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SUBJECTS
Coumadin Instructions Treatement Pulmonary Embolism Protocol Warfari

0603 -
0603 -    ..
0604 - Summary/Objective
0605 -
060501 - Follow up ref SDS 7 0000. ref SDS 5 0000.
060502 -
060503 -
060504 -
060505 -
060507 -  ..
0606 -
0607 -
0608 - Progress
0609 -
060901 - Millie received ref DRT 1 0001 from Gloria at Kaiser implementing
060902 - planning in Gloria's letter received on 080121. ref SDS 5 RT5J
060904 -         ..
060905 -    1.  Your INR Result:  INR 2.3 01/10/2008, ref DRT 1 0001
060907 -         ..
060908 -    2.  Your Target Range:  INR Low Range: 2 -- INR High Range: 3,
060909 -        ref DRT 1 RM5N
060911 -         ..
060912 -    3.  Your results are within the goal range. ref DRT 1 BI6F
060914 -         ..
060915 -    4.  Thank you for taking your protime blood test.  This is the best
060916 -        way to know that your Warfarin (generic for Coumadin) dose is
060917 -        safe and working well for you. ref DRT 1 VR6H
060919 -         ..
060920 -    5.  Continue same dose and get regular protime blood tests.
060921 -        ref DRT 1 546N
060923 -         ..
060924 -    6.  Warfarin Dosing Instructions:  Using Warfarin 4 MB Tablet (BLUE in color):
060925 -
060926 -        1.  Take 6 MG (1 & .5 tablets) every Thursday;, ref DRT 1 H47H;
060927 -
060928 -        2.  Take 4 MB (1 tablet) all other days of the week.
060929 -            ref DRT 1 O47L
060931 -         ..
060932 -    7.  Please have your next protime blood test on:  Follow up date:
060933 -        2/25/2008, ref DRT 1 1043
060935 -  ..
060936 - Millie's letter to Gloria on 080122 advised the next blood test at
060937 - UCSF will be 080207. ref SDS 7 6D5I
060938 -
060939 -            [On 080207 blood test shows INR 2.4. ref SDS 13 PU7Y
060940 -
060941 -            [On 080226 INR 2.4 results submitted to Kaiser for Coumadin
060942 -            management pulmonary embolism. ref SDS 14 LZ9H
060944 -  ..
060945 - Gloria's letter from Kaiser continues...
060946 -
060947 -    8.  If possible, do not have your INR labs done on Fridays or
060948 -        weekends.  For same day results, go to the lab before 11 am.
060949 -        ref DRT 1 008M
060951 -         ..
060952 -    9.  Please contact us at 925 372 1628 or Fax 925 372 1229.
060953 -
060954 -        1.  If your dose is different than what is written above.
060955 -            ref DRT 1 P58K
060956 -
060957 -        2.  If you do not receive a call or a letter in on eweek after
060958 -            your lab work. ref DRT 1 469F
060960 -             ..
060961 -        3.  If you have any unusual bruises or bleeding. ref DRT 1 D69I
060963 -                ..
060964 -               [On 080125 Millie suffered a fall which caused severe
060965 -               bruising to right eye and forehead, and to the right
060966 -               arm. ref SDS 8 N65K
060968 -                ..
060969 -               [On 080131 nurse at UCSF advises patients should be
060970 -               examined at ER whenever there is a significant fall,
060971 -               because Coumadin patients are at risk for internal
060972 -               bleeding. ref SDS 9 CX9O
060974 -                ..
060975 -               [On 080202 examination shows a major bruise on the upper
060976 -               right arm; the appearance is of massive internal
060977 -               bleeding, consistent with Coumadin treatments,
060978 -               ref SDS 10 PPWU, Millie decided not to notify anyone,
060979 -               and to consider going to Kaiser Minor Injury Clinic for
060980 -               examination on Monday. ref SDS 10 6244
060982 -                ..
060983 -               [On 080204 Millie examined at Minor Injury Clinic at
060984 -               Kaiser in Walnut Creek; no finding of serious injury; no
060985 -               xrays were taken, ref SDS 11 546N; Motrin was prescribed
060986 -               to control pain; treatment was heating pad for 20
060987 -               minutes 4 times a day to speed recovery from bruises.
060988 -               ref SDS 11 T56H
060990 -                ..
060991 -               [On 080204 Gloria in Kaiser Coagulation Control Clinic
060992 -               recommended patients taking Coumadin, use Tylenol to
060993 -               control pain rather than Motrin, because Motrin can
060994 -               cause internal bleeding, which Coumadin can make life
060995 -               threatening. ref SDS 12 S65I
060997 -                ..
060998 -               [On 080226 Millie's letter confirms telecon notifying
060999 -               Kaiser Coagulation Control Department of bruising from
061000 -               fall on 080125. ref SDS 14 S13Y
061002 -  ..
061003 - Gloria's letter from Kaiser continues...
061004 -
061005 -        4.  If there are changes in your medications, vitimin k intake
061006 -            in your diet, vitimins, herbal products, or alcohol use.
061007 -            ref DRT 1 S69K
061009 -             ..
061010 -        5.  If you become ill or have decreased appetite, diarrhea,
061011 -            vomiting. ref DRT 1 779N
061013 -             ..
061014 -        6.  Also call us if you are planning to have surgical or dental
061015 -            procedure. ref DRT 1 F74F
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