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SUBJECTS
VA Pharmacy Order Omeprazole Treat Esophagitis Dose Doubled Prescrip

2803 -
2803 -    ..
2804 - Summary/Objective
2805 -
280501 - Follow up ref SDS 47 0000. ref SDS 42 0000.
280502 -
280503 -
280504 -
280505 -
280507 -  ..
2806 -
2807 -
2808 - Background
2809 -
280901 - EGD on 101210, seems to show progress recovering from esophagitis; the
280902 - doctor dilated the LESV from 11 to 14 cm, reported on 101210 0930,
280903 - ref SDS 49 XG6J
280905 -  ..
280906 - Follow up EGD planned for February, ref SDS 49 L94L.
280908 -  ..
280909 - Doctor Lee prescribed doubling dose of Omeprazole to increse recover
280910 - from esophagitis, reported on 101210 0930. ref SDS 49 ZN4M
280911 -
280912 -
280914 -  ..
2810 -
2811 -
2812 - Progress
2813 -
281301 - There about 8 to 10 days of Omeprazole pills remaining.  On 101210,
281302 - the doctor doubled the dose, ref SDS 49 ZN4M, so need refill.
281304 -  ..
281305 - Ordered refill using VA Internet prescription services, explained in
281306 - the record on 070312 1200. ref SDS 4 749G
281308 -  ..
281309 - VA's pharmacy website lists 2 active medications...
281310 -
281311 -                Refill
281312 -                Submit   Fill     Refills
281313 -                Date     Date     Remaining   Prescription
281314 -
281315 -    1.  Active           101210      3        RX # 10864663
281317 -         ..
281318 -    2.  Active  101105   101105      2        RX # 10831035
281320 -  ..
281321 - The second entry is for Simvastatin, which was refilled as shown in
281322 - the record on 101104 2338. ref SDS 47 TQ5G
281324 -  ..
281325 - Therefore by default, the 1st entry should be Omeprazole, however
281326 - prescription # 10864663 on the VA website does not match the number on
281327 - the bottle......
281328 -
281329 -                         10840294
281331 -  ..
281332 - Since there is no explanation of the scope for prescription #
281333 - 10864663, there is no verification showing this is Omeprazole.
281335 -  ..
281336 - Another VA website shows...
281337 -
281338 -        Prescription number 10864663
281339 -        Fill Date................................. 101210
281340 -        Dispensed On.............................. 101214
281341 -        Refill Status............................. Active
281342 -        Facility.................................. VANCHCSM
281343 -        Ordered On................................ 101210
281344 -        Quantity.................................. 360
281345 -        Refills Remaining......................... 3
281346 -        Expiration Date........................... 111211
281348 -  ..
281349 - This record suggests that Doctor Lee placed an order for Omeprazole
281350 - after the meeting on 101210, and this order created a new prescription
281351 - number, per above. ref SDS 0 Q84L  As a result, the prescription on
281352 - the bottle at the house does not match the number on the VA's website.
281354 -  ..
281355 - Further indicates it is not necessary to place a refill order.
281356 -
281357 -            [...below on 101216 1021 at 1201 letter to VA GI Department
281358 -            in Martinez, requests confirmation that refill on
281359 -            Omeprazole was ordered by the doctor, and that the name for
281360 -            the prescription number on the VA's online pharmacy is for
281361 -            Omeprazole. ref SDS 0 K44P
281363 -             ..
281364 -            [On 101218 1642 stomach pain, fatigue, and severe dry feet
281365 -            with peeling, cracking, and minor bleeding may be related
281366 -            to side effects of Omeprazole increasing dose from 20 to 80
281367 -            mg per day, ref SDS 51 8Q5I, citing case study on 101010
281368 -            0744. ref SDS 46 11Y4
281370 -             ..
281371 -            [On 101219 1402 letter notifies medical team of rising
281372 -            symptoms which may relate to Omeprazole, and requests
281373 -            adjustments in dose, remedial measures. ref SDS 53 5N3O
281375 -  ..
281376 - Would be helpful, for VA website to enter a narrative description of
281377 - the prescription medication to aid understanding on placing refills.
281378 -
281380 -  ..
2814 -
2815 -
2816 - 1201
2817 -
281701 - Submitted letter to medical team saying...
281702 -
281703 -    1.  Subject: Meeting Doctor Lee EGD Dec 10 and Prescription Refill
281704 -        Date: Thu, 16 Dec 2010 12:01:39 -0800
281719 -         ..
281720 -    2.  Excellent work by the team on Dec 10, getting the EGD done
281721 -        without a driver. ref SDS 49 KJ5N
281722 -
281723 -            [On 101223 1030 Doctor Sandhu received a copy of the letter
281724 -            today on 101216 1021, ref SDS 0 K35G, and reported there is
281725 -            no record of work on 101210, as yet posted in the VA
281726 -            medical chart. ref SDS 54 4N4O
281728 -         ..
281729 -    3.  Received a letter from the VA scheduling next EGD procedure on
281730 -        110218 0730. [...reported on 101214 2330. ref SDS 50 ZG7O...]
281731 -        Hopefully, driver issues can be resolved.
281732 -
281733 -            [On 101218 1738 Peggy called with congratulations
281734 -            responding to the letter today on getting EGD without a
281735 -            driver. ref SDS 52 XJ5I
281737 -             ..
281738 -            [On 110105 1548 VA passenger van parked at Fry's advertises
281739 -            phone number to call 800 382 8387 (VETS) for Veteran
281740 -            Transportation services. ref SDS 55 NH5H
281742 -         ..
281743 -    4.  On 101210, Doctor Lee doubled the dose for Omeprazole.  This
281744 -        morning, tried to order a refill.  The VA online pharmacy does
281745 -        not show a correlation between the prescription number and the
281746 -        number on the bottle; nor is there a narrative description of
281747 -        the medication.  Additionally, the VA's online pharmacy seems
281748 -        to indicate that the doctor ordered a refill on 101210.
281749 -        ref SDS 0 5N3O
281751 -         ..
281752 -    5.  Please let me know if refill for Omeprazole has already been
281753 -        ordered, and, if not, whether the prescription number on the
281754 -        VA's online pharmacy is for Omeprazole.
281755 -
281756 -            [On 101218 1642 stomach pain, fatigue, and severe dry feet
281757 -            with peeling, cracking, and minor bleeding may be related
281758 -            to side effects of Omeprazole increasing dose from 20 to 80
281759 -            mg per day, ref SDS 51 8Q5I, citing case study on 101010
281760 -            0744. ref SDS 46 11Y4
281762 -             ..
281763 -            [On 101219 1402 letter notifies medical team of rising
281764 -            symptoms which may relate to Omeprazole, and requests
281765 -            adjustments in dose, remedial measures. ref SDS 53 5N3O
281766 -
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281774 -
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2818 -