1. Patient name:
   ..
   
2. MRN:
   ..
   
3. Appointment Type: NS
   ..
   
4. Appointment Date: January 29, 2009
   ..
   
5. Appointment Day: Thursday, 1:30 PM
   ..
   
6. Provider: M A Brocato P A
   ..
   
7. Home Page:
   
   http://www.kp.org/mydoctor/brocatomichele
   ..
   
8. Facility: Walnut Creek Medical Center
   ..
   
9. Department: Orthopaedic Department - WCR
   ..
   
10. Location: MOB1, First Floor
    ..
    
11. Cancellation Number: 925 295 4130 (Mon - Sun, 12 AM - 12 PM)
    ..
    
12. Rebook Number: 925 295 4130 (Mon - Sun, 8 AM - 5 PM)
    ..
    
13. Appointment Messages: Copays are due at time of service. For copay information call 1 800 464 4000
    ..
    
14. Note: Orthopaedics is located in MOB 1, on the first floor, in WC.

1. Your Kaiser Permanente Care Instructions
   
   The care you need depends on the type of wound you have. Taking good care of your wound at home will help it heal quickly and will reduce yor chance of infection.
   ..
   Even though you have been released from the emergency department, you still need to watch for any problems. The doctor or other health care professional carefully checked you. But sometimes problems can develop later. If you have new symptoms, or if your symptoms do not get better, return to the emergency department or call your doctor right away.
   ..
   A visit to the emergency department is only once step in your treatment. Even if your feelk better, you still need to do what your doctor or other health care provessional recommends, such as going to all arranged follow-up appointments, finding out the results of all tests and labs ordered as part of your care, and taking medicines exactly as directed. This will help you recover and help prevent future problems.
   ..
   
2. Hou can you care for yourself at home?
   1. Clean the area with soap and water 2 times a day, or as your doctor or other health care provider tells you. Certain cleaning products, such as hydrogen peroxide can delay wound healing.
      ..
      1) Unless your doctor or other health care professional gives you other directions, cover the wound with a thin layer of antibiotic ointment, such as bactracin, and a bandage. Do not us an ointment that ocntainsneomycin, because it can irritate the skin.
      ..
      2) Apply more ointment and replace the bandage as yuour doctor or other health care professional tells you.
      ..
      
   2. For a scalp wound, follow your doctor's or other health care professional's directions about when you can shampoo your hair. If you have a pressure dressing, you may need to wait 24 hours to wash your hair. Put a new dressing on the wound after you wash your hair.
      ..
      
   3. If the wound is in your mouth, rinse with salt water a few times during the day. You can use ice to help reduce swelling.
      ..
      
   4. If you have a finger injury, you may have a splint or guaze tube bandage. Follow your doctor's or other healh care professional's direction s on how to care for your injured finger.
      ..
      
   5. Ask your doctor or other health care professional if you can take an over-the-counter pain medication. Do not take two or more pain medicines at the same time unless the doctor or other health care professional told you to. Many paint medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
      ..
      
   6. Your doctor or other health care professional may have closed your wound with stitches (sutures), staples, or skin glue.
      ..
      1) If you have stitches, your doctor or other health care professional may remove them after several days to 2 weeks. You can rub the wound with bacitracin or Valeline the day before you have the stitches removed. This will make it easier to take out the stitches.
      ..
      2) If you have staples, your doctor or other health care professional may remove them after 7 to 10 days.
      ..
      3) If your wound was closed with skin glue, the glue will wear off within 2 weeks.

1. You have signs of infection, such as:
   1. Increased pain, swelling, warmth, or redness around the wound.
      
      
   2. Red streaks leading from the wound.
      ..
      
   3. Pus draining from the wound.
      ..
      
   4. Swollen lymph nodes in your neck, armpits, or groin.
      
      
   5. A fever.
   ..
   
2. The wound starts to bleed, and blood soaks through the bandage. Oozing small amounts of blood is normal.
   ..
   
3. You have signs of nerve or tendon damage in an injured finger. this may includ numbness, not being able to move your finger, or changes in hour your finger looks.

1. The wound is not getting better each day.
   
   
2. You have any new symptoms.
   
   
3. You have any problems with your medicine.
   ..
   
4. You have quetions or concerns.

1. Log on: members.kp.org
   
   Search for cuts in the Health encyclopedia
   
   
2. Look in: Kaiser Permanente Healthwise Handbood.

1. If the doctor or other health care professoinal put your arm in a sling or shoulder immobilizer, wear it as directed. Do not take it off before your doctor or other health care professional tells you to.
   
   
2. Take pain medicines exactly as directed.
   
   ..
   
   1. If the doctor or other health care professional gave you a prescription medicine for pain, take it as prescribed.
      
      
   2. If you are not taking a prescription pain medicine, take an over-the-counter one to reduce pain as needed, such ibuprofen (Advil or Motrin) or naproxen (Aleve). Read and follow all instructions on the label.
      ..
      
   3. Do not take two or more pain medicines at the same time unless the doctor or other health care professional told you to.
   ..
   
3. Put ice or a cold pack on your shoulde4r for 10 to 15 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days. Put a thin cloth between the ice pack and your skin.
   
   
4. Do not do anything that makes the pain worse.

1. Your shoulder comes ot of its socket again and does not go back in.

1. Your pain gets a lot worse.
   
   
2. Your sling or immobilizer feels too tight, and you cannot loosen it.
   
   
3. You have new or increased swelling in yuor arm.
   ..
   
4. You have new pain in another area of the hurt arm. For example, you have pain in yhour hand or elbow.

1. Log on: members.kp.org
   
   Search for shoulder problems in the Health encyclopedia.

1. Omeprazole 20 mg oral CPDR SR CAP, Sig: Take 1 capsule orally daily
   
   
2. Cyclophosphamide 50 mg oral Tab , Sig: Take 1 tablet orally daily Special Order item: Allow 5 working days.
   ..
   
3. Timolol Maleate 0.5% OPHT DFROP, Sig: Instill 1 drop into each eye 2 times a day
   
   
4. Warfarin 4 mg oral tab, Sig: Take as directed
   
   
5. Lorazepam 1 mg oral tab, Sig: Take 1 tablet orally 3 times a day
   
   
6. Ondansetron HCL 8 mg oral tab, Sig: Take 1 tables orally every 8 hours when needed for nausea. Prescribing MD FNP Miralda, Brigid.

1. Ibuprofen 600 MG oral Tab, Sig: Take on tablet every 6 hours as needed for pain.
   ..
   
2. Hydrocodone-acetaminophen 5 500 mg oral tab, Sig: Take 1 - 2 tablets orally every 4 - 6 hours as needed for breakthrough pain

1. Ibuprofen 600 MG oral Tab, Sig: Take on tablet every 6 hours as needed for pain.
   ..
   
2. Hydrocodone-acetaminophen 5 500 mg oral tab, Sig: Take 1 - 2 tablets orally every 4 - 6 hours as needed for breakthrough pain

     Date & Time   Provider                  Department              Center



     090123 0830   Florida G (LVN) Rull      Wcr-Cmo* >Main Campus   WCRA
                   Licensed Vocational
                   Nurse

..

      090124 0930   Infusion Nurse Chair 1-   Wcr-Cmo* >Main Campus   WCRA
                   Wcr



     090129 1330   Michele Anthony (PA)      Wcr-Cmo* >Main Campus   WCRA
                   Brocato, Physician
                   Assistant



     090130 0830   Chemo Chair 6 -Wcr        Wcr-Cmo* >Main Campus   WCRA

..

      090131 0930   Infusion Nurse Chair 1-   Wcr-Cmo* >Main Campus   WCRA
                   Wcr



     090213 1100   Chemo Chair 12 -Wcr       Wcr-Cmo* >Main Campus   WCRA



     090213 1140   Robert Allston (MD)       Wcr-Cmo* >Main Campus   WCRA
                   Johnson Jr., Medical
                   Doctor

..

      090214 0930   Infusion Nurse Chair 1-   Wcr-Cmo* >Main Campus   WCRA
                   Wcr



     090220 1030   Chemo Chair 16 -Wcr       Wcr-Cmo* >Main Campus   WCRA



     090221 0900   Infusion Nurse Chair 1-   Wcr-Cmo* >Main Campus   WCRA
                   Wcr

..

      090227 0930   Chemo Chair 10 -Wcr       Wcr-Cmo* >Main Campus   WCRA



     090228 0900   Infusion Nurse Chair 1-   Wcr-Cmo* >Main Campus   WCRA
                   Wcr



     090318 0830   Frances Mary (MD)         Sha-Oph* >Lennon Lane   SHAA
                   Dossetor, Medical
                   Doctor