CONTACTS 

SUBJECTS
Eye Examination Ulcerated Corneal Roscia Cured No Evidence Disease C

1603 -
1603 -    ..
1604 - Summary/Objective
1605 -
160501 - Follow up ref SDS 56 0000. ref SDS 55 0000.
160502 -
160503 -
160504 -
160506 -  ..
1606 -
1607 -
1608 - Progress
1609 -
160901 - Eye Left Corneal Rosacia Kerstitis Ulcerated Cornea Improving
160902 -
160903 - Follow up ref SDS 56 UF6K, ref SDS 55 UF6K.
160904 -
160905 - Background is reported in the record on 070221. ref SDS 52 UF6K
160906 -
160907 - Doctor Len conducted an examination.
160909 -  ..
160910 - The doctor reviewed the record from the meeting on 070312, ref SDS 56
160911 - UF6K, to determine the scope of work today, following the practice on
160912 - 070221. ref SDS 52 5D88
160914 -  ..
160915 - Examination findings...
160916 -
160917 -    1.  Rosacia significant improvement.
160918 -
160919 -        Management of this issue was transferred to the Dermatology
160920 -        Department on 070312. ref SDS 56 4Z7O
160922 -         ..
160923 -        Dermatology made examination today, including biopsy, reported
160924 -        below. ref SDS 0 IK9N
160926 -         ..
160927 -    2.  Left eye ulcerated cornea diagnosed on 070221, ref SDS 52 BM62,
160928 -        essentially healed, reported on 070312. ref SDS 56 OY8H
160930 -         ..
160931 -        Doctor Leng found today there is no evidence of progression
160932 -        nor recurrence of disease.
160934 -         ..
160935 -    3.  Vision tested and found essentially 20 20, no requirement for
160936 -        glasses, aligned with prior examination on 060512. ref SDS 48
160937 -        UF6K
160939 -         ..
160940 -    4.  Glaucoma test today indicates borderline issue, similar to
160941 -        findings on 060512, ref SDS 48 6D3F, and which may relate to
160942 -        odd genetic configuration of optic nerve, also, reported on
160943 -        060512. ref SDS 48 VU4W
160944 -
160946 -  ..
160947 - Doctor Len prescribed maintenance treatment to continue...
160948 -
160949 -    1.  Rosacia medication prescription for continuing treatment was
160950 -        renewed by Doctor Leng today; this is reported under
160951 -        dermatology, which was checked and approved by Doctor Mesgar,
160952 -        per below. ref SDS 0 IK9N
160954 -         ..
160955 -        Initial prescription on 070221 was for Docycycline Hyclate 100
160956 -        MG capsules, ref SDS 52 BN32, but was problematic due
160957 -        swallowing requirement impeded by achalasia still pending
160958 -        treatment. ref SDS 52 J15J  On 070226 the doctor continued the
160959 -        prescription for pills. ref SDS 53 HG8J  On 070312 the doctor
160960 -        changed the prescription for rosacia to a liquid that is easier
160961 -        to digest with achalasia. ref SDS 56 HB9G
160963 -         ..
160964 -    2.  Wash face with mild soap, for example Dove or Ivory.
160966 -         ..
160967 -    3.  Hot soaks eyes daily, drape warm wash cloth over each eye (eyes
160968 -        closed) for 10 minutes.  Make cloth hot every 2 minutes.
160970 -         ..
160971 -    4.  Antibiotic eye ointment 1 daily treatment for maintenance,
160972 -        changing plan on 070312, ref SDS 56 FN5M
160974 -         ..
160975 -        Bacitracin Ophthalmic Ointment.......... 500 UNT/GM 3 Tubes
160976 -        Provider:  Doctor Cheri Leng
160977 -        64-203
160978 -        612-62088303 Date:  071128
160979 -        RX # 10620324
160980 -        NDC:  00168002638
160981 -        Refills:  11 remaining before 081128 (November 28, 2008)
160982 -        No copay
160984 -         ..
160985 -    5.  Eye drops as needed for irritation.
160986 -
160987 -        Refresh Tears
160988 -        Provider:  Doctor Cheri Leng
160989 -        Carboxymethylcellulose NA 0.5% OPH SOLN.......... Qty 30 ML
160990 -        45-241
160991 -        612-62088303 Date:  071128
160992 -        RX # 10620326
160993 -        NDC:  00023079830
160994 -        Refills:  11 remaining before 081128 (November 28, 2008)
160995 -        No copay
160997 -         ..
160998 -    6.  Scrub eyelashes once per week (eyes closed) with wash cloth
160999 -        dipped ina mixture of baby shampoo and warm water (No Tears
161000 -        Johnson's Baby Shampoo or Baby Magic - 1/3 shampoo, 2/3 water.)
161001 -        Generally aligns with original instructions on 070221.
161002 -        ref SDS 52 WW4R
161004 -         ..
161005 -    7.  Scheduled field vision test for glaucoma, following up prior
161006 -        test on 060926. ref SDS 49 I73F
161007 -
161008 -
161009 -
161010 -
161011 -
1611 -

SUBJECTS
VA Means Assessment Elegibility Health Care Medical Treatment

1903 -
190401 -  ..
190402 - VA Means Elegibility Assessment
190403 -
190404 - Follow up ref SDS 24 4N5M.
190405 -
190406 - Initially met with means evaluation officer, Jerry.  He prepared
190407 - another report on income.  Reported VA only health insurance
190408 - available.
190409 -
190410 -
190411 -
190412 -
190413 -
190414 -
190415 -
190416 -
1905 -

SUBJECTS
Dermatology Examination Rosacia Medication Prescription Renewed Trea

3203 -
320401 -  ..
320402 - Biopsy Nose Sore Persistant Slow Healing Rosacia
320403 - Nose Sore Persistant Slow Healing Rosacia Biopsy
320404 - Rosacia Examination Biopsy Slow Healing Sore on Nose
320405 -
320406 - Follow up ref SDS 56 675M.
320407 -
320408 - Met with dermatologist, Doctor Mesgar, who replaced Doctor Bethra from
320409 - the meeting on 070312. ref SDS 56 675M
320411 -  ..
320412 - For rosacia medication treatment the doctor approved prescription by
320413 - Doctor Leng, per eye examiation reported above, ref SDS 0 FN5M, and
320414 - citing background on treatment for rosacia. ref SDS 0 7J9H
320415 -
320416 -    1.  Metronidazole 0.75% Top Cream............ 45 gm
320417 -        612GF
320418 -        NDC # 05936628765
320419 -        Provider:  Doctor Cheri Leng............. 3063453
320420 -        50-120
320421 -        612-62088-303
320422 -        Refills:  3 remaining before 081128 (November 28, 2008)
320423 -        Rx # 10567644A
320424 -        No copay
320426 -         ..
320427 -    2.  Doxycycline Calcium
320428 -        (Vibramycin) Syrup.................... 50 mg/5 ml 1 pint 473 ml
320429 -        Oral suspension raspberry apple flavored
320430 -        Provider:  Doctor Cheri Leng
320431 -        NDC 0069 0971 93
320432 -        Pfizer Labs
320433 -        Rx # 10575889A
320434 -        Refills:  5 remaining before 081128 (November 28, 2008)
320435 -        No copay
320437 -  ..
320438 - The doctor asked about blisters on feet, and was pleased to hear that
320439 - treatment plan on 070312 was effective. ref SDS 56 IC7L
320441 -  ..
320442 - Doctor Mesgar took a biopsy of the sore on the right side of the nose,
320443 - which has taken time to heal due to rosacia.
320444 -
320445 -    [On 071205 biopsy shows sore on nose is cancer, and so scheduled
320446 -    surgery. ref SDS 57 HS6G
320447 -
320448 -    [On 071207 VA Sacramento called; need photograph for scope
320449 -    assessment prior to scheduling the work; actually should have
320450 -    taken photograph prior to biopsy procedure. ref SDS 58 HS6G
320452 -     ..
320453 -    [On 071210 photograph taken at VA Martinez, CA. ref SDS 59
320454 -    HS6G
320456 -     ..
320457 -    [On 071210 evident improvement in nose blemish with treatment for
320458 -    rosacia; seems conflicting with biopsy findings of cancer.
320459 -    ref SDS 59 TV6R
320461 -     ..
320462 -    [On 071211 notified Lisa in Sacramento of evident improvement in
320463 -    nose blemish with treatment for rosacia; seems conflicting with
320464 -    biopsy findings of cancer. ref SDS 60 MV8X
320466 -     ..
320467 -    [On 071223 received letter from VA dated 071214 scheduling
320468 -    surgery on 080227 0830. ref SDS 61 HS6G
320469 -
320470 -
320471 -
320472 -
3205 -