reports that she had been doing quite a bit of gardening just prior to surgery and this was most likely contact dermatitis, most likely due to her gardening activities preoperatively.  She was treated with betamethasone cream applied to the rash b.i.d.  The patient's therapy had progressed and she continued to make a good progress.  At one point, the patient reported some insomnia due to right knee pain.  She was switched from Percocet to oxycodone SR 20 mg b.i.d. and she had good pain control with this using the Percocet only for breakthrough pain.  The DVT prophylaxis was maintained with Lovenox 40 mg subcu daily until the INR was greater than 1.7 and it was discontinued on 08/30/2007 when the INR was 1.92 within therapeutic range.  The Coumadin was adjusted accordingly according to the INRs during her hospital course.  Early in the hospital course, the patient had reported right calf tenderness and a venous Doppler study obtained on 08/27/2007 showed no DVT bilaterally.  Initial laboratory data includes a UA on 08/28/2007, which was negative.  Additionally, CBC showed a white count of 6.3, hemoglobin was 12.1, hematocrit was 35.3, and platelets were 278,000.  Chemistries were within normal limits.  Creatinine was 0.8, BUN was 8, anion gap was slightly decreased at 5, fasting glucose was 102.  The remainder of chemistries was unremarkable.  The patient continued to make great progress with her therapies so much so that we are anticipating her discharge on Monday, 09/03/2007.