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: March 2, 2010 03:03 PM Tuesday; Rod Welch

Ed diagnosed with lung cancer, pneumonia, and nerve injury to back.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Birthday 65th Congratulations Fond Memories Growing Up Cupertino Fam

0703 -
0703 -    ..
0704 - Summary/Objective
0705 -
070501 - Follow up ref SDS 17 0000. ref SDS 16 0000.
070502 -
070503 -
070504 -
070505 -
070507 -  ..
0706 -
0707 -
0708 - Background
0709 -
070901 - On 100211 0752 letter sending congratulations and wishing Rob Happy
070902 - Birthday on reaching 65. ref SDS 11 6I6I
070904 -  ..
070905 - On 100211 1438 received letter from Rob saying he has had a good life,
070906 - and has had minimal health problems, ref SDS 12 6I6I, and reporting he
070907 - got married last year. ref SDS 12 4P56
070909 -  ..
070910 - On 100217 1952 called Ed and Kathy, Ed has been sick since October.
070911 - Yesterday on 100217 Kathy took Ed to the Emergency Care Department at
070912 - the VA.  He was diagnosed with pneumonia. ref SDS 13 6I6I
070914 -  ..
070915 - On 100218 0009 letter to Ed and Kathy with background on working with
070916 - VA the past 5 years. ref SDS 14 6I6I
070918 -  ..
070919 - On 100218 1302 letter from Eddie presents plans to notify of progress
070920 - in his care at the VA in Sacramento. ref SDS 15 6I6I
070922 -  ..
070923 - On 100301 0253 received letter from Kathy dated 100228 reporting Ed
070924 - hospitalized at VA in Sacramento; required treatment in Emergency Care
070925 - Department to control pain. ref SDS 16 6I6I
070927 -  ..
070928 - On 100301 0313 letter thanks Kathy for update on Ed; sent copies to
070929 - family members.  Ask Kathy for phone number in hospital for Ed.
070930 - ref SDS 17 6I6I
070932 -  ..
070933 - On 100302 1506 Kathy reports Ed diagnosed with lung cancer; he is
070934 - getting treatment for pain, and so can sleep better now. ref SDS 0
070935 - 6I6I
070936 -
070937 -
070938 -
070939 -
070941 -  ..
0710 -
0711 -
0712 - Progress
0713 -
071301 - Letter from Kathy says...
071302 -
071303 -    1.  Subject: Re: Ed admitted to hospital
071304 -        Date: Tue, 2 Mar 2010 21:08:20 +0000 (UTC)
071311 -         ..
071312 -    2.  CT test yesterday shows Ed has lung cancer.
071314 -         ..
071315 -    3.  Today they did did a biopsy on a lymph node just above his
071316 -        right collar bone and said they got the specimen they needed to
071317 -        prevent the necessity of doing a broncoscopy which Ed was
071318 -        needless to say anxious about.
071319 -
071320 -            [...called Ed at hosptial and discussed details on
071321 -            prospects for recovery. ref SDS 0 PK8I; medical team
071322 -            planning bronscopy afterall, with work performed at UC
071323 -            Davis Medical School, and to include placing a stint to
071324 -            relieve pain from irritation to a nerve. ref SDS 0 OJ4N
071326 -         ..
071327 -    4.  A tumor in his left lower lung was obscured on xray by the
071328 -        infection in his lung.  The doctor said it has probably been
071329 -        there for quite some time.
071331 -         ..
071332 -    5.  He has many peolpe looking after him, ready to evaluate all the
071333 -        info and move forward with a plan.
071335 -         ..
071336 -    6.  Somehow I do not have your phone#.
071337 -
071338 -            [...below, called Kathy and gave her the phone #.
071339 -            ref SDS 0 PK8S
071345 -         ..
071346 -    8.  E does feel much better coughing and breathing wise but he
071347 -        still has a great deal of pain in his back on the right side
071348 -        which the pulmonary doctor said was because the infectionn was
071349 -        in the plueral space which could cause supreme pain.  They are
071350 -        attempting to adjust the medication to make him comfortable.
071352 -         ..
071353 -    9.  He did get the Toradol and Morphine last night and a sleeping
071354 -        pill and got his first solid sleep in probably two months and
071355 -        he looked like it too.  Going to get some stuff done here at
071356 -        home and go back to see  him this afternoon.
071357 -
071361 -
071362 -
071364 -  ..
0714 -
0715 -
0716 - 1515
0717 -
071701 - Called Kathy at home.  Gave her the phone number in Concord.
071713 -  ..
071714 - Though disappointed the VA missed the main problem of lung cancer, and
071715 - injury to a spinal nerve, when Ed was hospitalized 2 weeks ago, Ed and
071716 - Kathy are greatly relieved that the medical team has finally diagnosed
071717 - problems causing his pain and suffering the past few months.
071719 -  ..
071720 - Kathy will get a pad of paper and pen, so he can support the medical
071721 - team with comprehensive understanding of patient history.
071723 -  ..
071724 - Good to hear that the VA in Sacramento has contracted out to UC Davis
071725 - medical school for doctors and interns to treat patients.  This was
071726 - shown to be very effective getting treatment at the VA Medical Center
071727 - in San Francisco, where doctors are contracted from UCSF.
071728 -
071729 -
071730 -
071731 -
071733 -  ..
0718 -
0719 -
0720 - 0644
0721 -
072101 - Called and talked to Ed at the hospital.  Kathy was with him in the
072102 - hospital room.
072104 -  ..
072105 - Ed had a lot of meetings today with a wide range of medical
072106 - specialists.
072108 -  ..
072109 - Sounded like the team has determined Ed's severe pain the past few
072110 - months has been caused by liquid buildup, possibly from pneumonia
072111 - driven by infection from dental problems, and which creates pressure
072112 - that irritates a major spinal nerve.
072114 -  ..
072115 - Ed seemed to say that the medical team has decided to perform a
072116 - broncoscopy, after initially indicating the biopsy on supraclavicular
072117 - would avoid need for this procedure, per Kathy's letter this morning,
072118 - shown above. ref SDS 0 W64H   There has been discussion of performing
072119 - the bronscopy at UC Davis Medical School, and during the procedure a
072120 - stint will be placed to relieve pressure on the nerve that has been
072121 - causing severe pain since last October.
072122 -
072123 -        [On 100303 0233 after PET scan test medical team decided not to
072124 -        use a stint to prevent irritation of the nerve causing severe
072125 -        back pain; plan is that recovery from pneumonia with drugs will
072126 -        reduce fluid and this will resolve pressure on the nerve, also
072127 -        resolving back pain. ref SDS 18 OK9J
072129 -  ..
072130 - Ed will ask for a copy of the blood test on Monday to check on albumin
072131 - and pre-albumin to assess nutrition problems that may be causing
072132 - severe weight loss suffered in recent months.  Better dental condition
072133 - seems essential for digestion to lift and maintain nutrition needed
072134 - for recovery from penumonia and cancer, similar to discussions at VA
072135 - Medical Center in San Francisco on 091029.  At that time, treatment
072136 - for achalsia was essential to improve nutrition for recovery from
072137 - heart surgery. ref SDS 7 RE6J
072139 -  ..
072140 - Tomorrow, Ed will ask the team about addressing dental issues to
072141 - eliminate infection that may be causing or otherwise resisting
072142 - recovery from pneumonia, and further to enable sufficient nutrition
072143 - for recovering from both pneumonia and cancer.
072145 -  ..
072146 - Bad news - diagnosis from CT test yesterday finding lung cancer, and
072147 - with swelled lymph nodes (LNs) in both the left and right
072148 - supraclavicular.  Ed recalled the doctor mentioning LNs on the order
072149 - of 1 cm.
072151 -  ..
072152 - Tomorrow, Ed will ask the doctor for a copy of the report on the CT
072153 - test to see precisely what findings and conclusions are presented.
072155 -  ..
072156 - Good news - Ed seemed to recall someone saying something like "stage
072157 - II."
072159 -  ..
072160 - If the diagnosis is stage II cancer, then even with LNs in the range
072161 - of 1 cm, he has a good chance for achieving remission with adjuvant
072162 - care, based on Millie's 9-year survival of stage IV cancer with LNs
072163 - much larger than 1 cm, and having never achieved remission.
072165 -  ..
072166 - Ed might consider asking the oncologist about prescribing "targeted"
072167 - agents that minimize side effects.  This may be an option down the
072168 - line after adjuvent treatment.
072170 -  ..
072171 - Surgery might also be an option after chemo reduces the size of the
072172 - tumor, assuming cancer is localized, which seems unlikely with spread
072173 - to LNs.  None-the-less, Millie with similar condition of tumor and LNs
072174 - was treated twice with surgery, though ultimately without success in
072175 - her case.
072177 -  ..
072178 - Kathy brought Ed a yellow pad and pen today.  He will begin tracking
072179 - results of meetings, and preparing agendas to support the medical
072180 - team.
072182 -  ..
072183 - Ed has been very pleased with the quality of care.  He concurred with
072184 - Kathy's comment earlier today, per above, that his doctors all have UC
072185 - Davis Medical School identification, per above. ref SDS 0 DG4L
072187 -  ..
072188 - Initial outlines of work plan for Ed's recovery...
072189 -
072190 -        1.  Treatment at UC Davis removing fluid and placing a stint to
072191 -            prevent irritation of a major spinal nerve, and which will
072192 -            relieve severe pain. ref SDS 0 PK91
072193 -
072194 -               [On 100303 0233 after PET scan test medical team decided
072195 -               not to use a stint to prevent irritation of the nerve
072196 -               causing severe back pain; plan is that recovery from
072197 -               pneumonia with drugs will reduce fluid and this will
072198 -               resolve pressure on the nerve, also resolving back pain.
072199 -               ref SDS 18 OK9J
072201 -                ..
072202 -               [On 100304 0742 at 2121 Ed diagnosed with lung cancer
072203 -               that spread to the brain and impacting nerve in his
072204 -               back. ref SDS 19 8R6H
072206 -             ..
072207 -        2.  Recovery from pneumonia, which may require dental work.
072208 -            ref SDS 0 HE3N
072210 -             ..
072211 -        3.  Adjuvant out-patient treatment to recover from stage II
072212 -            lung cancer. ref SDS 0 UQ9K
072214 -  ..
072215 - If all goes well with steps 1 and 2, (relieving irritation to the
072216 - nerve, and recovering from pneumonia), Ed seemed to expect release for
072217 - out-patient care (step 3) in a week or so.
072218 -
072219 -
072220 -
072221 -
072222 -
072223 -
072224 -
072225 -
072226 -
0723 -