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: May 14, 2009 03:50 PM Thursday; Rod Welch

Millie meeting review separated shoulder Kaiser Orthopedics Department

1...Summary/Objective
2...Orthopedic Examination Recovery Dislocated Shoulder


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 11 0000. ref SDS 10 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background...
040902 -
040903 -    1.  Millie fell and dislocated her shoulder
040904 -        at exercise class and was treated
040905 -        at Kaiser............................ 090122, ref SDS 1 CW6J
040907 -         ..
040908 -    2.  Shoulder was restored with
040909 -        reduction procedure.................. 090122, ref SDS 1 LV3O
040910 -        evaluation examination scheduled in
040911 -        Orthopedics 090129 1330.............. 090122, ref SDS 1 HW4H
040913 -         ..
040914 -    3.  Right eye above brow deep cut
040915 -        clean and suture remove stitches
040916 -        in Orthopedics Dep................... 090122, ref SDS 1 WX4M
040917 -        Special Instructions say remove
040918 -        stitehcs in 5
040919 -        days................................. 090122, ref SDS 1 4Y5K
040921 -         ..
040922 -    4.  Eye right brow stitches removed
040923 -        from cut............................. 090129, ref SDS 5 01FH
040925 -         ..
040926 -    5.  Xray shows no fracture and shoulder
040927 -        still positioned correctly 7
040928 -        days after reduction
040929 -        procedure............................ 090129, ref SDS 5 ZF7J
040931 -         ..
040932 -    6.  Clinical examination testing range
040933 -        motion indicates shoulder healing
040934 -        normally............................. 090129, ref SDS 5 YU7M
040936 -         ..
040937 -    7.  Immobilizer was prescribed for 2
040938 -        weeks 24-7........................... 090129, ref SDS 5 YU8W
040940 -         ..
040941 -    8.  Exercises demonstrated for range of
040942 -        motion............................... 090129, ref SDS 5 TE5M
040944 -         ..
040945 -    9.  Lymphedema recurrence on left arm
040946 -        from constriction caused by
040947 -        immobilizer on right arm, so
040948 -        this was removed..................... 090201, ref SDS 7 KN4S
040950 -         ..
040951 -   10.  Right arm manipulated on 090209 by doctor
040952 -        at UCSF for xray and CT scans to plan
040953 -        hyperthermia treatment required for
040954 -        Millie to recover from cancer
040955 -        reported............................. 090212, ref SDS 10 6X9H
040957 -         ..
040958 -   11.  Orthopedic examination finds progress
040959 -        recovering from separated shoulder;
040960 -        testing range of motion shows Millie
040961 -        ready to continue using sling support;
040962 -        begin home exercises and
040963 -        schedule physical
040964 -        therapy.............................. 090212, ref SDS 10 N259
040966 -         ..
040967 -   12.  Orthopedic examination finds good progress
040968 -        recovery from dislocated right shoulder
040969 -        with increased range of motion and
040970 -        strength; prescribe Millie to start
040971 -        physical therapy at Kaiser
040972 -        tomorrow............................. 090303, ref SDS 11 6X9H
040973 -
040974 -
040975 -
040977 -  ..
040978 - Orthopedic Examination Recovery Dislocated Shoulder
040979 -
040980 - Follow up ref SDS 11 6X9H, ref SDS 10 6X9H.
040981 -
040982 - Millie reported increased strength, and range of motion resulting from
040983 - physicial therapy ordered during the prior meeting at Kaiser on
040984 - 090303. ref SDS 11 I67G   Millie has also been working out in the gym,
040985 - planned during meeting with primary care physician on 090325.
040986 - ref SDS 12 NE8J
040988 -  ..
040989 - Laura had Millie perform range of motion tests moving her arm and
040990 - fingers in various ways, similar to examination on 090303. ref SDS 11
040991 - 6X9H  She feels Millie demonstrates today rapid recovery from severe
040992 - separation, and so Millie is ahead of schedule compared to other
040993 - patients with similar injuries.
040995 -  ..
040996 - Laura asked about pain?
040998 -  ..
040999 - Millie said that since ending treatments on 090317 with radiation and
041000 - hyperthermia that were very uncomfortable, pain in the upper right arm
041001 - and shoulder have substantially subsided, following the report on
041002 - 090303. ref SDS 11 6H48  There is still some tenderness in the
041003 - shoulder with some movements.
041005 -  ..
041006 - Laura wants to monitor the condition for another month.  She explained
041007 - that cortisone injection can sometimes aid recovery enabling patients
041008 - to exercise that otherwise causes slight pain.  Laura scheduled
041009 - Millie's next visit in June, and will arrange to conduct the
041010 - examination for continuity of care assessing need for cortisone.
041011 -
041012 -
041013 -
041014 -
041015 -
041016 -
041017 -
041018 -
0411 -