CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 42 0000. ref SDS 41 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 091103 Paula reported the VA has scheduled a meeting today with
040902 - Doctor Stewart for planning Heller Myotomy surgery to correct
040903 - achalasia problem. ref SDS 20 PS60  On 091104 0718 Medical Chart
040904 - discharge guidance lists meeting with Doctor Stewart 091117 1300,
040905 - which conflicts with patient history today. ref SDS 21 Q03J  On 091119
040906 - 1000 Erick confirmed visit with Doctor Stewart on 091208, and is
040907 - reviewing date of surgery scheduled for 091217. ref SDS 23 935H
040909 -  ..
040910 - On 091208 Doctor Stewart advanced the schedule for surgery one day to
040911 - 091216. ref SDS 25 6E41
040913 -  ..
040914 - On 091216 0600 meeting Doctor Stewart for Heller Myotomy surgery to
040915 - correct achalasia; check in at ASU. ref SDS 29 PP8W
040917 -  ..
040918 - On 091217 0600 meeting with Joe and Jon on recovring from Heller
040919 - Myotomy surgery; report of complication during surgery on 091216,
040920 - which was repaired, with plan for test to evaluate recovery. reported
040921 - on 091217 0600, ref SDS 30 0042  Doctor Stewart visited and expects
040922 - can start eating after favorable test. ref SDS 30 027A
040924 -  ..
040925 - On 091218 0600 xray with gastrogafin to evaluate repair for
040926 - complicaiton during Heller Myotomoy surgery Wednesday, ref SDS 31 PP8W,
040928 -  ..
040929 - On 091219 0600 doctor plans discharge tomorrow after evaluating
040930 - progress eating solid food today. ref SDS 32 PP5V  Since now eating
040931 - solid food, switched to oral pill medication to replace IV injections;
040932 - this relieved pain that has been increasing using IV catheters set on
040933 - Wednesday, ref SDS 32 PQPX, and also eliminated need to replace IV
040934 - catheters per TCU protocol. ref SDS 32 7Q55  Doctors prescribed hiking
040935 - to recover from Heller Myotomy surgery resolving achalasia.
040936 - ref SDS 32 7Q6P   Doctor Ratcliff and Neil visit and discussing doing a
040937 - small business trial to apply SDS technology for upgrading VA and UCSF
040938 - case management. ref SDS 32 0M6S  Nurse advises that patient approved
040939 - for moving to a ward for non-critical care, as a predicate to
040940 - discharge, but since there are no rooms available, patient will remain
040941 - in TCU untill a room is available. ref SDS 32 0M8S
040943 -  ..
040944 - On 091220 0527 discharge approved from hospital today. ref SDS 33 PP8W
040945 - Left the hospital about 1220. ref SDS 33 HB5O
040947 -  ..
040948 - On 091221 1532 Isagani called to schedule meeting with Doctor Stewart
040949 - at VA in San Francisco on 100105. ref SDS 34 PP8W
040951 -  ..
040952 - On 091222 1109 letter from Isagani says meeting with Doctor Stewart is
040953 - on 100112 1400, not Jan 5th; possibly there are 2 meetings scheduled.
040954 - ref SDS 35 J57K
040956 -  ..
040957 - On 091223 1452 VA letter says meeting with Doctor Stewart scheduled on
040958 - 100105 1400, ref SDS 36 PP8W
040960 -  ..
040961 - On 091228 1049 letter to VA asks Isagani to clarify date for meeting
040962 - with Doctor Stewart, and whether there are two (2) meetings?
040963 - ref SDS 37 PP8W
040965 -  ..
040966 - On 091228 1418 letter from Isagani says meeting with Doctor Stewart is
040967 - on 100105, and there is only 1 meeting scheduled, not 2. ref SDS 38
040968 - PP8W
040970 -  ..
040971 - On 100104 0930 met with Doctor Sandhu to begin care for heart surgery
040972 - and follow up on Heller Myotomy surgery to recover from achalasia.
040973 - ref SDS 39 PP8W
040975 -  ..
040976 - On 100105 1300 meeting with Jan and Doctor Stewart; examination finds
040977 - good progress recovering from Heller Myotomy surgery on 091216, and
040978 - procedure seems effective resolving achalasia problem, swallowing
040979 - improved. ref SDS 41 PP8W
040981 -  ..
040982 - On 100127 1210 submitted agenda in a letter to the medical team for
040983 - the meeting at the VA in Martinez scheduled for 100202; primary
040984 - objective to evaluate recovery from achalasia following Heller Myotomy
040985 - surgery at the VA in San Fancisco on 091216 0700. ref SDS 42 PP8W
040987 -  ..
040988 - On 100202 1400 met with Doctor Lee in GI Department VA Martinez, and
040989 - to follow up heart surgery and Heller Myotomy surgery to recover from
040990 - achalasia. ref SDS 43 PP8W
040992 -  ..
040993 - On 100301 0418 notified medical team at VA that fibrilliation
040994 - occurred, ref SDS 0 5T8Q, and asks about vaccination for shingles.
040995 - ref SDS 0 5T9W
040996 -
040997 -
040999 -  ..
0410 -
0411 -
0412 - Progess
0413 -
041301 - Letter to medical team says...
041302 -
041303 -    1.  Subject: Heart Fibrillation Vaccine for Shingles
041304 -        Date: Mon, 01 Mar 2010 04:23:35 -0800
041314 -         ..
041315 -    3.  This is an update from the meeting with Doctor Lee at VA
041316 -        Martinez on 100202. ref SDS 43 PP8W
041318 -         ..
041319 -    4.  I am scheduled for endoscopy and colonoscopy on Friday, 100305
041320 -        1000.  This is preventive maintenance.  No symptoms of anything
041321 -        at this time.  Doctor Lee wants to check for cancer,
041322 -        ref SDS 43 5K6I, now that Heller Myotomy surgery has been done,
041323 -        thanks to Doctor Stewart on 091216, ref SDS 29 4M5T, and with
041324 -        Doctor Ratcliffe's leadership on 091030. ref SDS 17 03GF
041326 -         ..
041327 -    5.  For Doctor Stewart, swallowing seems about 80%, which is a huge
041328 -        improvement.  Formerly reported 90%, but that may be
041329 -        optimistic, since occasionally, will throw up a lot of stuff.
041330 -        It is a great relief to lie down in bed, rather than sitting up
041331 -        in a chair for sleep.  So, esophageal surgery has been a big
041332 -        success.
041334 -         ..
041335 -    6.  Occasionally, and specifically this morning about 0330, I
041336 -        experienced what seems like heart fibrillation when lying down.
041337 -        Since I just noticed it I got up to report the issue.  Seems
041338 -        similar to a-fib that occurred twice after heart surgery on
041339 -        091022.  The body rocks noticeably back and forth.  No pain.
041340 -        Checked vitals: BP 133 77 HR 72, so nothing remarkable.
041342 -  ..
041343 - Need to also ask about dose of aspirin.  Current prescription is for
041344 - 325 mg, reported on 091104 0718. ref SDS 21 414R
041346 -  ..
041347 - Some authorities discuss half that amount to reduce risk of stomach
041348 - problems, while benefiting from safety for heart and circulatory
041349 - function.
041351 -  ..
041352 - Letter to VA continues...
041353 -
041354 -    7.  A few weeks ago I noticed what seemed like slight pressure in
041355 -        the chest.  This dissipated the next day.  Seems like it has
041356 -        occurred previously, but have not kept a record.  This is not
041357 -        like pain experienced when hiking last September, leading to
041358 -        heart surgery.  May be my imagination.
041360 -         ..
041361 -    8.  Have felt nothing when hiking.  Yesterday did 5.5 miles, and
041362 -        today planning on 3 laps, 8.25 miles; we'll see how that goes.
041363 -        As reported previously heart rate has stayed mostly below 150,
041364 -        even with a fast pace, though yesterday it jumped to 166 for
041365 -        the first time since the surgery.  Recall, prior to surgery
041366 -        heart rate would max out at 200+ on going up hills with fast
041367 -        pace.  So, I am still significantly better than prior
041368 -        performance.
041370 -         ..
041371 -    9.  Breathing is also improving,  Numbness in lower right led is
041372 -        mostly recovered.  So, on most issues seem to be doing well.
041374 -         ..
041375 -   10.  On breathing -- now seems likely that prior symptoms which were
041376 -        reported as being out of shape, were probably heart pain.  I
041377 -        have breathing problems now, and they are not like symptoms
041378 -        that occurred for several years prior to surgery, and then
041379 -        increased last September.  Previously, the pain would subside
041380 -        after half a lap, which gave the impression of correlation with
041381 -        conditioning.
041383 -         ..
041384 -   11.  On another matter, Millie was diagnosed with shingles on
041385 -        100104, ref SDS 40 BW8I, and required 3 10-day treatments.  She
041386 -        relapsed last week, and so is back on treatment.  Research
041387 -        indicates folks over 60 are at higher risk, ref SDS 40 PS4J,
041388 -        and there is a vaccine to reduce this risk.  I don't know if
041389 -        proximity is another risk factor. ref SDS 40 5D3J
041391 -         ..
041392 -   12.  Please let me know if vaccine for shingles should be considered
041393 -        in my case.
041394 -
041395 -            [On 100301 0942 Doctor Stewart's assistant, Isagani,
041396 -            recommends discussing vaccination for shingles with primary
041397 -            care physician. ref SDS 44 PP8W
041399 -             ..
041400 -            [On 100302 0830 during meeting at Kaiser in Walnut Creek,
041401 -            Doctor Johnson recommends consideration of vaccination
041402 -            against shingles for care givers because Millie has a
041403 -            severe case of shingles. ref SDS 45 GS5J
041405 -             ..
041406 -            [On 100305 1000 Doctor Lee did not get a copy of the report
041407 -            to the medical team on 100301, ref SDS 0 5T9W, and which
041408 -            asked about vaccination for shingles. ref SDS 46 GP6O
041409 -            Doctor Lee ordered vaccination for shingles, and this was
041410 -            done by Evelyn at 1517. ref SDS 46 GT5G
041411 -
041418 -
041419 -
041420 -
041421 -
041422 -
041423 -
041424 -
0415 -