THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net


S U M M A R Y


DIARY: August 9, 2005 02:00 PM Tuesday; Rod Welch

Meeting at VA in Martinez for dermatology procedure.

1...Summary/Objective
2...Salivary Duct Stones Discomfort Right Upper Jaw
3...Discomfort Right Upper Jaw Salivary Duct Stones


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CONTACTS 

SUBJECTS
Operation Remove Mole Provides Outpatient Guidance on Home Dressing

0503 -
0503 -    ..
0504 - Summary/Objective
0505 -
050501 - Follow up ref SDS 14 0000. ref SDS 13 0000.
050502 -
050503 - Operation on neck to remove mole went smoothly, very professional work
050504 - by Doctor Gallacher assisted by Nurse Law.
050505 -
050506 -
050507 -
050509 -  ..
0506 -
0507 -
0508 - Progress
0509 -
050901 - Doctor Gergana Gallacher.
050903 -  ..
050904 - Scope....
050905 -
050906 -        1.  Neck blemish for cancer, based on meeting with Doctor
050907 -            Sandhu on 050629. ref SDS 13 HU7L
050909 -  ..
050910 - Remove neck blemish.
050912 -  ..
050913 - This was an operation that took about 30 minutes.  Novicane was given
050914 - for a local anesthetic.  The doctor was ably assisted by a nurse,
050915 - Laura Law.  Thye nurse did the set up, and offered support during the
050916 - procedure.
050918 -  ..
050919 - There was a slight sting for the novicane, the rest of the operation
050920 - was fully tolerable, with no noticable discomfort.
050922 -  ..
050923 - This procedcure was markedly different from a prior mole removal that
050924 - used a spray can to freeze the mole, and then remove it in about 2
050925 - minutes.
050927 -  ..
050928 - After the operation was completed, the wound was stitched.  The
050929 - stiches do not have to be removed; they will disolve from taking a
050930 - shower.  The bandage has to stay in place for a day.  Then remove the
050931 - bandage and use some anticeptic cream provided  by Laura with a
050932 - bandaid for another few days.  During this period avoid getting the
050933 - wound and bandaging wet, so shower from below the neck down.  After
050934 - the wound appears to be healing normally, the bandaid is no longer
050935 - needed.
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SUBJECTS
Rosacia Treatment Begun Metrogel and Tetracycline 500MG Capsules No

0703 -
070401 -             ..
070402 -        2.  Rosacia.
070404 -  ..
070405 - On 050801 the doctor prescribed...
070406 -
070407 -                    Metrogel
070408 -                    Tetracycline  500MG capsules
070410 -  ..
070411 - ...pills to treat rosacia, ref SDS 14 WH8P, similar to the treatment
070412 - by Doctor Ziperstein on 000216. ref SDS 1 PQ5K
070414 -  ..
070415 - Began trying these this morning.
070417 -  ..
070418 - The doctor did not comment on this issue today.
070419 -
070420 -
070421 -
070422 -
0705 -

SUBJECTS
Salivary Duct Stones Discomfort Right Upper Jaw JJ Doctor JJ Examins

0903 -
090401 -  ..
090402 - Salivary Duct Stones Discomfort Right Upper Jaw
090403 - Discomfort Right Upper Jaw Salivary Duct Stones
090404 -
090405 - Past few days right upper jaw has been hurting.  The teeth seem okay,
090406 - but could still be a dental issue, based on Steve's list of pending
090407 - issues reported on 050518. ref SDS 7 J87K
090408 -
090409 - Asked about this problem.
090411 -  ..
090412 - May see Doctor Sandhu.
090414 -  ..
090415 - Saw JJ.
090417 -  ..
090418 - He diagnosed saliva duct stone, where something somehow got into a
090419 - saliva duct in the mouth and plugged the flow.  This is causing
090420 - pressure to build up that is painful.
090422 -  ..
090423 - Prescription is to suck on sour candy to force saliva flow to unplug
090424 - the duct.  Also apply pressure to the area on the ouside of the cheek.
090425 -
090426 -     [On 050816 met with Doctor Sandhu; he will tell JJ thanks for
090427 -     treatment plan that worked effectively. ref SDS 15 DG94
090428 -
090430 -  ..
0905 -
0906 -
0907 - 2040
0908 -
090801 - This evening, after trying the prescribed procedure, the condition
090802 - seems improved.
090804 -  ..
090805 - Earlier had difficulty eating.  At this time the jaw and cheek seem
090806 - less sensitive to pressure.
090808 -  ..
090809 - Research found an article on the Internet last updated on 050123,
090810 - which seems fairly current....
090811 -
090812 -        Medical Encyclopedia
090813 -        Salivary Duct Stones
090814 -
090815 -            http://www.nlm.nih.gov/medlineplus/ency/article/001039.htm
090817 -         ..
090818 -        Alternate name...
090819 -
090820 -            Sialolithiasis
090822 -         ..
090823 -        Definition...
090824 -
090825 -            Salivary duct stones are crystallized minerals in the
090826 -            ducts that drain the salivary glands. Salivary duct stones
090827 -            are one of the salivary gland disorders.
090829 -         ..
090830 -        Causes and risk factors...
090831 -
090832 -            During eating, saliva (spit) is produced by the salivary
090833 -            glands in the mouth. The chemicals in saliva can
090834 -            crystallize into a stone that can block the salivary
090835 -            ducts. When saliva cannot exit a blocked duct, it backs up
090836 -            into the gland, causing pain and swelling of the gland.
090837 -            The submandibular glands, at the back of the mouth on both
090838 -            sides of the jaw, are most often affected by stones.
090840 -         ..
090841 -        Symptoms
090842 -
090843 -            Swelling of the face or neck
090844 -            Pain in the face or mouth
090845 -            Dry mouth
090847 -  ..
090848 - In this case, all of these symptoms have been experienced.
090850 -  ..
090851 - Medical Encyclopedia continues...
090852 -
090853 -            An examination of the head and neck by the health care
090854 -            provider or dentist shows one or more enlarged, tender
090855 -            salivary glands. The doctor may be able to feel the stone
090856 -            during examination.
090858 -             ..
090859 -            Facial X-rays or a CT scan can confirm the diagnosis
090861 -         ..
090862 -        Treatment
090863 -
090864 -            The goal is to remove the stone. The health care provider
090865 -            or dentist may be able to push the stone out of the duct.
090866 -            In some cases, the stone may need to be surgically cut
090867 -            out.
090869 -  ..
090870 - In this case, the doctor prescribed sour candy, and pressure with the
090871 - hand on the sensitive area.  This seems to be effective.  The next
090872 - day after following the prescription, swelling and pain subside to
090873 - permit eating normally.
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