Welch Company
San Francisco, CA


S U M M A R Y


DIARY: November 23, 2011 06:47 PM Wednesday; Rod Welch

Bob called about recovering knee surgery and rehabilitation.

1...Summary/Objective
2...Bob Cut Loose by Mission View Refusal Treat Surgery Complications
3...Mission View Refuse Treat Surgery Complications Release Bob Saturday
4...Bob Release Saturday Mission View Refuse Treat Surgery Complications
5...Bob Struggling with Home Care and Rehab Challenges


..............
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CONTACTS 
SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 18 0000. ref SDS 17 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040506 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - Bob Cut Loose by Mission View Refusal Treat Surgery Complications                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040902 - Mission View Refuse Treat Surgery Complications Release Bob Saturday                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040903 - Bob Release Saturday Mission View Refuse Treat Surgery Complications                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040904 - 
040905 - Follow up ref SDS 18 M05H, ref SDS 17 M05H.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040906 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040907 - Background, briefed Robin in letter on 111117 0017. ref SDS 15 SO7Q,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040908 - and again last night on 111118 0818 at 2154. ref SDS 16 IT9K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040910 -  ..
040911 - On 111119 0933 Bob was released from Mission View. ref SDS 18 ON8M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040913 -  ..
040914 - Drove to Nipomo for birthday (84) party to welcome Bob home from the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040915 - hospital. 111119 0933 at 1738. ref SDS 18 PQUY                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040916 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040917 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040919 -  ..
040920 - Bob Struggling with Home Care and Rehab Challenges                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040921 - 
040922 - Returned Bob's call this morning, reported on the telephone message                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040923 - system.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040925 -  ..
040926 - Bob said he had a great day today.  He drove his car to Santa Maria                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040927 - for a hamburger at the In-and-Out fast food restaraunt.  He used the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040928 - cain, rather than the walker to go into the restaraunt.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040930 -  ..
040931 - Asked Bob why Terreas didn't drive him to Santa Maria?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040933 -  ..
040934 - He said it isn't necessary now.  He is doing really well.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040936 -  ..
040937 - Asked why he didn't use the walker?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040939 -  ..
040940 - Bob explained that the walker only has 2 wheels, so the back legs get                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040941 - stuck when he pushes forward on pavement, like in a parking lot, going                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040942 - through a door across a threshold, that kind of thing.  He said that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040943 - his cain is faster and easier to handle.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040945 -  ..
040946 - We briefly discussed again advantages getting a rollater walker that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040947 - has 4 wheels, reviewed previously on 111118 1005 at 1448. ref SDS 17                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040948 - EZ8M  It works like a push cart going shopping, and has a seat to rest                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040949 - when necessary.  The wheels are bigger than on his current walker, so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040950 - they easily handle small obstructions.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040952 -  ..
040953 - Bob still feels he doesn't need it; said he is recovering faster than                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040954 - expected.  He said don't worry - everything will okay, as related                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040955 - previously on 111118 1005 at 1554. ref SDS 17 VA4R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040957 -  ..
040958 - Bob said he got tired standing in line at In-and-Out Burger waiting to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040959 - place his order, so he drove to another place for a hamburger, sounded                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040960 - like he said "Margie's" or something like that.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040962 -  ..
040963 - Bob said he was very tired after getting home so he went to bed for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040964 - rest.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040965 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040966 -            [On 111127 1810 Bob had similar experience going shopping                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040967 -            at the grocery store; after buying only 6 items, he got                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040968 -            very tired and had to return home and rest in bed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040969 -            ref SDS 20 NG5U                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040971 -  ..
040972 - Bob explained the physical therapist came by late this afternoon.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040973 - was concerned that Bob is not yet ready for using a cain, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040974 - indicated that at this stage in Bob's rehabilitation using a can                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040975 - causes unequal pressure that torques his knee.  This prevents healing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040976 - correctly, and could damage the knee replacement mechanism.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040977 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040978 -            [On 111127 1810 Bob reports abandoning walker and relying                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040979 -            only on his cain for support walking; physical therapist                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040980 -            evidently advised again that using the walker provides                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040981 -            essential support at this stage of rehabilitation for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040982 -            recovering from knee replacement surgery; Bob likes ease                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040983 -            and convenience of using the cain. ref SDS 20 FM9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040985 -  ..
040986 - Bob said he feels funny out in public with the walker, and the walker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040987 - is less efficient than the cain.  He feels the cain is okay as long as                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040988 - he doesn't use it too much.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040990 -  ..
040991 - Asked Bob if Terreas is a good cook?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040993 -  ..
040994 - Bob said that Terreas cooked a frozen food dish from the freezer.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040995 - thought it wasn't cooked long enough.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040997 -  ..
040998 - Bob said he doesn't need help at home now.  He is doing okay by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040999 - himself.  He feels ready now to perform all of the tasks for home                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041000 - care, including maintenance, laundry, cooking, cleaing up.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041001 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041002 -            [On 111127 1810 Bob said he asked Shari to clean the house,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041003 -            because he is too tired for doing routine tasks at home.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041004 -            ref SDS 20 PN8M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041006 -  ..
041007 - Asked how Terreas was doing helping him with physical therapy at home?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041009 -  ..
041010 - Bob said that Terreas ovecharged him for what she did.  He paid less                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041011 - than she requested.  Bob is not sure Terreas is coming back.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041013 -  ..
041014 - Asked if he can go to the gym to exercise his leg on the gym                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041015 - equipment?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041017 -  ..
041018 - Bob said he's not ready for that much exercise yet.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041020 -  ..
041021 - Asked if Bob is doing exercises at home that the doctor and physical                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041022 - therapist prescribed for his leg to recover?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041024 -  ..
041025 - Bob said he feels it is unnecessary, because he is doing more walking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041026 - than most patients at this stage recovering from knee replacement                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041027 - surgery.  Bob said the physical therapist today told him it is okay                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041028 - not to exercises at home for rehabilitation, because Bob is doing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041029 - better than most patients.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041031 -  ..
041032 - Congratulated Bob on being ahead of schedule rehabilitating his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041033 - surgically replaced knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041035 -  ..
041036 - Told Bob will keep in touch.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041037 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041039 -  ..
0411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0413 - 1902                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041401 - Called Shari                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041402 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041403 -              805 929 8299                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041405 -  ..
041406 - Shari said that Terreas briefly visited today, but would not explain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041407 - the problems she had with Bob.  Terreas did tell Shari that Bob would                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041408 - not pay for the full time she worked.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041410 -  ..
041411 - This aligns with Bob's understanding about differences on what was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041412 - owed, per above. ref SDS 0 4X3G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041414 -  ..
041415 - Terreas was also claimed that Bob was drinking alcohol while taking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041416 - vicadin, and refused medical advice to avoid this practice.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041418 -  ..
041419 - Possibly indicates Bob was not receptive to behavioral advice.  Back                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041420 - in September, he mentioned something about not wanting home help that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041421 - tells him what to do.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041423 -  ..
041424 - Shari said that Terreas would not sit down and discuss her experience                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041425 - working for Bob.  She has left town for LA.  Shari does not know at                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041426 - this point, when Terreas will return, or if she will even call.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041428 -  ..
041429 - Appologized about how this has turned out, and thanked Shari for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041430 - trying to arrange with Terreeas to provide help Bob needs to recover                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041431 - from knee surgery.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041433 -  ..
041434 - Part of the problem is that Bob does not want assistance at home doing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041435 - exercises prescribed for recovery, per above. ref SDS 0 FN3U                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041437 -  ..
041438 - Also explained Bob is driving his car, placing him in situations that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041439 - over-fatigues his body, which increases chances of accidents, like                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041440 - driving or falling, per above. ref SDS 0 FM9V  He had a minor car                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041441 - accident before his surgery.  Driving at this time, seems even higher                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041442 - risk causing another accident that will injure him and others.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041444 -  ..
041445 - Suggested that Shari call Bob and invite him for Thanksgiving, as a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041446 - way to open conversation.  He will likely decline, but might help Bob                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041447 - become more forthcoming about needing Terreas or someone for home                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041448 - care.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041450 -  ..
041451 - Shari will think about this.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041453 -  ..
041454 - Hopefully, Bob will come to realize he needs help before suffering an                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041455 - accident, which is why Mission View originally planned to keep him for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041456 - another 2 weeks or more.  In the controlled environment of Mission                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041457 - View, the patient has constant support to avoid high risk behavior,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041458 - and ensure physical therapy is performed that enables full recovery.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041459 - If he does suffer problems, staff is available for immediate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041460 - assistance and damage is contained.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041462 -  ..
041463 - At this stage, nobody knows what transpired between Bob and his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041464 - primary care doctor yesterday.  Who is managing Bob's case?  Where is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041465 - the record of anybody doing anything?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041467 -  ..
041468 - Most likely, Bob will go to the meeting alone with the surgeon, Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041469 - Fow, scheduled on Nov 30th.  Hope he uses the walker, but probably                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041470 - won't, because he does not have experience to understand why he can't                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041471 - do things he wants to do just yet.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041473 -  ..
041474 - Asked Shari to convery my deepest appologies for Bob being such a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041475 - difficult customer and to thank her for all she has tried to do.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041476 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041477 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041478 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041479 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041480 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041481 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041482 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041483 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041484 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0415 -