CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 19 0000. ref SDS 18 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040963 -  ..
040964 - On 091104 left leg incision recovering better implemeting Jan's
040965 - suggestion to elevate after hiking, 091104 0718, ref SDS 17 I15I,
040966 - Paula visits and concurs left leg looks much better. ref SDS 17 4Z7N
040967 - lab reports WBC 12 droped from 19 the day before, reflecting
040968 - improvement in left leg incision recovery. ref SDS 17 PRPV  Doctor
040969 - Tseng and medical team visits and confirms patient can be discharged
040970 - today. ref SDS 17 PR4V
040972 -  ..
040973 - On 091117 1317 Ramone called to confirm meeting with Neal on Thursday
040974 - at 1000, and requested arriving early to get labs and tests done prior
040975 - to 1000 meeting; discussed coordinating with VA in Martinez to
040976 - consolidated labs being performed today to test INR. 091117 1317,
040977 - ref SDS 18 QF7O
040979 -  ..
040980 - On 091117 1500 visited VA in Martinez for blood draw, consolidated
040981 - with requirements for labs to meet in San Francisco on 091119,
040982 - ref SDS 19 TC4I; after blood draw, Coagulation Control Case Manager
040983 - performed finger prick test and reported INR 1.5; increased Coumadin
040984 - by 25%, continuing with 2 mg, and increasing to 3 mg every other day.
040985 - ref SDS 19 TD4L  After meeting with Coagulation Control Case Manager
040986 - went to Radiology Department; got xrays and EKG tests for meeting with
040987 - Neal in San Francisco on 091119. ref SDS 19 TD6M
040989 -  ..
040990 - On 091119 1000 visited medical team at the VA in San Francisco
040991 - Cardiothoracic Surgery Clinic.  Examination shows good progress
040992 - recovering from heart surgery on 091022. ref SDS 21 938N
040993 -
040994 -
040996 -  ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Visit VA in Martinez to meet with Coagulation Control Case Manager
041302 - for evaluating Coumadin treatment based on reaching INR between 2.0
041303 - and 3.0.
041305 -  ..
041306 - INR today is 1.7, up from 1.5 reported last week on 091117.
041307 - ref SDS 19 TD4L
041309 -  ..
041310 - Coumadin increased to 3 mg per day, which is 1.5 of 2 mg pills per
041311 - day.
041312 -
041313 -     [On 091201 0900 INR still 1.7, so Coumadin increased to 4.5 mg on
041314 -     Tuesday and Thursday, and held at 3 mg per day for rest of week.
041315 -     ref SDS 22 NU5L
041317 -  ..
041318 - Diana updated medication from medical chart on 091104. ref SDS 17 4193
041319 -
041321 -  ..
041322 - Diana wrote a new prescription for 3 mg Coumadin pills.  She left the
041323 - meeting and visited the Pharmacy for about 15 minutes.  Diana returned
041324 - with the additional medication for the prescription, which will be
041325 - needed in about 4 days, after the 2 mg pills are consumed.
041327 -  ..
041328 - Diana asked about the determination by the medical team on pausing
041329 - aspirin while on Coumadin, and which was asked during the meeting last
041330 - week on 091117. ref SDS 19 MG6G  This issue was submitted in the
041331 - agenda for the meeting in San Francisco, submitted on 091118.
041332 - ref SDS 20 Z65T
041334 -  ..
041335 - Advised this issues was presented during the meeting on 091119 to
041336 - medical team for Cardiothoracic Surgery at the VA in San Francisco.
041337 - At that time, Erick commented that aspirin should continue concurrent
041338 - with Coumadin. ref SDS 21 934K
041340 -  ..
041341 - Diana presented two (2) related issues for Cardiothoracic Surgery
041342 - team...
041343 -
041344 -        1.  When should Coumadin be paused for Heller Myotomy surgery
041345 -            scheduled for 091217?
041346 -
041347 -            Typically this occurs 5 days in advance of surgery.
041349 -             ..
041350 -            In this case 6 week Coumadin regimen prescribed by the
041351 -            medical team to treat DVT problem from Cordis catheter
041352 -            placed on 091022 for heart surgery, and later diagnosed on
041353 -            091030 with Sonogram testing, ref SDS 12 KF5W, will end on
041354 -            091212, also reported on 091030. ref SDS 12 GX3W
041356 -             ..
041357 -        2.  Should Coumadin be continued past 6 weeks initial
041358 -            prescription and until follow up Sonogram test establishes
041359 -            that DVT identified on 091030, ref SDS 12 KF5W, has been
041360 -            fully resolved, as discussed with the medical team on
041361 -            091119? ref SDS 21 K24M
041363 -             ..
041364 -            Diana commented today there is a note in the record for the
041365 -            meeting on 091119 that is inconclusive on this matter.
041367 -  ..
041368 - Will meet again next Tuesday and evlauate INR for adjusting Coumadin.
041370 -  ..
041371 - Diana scheduled the next meeting for 0900 to correlate with Millie
041372 - getting a blood draw at Kaiser around the corner, also at 0900 on
041373 - 091201.
041374 -
041375 -
041376 -
041377 -
041378 -
041379 -
041380 -
041381 -
0414 -