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


S U M M A R Y


DIARY: September 14, 2006 05:22 PM Thursday; Rod Welch

Millie fell at the BART station and sprained a finger on her left hand.

1...Summary/Objective


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SUBJECTS
Finger Sprained Left Hand Fall BART Station Tired Fatigued Dizzy Sho

1003 -
1003 -    ..
1004 - Summary/Objective
1005 -
100501 - Follow up ref SDS 2 0000, ref SDS 1 0000.
100502 -
100503 -
100504 -
100506 -  ..
1006 -
1007 -
1008 - Progress
1009 -
100901 - This afternoon Millie fell at the BART station in Concord, coming
100902 - home.
100904 -  ..
100905 - Millie has experienced increasing fatigue for the past few weeks,
100906 - possibly months, having shortness of breath making the short walk from
100907 - BART to her office at Embacadero #2 in San Francisco, and especially
100908 - climbing stairs.  Low energy is an expected part of chemotherapy,
100909 - which she started on 060721.  The current level of fatigue and
100910 - breathing difficulties has begun to seem even more severe than
100911 - difficult side effects of treatment for cancer.  She was tired all day
100912 - at work today, and still felt very tired, and possibly a bit dizzy
100913 - after getting off the train from San Francisco arriving at the Concord
100914 - Station.  She stepped slightly off balance, and her ankle gave way.
100915 - She caught herself with her left hand to avoid a serious fall, but her
100916 - middle index finger was badly sprained in taking the force of the
100917 - fall.
100919 -  ..
100920 - By the time she got home her hand was already swollen, and her left
100921 - arm seemed more swollen due to lymphedema.
100923 -  ..
100924 - Discussed going to the Emergency Room for xrays.  Millie wants to
100925 - wait a few days to see if the problem heals by itself.
100926 -
100927 -     [On 060922 Millie notified Kaiser of her fall, and that lymphedema
100928 -     has increased. ref SDS 3 0D4X
100929 -
100930 -     [On 061016 finger healed very slowly; Millie went to Kaiser for
100931 -     treatment; xrays showed her finger is broken, and ligaments are
100932 -     torn. ref SDS 7 IP5I
100934 -      ..
100935 -     [On 061019 orthopedic doctor removed the cast, and prescribed
100936 -     continued exercise to maintain range of motion; prognosis is
100937 -     long slow healing process. ref SDS 8 087I
100939 -  ..
100940 - She was a bit shaken, because this is the first time she had a fall
100941 - like this in very long time, if ever.  Millie blamed herself for not
100942 - paying attention, and was mad about doing something so inexplicable
100943 - that compounded the lymphedema problem on the left arm.
100944 -
100945 -     [On 060929 doctor orders CT test for pulmonary embolism recurrence
100946 -     based on patient history of fatigue, shortness of breath, heavy
100947 -     chest. ref SDS 4 B56N
100949 -      ..
100950 -     [On 061002 primary care physician leaves message that CT test is
100951 -     positive for pulmonary emboli; Millie must resume treatment
100952 -     previously ended on 051007. ref SDS 5 MI5I
100954 -      ..
100955 -     [On 061012 review of CT test discloses findings of enlarged
100956 -     right ventricle that complicates pulmonary embolism. ref SDS 6
100957 -     7E5L
100959 -      ..
100960 -     [On 061027 Millie hospitalized during cancer treatment cycle
100961 -     temperature 102.6, ref SDS 9 HP52; severe red rash and swelling
100962 -     envelops left arm and shoulder; diagnosis cellulitus caused by
100963 -     reaction to tramua from fall that broke middle finger of left hand
100964 -     on 060914, creating complications of lymphedema from loss of
100965 -     lymphatics removed during surgery on 051021 for left breast
100966 -     mastectomy. ref SDS 9 V759
100967 -
100968 -
100969 -
100970 -
100971 -
100972 -
100973 -
1010 -