Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: allergies: heparin agents attending: chief complaint: midline parastomal hernia with hx of ulcerative colitis (rectum is in place) major surgical or invasive procedure: completion proctectomy, resiting stoma, ventral hernia repair with component separation history of present illness: mr. is a well known patient with ulcerative colitis s/p total abdominal colectomy and ileostomy from . the patient was followed as an outpatient, and post-opeartively developed a parastomal hernia, midline incisional hernia, and continued to have drainage and symptoms of ulcerative colitis of the rectum. mr. was seen in clinic with dr. , who evaluated the hernias and recommended (as he was symptomatic from them) that surgical repair was indicated. it was also decided that during this surgical intervention, the remaining portion of the rectum would be removed as well given continued symptoms and increased cancer risk. the patient was evaluated as an outpatient with dr. in plastic surgery clinic and appropriate arrangments were made for surgical intervention. the patient is followed by hematology for coagulopathy, and appropriate recommendations for bridging pre-operatively were made. past medical history: ulcerative colitis (last colonoscopy : sigmoid with active chronic colitis without granulomas, no evidence of ischemic colitis) lower gi bleed (brbpr - , hct 15, transfused 6 units prbc, c. diff negative, colonoscopy with severe ulceration from anus to 70 cm / splenic flexure, negative h. pylori, iv solumedrol and asacol 1200 mg tid, egd mild gastritis, flagyl / levaquin initially but discontinued when stool cultures negative for salmonella, shigella, campylobacter, and e. coli. flex sig showed severe ulcerative colitis, contraindicated to anticoagulate, therefore ivc filter was placed). past surgical history: - tonsillectomy - ivc filter (initially presented with lle dvt, had ivc filter placed, then re-presented with rle dvt: not candidate for tpa or thrombectomy by vascular surgery, ct chest with rul/rll and lul segmental pe's--main pulm a 2.5 cm--fragmin and coumadin initiated) social history: single, works in a grocery store and lives with his brother. a history of drinking half to a full pint 5 days per week, but has not had a drink for almost two months. smokes 1.5 packs per day since the age of 13. denies illicit drug use. family history: does not know his father's medical history. mother died of breast cancer in her 60s and did not have known abnormal clotting. his brother has problems with pancreatitis. physical exam: discharge physical exam: 98.6 98.4 71 166/82 18 96% ra gen - nad, aaox3 heent - ncat, mmm, perrl, wears glasses cv - rrr resp - ctab abd - s, nt/nd, ostomy intact w/ stool output wound - perineal incision c/d/i, dsg in place, jp drain x2 in lower right quadrant with scant sero/sang drainage, horizontal abdominal incision intact with dermabond w/o drainage. ext - no c/c/e, wwp neuro - cn 2-12 grossly intact pertinent results: admission labs 06:15am blood wbc-10.9# rbc-3.20* hgb-9.6* hct-27.6* mcv-87 mch-30.0 mchc-34.8 rdw-13.4 plt ct-192 07:10pm blood hct-30.0* 06:15am blood plt ct-192 06:15am blood glucose-127* urean-15 creat-0.8 na-141 k-4.4 cl-106 hco3-24 angap-15 07:10pm blood na-140 k-4.3 cl-108 06:15am blood calcium-7.6* phos-4.2# mg-2.3 07:10pm blood mg-1.5* discharge labs 07:30am blood wbc-5.0 rbc-2.86* hgb-8.6* hct-25.7* mcv-90 mch-30.0 mchc-33.4 rdw-14.8 plt ct-268 10:17am blood pt-36.3* inr(pt)-3.3* 07:30am blood glucose-94 urean-12 creat-1.0 na-139 k-4.2 cl-107 hco3-26 angap-10 07:30am blood calcium-8.2* phos-3.6 mg-2.3 07:30am blood digoxin-1.3 07:30am blood digoxin-1.3 brief hospital course: the patient was admitted to the inpatient colorectal surgery service postoperatively and was stable overnight into post-operative day one. the patient tolerated ice chips and medications by mouth on post-operative day one. the patient's hematocrit was slightly lower than pre-operatively, 27.6 from 30.1. all other laboratory values were stable post-operatively, however, and the hematocrit was repeated in the afternoon. it was 25 and was monitored, remaining the same. the patient was stable; pain was controled with pca hydromorphone and intravenous tylenol. anticoagulation was continued post-operatively with subcutaneous fondaparinux, but this was discontinued and held until the hematocrit remained stable. it was restarted during the afternoon of post-operative day two. the patient wore pneumoboots and was ambulating post-operative day one with an abdominal binder in place. an air-matress was obtained and used to redistribute pressure from the area of the perianal incision line. the wound ostomy nurses met with the patient, and he was given information regarding the ileostomy, although this was not new to him. the patient had minimal serous output from the ileostomy on pod 1. jp drains were monitored and recorded and on pod1 drained moderate amounts of serosanguenous drianage. the patient complained of pain at the lower right quadrant jp drain site on the morning of post-operative day two. this pain was only present when moving from bed to standing and with moving his right leg forward during ambulation. this was monitored closely, and treated with hot packs and pain medication. on pod 3, the patient was found to be in a-flutter on a routine vitals check. rate was not controlled with 3 doses of lopressor and 2 doses of diltiazem. he was transfered to the for an amiodarone drip. his blood pressure was stable. the amiodarone drip did not convert him and cardiology suggested stopping it, starting metoprolol 50mg po q6 and giving 3 doses of digoxin. throughout this time his heart rate remained in the 140s with a stable systolic blood pressure until pod5 when he had some orthostatic hypotension with a sbp of 77. cardiology scheduled him for tee/cardioversion the morning of , but he converted spontaneously without cardioversion while on the beta blockade and digoxin. he was transferred back to the floor, and the remainder of his hospital course was uneventful. he was discharged from the hospital to home in stable condition on . a visiting nurse will monitor his inr and check a digoxin level and pt will assist him with mobility issues during his recovery. he will also see plastic surgery for follow-up and drain removal. medications on admission: the preadmission medication list is accurate and complete. 1. acetaminophen 650 mg po q6h:prn pain 2. atenolol 25 mg po daily 3. warfarin md to order daily dose po days (,mo,tu,we,th,fr,sa) 4. dalteparin (porcine) *nf* dose is unknown subcutaneous 5. ferrous sulfate 325 mg po daily 6. furosemide 20 mg po undefined 7. multivitamins 1 tab po daily 8. whey *nf* 9 gram oral daily 9. omeprazole 40 mg po undefined 10. calcium carbonate 500 mg po undefined gerd 11. ascorbic acid 500 mg po daily discharge medications: 1. metoprolol succinate xl 200 mg po daily start in the morning of thursday . rx *metoprolol succinate 200 mg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*0 2. acetaminophen 650 mg po q6h:prn pain 3. calcium carbonate 500 mg po undefined gerd 4. omeprazole 40 mg po undefined 5. ferrous sulfate 325 mg po daily 6. multivitamins 1 tab po daily 7. whey *nf* 9 gram oral daily 8. ascorbic acid 500 mg po daily 9. warfarin 3 mg po daily16 please take for next 2 days and and call result to at contact information listed. rx *warfarin 1 mg 3 tablet(s) by mouth once a day disp #*10 tablet refills:*0 10. bacitracin ointment 1 appl tp rx *bacitracin zinc 500 unit/gram one application to perianal wound twice a day disp #*1 tube refills:*0 11. digoxin 0.25 mg po daily please check digoxin level tuesday rx *digoxin 250 mcg 1 tablet(s) by mouth once a day disp #*30 tablet refills:*0 12. loperamide 2 mg po bid rx *loperamide 2 mg 1 tablet by mouth twice a day disp #*60 tablet refills:*1 13. metoprolol tartrate 50 mg po q6h duration: 2 doses please take today at 6pm and 11pm-12am (midnight) and stop. you will start toprol xl tomorrow morning. rx *metoprolol tartrate 50 mg 1 tablet(s) by mouth every six (6) hours disp #*2 tablet refills:*0 14. oxycodone (immediate release) 5-10 mg po q4h:prn pain rx *oxycodone 5 mg tablet(s) by mouth every four (4) hours disp #*30 tablet refills:*0 15. tamsulosin 0.4 mg po hs 16. outpatient lab work please check inr on and call into at , md 17. outpatient lab work digoxin level , call into , md discharge disposition: home with service facility: vna assoc. of discharge diagnosis: ulcerative colitis, midline incisional hernia/parastomal hernia discharge condition: mental status: clear and coherent. level of consciousness: alert and interactive. activity status: ambulatory - independent. discharge instructions: you were admitted to the hospital after a completion proctectomy, repair of parastomal hernia, resiting of the stoma for surgical management of your ulcerative colitis and hernia. you have recovered from this procedure well and you are now ready to return home. samples from your colon were taken and this tissue has been sent to the pathology department for analysis. you will receive these pathology results at your follow-up appointment. if there is an urgent need for the surgeon to contact you these results they will contact you before this time. you have tolerated a regular diet, passing gas and stool from the ileostomy and your pain is controlled with pain medications by mouth. you may return home to finish your recovery. you have an incision on your bottom closed with suture. this should be inspected daily. apply bacitracin ointment and cover with dry sterile gauze and wear gauze underwear. you may sit on bottom for less than 1hr at a time. you may lay on the sides or stand up to avoid pressure on perineal wound. you have an ileostomy. the most common complication from a new ileostomy placement is dehydration. the output from the stoma is stool from the small intestine and the water content is very high. the stool is no longer passing through the large intestine which is where the water from the stool is reabsorbed into the body and the stool becomes formed. you must measure your ileostomy output for the next few weeks. the output from the stoma should not be more than 1200cc or less than 500cc. if you find that your output has become too much or too little, please call the office for advice. the office nurse or nurse practitioner can recommend medications to increase or slow the ileostomy output. keep yourself well hydrated, if you notice your ileostomy output increasing, take in more electrolyte drink such as gatorade. please monitor yourself for signs and symptoms of dehydration including: dizziness (especially upon standing), weakness, dry mouth, headache, or fatigue. if you notice these symptoms please call the office or return to the emergency room for evaluation if these symptoms are severe. you may eat a modified regular diet with your new ileostomy. however it is a good idea to avoid spicy or fatty foods for the next 5-7 days. please monitor the appearance of the ostomy and stoma and care for it as instructed by the wound/ostomy nurses. the stoma (intestine that protrudes outside of your abdomen) should be beefy red or pink, it may ooze small amounts of blood at times when touched and this should subside with time. the skin around the ostomy site should be kept clean and intact. monitor the skin around the stoma for buldging or signs of infection listed above. please care for the ostomy as you have been instructed by the wound/ostomy nurses. you will be able to make an appointment with the ostomy nurse in the clinic 7 days after surgery, you will have a visiting nurse at home for the next few weeks helping to monitor your ostomy until you are comfortable caring for it on your own. unfortunately you developed an irregular heart rate during your admission. you were seen by cardiology and you must see them in follow-up as listed below. please continue to take the medication metoprolol for two more doses, tonight when you go home with dinner, and around midnight, and tomorrow you will start a medication called toprol xl which you will take once daily. you will also be taking a medication called digoxin which is a once daily medication however you will need a digoxin level 7 days after the last level with would be next tuesday . this can be checked by the vna at home and the results should be sent to , md who will be our cardiologist. . you will continue to take your coumadin however, your inr has been slightly elevated. you should changed your dose to 4mg for the next 2 days and have an inr check on each of these days and and these results can be sent to your hem/onc , md . please follow your discharge instructions precisely. . personal care: 1. leave your abdominal incision open without a dressing. 2. clean around the drain site(s), where the tubing exits the skin, with soap and water. 3. strip drain tubing, empty bulb(s), and record output(s) times per day. 4. a written record of the daily output from each drain should be brought to every follow-up appointment. your drains will be removed as soon as possible when the daily output tapers off to an acceptable amount. 5. you may shower daily. no baths until instructed to do so by dr. . 6. you should wear your abdominal binder at all times. . activity: 1. you may resume your regular diet. 2. do not lift anything heavier than 5 pounds or engage in strenuous activity until instructed by dr. . call the office immediately if you have any of the following: 1. signs of infection: fever with chills, increased redness, swelling, warmth or tenderness at the surgical site, or unusual drainage from the incision(s). 2. a large amount of bleeding from the incision(s) or drain(s). 3. separation of the incision. 4. severe nausea and vomiting and lack of bowel movement or gas for several days. 5. fever greater than 101.5 of 6. severe pain not relieved by your medication. . return to the er if: * if you are vomiting and cannot keep in fluids or your medications. * if you have shaking chills, fever greater than 101.5 (f) degrees or 38 (c) degrees, increased redness, swelling or discharge from incision, chest pain, shortness of breath, or anything else that is troubling you. * any serious change in your symptoms, or any new symptoms that concern you. . drain discharge instructions you are being discharged with drains in place. drain care is a clean procedure. wash your hands thoroughly with soap and warm water before performing drain care. perform drainage care twice a day. try to empty the drain at the same time each day. pull the stopper out of the drainage bottle and empty the drainage fluid into the measuring cup. record the amount of drainage fluid on the record sheet. reestablish drain suction. please take oxycodone as ordered. do not drink alcohol while taking this medication. do not drive a car while taking this medication. you may take tylenol as ordered, do not take more than 4000mg of tylenol daily. do not drink alcohol while taking tylenol. followup instructions: please call the colorectal surgery clinic at to make an appointment 2-3 weeks from discharge for follow-up with , np or , np and the wound ostomy nurses, . please call this number with any questions or concerns related to your surgery. please call dr. office at ( to make a follow-up appointment. department: cardiac services when: friday at 9:40 am with: , md building: sc clinical ctr campus: east best parking: garage department: hematology/oncology when: friday at 11:00 am with: , md building: sc clinical ctr campus: east best parking: garage department: hematology/oncology when: friday at 10:30 am with: , md building: sc clinical ctr campus: east best parking: garage procedure: revision of stoma of small intestine other open incisional hernia repair with graft or prosthesis repair of pericolostomy hernia other resection of rectum diagnoses: esophageal reflux tobacco use disorder unspecified essential hypertension atrial fibrillation atrial flutter alcohol abuse, unspecified incisional hernia without mention of obstruction or gangrene long-term (current) use of anticoagulants iron deficiency anemia, unspecified personal history of venous thrombosis and embolism personal history of pulmonary embolism attention to ileostomy other colostomy and enterostomy complication other ulcerative colitis 

Answer: The patient is high likely exposed to