CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 4 0000, ref SDS 3 0000.
040502 -
040503 -
040504 -
040506 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Discharge documents received from the VA on 091104 scheduled meeting
040902 - for tomorrow on 091117 1000. ref SDS 4 GU3O
040904 - ..
040905 - On 091117 Ramon called, and coordinated getting tests done at VA in
040906 - Martinez to support the meeting tomorrow in San Francisco. ref SDS 5
040907 - QF7O
040909 - ..
040910 - Submitted following letter to Karen and Ramone to forward to the
040911 - medical team for the agenda on meeting tomorrow on 091119 1000...
040912 -
040913 - 1. Subject: Agenda Meeting Progress Review Recover Heart Surgery Oct 22
040914 - Date: Wed, 18 Nov 2009 13:38:36 -0800
040915 - From: Rod Welch
040916 - To: "Rehder, Karen B."
040917 - CC: ramon.datar@va.gov
040919 - ..
040920 - 2. Dear Karen, and Neil,
040922 - ..
040923 - 3. Thanks for your letter on 091023 identifying the team who
040924 - provided excellent care and support performing angiogram test
040925 - on 091021, ref SDS 1 025B, and heart bypass surgery the next
040926 - day on 091022. ref SDS 2 01F9
040928 - ..
040929 - 4. Thanks as well to Ramon for coordinating yesterday to
040930 - consolidate blood draws and tests at VA in Martinez, reported
040931 - on 091117 1317. ref SDS 5 GX9L in order to be prepared for
040932 - meeting with Neal on Thursday, 091019 1000. This avoids
040933 - getting stuck in traffic driving to the City during the morning
040934 - commute to otherwise arrive early enough to do tests at the VA
040935 - in San Francisco. Kudos to the VA for supporting the customer.
040936 -
040937 - [On 091119 1000 Erick reportes there wasn't enough time
040938 - to get the agenda for the meeting, so everybody relied
040939 - on memory. ref SDS 7 PR7Y
040941 - ..
040942 - 5. Good news...
040943 -
040944 - 1. Scar on right leg where tissue was harvested for the bypass
040945 - op, has nearly healed. There is about 5% scar near the
040946 - ankle. Swelling has also dissipated.
040947 -
040948 - 2. Had some occasional breathing issues while talking for a
040949 - few days last week, but this has also subsided with
040950 - exercise the past few weeks.
040952 - ..
040953 - 3. Have been hiking 4 - 6 miles per day mostly flat terrain,
040954 - so getting stronger.
040956 - ..
040957 - 4. Went hiking at Lafayette Reservoir yesterday, and was
040958 - pleased that going up the hills did not cause any chest
040959 - pain, which originally signaled problems that led to
040960 - surgery on 091022. Did a full lap 2.75 miles in 55
040961 - minutes. Not setting world on fire, but a good start the
040962 - first time out. That was a relief. Felt ok to do another
040963 - lap, but saved it for next time.
040964 -
040965 - [On 091119 1000 Erick reportes xray taken at VA
040966 - Martinez on 091117 shows reduced fluid on the lungs,
040967 - following increased exercise hiking at Lafayette
040968 - Reservoir. ref SDS 7 LC8G
040970 - ..
040971 - 6. As you know, eating has been the only big issue. Can't really
040972 - eat any regular food, because while over time some breaks up in
040973 - the throat and seeps into the digestion system, most of it
040974 - comes back up due to achalasia and brings the medication with
040975 - it. So, just going with Ensure, and this allows medications to
040976 - stay down and take effect.
040978 - ..
040979 - 7. Got a call canceling a meeting on 091117 with Doctor Stewart to
040980 - visit in San Francisco on planning Heller myotomy to resolve
040981 - achalasia. The 091117 date [conflicted with the schedule
040982 - submitted by Paula on 091103 saying the VA scheduled a meeting
040983 - with Doctor Stewart on 091208 to plan surgery, and another
040984 - meeting on 091217 to perform Heller Myotomy surgery that will
040985 - correct achalasia. 091103 0347, ref SDS 3 PS60, and further...]
040986 - conflicted with another meeting scheduled for VA in Martinez,
040987 - which occurred yesterday, as further related below. ref SDS 0
040988 - Z65T Hopefully, tomorrow on Thursday, the consult meeting with
040989 - Doctor Stewart can be scheduled, so that surgery can proceed as
040990 - currently scheduled on 091217 (I think).
040992 - ..
040993 - 8. Yesterday, at the VA in Martinez, the Coagulation Control Case
040994 - Manager presented a question for the CT medical team on whether
040995 - aspirin conflicts with Coumadin. She proposes pausing aspirin
040996 - until Coumadin treatment ends in 3 more weeks, reported on
040997 - 091117 1500. ref SDS 6 MG6G
040998 -
040999 - [On 091119 1000 Erick at Va in San Francisco advised that
041000 - aspirin should not be paused while taking Coumadin for next
041001 - 3 weeks, and that instead Coumadin can be adjusted as needed
041002 - to maintain INR between 2.0 - 3.0. ref SDS 7 934K
041004 - ..
041005 - [On 091124 0827 during meeting at VA in Martinez, Diana, the
041006 - Coagulation Control Case Manager, was notified that the
041007 - Cardiothoracic Surgery team wants to continue aspirin
041008 - concurrent with Coumadin. ref SDS 8 D234
041010 - ..
041011 - 9. My deep thanks again to Doctor Tseng for excellent work leading
041012 - and performing complex surgery, and to Doctor Ratcliff on
041013 - directing post-surgery recovery.
041015 - ..
041016 - 10. Doctor Shunk provided thorough analysis on trade-offs for
041017 - treating issues he discovered with the test on 091021. His
041018 - assistant Dennis was outstanding discussing prospects for
041019 - recovery, and demonstrating exceptional competence that lifted
041020 - confidence making an important decision. Neal, KC, Joe, of
041021 - course Paula, and later Erick all make patients proud to be
041022 - veterans and privileged to receive the best care in the world.
041023 - As well, the two (2) Joe's in the ICU saw me through difficult
041024 - moments. Pat and Jan in TCU provided transition for timely
041025 - discharge. Jan's suggestion to elevate the right leg after
041026 - hiking the hallways proved effective to relieve trama in the
041027 - lower right leg that elevated WBC, causing concerns about
041028 - aspiration pneumonia. From top to bottom, Va San Francisco has
041029 - leadership that makes talent productive.
041031 - ..
041032 - 11. Looking forward to meeting on Thursday.
041033 -
041040 -
041041 -
041042 -
041043 -
0411 -