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 12, 2008 07:42 PM Friday;
Rod Welch
Millie letter asks Kaiser omission of CT reporting cancer in neck shows prior findings resolved?
1...Summary/Objective
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 8 0000. ref SDS 7 0000.
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040504 -
040506 - ..
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0407 -
0408 - Progress
0409 -
040901 - Millie had a CT test at Kaiser in Oakland yesterday. ref SDS 6 358L
040902 - Everything went well. ref SDS 6 LK3R Problems that occurred on the
040903 - previous CT test on 080718, ref SDS 1 LK3R, at Kaiser in Walnut Creek
040904 - did not occur yesterday in Oakland.
040906 - ..
040907 - This afternoon, the primary care physician submitted the pathology
040908 - report for the test. It was transmitted through Kaiser's Knowledge
040909 - Management dedicated email system. This was reviewed carefully in
040910 - another record later in the evening today 080912. ref SDS 9 6V5I
040912 - ..
040913 - Initial review showed the analyst did not follow up Interstitional
040914 - lung disease, ref SDS 9 TS4J, which was reported as a new issue in the
040915 - CT test on 080718, reviewed a week later on 080723. ref SDS 2 TS4J
040917 - ..
040918 - Millie sent a letter to the doctor using the dedicated email program
040919 - in Kaiser's Knowledge Mangaement system asking if failure of the
040920 - report to mention Interstitional Lung disease indicates the condition
040921 - is resolved, or that the analyst did not look for it. ref SDS 7 LO9U
040923 - ..
040924 - Millie received a letter from the primary care physician indicating
040925 - that omission of findings in the CT test indicate good news that
040926 - Interstitional Lung disease is not worsening and is negligible.
040927 - ref SDS 8 HI8N
040929 - ..
040930 - Millie responded in a letter thanking the doctor for clarification of
040931 - test findings, and asking if the same analysis applies to lympth
040932 - adenopathy in the left supraclavicular which was also not mentioned in
040933 - the CT test on 08011 after findings reported at UCSF on 080821, and
040934 - coorborated by the primary care physician at Kaiser on 080829...
040935 -
040936 - 1. Subject: CT Chest resultsPrinter-friendly version
040937 - Date Sent: 9/12/08 7:49 PM
040944 - ..
040945 - 2. Is it correct then to conclude [from Kaiser's response earlier
040946 - today on 080912 saying omission of findings in the report for
040947 - the CT test on 080911 shows Interstitional Lung disease has not
040948 - worsened since the prior test on 080718, or is negigible,
040949 - ref SDS 8 HI8N] that nothing in the report for the CT test on
040950 - 080911 conveys any discussion of "interstitional disease"?
040951 - Whatever was there 8 weeks ago has now been resolved, i.e., too
040952 - small for a CT test to detect. Very good news.
040954 - ..
040955 - This asks if the report received on 080912 for the CT test on 080911
040956 - that may present findings on Interstitional Lung disease using other
040957 - language which is recognizable by a a professional health care
040958 - provider?
040959 -
040960 - [On 080915 the primary care physician responds to this
040961 - letter without clarifying understandings from the CT test
040962 - on 080911 with respect to Interstitional Lung disease.
040963 - ref SDS 10 XE9M
040964 -
040966 - ..
040967 - Millie's letter to Kaiser continues...
040968 -
040969 - 3. Similarly, since there is no discussion in the CT report of
040970 - swelling nodes in the left supraclavicular [reported in the
040971 - record reviewing the test on 080911 later today on 080912,
040972 - ref SDS 9 5O6N], does this show that swelling which you noticed
040973 - on 080829, ref SDS 4 RP8T, and which Lynn reported palpating
040974 - at UCSF on 080821, ref SDS 3 4C6O, has subsequently subsided?
040975 -
040976 - [On 080915 primary care physician at Kaiser responds to
040977 - Millie's letter on 080912 and does not answer the request
040978 - today asking if omission of findings on in the report on
040979 - 080912 (today) for the CT test on 08911 shows cancer in left
040980 - supraclavicular has been resolved. ref SDS 10 XE9M
040982 - ..
040983 - [On 080918 Brigid could not find swelling in the left
040984 - supraclavicular, which may align with the CT test not
040985 - reporting findings in this area. ref SDS 11 N65G
040987 - ..
040988 - [On 081022 Doctor Daamen takes biopsy of swelled lymph node
040989 - in left supraclavicular, and reviews CT test on 080911, and
040990 - says the scans did not include enough of the neck to
040991 - evaluate the node in the left supraclavicular. ref SDS 9
040992 - 516F
040994 - ..
040995 - [On 081023 Kaiser reports pathology of biopsy positive for
040996 - breast cancer. ref SDS 12 4Q9Q
040998 - ..
040999 - [On 081113 report for CT test of the neck on 081107 finds
041000 - cancer in right supraclavicular "increased" from prior test,
041001 - ref SDS 13 4K5H, which is incorrect, because the prior test
041002 - on 080718 reviewed on 080723, ref SDS 2 EO8F, and referenced
041003 - in the report for the test on 081107 does not present
041004 - findings of anything in the right supraclavicular,
041005 - ref SDS 13 SE9H, and neither does any other test in
041006 - patient's 7 year history of testing, including the report
041007 - today for the test on 080911. ref SDS 9 5O6N
041009 - ..
041010 - 4. Thanks too for following up on doing CT tests at WC, rather
041011 - than Oakland. Melissa, the head of Interventionary Radiology
041012 - at Oakland said today that it is still pretty rare to do the
041013 - tests with Power Ports. The key seems to be having the
041014 - Infusion Clinic nurses access the port. May still need to
041015 - assign a nurse from Interventionary Radiology to be on hand for
041016 - the test, but not to access the port. Looks like all the
041017 - pieces are in place for a solution.
041018 -
041019 - [On 080915 the primary care physician reported receiving no
041020 - feedback from the CT Department on upgrading services for
041021 - patients getting tests using Power Port technology for
041022 - injecting contrast medium. ref SDS 10 9I5N
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