CONTACTS 
0201 - Kaiser Permanente - Shadelands       925 906 2200
020101 - Walnut Creek, CA
020102 - Ms. Jeanne Bradley; Coordinator =925 906 2204
020103 - Jeanne.Bradley@ncal.kaiperm.org
020104 - Administration Department
0202 - Kaiser Permanente - Shadelands       925 906 2200
020201 - Walnut Creek
020202 - Dr. Thomas E. Connolly; Physician Leader  =Telephone
020203 - tom.connolly@ncal.kaiperm.org
020204 - Physician in Chief =925 206 2040

SUBJECTS
Colonoscopy Test

0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 64 0000, ref SDS 63 0000.
040502 -
040503 - In accordance with instuctions from Jeanne Bradley received on 000121,
040504 - ref SDS 65 1681, arrived about 1055.  Waited for about 10 minutes.
040505 -
040506 -     [On 010110 received notice to have this procedure done again.
040507 -     ref SDS 66 0001
040508 -
040509 - Did the enima to clean the bowel region.  This seemed to work okay,
040510 - although the application if pretty awkward.
040511 -
040512 - Sigmoidoscopy examination was performed by...
040513 -
040514 -                            Doctor Dyke Edward
040515 -                            Alergy Department
040516 -                            Lassen Building
040517 -                            Park Shadelands
040518 -
040519 -                            000208 1100
040520 -
040521 - Nurse attended the examination.
040522 -
040523 - Doctor Edward said this is similar to colonoscopy, or at least that
040524 - term is sometimes used by patients referring to the sigmoidoscopy
040525 - examination performed today.
040526 -
040527 - Initially, the doctor penetrates the rectum with a gloved finger to
040528 - lubricate the cavity.
040529 -
040530 - The instrument is forced up into the bowel, and the film is projected
040531 - onto a large screen television monitor screen, so the patient sees
040532 - what the doctor observes.
040533 -
040534 - The process evidently forces air into the upper region, and this feels
040535 - very uncomfortable.  The urge to expunge grows significantly, with the
040536 - worry that a big mess will ensue.  The pre-op enima eliminates this
040537 - problem, but the feeling is nearly overwhelming.
040538 -
040539 - The doctor gives an initial notice that if the process becomes
040540 - unbearable, the examination will be stopped.
040541 -
040542 - The doctor and the nurse, said they were able to complete a full
040543 - examination, reaching farther into my body than with other patients.
040544 -
040545 - I said they probably say that to everyone.
040546 -
040547 - The process does not capture a permanent film.  If they spot a
040548 - problem, they take a picture for further study,  The doctor seemed to
040549 - indicate that they are also prepared to operate immediately to remove
040550 - any serious problem.
040551 -
040552 - There was a slight lesion.  The nurse said that is typical from the
040553 - enima process this morning.
040554 -
040555 - The doctor and nurse both reported the examination shows a healthy
040556 - condition.
040557 -
040558 - The doctor said this examination is only needed about once every 10
040559 - years, unless some specific symptom occurs that suggests a problem.
040560 -
040561 -
040562 -
040563 -
040564 -
040565 -
040566 -
040567 -
040568 -