CONTACTS 

SUBJECTS
Letter to Primary Care Physician Notify Worsening Lymphedema and PET

0503 -
0503 -    ..
0504 - Summary/Objective
0505 -
050501 - Follow up ref SDS 10 0000, ref SDS 8 0000.
050502 -
050503 - Drafted letter for Millie to follow up meeting with doctor on 060217,
050504 - and submitted this to Mil for review.
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050508 -
050510 -  ..
0506 -
0507 -
0508 - Progress
0509 -
050901 - Physical Therapy Lymphedema Personal Treatment
050902 -
050903 - Follow up ref SDS 10 Q05H, ref SDS 8 Q05H.
050904 -
050905 - Sent letter to Millie on results of the meeting with the Primary Care
050906 - Physician on 060217, ref SDS 7 0001, citing action items.
050907 -
050921 -         ..
050922 -    4.  Later, on 060126 you used the new system, ref SDS 6 XY8O, and
050923 -        the doctor responded using electronic communication to submit
050924 -        partial results of the PET scan test. ref SDS 6 XY8O  After we
050925 -        got the full report during the meeting on 060217, review showed
050926 -        that while the PET scan found no evidence of cancer, and did
050927 -        not address lymphedema, there was a report of esophagitis, see
050928 -        pending action item in the record on 060217. ref SDS 7 DH4O
050930 -         ..
050931 -    5.  This suggests an issue has slipped through the cracks, and so
050932 -        should be presented for evaluation and comment by the doctor,
050933 -        based on patient history listed on 060126. ref SDS 6 D68K
050935 -         ..
050936 -    6.  Based on this history, suggest sending the following letter to
050937 -        the doctor, as he requested on 051121. ref SDS 4 DO6F
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0510 -

SUBJECTS
Esophagitis PET Scan Findings Requires Examination Based on Patient

0803 -
080401 -  ..
080402 - Esophagitis in PET Scan Requires Examination Based on Patient History
080403 -
080404 - Follow up ref SDS 7 DH4O.
080406 -         ..
080409 -         ..
080410 -    8.  Following the meeting on February 17, I have looked through the
080411 -        full PET scan test report you submitted at that time.  There
080412 -        appears to be findings of esophagitis, ref SDS 7 DH4O, which
080413 -        aligns with patient history the past 6 months or so, related in
080414 -        the record on 060126. ref SDS 6 DH4O
080416 -         ..
080417 -    9.  I apologize for bringing this up after the fact, but without
080418 -        the full report, I was not alerted to mention esophageal issues
080419 -        during our meeting.  My feeling is that this can wait for
080420 -        examination during the next meeting OA April 17, but wanted to
080421 -        give you a chance for timely professional review of PET scan
080422 -        findings.
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0805 -

SUBJECTS
Emotional Support Unit at Kaiser Not Very Supportive Letter to Prima

1503 -
150401 -  ..
150402 - Emotional Support Unit at Kaiser Not Very Supportive
150403 -
150404 -
150405 -   10.  I was not favorably impressed meeting with the emotional
150406 -        support doctor, following up your referral on 060217.
150407 -        ref SDS 7 Y64H  I got the impression that unless I came in with
150408 -        a straightjacket, dribbling, and shouting epithets about the
150409 -        Iraq war, or something, this unit was not equipped to provide
150410 -        support.  No matter.  Exercise and work seem to help focus on
150411 -        other things.  This is just a heads up on results of the
150412 -        referral.
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1505 -

SUBJECTS
Lymphedema Worsens Physical Therapy Treatment Seems to Have Reduced
Letter to Primary Care Physician Notify Worsening Lymphedema and PET

2404 -
240501 -  ..
240502 - Lymphedema Worsens Physical Therapy Very Effective
240503 -
240504 - Follow up ref SDS 10 Q05H, ref SDS 7 T56K.
240505 -
240506 -   11.  I was very favorably impressed by Mary Andre in the physical
240507 -        therapy department.  My condition has worsened since the
240508 -        meeting with you when we noticed that prior swelling on 060106
240509 -        had greatly reduced.  I don't think the bubble under the arm
240510 -        has gotten back to the level on 060106, but the left arm,
240511 -        especially the lower arm, wrist and hand have noticeably
240512 -        swelled.
240514 -         ..
240515 -   12.  Mary did a great job demonstrating exercises for personal
240516 -        treatment.  I believe you signed off on prescribing a treatment
240517 -        sleeve.  So far things have gotten slightly worse, and now I
240518 -        think they are slightly better, based on taking daily
240519 -        measurements of swelling.  You can see this history listed in
240520 -        the record following up our meeting on 060217. ref SDS 7 VY3F
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2406 -

SUBJECTS
Surgeon Review Schedule for Guidance on Treatment Lymphedema Letter

3003 -
300401 -  ..
300402 - Surgeon Review Schedule for Guidance on Treatment Lymphedema
300403 -
300404 -
300405 -   13.  I would like to schedule review with the surgeon for anything
300406 -        that might have occurred during the operation on 051021 which
300407 -        contributed to the sudden acceleration of this problem.  She
300408 -        indicated following surgery that additional lymph nodes were
300409 -        not removed in order to avoid risk of lymphedema.  Since
300410 -        lymphedema has occurred following the operation this suggests
300411 -        some aspect of the work may have had collateral effects.  The
300412 -        original work plan, and record of contemporaneous notes during
300413 -        the operation may help guide treatment going forward.
300415 -         ..
300416 -   14.  If I don't hear from you, I assume we can discuss things on
300417 -        April 17, just want to get this in the record, so we don't
300418 -        forget.
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