CONTACTS 

SUBJECTS
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7003 -
7003 -    ..
7004 - Summary/Objective
7005 -
700501 - Follow up ref SDS 7 039G.
700502 -
700503 -
700505 -  ..
7006 -
7007 -
7008 - Progress
7009 -
700901 - This morning drove to the GI Clinic at the VA in Martinez to speak
700902 - with Kim, Jennifer, or Kendall to clarify and /or confirm Jennifer's
700903 - telephone message received Friday afternoon, seeming to say Doctor Lee
700904 - approved getting the EGD test at the GI Clinic at the VA Medical
700905 - Center in San Francisco, reported on 101112 0952, ref SDS 7 039G, and
700906 - in order to solve the driver problem presented in the letter to the
700907 - medical team on 101108 0929. ref SDS 4 6X3P
700909 -  ..
700910 - The clinic was packed.  There was a long line at the patient counter.
700911 - Did not stay, since it would have taken over an hour to get to the
700912 - counter, and the administrative issue would have taken medical staff
700913 - time away from patients who need care.
700915 -  ..
700916 - In the afternoon, called VA Clinic Martinez to confirm telephone
700917 - message from Jennifer last Friday on 101112 0952. ref SDS 7 4R4U
700919 -  ..
700920 - They closed at 1630, so missed them by 10 seconds.
700921 -
700922 -
700923 -
7010 -

SUBJECTS
Atrial Fibrillation A-fib Causes Strokes Death Television Commercial

A103 -
A10401 -  ..
A10402 - Atrial Fibrillation a-fib Causes Strokes Death
A10403 - Strokes Death Atrial Fibrillation a-fib Causes
A10404 -
A10405 - Just now there was an advertisement on television that seemed to say
A10406 - atrial fibrillation (a-fib) can cause strokes, so decided to follow up
A10407 - the letter asking about recent a-fib events, submitted on 101105 2223.
A10408 - ref SDS 3 755I, and follow up with another letter on 101110 1115.
A10409 - ref SDS 5 TT5G
A10411 -  ..
A10412 - Research on the Internet does not list chest rocking back and forth as
A10413 - symptom of a-fib (see below, ref SDS 0 RD4L).
A10415 -  ..
A10416 - Called Karen at the VA Cardiology Department Medical Center...
A10417 -
A10418 -                     415 221 4810 ext 3181
A10420 -  ..
A10421 - Got the number from her letter on 091006 0843. ref SDS 1 7M6R
A10423 -  ..
A10424 - Left a message asking Karen to facilitate communication with the
A10425 - medical team on letters reporting possible a-fib events 1-year post
A10426 - cabg, initially on 101105 2223, ref SDS 3 755I, and follow up letter
A10427 - last week on 101110 1216. ref SDS 6 755I
A10428 -
A10429 -            [On 101117 0530 met with VA Medical Center San Francisco
A10430 -            Module #1; Neil has left cardiothoriacic surgery team;
A10431 -            Ramone advised letters on 101105, and follow up 101110,
A10432 -            were forwarded to Michael Byrd in General Surgery on 3rd
A10433 -            Floor. ref SDS 8 PPWU
A10435 -  ..
A10436 - Research on the Internet found...
A10437 -
A10438 -    1.  Emedicinehealth
A10439 -
A10440 -                  http://www.emedicinehealth.com/atrial_fibrillation/article_em.htm#Atrial%20Fibrillation%20Overview
A10442 -             ..
A10443 -        Atrial Fibrillation Overview
A10445 -             ..
A10446 -        1.  Atrial fibrillation describes an irregular and often rapid
A10447 -            heart rhythm.  The irregular rhythm, or arrhythmia...
A10448 -
A10449 -                  http://www.emedicinehealth.com/script/main/art.asp?articlekey=2328
A10450 -
A10451 -            ...results from abnormal electrical impulses in the heart.  The irregularity
A10452 -            can be continuous, or it can come and go.
A10454 -             ..
A10455 -        2.  Normal heart contractions begin as an electrical impulse in the right atrium.
A10456 -            This impulse comes from an area of the atrium called the sinoatrial (SA) or
A10457 -            sinus node, the "natural pacemaker."
A10458 -
A10459 -                  http://www.emedicinehealth.com/script/main/art.asp?articlekey=19483
A10460 -
A10462 -                 ..
A10463 -            1.  As the impulse travels through the atrium, it produces
A10464 -                a wave of muscle contractions.  This causes the atria
A10465 -                to contract.
A10467 -                 ..
A10468 -            2.  The impulse reaches the atrioventricular (AV) node in
A10469 -                the muscle wall between the 2 ventricles.  There, it
A10470 -                pauses, giving blood from the atria time to enter the
A10471 -                ventricles.
A10473 -                 ..
A10474 -            3.  The impulse then continues into the ventricles, causing
A10475 -                ventricular contraction that pushes the blood out of
A10476 -                the heart, completing a single heartbeat.
A10478 -             ..
A10479 -        3.  In a person with a normal heart rate and rhythm the heart
A10480 -            beats 50-100 times per minute.
A10481 -
A10482 -            1.  If the heart beats more than 100 times per minute, the
A10483 -                heart rate is considered fast (tachycardia).
A10484 -
A10485 -                    http://www.emedicinehealth.com/script/main/art.asp?articlekey=5698
A10487 -                 ..
A10488 -            2.  If the heart beats less than 50 times per minute, the
A10489 -                heart rate is considered slow (bradycardia).
A10490 -
A10491 -                    http://www.emedicinehealth.com/script/main/art.asp?articlekey=2515
A10493 -             ..
A10494 -        4.  In atrial fibrillation, multiple impulses travel through the atria at the same
A10495 -            time.
A10496 -
A10497 -            1.  Instead of a coordinated contraction, the atrial
A10498 -                contractions are irregular, disorganized, chaotic, and
A10499 -                very rapid.  The atria may contract at a rate of
A10500 -                400-600 per minute.
A10502 -                 ..
A10503 -            2.  These irregular impulses reach the AV node in rapid
A10504 -                succession, but not all of them make it past the AV
A10505 -                node.  Therefore, the ventricles beat slower, often at
A10506 -                rates of 110-180 beats per minute in an irregular
A10507 -                rhythm.
A10509 -                 ..
A10510 -            3.  The resulting rapid, irregular heartbeat causes an
A10511 -                irregular pulse and sometimes a sensation of fluttering
A10512 -                in the chest.
A10514 -             ..
A10515 -        5.  Atrial fibrillation can occur in several different patterns.
A10516 -
A10517 -            1.  Intermittent (paroxysmal): The heart develops atrial
A10518 -                fibrillation and typically converts back again
A10519 -                spontaneously to normal (sinus) rhythm.  The episodes
A10520 -                may last anywhere from seconds to days.
A10522 -                 ..
A10523 -            2.  Persistent: Atrial fibrillation occurs in episodes, but
A10524 -                the arrhythmia does not convert back to sinus rhythm
A10525 -                spontaneously.  Medical treatment is required to end
A10526 -                the episode.
A10528 -                 ..
A10529 -            3.  Permanent: The heart is always in atrial fibrillation.
A10530 -                Conversion back to sinus rhythm either is not possible
A10531 -                or is deemed not appropriate for medical reasons.
A10533 -             ..
A10534 -        6.  Atrial fibrillation, often called A Fib, is a very common heart rhythm
A10535 -            disorder.
A10536 -
A10537 -            1.  It affects about 1% of the population, mostly people
A10538 -                older than 50 years.  This amounts to more than 2
A10539 -                million people.
A10541 -                 ..
A10542 -            2.  The risk of developing atrial fibrillation increases as
A10543 -                we get older.  About 5% of people older than 80 years
A10544 -                have atrial fibrillation.
A10546 -             ..
A10547 -        7.  For many people, atrial fibrillation may cause symptoms but
A10548 -            does no harm.
A10549 -
A10550 -            1.  Complications can arise, but appropriate treatment
A10551 -                reduces these risks.
A10552 -
A10553 -            2.  If treated properly, atrial fibrillation rarely causes
A10554 -                serious or life-threatening problems.
A10556 -         ..
A10557 -        Symptoms....
A10558 -
A10559 -        1.  Symptoms of atrial fibrillation vary from person to
A10560 -            person.
A10561 -
A10562 -            1.  A number of people have no symptoms.
A10564 -                 ..
A10565 -            2.  The most common symptom in people with intermittent
A10566 -                atrial fibrillation is palpitations...
A10567 -
A10568 -                    http://www.emedicinehealth.com/script/main/art.asp?articlekey=58684
A10569 -
A10570 -                ...a sensation of rapid or irregular heartbeat.  This
A10571 -                may make some people very anxious.  Many people also
A10572 -                describe an irregular fluttering sensation in their
A10573 -                chests.
A10575 -                 ..
A10576 -            3.  Some become light-headed or faint.
A10578 -                 ..
A10579 -            4.  Other symptoms include weakness, lack of energy or
A10580 -                shortness of breath with effort, and chest pain.
A10582 -         ..
A10583 -        Causes A-fib....
A10585 -         ..
A10586 -        Atrial fibrillation frequently occurs after cardiothoracic
A10587 -        (open heart) surgery, but often resolves in a few days.
A10589 -  ..
A10590 - This was experience on 091024, 2-days after heart surgery, ref SDS 2
A10591 - HR7G; evident physicial symptom however was upper body chest rocking
A10592 - left and right (swaying). 091024 0600, ref SDS 2 HR8O
A10594 -         ..
A10595 -    2.  Wikipedia
A10596 -
A10597 -                  http://en.wikipedia.org/wiki/Atrial_fibrillation
A10599 -         ..
A10600 -        Atrial fibrillation is often asymptomatic and is not in itself
A10601 -        generally life-threatening, but it may result in palpitations,
A10602 -        fainting, chest pain, or congestive heart failure.  People with
A10603 -        AF usually have a significantly increased risk of stroke (up to
A10604 -        7 times that of the general population).  Stroke risk increases
A10605 -        during AF because blood may pool and form clots in the poorly
A10606 -        contracting atria and especially in the left atrial appendage
A10607 -        (LAA).[5] The level of increased risk of stroke depends on the
A10608 -        number of additional risk factors.  If a person with AF has
A10609 -        none, the risk of stroke is similar to that of the general
A10610 -        population.[6] However, many people with AF do have additional
A10611 -        risk factors and AF is a leading cause of stroke.[7]
A10613 -         ..
A10614 -        Symptoms...
A10616 -         ..
A10617 -        Atrial fibrillation is usually accompanied by symptoms related
A10618 -        to a rapid heart rate.  Rapid and irregular heart rates may be
A10619 -        perceived as palpitations, exercise intolerance, and
A10620 -        occasionally produce angina (if the rate is faster and puts the
A10621 -        heart under strain) and congestive symptoms of shortness of
A10622 -        breath or edema.  Sometimes the arrhythmia will be identified
A10623 -        only with the onset of a stroke or a transient ischemic attack
A10624 -        (TIA).  It is not uncommon for a patient to first become aware
A10625 -        of AF from a routine physical examination or ECG, as it may be
A10626 -        asymptomatic in many cases.[8]
A10628 -         ..
A10629 -        As most cases of atrial fibrillation are secondary to other
A10630 -        medical problems, the presence of chest pain or angina,
A10631 -        symptoms of hyperthyroidism (an overactive thyroid gland) such
A10632 -        as weight loss and diarrhea, and symptoms suggestive of lung
A10633 -        disease would indicate an underlying cause.  A previous history
A10634 -        of stroke or TIA, as well as hypertension (high blood
A10635 -        pressure), diabetes, heart failure and rheumatic fever, may
A10636 -        indicate whether someone with AF is at a higher risk of
A10637 -        complications
A10638 -
A10639 -
A10640 -
A10641 -
A10642 -
A10643 -
A10644 -
A107 -