Miles Norton

Reason: Office Visit ElationNoteColOne: HPI: Hpi: 1. ADHD [F90.9] * He is taking guanfacine 1.5 mg twice daily and loratadine. * He feels the medication is not working well. * Per mother, he has been sleeping a lot; this was also noted abou

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Narrative: SPRUCE MESSAGE VISIT Date: 2026-07-22 Encounter: Spruce text message CC: Parent inquiring about a prescription refill for Miles that had not been received at CVS. HPI: Miles is on an ongoing prescription medication (identity unsp

Narrative: SPRUCE MESSAGE VISIT Date: 2026-04-29 Encounter: Spruce text message CC: Back pain for the past two days without a known precipitating event. HPI: Miles is a child weighing 110 lbs who has had central low back pain (above the but

Narrative: SPRUCE MESSAGE VISIT Date: 2026-03-22 Encounter: Spruce text message CC: Sudden onset of excessive sleepiness over the past two weeks, falling asleep in unusual places. HPI: Miles, age unknown, has been sleeping significantly mor

Narrative: SPRUCE MESSAGE VISIT Date: 2026-01-04 Encounter: Spruce text message CC: Ongoing impulse control difficulties on current guanfacine dose, with parent questioning whether a higher dose is needed. HPI: Miles had been on guanfacine

Narrative: SPRUCE MESSAGE VISIT Date: 2025-11-30 Encounter: Spruce text message CC: Recurrent episodes of chest/esophageal discomfort after swallowing guanfacine capsule, suggesting the capsule is dissolving in the esophagus. HPI: Miles had

Reason: Vaccine Narrative: vaccine vist Tdap/mcv4/HPV

Reason: Office Visit Narrative: **SUBJECTIVE:** Chief Complaint: 11-year-old well child check HPI: 11-year-old male presents for routine well child examination. Reports not feeling well for the past 2 days with mild sore throat. Denies feve

Narrative: SPRUCE MESSAGE VISIT Date: 2025-11-09 Encounter: Photo review (throat photo sent by parent) followed by in-person visit CC: Sore throat described as 'bubbly,' with ear and neck pain and refusal to eat or drink. HPI: Miles present

Narrative: SPRUCE MESSAGE VISIT Date: 2025-07-31 Encounter: Spruce text message CC: Stomach aches since starting guanfacine 1mg twice daily. HPI: Miles had recently restarted guanfacine at 1mg twice daily following the medication change dis

Narrative: SPRUCE MESSAGE VISIT Date: 2025-07-18 Encounter: Phone call via Spruce CC: Parent requesting medication change after Strattera (atomoxetine) was stopped due to lack of efficacy and difficulty swallowing capsules. HPI: Miles had b

Narrative: SPRUCE MESSAGE VISIT Date: 2025-04-30 Encounter: Spruce text message CC: New onset dizziness and transient lower extremity numbness after hitting his head during a basketball game. HPI: Miles reported dizziness that began on 2025

Narrative: SPRUCE MESSAGE VISIT Date: 2025-01-14 Encounter: Spruce text message CC: Deep congested cough persisting for several days with no fever or other symptoms, parent querying possible COVID-19. HPI: Miles had a deep congested cough f

Narrative: SPRUCE MESSAGE VISIT Date: 2024-09-03 Encounter: Spruce text message CC: Inadequate response to starting dose of Strattera with increased hyperactivity, emotional dysregulation, and poor focus since school started. HPI: Miles sta

Narrative: SPRUCE MESSAGE VISIT Date: 2024-08-24 Encounter: Spruce text message CC: New painful red bump on one foot, noticed over the past week. HPI: Miles had a red, raised, and tender bump on one foot that had developed over the prior we

Narrative: SPRUCE MESSAGE VISIT Date: 2024-08-19 Encounter: Spruce text message CC: Continued ear and throat soreness with no fever, plus discussion of initiating Strattera (atomoxetine) for ADHD and anxiety. HPI: Miles had ongoing intermit

Narrative: SPRUCE MESSAGE VISIT Date: 2024-08-17 Encounter: Spruce text message CC: Sore throat described as a 'bubble' in the throat, with pain but no fever. HPI: Miles presented with a sore throat that he described as a 'bubble' sensation

Narrative: SPRUCE MESSAGE VISIT Date: 2024-05-01 Encounter: Spruce text message CC: Recurrent sore throat with apparent illness, possible strep recurrence approximately five weeks after previous antibiotic course. HPI: Miles had no illness

Narrative: SPRUCE MESSAGE VISIT Date: 2024-03-27 Encounter: Spruce text message followed by in-person visit CC: Sore throat with pain on swallowing, progressing to low-grade fever and ear pain requiring an in-person visit. HPI: Miles came h

Narrative: SPRUCE MESSAGE VISIT Date: 2024-03-07 Encounter: Photo review (photo of foot sent by parent) CC: Plantar wart on the bottom of Miles's foot unresponsive to over-the-counter cryotherapy. HPI: Miles had a plantar wart on the bottom

Narrative: SPRUCE MESSAGE VISIT Date: 2024-02-26 Encounter: Spruce text message CC: Parents tested positive for COVID-19 and sought guidance on whether to test Miles and how to manage his exposure. HPI: Both parents tested positive for COVI

Narrative: SPRUCE MESSAGE VISIT Date: 2023-11-13 Encounter: Spruce text message CC: Diarrhea with liquid stools and undigested food, starting the day prior and persisting overnight. HPI: Miles presented with diarrhea that began the day befo