Welch Company
San Francisco, CA
S U M M A R Y
DIARY: December 6, 2010 03:42 PM Monday;
Rod Welch
VA agenda meeting Doctor Lee prepare EGD test Dec 10th.
1...Summary/Objective
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CONTACTS
SUBJECTS
Agenda Meeting 101207 Planning EGD Test Schedule 101210 Doctor Lee G
6103 -
6103 - ..
6104 - Summary/Objective
6105 -
610501 - Follow up ref SDS 5 0000.
610502 -
610503 -
610505 - ..
6106 -
6107 -
6108 - Progress
6109 -
610901 - Sent letter to Kim for Doctor Lee saying...
610902 -
610903 - 1. Subject: Agenda Meeting Doctor Lee Dec 7th Prepare EGD Dec 10
610904 - Date: Mon, 06 Dec 2010 16:13:22 -0800
610913 - ..
610914 - 2. Agenda for meeting tomorrow...
610916 - ..
610917 - 1. Have regularized taking prescribed Omeprazole with dose
610918 - doubled on 100827, as shown in case study on 101010.
610919 - ref SDS 4 QJ5I
610921 - ..
610922 - The journal tracks medication, exercise, and vitals.
610923 - Generally, blood pressure and heart rate seem strong,
610924 - indicating recovery from cabg on 091022.
610925 -
610926 - [On 101207 1000 VA did not have time to review agenda to
610927 - prepare for meeting; used c16 notebook for Doctor Lee to
610928 - guide discussion on agenda, ref SDS 8 IR8G, including
610929 - review patient history in the SDS record on 101010.
610930 - ref SDS 4 QJ5I
610932 - ..
610933 - 2. After EGD test on 100827, when esophagus was dilated,
610934 - swallowing got worse for a day or so, then improved for
610935 - several weeks. Doctor Lee's suggestion on 101012, to break
610936 - open the plastic Omeprazole pills and swallow the small
610937 - pellets in water, has worked well.
610939 - ..
610940 - In the past few weeks beginning on 101123, swallowing has
610941 - increasingly declined, reported in the case study.
610942 - ref SDS 4 BT8N
610944 - ..
610945 - Acid reflux causing throat to swell seems conflicting with
610946 - so little food getting into the stomach.
610947 -
610948 - [On 101207 1000 Doctor Lee seemed to indicate rising
610949 - problems swallowing reported beginning on 101123, set
610950 - out in case study on 101010, ref SDS 4 BT8N, shows
610951 - progress healing esophagitis, which when complete will
610952 - relieve swallowing problems. ref SDS 8 WH4N
610954 - ..
610955 - [On 101210 0930 Doctor Lee dilated esophageal sphincter
610956 - from 11 to 14 mm, and doubled dose for Omperazole 80 mg
610957 - per day, to relieve swallowing problem, ref SDS 9 BF6L;
610958 - and VA medical chart shows Recommendations doubling
610959 - Omeprazole. ref SDS 9 XT5N
610961 - ..
610962 - By copy notifying Doctor Stewart's team that swallowing now
610963 - seems regressed to level prior to Heller Myotomy surgery at
610964 - the Medical Center on 091216. ref SDS 1 KE9U
610966 - ..
610967 - Good news - despite increase in vomiting, can still sleep
610968 - laying down in bed, rather than sitting up in a chair, as
610969 - in years prior to surgery on 091216.
610971 - ..
610972 - 3. Salt intake has been presented as possibly bloating the
610973 - throat, causing increased vomiting problem [...discussed in
610974 - the record on 101130 0400. ref SDS 6 GP5N...] Doctor Lee
610975 - can comment in the meeting tomorrow.
610976 -
610977 - [On 101207 1000 Doctor Lee indicted excessive salting
610978 - food not likely to compound swelling esophagus that
610979 - restricts swalloing. ref SDS 8 PD6O
610981 - ..
610982 - 4. Beginning 101130, sick with something causing initial
610983 - sneezing and congestion. Entire body ached for days. Temp
610984 - 100, but only for a day. Sneezing and aching subsided days
610985 - ago, but congestion continues, although today (right now)
610986 - seem fine. Took two aspirin yesterday. Relieving
610987 - congestion caused bloody nose, very messy, as reported in
610988 - case study on medication, exercise, vitals, and swallowing,
610989 - shown in the record on 101010. ref SDS 4 EE6J
610991 - ..
610992 - [On 101223 1030 Doctor Sandhu diagnosed flu symptoms
610993 - caused by excessive exercise cutting down 10 pine trees.
610994 - ref SDS 10 KI5J
610996 - ..
610997 - Actually, was similarly sick earlier on 101103, but that
610998 - only lasted a day or so - no bloody nose.
611000 - ..
611001 - Concern is WBC has been 11 +/- for years, and never got
611002 - sick. Lab on 100721 reported sudden severe drop to WBC
611003 - 7.3. ref SDS 2 X19J
611005 - ..
611006 - Meeting is scheduled with Doctor Sandhu in Primary Care on
611007 - 101223 to review lab, so will get blood draw tomorrow.
611008 - Results may be available to discuss for EGD on 101210.
611009 - Hoping WBC has not further declined signaling some new
611010 - issue, with rising exposure to infection and virus.
611012 - ..
611013 - [On 101207 0906 blood draw for lab to prepare for
611014 - meeting with Doctor Lee on 101210, and Doctor Sandhu on
611015 - 101223. ref SDS 7 PP8W
611017 - ..
611018 - 5. VA has begun making the medical chart available to patients
611019 - on a CD, which provides excellent communication on case
611020 - management, e.g., see the record on 100827. ref SDS 3 LB6J
611022 - ..
611023 - 3. Looking forward to meeting tomorrow.
611024 -
611030 -
611031 -
611032 -
611033 -
611034 -
611035 -
611036 -
611037 -
611038 -
611039 -
6111 -