Welch Company
San Francisco, CA


S U M M A R Y


DIARY: November 21, 2011 05:27 PM Monday; Rod Welch

VA ordered rosuvastatin cheolesterol medication.

1...Summary/Objective


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CONTACTS 
SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 8 0000, ref SDS 7 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040505 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - On 110823, received from VA in US mail rosuvastatin 20 mg, ref SDS 8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040902 - UY5G, prescribed to take 10 mg per day, to replace simvastatin 40 mg,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040903 - and in lieu of increasing prescription to simvastatin 80 mg, and to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040904 - implement order by Doctor Egan at VA on 110817 1030. ref SDS 7 DG36                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040906 -  ..
040907 - Now running out of pills, so ordered refill on prescription.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040909 -  ..
040910 - Background on ordering prescriptions from VA are listed on 110804                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040911 - 1026. ref SDS 6 5N3O, and citing the record on 070312 1200.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040912 - ref SDS 1 749G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040914 -  ..
040915 - Ordered refill on prescription for...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040916 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040917 -        Rosuvastatin 20 mg........................ RX#10927080                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040918 -        Fill Date................................. 111121                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040919 -        Quantity.................................. 45 20 mg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040920 -        Refills Remaining......................... 2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040921 -        Expiratioh date........................... 120803                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040922 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040924 -  ..
040925 - Cholesterol increased significantly past 3 months, shown in lab on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040926 - 111117, ref SDS 10 IM9N, after switching from Simvistatin 40 mg to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040927 - Rosuvastatin 10 mg, starting on 110823. 110823 1312, ref SDS 8 UY5G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040929 -  ..
040930 - Increased cholesterol may be caused by...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040931 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040932 -        1.  Rosuvastatin 10 mg dose too low - need 20 mg.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040934 -             ..
040935 -        2.  Hiking reduced last 3 weeks, from 40 miles to 2 miles per                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040936 -            week due to providing patient case management starting on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040937 -            111030, shown case study on 101010 0744. ref SDS 4 UT6K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040939 -             ..
040940 -        3.  Rosuvastatin pills left in Nipomo week pior to lab, so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040941 -            missed 1 week treatment until pills received in mail, shown                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040942 -            in case study on 101010 0744. ref SDS 4 WWSQ                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040944 -  ..
040945 - Blood pressure increased suddenly 2 months after taking Rosuvastatin,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040946 - and beginning about 3 weeks ago on 110101, shown in case study on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040947 - 101010 0744. ref SDS 4 H14I  Higher blood pressure may correlate to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040948 - increased cholesterol narrowing arteries.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040950 -  ..
040951 - Rosuvastatin Side effects - research listed on 110802 1639.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040952 - ref SDS 5 JH7N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040954 -  ..
040955 - At this time, after 3 months taking Rosuvastatin only evident side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040956 - effects taking Rosuvastatin...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040957 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040958 -        1.  Urination increased cited on............. 110802 1639, ref SDS 5 IT9N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040959 -            Urination increased cited on............. 110802 1639, ref SDS 5 E26O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040960 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040961 -            Similar effects to IV lasix taken post CABG, reported on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040962 -            091102 0642, ref SDS 2 WB8Q, and on discharge in pill form                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040963 -            ordered on 091104 0718. ref SDS 3 V25R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040965 -             ..
040966 -            Could not drive 3.3 hours without stopping on 111119 0933.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040967 -            ref SDS 11 CJ9O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040969 -             ..
040970 -        2.  Sleep difficulty......................... 110802 1639, ref SDS 5 L65N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040971 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040972 -            Difficult to pinpoint this to Rosuvastatin, since normally                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040973 -            work past midnight.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040974 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040976 -  ..
040977 - Benefits ending Simvastatn on 110823...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040978 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040979 -        1.  Myopathy left shoulder noticably improved - can do pushups                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040980 -            again.  Range of motion left arm greatly expanded.  Still                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040981 -            have pain lifting left arm above horizontal and reaching                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040982 -            behind line between shoulders.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040984 -             ..
040985 -        2.  Total Bilirubin dropped from 3.0 to 1.3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040987 -  ..
040988 - Work Plan possibilities...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040989 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040990 -        1.  Rosuvastatin 20 mg increase from 10 mg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040991 -        2.  Maintain daily dose avoid lapses Rosuvastatin 20 mg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040992 -        3.  Hiking increase from 2 back to 40 miles per week.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040994 -  ..
040995 - Risks - side effects may increase...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040996 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040997 -        1.  Myopathy                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040998 -        2.  Urination frequency with collateral damage.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040999 -        3.  Other side effects from long list on 110802 1639. ref SDS 5 QI3K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041000 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041001 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041002 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041003 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041004 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041005 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0411 -