CONTACTS 

SUBJECTS
Lump on Upper Left Back Observed by Teresa Calls Kim to Schedule Exa                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
Endoscopy Gastrointestinal (GI) Clinic Meeting Evaluate Digestion Pr                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
Flu Shot at VA Hospital in Martinez Ethyl                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
1405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1405 -    ..
1406 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
1407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
140701 - Follow up ref SDS 28 0000. ref SDS 26 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
140702 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
140703 - The doctor performed endoscopy test, ref SDS 0 CY5M, and reported                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
140704 - there was no evident cancer, nor other affliction except achalasia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
140705 - caused by constricted esophageal sphincter valve. ref SDS 0 PRRT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
140706 - There was no evidence of problems to the stomach nor to the duodenum.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
140707 - Biopsy results will be reported a few weeks, ref SDS 0 5B5K, and if                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
140708 - these tests do not show cancer, then an operation will be scheduled                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
140709 - for next month to treat achalasia with dilation of the exophageal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
140710 - sphincter valve. ref SDS 0 NZ5H  Millie noticed a bump on the back,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
140711 - and this was reported to the primary care physician.  The nurse also                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
140712 - asked a nurse in the Primary Care Department to schedule a meeting for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
140713 - examination. ref SDS 0 3X5F  Got a flu shot before meeting for the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
140714 - endoscopy procedure. ref SDS 0 HP9H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
140715 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
140716 -     [On 051212 Irene called for due diligence on endoscopy procedure;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
140717 -     reported no adverse after affects. ref SDS 30 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
140719 -      ..
140720 -     [On 051222 cancer negative findings pathology report on biopsies                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
140721 -     taken today consistant with achalasia. ref SDS 32 FT6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
140723 -      ..
140724 -     [On 060111 received letter from Doctor in the Gastrointestinal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
140725 -     (GI) Clinic reporting that the biopsy was negative for cancer and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
140726 -     infection; next step is another test, then treatment for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
140727 -     achalasia. ref SDS 33 4Q3R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
140729 -      ..
140730 -     [On 060125 manometry test scheduled for 060209 0800. ref SDS 34                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
140731 -     GG9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
140733 -      ..
140734 -     [On 060209 meeting at VA Mather AFB in Sacramento, test was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
140735 -     postponed until 060223 due to equipment failure. ref SDS 36 OW6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
140737 -      ..
140738 -     [On 060330 0712 another endoscopy performed at VA in Sacramento to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
140739 -     supplement endoscopy test finding no evidence of throat nor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
140740 -     stomach cancer, performed at VA in Martinez today by Doctor Lee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
140741 -     ref SDS 39 MC6H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
140742 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
140743 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
140744 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
140745 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
140747 -  ..
1408 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1410 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
141101 - Flue Shot Primary Care Clinic                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
141102 - Lump on Back Found Teresa Orders Examination in Primary Care                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
141103 - Meeting Gastrointestinal Department Evaluate Digestion Problem                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141104 - 
141105 - Follow up ref SDS 28 HP9H.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
141106 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141107 - Flue shot treatment prior to endoscopy test.  Checked in at the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141108 - Primary Care Clinic, and got a flu shot from Ethyl.  She said there                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
141109 - are no side effects.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
141111 -  ..
141112 - While changing into a hospital gown, Millie observed swollen tissue                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
141113 - that appears tumor-like on the upper left side of the back.  The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
141114 - nurse, Teresa, took a look, and decided to notify the primary care                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141115 - physician.  She, also, called Kim in Primary Care.  Kim was out to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141116 - lunch, so Teresa left a message about scheduling a meeting to examine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
141117 - the lump for possible diagnosis.  About 15 years ago, Millie had a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141118 - similar bulge removed, and indicated this was an uncomfortable                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
141119 - procedure.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
141120 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141121 -     [On 051219 followed up contacted Primary Care about scheduling a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
141122 -     meeting on the lump. ref SDS 31 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
141124 -      ..
141125 -     [On 051222 examination by primary care physician indicates lump on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
141126 -     back is not cancer, and looks like lipoma. ref SDS 32 P18O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
141128 -  ..
141129 - After changing into hospital gown for setup, entered the record of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141130 - work in progress, while waiting for the doctor's schedule to clear and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
141131 - begin treatment.  This was about 30 minutes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
141133 -  ..
141134 - Meeting today was ordered by doctor in GI clinic during examination on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
141135 - 051202. ref SDS 28 H25N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
141137 -  ..
141138 - This referral complements prior testing....                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
141139 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141140 -            Endoscopy scope................. 051202, ref SDS 28 IA5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
141141 -            Ultrasound report............... 050906, ref SDS 24 BM6R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
141142 -            Barium test report.............. 050830, ref SDS 23 UR3M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
141144 -  ..
141145 - Vitals taken...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141146 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141147 -    Blood pressure    115 73                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
141148 -    Pulse             89                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
141149 -    EKG               77                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
141150 -    Temperature       98.1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
141151 -    Resp              13 RPM                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
141152 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141153 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141155 -  ..
141156 - Nurse:  Judith, and Teresa.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
141157 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141158 -    Connected an IV                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141159 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141160 -    Teresa used a stethescope to listen to heart, lungs, and stomach;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
141161 -    nothing reported.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
141163 -     ..
141164 -    Discharge papers signed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
141166 -     ..
141167 -    Consent for procedure signed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
141168 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141170 -  ..
1412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1414 - 1339                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
1415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
141501 - Talked to Irene.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
141502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141503 - She configured an IV, and with an assistant wheeled the gurney into                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
141504 - an operating room.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141506 -  ..
141507 - Irene installed oxygene for breathing support.  The other nurse                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141508 - sprayed the back of the throat with an antiseptic, which had a slight                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
141509 - cherry taste, but was somewhat unpleasant.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
141510 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141511 -     [On 051212 Irene called for due diligence on endoscopy procedure;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
141512 -     reported no adverse after affects. ref SDS 30 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
141514 -  ..
141515 - Irene reviewed the consent form.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
141517 -  ..
141518 - The other nurse asked about loosening the belt to avoid becoming                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
141519 - uncomfortable when the procedure forces air into the stomach for the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
141520 - test.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
141521 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141522 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141524 -  ..
1416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1418 - 1408                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
1419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
141901 - Meeting Doctor...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
141902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141905 -  ..
141906 - The doctor came into the room and discussed the procedure.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
141908 -  ..
141909 - The doctor said he has not had enough time to reivew the record for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
141910 - the meeting on 051202, ref SDS 28 0001, which was submitted two days                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
141911 - ago through Kimberley on 051207. ref SDS 29 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
141913 -  ..
141914 - The doctor explained the endoscopy procedure, which aligned with the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
141915 - record on 051202, ref SDS 28 IA5I, and showed the equipment that would                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
141916 - be used for the endoscopy, and which is forced down the throat,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141917 - through the esophagael sphincter, which is the problem area, and into                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
141918 - the stomach to the duodenum, per planning on 051202. ref SDS 28 NZ5H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
141919 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141920 -        [On 060330 0712 another endoscopy performed at VA in Sacramento                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
141921 -        to supplement endoscopy test finding no evidence of throat nor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
141922 -        stomach cancer, performed at VA in Martinez today by Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141923 -        Lee. ref SDS 39 MC6H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
141925 -  ..
141926 - This is a flexible tube about .25" in diameter, with a camera and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
141927 - lights on either side.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
141929 -  ..
141930 - We reviewed the primary purpose of the examination today is to look                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
141931 - for cancer or other abnormality that may be causing the esophageal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141932 - sphincter valve to function incorrectly. toward confirming initial                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141933 - diagnosis of achalasia, discussed on 051202. ref SDS 28 5B5K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
141935 -  ..
141936 - The consent form was signed at this time.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
141937 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
141939 -  ..
1420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1422 - 1313                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
1423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
142301 - The doctor left the room, and Irene then connected an anesthetic drug                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
142302 - through the IV.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
142303 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
142304 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
142305 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
142307 -  ..
1424 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1425 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1426 - 1530                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
1427 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
142701 - Woke up in the recovery room.  Millie had gone to lunch, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
142702 - returned.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
142704 -  ..
142705 - The nurse, Judith, brought some orange juice to drink.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
142707 -  ..
142708 - She asked about a sore throat or bloating feeling, which sometimes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
142709 - occur after endoscopy.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
142711 -  ..
142712 - None of these symptoms occurred.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
142713 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
142715 -  ..
1428 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1430 - 1540                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
1431 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
143101 - Got up and dressed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
143102 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
143103 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
143104 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
143105 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
143106 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
143107 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
143108 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
1432 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Endoscopy Images Examination Discussion with Doctor Pictures Esophag                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
1603 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1604 - 1557                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
160501 -  ..
160502 - Cancer Not Indicated Endoscopy Examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
160503 - Endoscopy Images Examination Do Not Indicate Cancer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
160504 - Discussion with Doctor Examination Does Not Indicate Cancer                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
160505 - Pictures Esophagus Do Not Indicate Cancer Endoscopy Examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160506 - 
160508 -  ..
160509 - After recovering from anesthesia, Doctor Lee visited to explain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160510 - preliminary findings.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160512 -  ..
160513 - The doctor advised there was nothing that looked like cancer.  He took                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160514 - some biopsies from the esophagus, the stomach and the duodenum.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160515 - Results will be reported in about two (2) weeks.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160516 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160517 -     [On 051212 Irene called for due diligence on endoscopy procedure;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
160518 -     reported no adverse after affects. ref SDS 30 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
160520 -      ..
160521 -     [On 051222 cancer negative findings pathology report on biopsies                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
160522 -     taken today consistant with achalasia. ref SDS 32 FT6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160524 -      ..
160525 -     [On 060111 received letter from Doctor in the Gastrointestinal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160526 -     (GI) Clinic reporting that the biopsy was negative for cancer and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160527 -     infection; doctor proposes next step is another test; a manometry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160528 -     test will further establish achalasia to prepare for treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160529 -     achalasia. ref SDS 33 4Q3R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
160531 -      ..
160532 -     [On 060202 confirmed understandings from the meeting, and notified                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
160533 -     of plan to have lipoma removed. ref SDS 35 G49P                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
160535 -      ..
160536 -     [On 060209 meeting at VA Mather AFB in Sacramento, test was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
160537 -     postponed until 060223 due to equipment failure. ref SDS 36 OW6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
160539 -      ..
160540 -     [On 060220 letter asks to confirm meeting on 060223, if equipment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
160541 -     has been repaired, or is there another delay. ref SDS 37 GG9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
160543 -      ..
160544 -     [On 060221 Jimmy says manometry equipment still broken; has been                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
160545 -     sent out for repairs and there is no date at this time on when the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160546 -     equipment will be available for use at the VA. ref SDS 38 ND7M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
160548 -      ..
160549 -     [On 060221 letter to Doctor asks about alternatives to manometry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
160550 -     testing, and whether treatment for achalasia can proceed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
160551 -     ref SDS 38 7U8H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
160553 -      ..
160554 -     [On 060330 0800 another endoscopy test was performed, ref SDS 39                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
160555 -     VX4G, and again found no evidence of cancer. ref SDS 39 MD4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160557 -      ..
160558 -     [On 091030 0810 Doctor Sawhney at the VA in San Francisco examined                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
160559 -     throat (esophagus) and stomach in connection with plading a feeder                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160560 -     tube, and reported finding no evidence of cancer. ref SDS 40 AS7N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
160562 -      ..
160563 -     [On 091208 1300 Doctor Stewart considers delaying surgery for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160564 -     Heller Myotemy to correct achalasia, and in order to perform                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160565 -     endoscopy, because results from testing at VA in Martinez on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160566 -     051209 cannot be found in VA computer, due in part to not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
160567 -     remembering the year 2005 when the test was performed. ref SDS 41                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
160568 -     BJ3H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
160569 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160571 -  ..
160572 - Four (4) pictures were presented during the meeting, and are                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
160573 - identified by date and time.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
160574 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160577 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
160578 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160579 -     1.  051209 143629                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160580 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160581 -         This shows the condition from the mouth leading to the throat                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160582 -         (esophagus).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
160584 -          ..
160585 -         The doctor said there is nothing remarkable shown in this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160586 -         picture.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160588 -          ..
160589 -     2.  051209 143730                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160590 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160591 -         This picture shows the exophagus (throat), and is heavily                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160592 -         coated with debris from food and drink.  It has a white, cream                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160593 -         to gray coloration, rather than pink-like appearance in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
160594 -         other pictures.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
160595 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160596 -             [On 051222 cancer negative findings pathology report on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
160597 -             biopsies taken today consistant with achalasia.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
160598 -             ref SDS 32 FT6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160600 -              ..
160601 -             [On 060111 received letter from Doctor Lee in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160602 -             Gastrointestinal (GI) Clinic reporting that the biopsy was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160603 -             negative for cancer and infection; doctor proposes next                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
160604 -             step is another test; a manometry test will further                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160605 -             establish achalasia to prepare for treating achalasia.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
160606 -             ref SDS 33 4Q3R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160608 -              ..
160609 -             [On 091030 0810 Doctor Sawhney used a camera in the throat                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
160610 -             and stomach in order to place a feeder tube; he reported                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
160611 -             finding no evidence of cancer or disease of any kind.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160612 -             ref SDS 40 AS6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160614 -          ..
160615 -         The doctor said this is normal coloration expected for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
160616 -         achalasia.  He found some fluid was still in this area, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
160617 -         removed it with suction equipment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
160619 -          ..
160620 -     3.  051209 144002                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160621 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160622 -         The doctor said this picture shows the stomach.  It seems                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160623 -         empty, somewhat smaller in diameter than expected.  It has a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
160624 -         near pristine appearance, indicating minimal use, since with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
160625 -         achalasia food only seeps through the esophageal sphincter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
160626 -         after being reduced to a near liquid state.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
160628 -          ..
160629 -         The doctor said there is nothing remarkable shown in this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160630 -         picture.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160632 -          ..
160633 -     4.  051209 144042                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
160634 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160635 -         The doctor described this picture showing the duodenum leading                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160636 -         to the upper intestine.  It looks bigger than the stomach.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
160638 -          ..
160639 -         The doctor said there is nothing remarkable shown in this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160640 -         picture.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160642 -          ..
160643 -         There is a considerable amount of white streaking in this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160644 -         picture, more than in pictures 1 and 3, and none in picture 2.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
160646 -          ..
160647 -         The doctor explained that this appearance of "streaking"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
160648 -         occurs from reflections of the lights configured with the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
160649 -         camera.  The duodenum tissue is more wrinkled than the other                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
160650 -         areas, so there are more reflections of light.  The doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
160651 -         said this condition is normal and so was expected.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
160652 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160653 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160654 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160655 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160656 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
160657 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
1607 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Achalasia Diagnosis Supported by Endoscopy Imaging Esophagus Sphinct                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2103 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
210401 -  ..
210402 - Throat Stomach No Evidence Affliction Cancer Endoscopy Examination                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
210403 - Achalasia Diagnosis Supported by Endoscopy Imaging Esophagus Sphincter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
210404 - Gastroesophageal Junction Achalasia Supported by Endoscopy Pictures                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
210405 - Esophagus Sphincter Valve Constricted Achalasia Supported by Endoscopy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
210406 - 
210407 - Follow up ref SDS 28 5B5K, ref SDS 21 DG8G.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
210408 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
210409 - The doctor indicated that examination today, ref SDS 0 PRRT, supports                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
210410 - initial diagnosis of achalasia on 051202. ref SDS 28 DX8K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
210412 -  ..
210413 - The doctor saw no evidence of cancer nor of any affliction in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
210414 - throat, the stomach and duodenum, per pictures above. ref SDS 0 Y69K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
210416 -  ..
210417 - After the pathology reports are available in about two (2) weeks, he                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
210418 - can confirm status of findings on cancer.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
210419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
210420 -     [On 060111 received letter from Doctor in the Gastrointestinal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
210421 -     (GI) Clinic reporting that the biopsy was negative for cancer and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
210422 -     infection; doctor proposes next step is another test; a manometry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
210423 -     test will further establish achalasia to prepare for treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
210424 -     achalasia. ref SDS 33 4Q3R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
210426 -      ..
210427 -     [On 060125 manometer test scheduled for 060209 0800. ref SDS 34                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
210428 -     GG9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
210429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
210430 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
210431 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2105 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Achalasia Schedule Esophageal Sphincter Dilation Treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
250401 -  ..
250402 - Achalasia Schedule Esophageal Sphincter Dilation Treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
250403 - Schedule Esophageal Sphincter Dilation Treatment for Primary Achalasia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
250404 - Esophageal Sphincter Dilation Treatment for Primary Achalasia Schedule                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
250405 - 
250406 - Follow up ref SDS 28 NZ5H, ref SDS 21 0G7M.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
250408 -  ..
250409 - The doctor expects to schedule dilation treatment for the espophageal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
250410 - sphincter sometime next month, provided the biopsy reports are                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
250411 - favorable as expected, based on preliminary results of endoscopy test                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
250412 - today, per above. ref SDS 0 PRRT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
250413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250414 -     [On 051212 Irene called for due diligence on endoscopy procedure;                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250415 -     reported no adverse after affects. ref SDS 30 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
250417 -      ..
250418 -     [On 051222 cancer negative findings pathology report on biopsies                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
250419 -     taken today consistant with achalasia. ref SDS 32 FT6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
250421 -      ..
250422 -     [On 060111 received letter from Doctor in the Gastrointestinal                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
250423 -     (GI) Clinic reporting that the biopsy was negative for cancer and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
250424 -     infection; doctor proposes next step is another test; a manometry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
250425 -     test will further establish achalasia to prepare for treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
250426 -     achalasia. ref SDS 33 4Q3R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
250428 -      ..
250429 -     [On 060125 manometry test scheduled for 060209 0800. ref SDS 34                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
250430 -     GG9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
250432 -      ..
250433 -     [On 060202 confirmed understandings from the meeting, and notified                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
250434 -     of plan to have lipoma removed. ref SDS 35 G49P                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250436 -      ..
250437 -     [On 060209 meeting at VA Mather AFB in Sacramento, manometry test                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250438 -     postponed until 060223 due to manometry equipment failure.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
250439 -     ref SDS 36 OW6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250441 -      ..
250442 -     [On 060220 letter asks to confirm meeting on 060223, if equipment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250443 -     has been repaired, or is there another delay. ref SDS 37 GG9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
250445 -      ..
250446 -     [On 060221 Jimmy says manometry equipment still broken; has been                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
250447 -     sent out for repairs and there is no date at this time on when the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
250448 -     equipment will be available for use at the VA. ref SDS 38 ND7M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
250450 -      ..
250451 -     [On 060221 letter to Doctor asks about alternatives to manometry                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
250452 -     testing, and whether treatment for achalasia can proceed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
250453 -     ref SDS 38 7U8H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
250454 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250455 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250456 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250457 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250458 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250459 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250460 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250461 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
250462 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2505 -