THE ATTENDING PHYSICIAN CONGRESS or THE UNITED STATES U.S. CAPITOL WASHINGTON. DI: 20515-9035 BRIAN P. MDNAHAN, MD, MACP espresson or: MEDICINE am: PATHOLOGY September 14, 2016 The Honorable Timothy M. Kaine United States Senate 231 Russell SOB Washington, D.C. 20510 Dear Senator Kaine: This letter summarizes your general health history and current medical evaluation prepared at your request. I have served as your physician for the past 3 years. I am certi?ed by the American Board of Internal Medicine in lntemal Medicine, Hematology, and Medical Oncology. You are active in your recreational lifestyle consisting of gymnasium workouts 3 times per week with cardiovascular training and calisthenics. You have a history of plantar fasciitis that is inactive. You have a history of a clavicle fracture and shoulder dislocations that are Your past surgical history is limited to third molar teeth extraction. Review of your family history is remarkable for your maternal history of breast cancer and paternal grandfather histOry of prostate cancer. You take no medications and have no drug allergies. Your most recent colonoscopy was in June 2003 and is next due in 2013. You have no history of tobacco use, and your use of alcohol is modest. You have received frequent comprehensive medical evaluations over the past 5 years. In 2013, you had a coronary calcium and chest CT scan, abdominal aortic ultrasound screening exam, and a carotid ultrasound screening examination, all of which were normal. A 5mm and a 7mm pulmonary nodule were identified on the chest CT scan in July 201 l, with follow-up interval CT scans performed in June 2012, and again on February 10, 2014 showing no change in theses nodules. No further follow-up of the nodules is required. I performed your most recent physical examination on February 12, 2016 when you were 57' years old, 71 inches tall and weighed 207.6 pounds. Your general physical and mental health examination was normal including a blood pressure of 120.1'81 mmHg, and a pulse of 71. A left mandibular tooth had a temporary restoration and was awaiting permanent repair. A 2 4 cm subcutaneous was present on your right costal margin that was unchanged. Comprehensive laboratory test results indicated your total cholesterol of 224 mgde, with an LDL cholesterol of 138 mgI?dL and an HDL cholesterol of 65 mg/dL. Your thyroid metabolic pro?le, urinalysis, and complete blood count was normal. Your fasting blood glucose was 57' Serial PSA testing has been 2.0 Your most recent vitamin level was low at 13.9 ng/dL. Your electrocardiogram was normal with the exception of left atrial enlargement. An echocardiogram performed on March 10, 2016 indicated normal left and right ventricular size and function, mild left atrial enlargement, structurally nortnal heart valves without evidence of valve malfunction and no evidence of abnormal intracardiac pressures. You are in overall excellent health and active in your professional work, and physical fitness endeavors without limitation. I recommend that you add a daily vitamin supplement of 1000 Units per day to your diet. Very truly yours, -, ,?zz Brian P. Monahan, MD, MACP