THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
S U M M A R Y
DIARY: March 6, 2009 08:00 AM Friday;
Olsen Dental service cleaning and extract tooth #2.
2...Additional Work Discovered Examination and Xrays
3...Examination and Xrays Disclose Additional Work Required
4...Teeth Cleaning Examination Xrays Discover Follow Up Work Required
5...Toothbrush Electric Sonar Technology Braun Vitality Precison Clean
6...Tooth #2 Extraction Consultation Planning Scope
7...Leverage Practice Synergy Olsen Integrated Practice
8...Treatment Customized for Patient Considerations
9...Pain Management Effective Multi-step Process
10...Infection Not Reported from Examination and Xrays
11...Knee Pain Osteoarthritis (OA) Glucosamine Chondrotin CAM NIH Study
12...Glucosamine Chondrotin Relieves Knee Pain NIH CAM Osteoarthritis (OA)
13...NIH CAM Osteoarthritis (OA) Glucosamine Chondrotin Relieves Knee Pain
14...Running Osteoarthritis (OA) Glucosamine Chondrotin Relieves Knee Pain
15...Extraction Complemented with Bone Grafts Enable Implants If Needed
16...Excellent Dental Procedure Oral Surgery Removing Tooth #2
17...Lip Stretch Discomfort Minimized for Access to Work Site Needs Research
18...Follow Up Examination Next Week May Do Comparitive Xray If Needed
19...Tooth #7 or #8 Not Cited for Future Work from Xray
20...3 Tasks Presented for Further Dental Work Need Cost and Schedule
21...Home Care Procedures Receive Instructions and Remedies
22...Comprehensive Dental Services Post-procedure Follow Up Oral Surgery
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0201 - Olsen Dental Services
020101 - Mr. Russell S. Harris, DDS; General and Cosmetic Dentistry
020103 - Dentists
0202 - Olsen Dental Services
020201 - Mr. Gregory S. Meyers, DDS, MSD; Oral Surgeon
020203 - Dentists
Dental Examination Teeth Cleaning and Extraction Tooth #2 Bone Graft
1603 - ..
1604 - Summary/Objective
160501 - Follow up ref SDS 27 0000. ref SDS 26 0000.
160503 - Doctor Harris and Doctor Meyer did excellent work today, performing
160504 - cleaning, ref SDS 0 PL7X, examination and consultation, and extracting
160505 - tooth #2. Synergy from integrated practice proved helpful today.
160506 - ref SDS 0 O13H Doctor Harris' analysis supported Doctor Graham's 2nd
160507 - opinion to take additional measures for future implants; Doctor Meyer
160508 - did the work including bone grafts. ref SDS 0 J55O Home care
160509 - instructions need clarification to guide length of implementation.
160510 - ref SDS 0 PF4G Follow up examination scheduled for next Friday,
160511 - 090313. ref SDS 0 QM5I Doctor Meyer called in the evening to check
160512 - for complications; fortunately, everything seems perfect. ref SDS 0
160513 - V45Y
160518 - ..
1608 - Background
160901 - 1. Repairing tooth #2 is reported on 090220. ref SDS 21 FQ5G At
160902 - that time on 090220, Christi advised that Russ would review the
160903 - chart, and call to discuss scope and price.
160905 - ..
160906 - 2. On 090223 Russ called from Steve Olsen's office, to follow up
160907 - the request for proposal on 090220. ref SDS 21 F066
160909 - ..
160910 - Russel indicated tooth #2 would require an implant, and this
160911 - would cost about $5K to accomplish. ref SDS 22 VY7W Christi
160912 - called back and scheduled an initial meeting on 080306. Russ
160913 - will spend an hour to clean the teeth, and take some xrays.
160914 - The Periodonist will make an examination for 30 minutes.
160916 - ..
160917 - For this 1.5 hours of work, and xrays, the Olsen office will
160918 - charge $500. ref SDS 22 9Z7I
160920 - ..
160921 - This cost seems higher than original pricing proposed on
160922 - 050518. ref SDS 5 ZZ4M
160924 - ..
160925 - 3. On 090223 called Richard. He indicated that tooth #2 often
160926 - does not require implant repair. He usually orders only an
160927 - extraction. ref SDS 23 JW9O Richard suggested calling his
160928 - dentist in Danville, David Graham. Richard went to dental
160929 - school with David, and has very high regard for his work,
160930 - especially because Doctor Graham continued to teach dentistry
160931 - at the UC Dental College in San Francisco, while also running
160932 - his own practice in Danville.
160934 - ..
160935 - On 090223 1118 called and scheduled meeting with Doctor Graham
160936 - this morning for 2nd opinion on repairing tooth #2. ref SDS 24
160937 - 8V9O
160939 - ..
160940 - 4. On 090302 0815 meeting Doctor Graham in Danville; 2nd opinion
160941 - recommended doing extraction only on tooth #2, ref SDS 24 H68W,
160942 - took xrays for referral to Doctor Keith in Walnut Creek.
160943 - ref SDS 24 RQ9N Analysis of xrays seems to indicate extraction
160944 - does not risk eruption of tooth #31. ref SDS 24 0326
160946 - ..
160947 - 5. On 090303 2053 letter to Doctor Russell Harris at Olsen Dental
160948 - Offices clarifying scope of work during meeting on 090306 to
160949 - include extraction of tooth #2. ref SDS 25 O13H
160951 - ..
160952 - 6. On 090304 1018 telecon with Eddie in Olsen Dental Office
160953 - confirmed the letter submitted on 090303 was recieved and
160954 - reviewed by Doctor Harris and Doctor Meyer, ref SDS 26 PY5F,
160955 - setting scope of work for meeting on 090306 to include
160956 - extraction of tooth #2.
160958 - ..
160959 - 7. On 090305 0938 Kristi clarified the meeting 090306 0800.
160960 - ref SDS 27 O13H Doctor Meyer has allocated an hour for doing
160961 - the extraction of tooth #2, per prior instructions. ref SDS 27
160962 - XA86
Dental Teeth Cleaning Examination Accommodate Patient Infirmities Ac
270401 - ..
270402 - Additional Work Discovered Examination and Xrays
270403 - Examination and Xrays Disclose Additional Work Required
270404 - Teeth Cleaning Examination Xrays Discover Follow Up Work Required
270406 - Todd did setup and initial polishing. He was very efficient and
270407 - thorough. Todd is retired from the Marines, where he served at
270408 - Guantonamo, but not in the Middle East. Was honored to thank Todd for
270409 - service to the nation.
270411 - ..
270412 - Todd and Russell were accomodating of the achalasia problem, working
270413 - from a sightly higher incline than normal. This aligns with Steve's
270414 - work on 050518, ref SDS 5 FB6L, and the next day on 050519, when
270415 - Doctor Hasse did the root canal repair. ref SDS 6 MO6N
270417 - ..
270418 - Russell did the cleaning. He had to use the ultrasonic scaler to
270419 - remove excessive buildbup on the inside bottom front teeth. This
270420 - method has presented pain issues, reported on 050518. ref SDS 5 FB6L
270421 - Today, Russell's careful work minimized pain using the ultrasonic
270422 - scaler. For the remainder of the work, Russell used a conventional
270423 - manual scaler that avoids pain suffered doing similar work on 050518.
270424 - ref SDS 5 F77P
270426 - ..
270427 - Teeth cleaning and examination went smoothly. Excellent work, as
270428 - Russell always does.
270430 - [...below Doctor Meyer extraction tooth #2 went better than
270431 - "well." ref SDS 0 546G
270433 - ..
270434 - Russell feels xrays done for second opinion support at Doctor Graham's
270435 - office on Monday, 090302, ref SDS 24 RQ9N, saved time getting things
270436 - done today.
270438 - [On 090312 0837 letter to Doctor Graham confirms work performed
270439 - by Olsen Dental Services; requests re-submission of 2nd opinon,
270440 - and requests invoice for consultation. ref SDS 28 Y16J
270444 - ..
270445 - Toothbrush Electric Sonar Technology Braun Vitality Precison Clean
270447 - Today, Russell concurs with Richard's suggestion on 090223 to use a
270448 - sonar electronic tooth brush that helps increase cleaning at the gum
270449 - line with daily brushing. ref SDS 22 QP5N Todd wrote this down
270451 - Russell specified...
270453 - Braun Vitality Precision Clean
270455 - ...toothbrush, available at Bed Bath & Beyond.
Tooth #2 Extraction Consultation Planning Scope Leverage Practice Sy
410401 - ..
410402 - Tooth #2 Extraction Consultation Planning Scope
410403 - Leverage Practice Synergy Olsen Integrated Practice
410405 - Follow up ref SDS 27 O13H, ref SDS 26 O13H.
410407 - Initial discussion with Russell indicated that the crown on tooth #31
410408 - would not be expected to prevent #31 from extruding into the space
410409 - created by removing tooth #2. He noted that a tooth does not "know"
410410 - it has a crown. Since tooth #2 has been significantly diminished for
410411 - several years, and since tooth #31 shows no signs of displacement,
410412 - this could indicate support for Doctor Graham's analysis on 090302.
410413 - ref SDS 24 0326 Russ reported observing today signs of some contact
410414 - between tooth #2 and #31. This observation, though difficult to
410415 - accomplish, may account for normal containment of tooth #31. Loss of
410416 - opposing force by extracting tooth #2 today, argues for doing an
410417 - implant, discussed initially on 090223. ref SDS 21 VY7W
410419 - [On 090312 0837 letter to Doctor Graham confirms work performed
410420 - by Olsen Dental Services; requests re-submission of 2nd opinon,
410421 - and requests invoice for consultation. ref SDS 28 Y16J
410423 - ..
410424 - Doctor Meyer did the extraction, and was assisted by Rick.
410426 - x
410427 - 1111111
410428 - 1234567890123456
410429 - R L
410430 - 3332222222222111
410431 - 2109876543210987
410432 - x
410434 - ..
410435 - Doctor Meyer did not comment on requirements for doing an implant,
410436 - relative to preventing tooth #31 extruding into the space created by
410437 - extracting tooth #2.
Treatment Customize Accommodate Patient Infirmities Aclasia Requirem
580401 - ..
580402 - Treatment Customized for Patient Considerations
580403 - Pain Management Effective Multi-step Process
580405 - The doctor managed pain exceptionally well. He seemed to initially
580406 - apply a surface agent that did partial numbing. After this took
580407 - effect, which took only a minute or so, he did more numbing with an
580408 - injection procedure. Needle penetration was tolerated easily because
580409 - of the first step.
580411 - ..
580412 - Doctor Meyer and Rick also accomodated the aclasia problem, discussed
580413 - above. ref SDS 0 V38S
580415 - ..
580416 - Consideration of patient infirmities caused no evident loss of
580417 - productivity nor inconvenience to the doctor.
580419 - ..
580420 - Feedback from the doctor can help clarify productivity issue.
Infection Tooth #2 Not Reported Examination Xrays Cited Patient Lett
720401 - ..
720402 - Infection Not Reported from Examination and Xrays
720404 - Neither Doctor Meyer nor Doctor Harris reported seeing evidence of
720405 - infection in tooth #2 from direct examination nor in the xrays taken
720406 - on 090302, which was cited as a possibility in the letter to the team
720407 - on 090303. ref SDS 25 0T8Q Previously, on 050518 Steve had cited
720408 - infecton was visible in the xray for tooth #19, which was the
720409 - rationale for doing extraction and root canal procedure. ref SDS 5
720410 - F79R
Glucosamine Chondroiten Relieves Severe Osteoarthritis OA Knee Pain
880401 - ..
880402 - Knee Pain Osteoarthritis (OA) Glucosamine Chondrotin CAM NIH Study
880403 - Glucosamine Chondrotin Relieves Knee Pain NIH CAM Osteoarthritis (OA)
880404 - NIH CAM Osteoarthritis (OA) Glucosamine Chondrotin Relieves Knee Pain
880405 - Running Osteoarthritis (OA) Glucosamine Chondrotin Relieves Knee Pain
880407 - Doctor Meyer is a runner. He has run with his wife in the Boston and
880408 - New York marathons, and gone to Paris to run. They combine marathons
880409 - to take a week of vacation. Mentioned that Millie and I met running
880410 - on the Embarcadero in 1980. The doctor is looking for another form of
880411 - exercise due to rising knee problems. Plans to run a half marathon
880412 - coming up for a charity event supporting medical research.
880414 - ..
880415 - Running gave way to tennis at 40. Courts at the Golden Gateway were
880416 - very convenient. Transitioned to hiking at 55, as knees finally gave
880417 - out. The study on 081207 shows hiking can run up good mileage without
880418 - the stress of running. ref SDS 16 X64F Golf is another way people
880419 - stay active, but is not aerobic, nor totally free of risks to knee
880420 - injury, shown by Tiger Woods surgery last year.
880422 - ..
880423 - Glucosamine Chondroitin was recommended by Doctor Boulris at Kaiser on
880424 - 990925. ref SDS 2 3120 Recent NIH study finding benefits "unlikely,"
880425 - conflicts with personal experience showing G&C has been a "lifesaver"
880426 - the past 5 years, shown in case study reported in the record on
880427 - 030807. ref SDS 4 FN9N The NIH study though generally reported to be
880428 - negative, has a specific finding that aligns with personal
880429 - experience...
880431 - National Institute of Health (NIH)
880432 - Complementary and Alternative Medicine (CAM)
880434 - http://nccam.nih.gov/news/newsletter/2006_spring/glucosamine.htm
880436 - ..
880437 - For a small group of participants [suffering osteoarthritis
880438 - (OA)], with moderate-to-severe pain glucosamine combined with
880439 - chondroitin sulfate provided significant pain relief compared
880440 - with placebo. However, because of this group's small size, the
880441 - researchers noted that this finding should be considered
880442 - preliminary and needs to be confirmed in further studies.
Extraction Tooth #2 Bone Grafts Enable Future Implant If Needed Impl
990401 - ..
990402 - Extraction Complemented with Bone Grafts Enable Implants If Needed
990404 - Olsen Dental practice synergy was helpful today implementing Doctor
990405 - Graham's 2nd opinion suggestion to prepare for future implant if
990406 - needed to restore tooth #2.
990408 - Russell's examination this morning finding contact between degraded
990409 - tooth #2 and tooth #31, ref SDS 0 O13H, was applied asking Doctor
990410 - Meyer about preparation work needed to preserve the option for doing
990411 - an implant later?
990413 - [On 090312 0837 letter to Doctor Graham confirms work performed
990414 - by Olsen Dental Services; requests re-submission of 2nd opinon,
990415 - and requests invoice for consultation. ref SDS 28 Y16J
990417 - ..
990418 - Doctor Meyer advised that adding bone grafts today after extraction
990419 - will maintain the structure of the jaw that enables doing an implant,
990420 - if needed later.
990422 - ..
990423 - Authorized additional work required for future bone grafts, as called
990424 - out in Doctor Graham's' 2nd opinion on 090302. ref SDS 24 H68W
990426 - ..
990427 - Doctor Meyer paused the work for about 20 minutes, while Cindy
990428 - prepared a revised estimate of cost that includes adding bone grafts.
990429 - Cindy came into the work room and showed a number approximately $1,800
990430 - for 2 hours work today using a doctor-assistant team. She later said
990431 - this amount includes the cost of follow up examination for 5-minutes
990432 - next week on 090313. Cindy further pointed to a discount of what
990433 - looked like $200 to reflect "insurance" rates, discussed with Russ on
990434 - 090223, ref SDS 21 ME4L, and cited by Kristi in her call to present
990435 - the proposal. ref SDS 21 KT4L
990437 - ..
990438 - Cindy did not have time to submit a copy of her estimate showing the
990439 - elements of the calculation. She plans to submit this via email later
990440 - today, so the record is clear on what services were done for the total
990441 - cost charged.
Excellent Dental Work Examination Teeth Cleaning and Oral Surgery Ex
AG0401 - ..
AG0402 - Excellent Dental Procedure Oral Surgery Removing Tooth #2
AG0403 - Lip Stretch Discomfort Minimized for Access to Work Site Needs Research
AG0405 - Three (3) roots were removed. The doctor reported no complications,
AG0406 - and said the work went well.
AG0408 - ..
AG0409 - Doctor Meyer's work was better than "well," matching Russell's high
AG0410 - standards, per above, ref SDS 0 RL8L, common at Olsen Dental Services.
AG0412 - ..
AG0413 - There was slight discomfort stretching the right lip joint and cheek
AG0414 - required for access to the site in the back of the mouth on the upper
AG0415 - right side. This causes an uncomfortable "tearing" feeling. There
AG0416 - may be no remedy.
AG0418 - ..
AG0419 - Research might be done for treatment that temporarily makes this
AG0420 - tissue more flexible; or, since post procedure there is no evident
AG0421 - damage, the lip and cheek might numbed along with the gum and jaw bone
AG0422 - area.
AG0424 - ..
AG0425 - Otherwise there was no sensation of any kind that the tooth was
AG0426 - removed. The only awareness that the tooth and roots were removed was
AG0427 - when the doctor said the work was completed.
Follow Up Examination Scheduled 090313 Comparitive Xray Verify Effec
AO0401 - ..
AO0402 - Follow Up Examination Next Week May Do Comparitive Xray If Needed
AO0404 - Xray was not done today comparing "before" and "after" to assess the
AO0405 - infection issue and verify comprehensive removal, which Doctor Hasse
AO0406 - did for tooth #19 on 050519. ref SDS 6 MM7O This may reflect
AO0407 - significant differences between doing a root canal procedure, and a
AO0408 - simple extraction with bone graft.
AO0410 - ..
AO0411 - Doctor Meyer wants a follow up examination next Friday, possibly to do
AO0412 - an xray to make the comparison after the jaw has resettled.
AO0414 - [...below in this record today on 090306 1808 Doctor Meyer
AO0415 - called to ask about patient response to oral surgery.
AO0416 - ref SDS 0 V45Y
AO0418 - ..
AO0419 - Cindy said that Doctor Meyer is not scheduled to come into the office
AO0420 - until 1200 on 090313, so she scheduled the follow up examination with
AO0421 - Doctor Harris on 090313 0800.
Planning Future Dental Work 3 Tasks Schedule Cost Pending Reported D
B40401 - ..
B40402 - Tooth #7 or #8 Not Cited for Future Work from Xray
B40403 - 3 Tasks Presented for Further Dental Work Need Cost and Schedule
B40405 - Neither Doctor Harris nor Doctor Meyer mentioned a problem with tooth
B40406 - #7 or #8 from reviewing the xray, cited by Doctor Graham as possibly
B40407 - requiring replacement, reported on 090302. ref SDS 24 0336
B40409 - ..
B40410 - Aligns with patient history of no reporting on this issue. This
B40411 - issue has visibility for future consideration.
B40413 - ..
B40414 - There were no "pockets" reported that require "deep cleaning," or
B40415 - other peridontal follow up, indicating Russell's work on 050518 is
B40416 - still effective. ref SDS 5 FB93
B40418 - ..
B40419 - Russell explained 3 issues need remedial dental work based on
B40420 - examinations today during teeth cleaning and extraction of tooth #2,
B40421 - and review of xrays. One of these is the chip on outside of tooth
B40422 - #14.
B40424 - ..
B40425 - Need proposal for additional work on 3 issues with cost and schedule.
Home Care Procedures Instructions Remedies Tooth #2 Oral Surgery Ext
BM0401 - ..
BM0402 - Home Care Procedures Receive Instructions and Remedies
BM0404 - Doctor Meyer said at the end of the work to eat on the left side; he
BM0405 - provided a rinse solution, and pain pills.
BM0407 - ..
BM0408 - The doctor likely said how long to apply these steps, but could not
BM0409 - remember, for reasons in Millie's letter to Kaiser on 081219.
BM0410 - ref SDS 17 J18N
BM0412 - ..
BM0413 - The doctor seemed to say instructions are in the documents received
BM0414 - today. Post-meeting review does not say how long these measures
BM0415 - should be followed, e.g., 1 day, 5 days, until everything feels
BM0416 - "okay."???
BM0418 - ..
BM0419 - [...below, Doctor Meyer called for follow up later in the
BM0420 - afternoon/early eveing; did not remember to ask how long to
BM0421 - continue home care. ref SDS 0 V45Y
BM0423 - ..
BM0424 - Received...
BM0426 - 1. Motrin for pain.
BM0428 - Directions for use:
BM0430 - 1 pill every 4 - 6 hours as needed.
BM0432 - ..
BM0433 - 2. Oral Rinse control bleeding.
BM0435 - Peridex NDC 48878 620 12
BM0436 - Chlorhexidine Gluconate 0.12%
BM0437 - 3M ESPE Dental Products
BM0438 - St Paul, MN 55144
BM0440 - ..
BM0441 - Directions for use:
BM0443 - ..
BM0444 - Swish 1 tablespoon (15 ml) in mouth undiluted for 30 seconds
BM0445 - then spit out. Use after breakfast and before bedtime. Or use
BM0446 - as prescribed. Note: To minimize medicinal taste, do not
BM0447 - rinse with water immediately after use.
BM0449 - [...below Periodontal Surgery Instructions clarify using
BM0450 - oral rinse. ref SDS 0 P24G
BM0452 - ..
BM0453 - [On 090313 0800 follow up examination prescription changed
BM0454 - from Peridex to oral rinse with simple salt water.
BM0455 - ref SDS 29 7I78
BM0457 - ..
BM0458 - 3. Instructions for Patients after Periodontal Surgery
BM0459 - Gregory S. Meyers, DDS, MSD
BM0461 - ..
BM0462 - Two Embarcadero Center, Promenade Level
BM0463 - San Francisco, CA 94111
BM0464 - 415 398 4400
BM0466 - a. Bleeding
BM0468 - Some bleeding may occur for the first few hours after the
BM0469 - opertion. This is not unusual. If bleeding seems profuse,
BM0470 - apply firm pressure to the bleeding site for 20 minutes
BM0471 - using either damp gause or a wet tea bag. Repeat if
BM0472 - necessary. Under no circumstances should rinsing be used
BM0473 - to stop the bleeding.
BM0475 - ..
BM0476 - b. Medication
BM0478 - Begin taking your pain medication before the anesthetic
BM0479 - wears off. If you have been given a prescription for
BM0480 - Iburprofen (Motrin), continue taking it even if there is no
BM0481 - pain. If you have been given an antibiotic, you must
BM0482 - finish it as prescribed; discontinue only if alergies
BM0483 - symptoms (itching, rash, swelling) ensue.
BM0485 - ..
BM0486 - c. Swelling
BM0488 - In some cases, swellingis to be expected. This can be
BM0489 - minimized by the applicatoin of cold packs (ten minutes at
BM0490 - a time) and by lying with your head elevated. If swelling
BM0491 - does not subside and is accompaneid by fever, call your
BM0492 - student dentist.
BM0494 - ..
BM0495 - d. Home Care
BM0497 - The cleaner yo keep the surgical site, the faster and more
BM0498 - comfortably it will heal. If you have been given a
BM0499 - prescription for a mouth rinse, ref SDS 0 ZM4M, you must
BM0500 - use it. Avoid vigorous rinsing/swishing, but rather hold
BM0501 - the rinse in your mought bathing the surgical site for 30
BM0502 - seconds to a minute. The other parts of your mouth should
BM0503 - be brushed as normal. after one week try to gently brush
BM0504 - the surgical site with a soft toothbrush; bleeding may
BM0505 - occur and is normal. Brush your tongue for additional
BM0506 - comfort and freshness.
BM0508 - [On 090313 0800 follow up examination prescription
BM0509 - changed from Peridex to oral rinse with simple salt
BM0510 - water. ref SDS 29 7I78
BM0512 - ..
BM0513 - e. Eating
BM0515 - Good nutrition is very important following surgery. Follow
BM0516 - your regular diet avoiding foods that are hard/sharp or
BM0517 - hot/spicy. Try to get adequate protein from foods such as
BM0518 - eggs, fish, milk/yogurt, or protein shakes. Try to
BM0519 - increase your intake of fluids to aid in healing.
BM0521 - ..
BM0522 - f. Smoking
BM0524 - Avoid smoking completely, as it will retard healing and
BM0525 - lead to increased pain.
BM0527 - ..
BM0528 - g. Emergency
BM0530 - In case of emergency or if any questions pleas call Doctor
BM0531 - Meyers at 415 336 1207
BM0533 - ..
BM0534 - email@example.com
Tooth #2 Extraction Post-procedure Review Oral Surgery Comprehensive
C104 - 1808
C10501 - ..
C10502 - Comprehensive Dental Services Post-procedure Follow Up Oral Surgery
C10504 - Doctor Meyer called.
C10506 - Asked how the patient is doing, any side effects of the procedure
C10507 - today?
C10509 - ..
C10510 - No evident pain, and no bleeding; everything seems okay.
C10512 - ..
C10513 - Thanked Doctor Meyer for excellent work today, and for follow up this
C10514 - evening.
C10516 - ..
C10517 - Forgot to ask how long to implement home care requirments. ref SDS 0
C10518 - PF4G
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