CONTACTS 

SUBJECTS
Examination Heart Surgery Recovery Good Health Improved Achalasia He

2603 -
2603 -    ..
2604 - Summary/Objective
2605 -
260501 - Follow up ref SDS 37 0000. ref SDS 36 0000.
260502 -
260503 -
260504 -
260506 -  ..
2606 -
2607 -
2608 - Background
2609 -
260901 - On 090908 1130 Doctor Lee prepared work plan, ref SDS 13 BU6W, for
260902 - treating achalasia and including resolving new symptom of chest pains.
260903 - ref SDS 13 FT6M
260905 -  ..
260906 - On 091002 met with Doctor Egan, Cardiologist at the VA.  The doctor
260907 - advised that 10 of 11 test points in the stress test showed positive
260908 - for circulation problems, and so the doctor ordered angiogram.
260909 - ref SDS 14 1W5I
260911 -  ..
260912 - 091021 0716 Meeting at VA to complete angiogram test meeting,
260913 - ref SDS 15 01F9, and perform test. ref SDS 15 025B  Results show
260914 - requirement for heart bypass surgery. ref SDS 15 7L47
260916 -  ..
260917 - On 091022 0700 Doctor Tseng, Casey and others performed quadruple
260918 - heart bypass surgery at VA in San Francisco. ref SDS 16 01F9
260920 -  ..
260921 - On 091031 0730 discussed scheduling surgery to fix achalasia problem
260922 - as essential predicate to maintain nutrition required for recovering
260923 - from heart surgery. ref SDS 19 PW5H
260925 -  ..
260926 - On 091103 Paula reported the VA has scheduled a meeting today with
260927 - Doctor Stewart for planning Heller Myotomy surgery to correct
260928 - achalasia problem. ref SDS 21 PS60  On 091104 0718 Medical Chart
260929 - discharge guidance lists meeting with Doctor Stewart 091117 1300,
260930 - which conflicts with patient history today. ref SDS 22 Q03J  On 091119
260931 - 1000 Erick confirmed visit with Doctor Stewart on 091208, and is
260932 - reviewing date of surgery scheduled for 091217. ref SDS 24 935H
260934 -  ..
260935 - On 091104 0718 discharged from VA recovering from quadruple heart
260936 - bypass surgery, ref SDS 22 PR4V, performed on 091022 0700. ref SDS 16
260937 - PQWU; received medical record with list of medications, also on 091104
260938 - 0718, ref SDS 22 1Q6P, and follow up meetings. ref SDS 22 9T6O
260940 -  ..
260941 - On 091208 Doctor Stewart advanced the schedule for surgery one day to
260942 - 091216. ref SDS 26 6E41
260944 -  ..
260945 - On 091216 0600 meeting Doctor Stewart for Heller Myotomy surgery to
260946 - correct achalasia; check in at ASU. ref SDS 30 PP8W
260948 -  ..
260949 - On 091217 0600 meeting with Joe and Jon on recovring from Heller
260950 - Myotomy surgery; report of complication during surgery on 091216,
260951 - which was repaired, with plan for test to evaluate recovery. reported
260952 - on 091217 0600, ref SDS 31 0042  Doctor Stewart visited and expects
260953 - can start eating after favorable test. ref SDS 31 027A
260955 -  ..
260956 - On 091218 0600 xray with gastrogafin to evaluate repair for
260957 - complicaiton during Heller Myotomoy surgery Wednesday, ref SDS 32 PP8W,
260959 -  ..
260960 - On 091219 0600 doctor plans discharge tomorrow after evaluating
260961 - progress eating solid food today. ref SDS 33 PP5V  Since now eating
260962 - solid food, switched to oral pill medication to replace IV injections;
260963 - this relieved pain that has been increasing using IV catheters set on
260964 - Wednesday, ref SDS 33 PQPX, and also eliminated need to replace IV
260965 - catheters per TCU protocol. ref SDS 33 7Q55  Doctors prescribed hiking
260966 - to recover from Heller Myotomy surgery resolving achalasia.
260967 - ref SDS 33 7Q6P   Doctor Ratcliff and Neil visit and discussing doing a
260968 - small business trial to apply SDS technology for upgrading VA and UCSF
260969 - case management. ref SDS 33 0M6S  Nurse advises that patient approved
260970 - for moving to a ward for non-critical care, as a predicate to
260971 - discharge, but since there are no rooms available, patient will remain
260972 - in TCU untill a room is available. ref SDS 33 0M8S
260974 -  ..
260975 - On 091220 0527 discharge approved from hospital today. ref SDS 34 PP8W
260976 - Left the hospital about 1220. ref SDS 34 HB5O
260978 -  ..
260979 - On 091221 1532 Isagani called to schedule meeting with Doctor Stewart
260980 - at VA in San Francisco on 100105. ref SDS 35 PP8W
260982 -  ..
260983 - On 091222 1109 letter from Isagana says meeting with Doctor Stewart is
260984 - scheduled on 100112 1400. ref SDS 36 PP8W
260986 -  ..
260987 - On 091223 1452 letter came in regular mail scheduling a meeting with
260988 - Doctor Stewart on 100105 1400. ref SDS 37 PP8W
260990 -  ..
260991 - On 100104 0930 met with Doctor Sandhu to begin care for heart surgery
260992 - and follow up on Heller Myotomy surgery to recover from achalasia.
260993 - ref SDS 0 PP8W
260994 -
260995 -
260996 -
260998 -  ..
2610 -
2611 -
2612 - Progess
2613 -
261301 - Met with Doctor Sandhu at the VA in Martinez, to follow up prior
261302 - meeting at VA in Martinez with Doctor Egan on 091002 0900. ref SDS 14
261303 - 1W5I
261305 -  ..
261306 - Doctor Sandhu indicated patient demonstrates good recovery from heart
261307 - surgery on 091022, ref SDS 16 PQWU, and Heller Myotomy surgery to
261308 - recover from achalasia, performed at VA in San Francisco on 091216.
261309 - ref SDS 30 KE8T
261311 -  ..
261312 - Reviewed current medications listed in discharge medical record
261313 - received from VA on 091220 0527. ref SDS 34 1Q6P
261315 -  ..
261316 - Advised Doctor Sandhu the only medications currently taking are...
261317 -
261318 -        1.  Metoprolol Tartrate..................... 25 MG
261319 -
261320 -            Take one half tablet twice per day, that controls heart
261321 -            rate and blood pressure. 091220 0527, ref SDS 34 OX9Q
261323 -             ..
261324 -        2.  Simvastatin............................. 20 MG
261325 -
261326 -            Take one tablet every day for cholesterol.
261328 -  ..
261329 - Working to increase exercise in order to elminate need for Metoprolol
261330 - to control heart rate and blood pressure.
261332 -  ..
261333 - Scheduled follow up in 6 months to check cholesterol, which was
261334 - checked previously on 091002 0900. ref SDS 14 LJ5H
261336 -  ..
261337 - Research on cholesterol also reported on 091002 0900. ref SDS 14 2F8K
261339 -  ..
261340 - Can get blood draw any time prior to meeting in July.
261341 -
261342 -            [On 100610 1046 lab blood test for cholesterol, at VA,
261343 -            ref SDS 40 JE4I; and scheduled meeting with Doctor Sandhu
261344 -            for 100722 0830.
261346 -  ..
261347 - The doctor ordered vacination for Swine Flue, H1N1, which was
261348 - performed today, before leaving the VA Clinic.
261349 -
261350 -            [On 101223 1030 received another vaccination for H1N1 flu.
261351 -            ref SDS 42 OR6H
261352 -
261353 -
261354 -
261355 -
261356 -
2614 -

SUBJECTS
SDS Commend Record Understand Patient History Saves Lives Time Money

4403 -
440401 -  ..
440402 - SDS Record Patient History Saves Time Money Health Care
440403 -
440404 - Doctor Sandhu advised that he followed treatment with heart bypass
440405 - surgery on 091022 to relieve chest pain, and later Heller Myotomy
440406 - surgery on 091216 to resolve achalasia swallowing problems, performed
440407 - at the VA Medical Center in San Francisco, with copies of
440408 - corresondence to the medical team linked to patient history presented
440409 - in the SDS record, per above. ref SDS 0 5R5H
440410 -
440411 -        [On 100610 1327 Jennifer at Kaiser Member Case Resolution
440412 -        Center reported SDS well ordered record on Internet makes
440413 -        understanding complex patient history fast and easy.
440414 -        ref SDS 41 XL76
440416 -  ..
440417 - He feels using the Internet in this case provides efficient
440418 - communication to coordiate across VA jurisdictions.  The doctor
440419 - described navigating in patient history on the Internet is pretty
440420 - slick.
440422 -  ..
440423 - This implements the doctor/patient partnership model used at Kaiser
440424 - and UCSF the past 9 years supporting Millie's recovery from stage V
440425 - cancer.  Doctor Sandhu's experience reported today getting timely and
440426 - accurate patient history aligns with Doctor Rugo's comments at UCSF on
440427 - 090616 1245, ref SDS 12 8G6M, and previously on 080403 0900.
440428 - ref SDS 10 4U9O
440429 -
440430 -        [On 101223 1030 Doctor Sandhu accessed case study to monitor
440431 -        consistent use of medication, and found exercise and vitals
440432 -        meet objectives for health care through doctor patient
440433 -        partnership. ref SDS 42 SE79
440434 -
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440436 -
440437 -
440438 -
440439 -
440440 -
4405 -