Welch Company
San Francisco, CA


S U M M A R Y


DIARY: November 27, 2011 06:10 PM Sunday; 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 21 0000. ref SDS 19 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 - Bob Struggling with Home Care and Rehab Challenges                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040905 - 
040906 - Follow up ref SDS 21 FM9I.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040907 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040908 - Bob called Friday, while I was out hiking.  When I returned the call                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040909 - in the afternoon, Bob said he is feeling much better now, and so has                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040910 - abandoned his walker, less than 4 weeks after knee surgery.  Bob said                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040911 - that he is now walking entirely with the cane.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040913 -  ..
040914 - Congratulated Bob making progress with just 2 weeks of rehabilitation                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040915 - after knee surgery, much faster than most patients, based on planning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040916 - at Mission View that Bob required more than 4 weeks of rehabilitation                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040917 - and medical support at Mission View, due to post-surgery infection,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040918 - reported in case study on 111116 0959. ref SDS 15 JT4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040920 -  ..
040921 - Asked Bob if the cane works as well as the walker for walking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040922 - vertically to rehabilitate his knee?  Mentioned that in September and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040923 - October, he was quite hunched over using the cane, e.g., on 110917                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040924 - 1420. ref SDS 2 N53I  Noted that change in normal upright posture                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040925 - caused by using a cane, torques his knee, which could damage                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040926 - recovering from knee surgery, cited by Doctor Fow after completing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040927 - Bob's surgery on 111031 0800. ref SDS 5 E86S                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040929 -  ..
040930 - Bob said he gets tired holding himself vertical with the cane, but it                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040931 - is more convenient than using the walker.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040933 -  ..
040934 - Asked if he has discussed switching from the walker to a cane, with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040935 - the physical therapist?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040937 -  ..
040938 - Bob further replied on Friday that the physical therapist told him he                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040939 - should use his walker to build strength and range of motion, so his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040940 - knee surgery heals correctly.  We recalled the physical therapist said                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040941 - this previously when Bob drove to Santa Maria for a hamburger on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040942 - 111123 1847. ref SDS 21 IL4J  Bob went on to say that he believes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040943 - there is more exercise walking with the cane, than with the walker,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040944 - since it is faster and easier to use the cane.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040946 -  ..
040947 - We discussed requirements to walk vertically using both hands on the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040948 - walker to equalize support, so his leg heals correctly and strengthens                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040949 - for walking normally.  Using a cane causes a hunched over, awkward                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040950 - motion.  Doctor Fow emphasized immediately after Bob's surgery that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040951 - following rehabilitation protocols is critical to recover from knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040952 - surgery, reported on 111031 0800. ref SDS 5 Y673  Bob remembered how                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040953 - difficult it was to use the cane months ago, reported previously on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040954 - 110917 1420. ref SDS 2 N53I  Bob explained that now he is less hunched                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040955 - over thanks to knee surgery, so he feels everything is okay using the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040956 - cane, instead of the walker.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040958 -  ..
040959 - Bob also said on Friday that he planned on driving to the store for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040960 - groceries, because he is out of everythng to eat, except for the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040961 - turkey he cooked on Thursday, and he is tired of turkey.  Bob                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040962 - explained that his pain medication reduces ability to taste food, so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040963 - he does not feel like eating.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040965 -  ..
040966 - Aked if he has anyone to drive him to the store?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040968 -  ..
040969 - Bob said he can drive himself.  He was adament not needing help for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040970 - driving nor help shopping for groceries.  He said he has driven                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040971 - himself many places since returning home on 111119. ref SDS 19 QR7O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040973 -  ..
040974 - We reviewed the record from his call last week, saying he drove                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040975 - himself to Santa Maria to get a hamburger, reported on 111123 1847,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040976 - ref SDS 21 FM9I, and that he got tired waiting in line to be served,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040977 - and so had to leave, ref SDS 21 FM4P,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040979 -  ..
040980 - Bob said he is getting stronger everyday, and so feels everything is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040981 - okay for him to drive.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040983 -  ..
040984 - That was all yesterday.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040985 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040986 - *********************                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040988 -  ..
040989 - In the call this evening, Bob sounds tired.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040991 -  ..
040992 - He is watching Secretariet on television, and having turkey for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040993 - dinner.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040995 -  ..
040996 - Bob said he went to the store today, rather than yesterday, discussed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040997 - in the prior call, per above. ref SDS 0 4V6V  He drove himself, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040998 - got very tired.  He only bought a few things (think he said "6"), and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040999 - then had to come home and go to bed for rest, similar to his first                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041000 - driving excursion last Tuesday going to Santa Maria for a hamburger,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041001 - reported on 111123 1847. ref SDS 21 FM4P                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041003 -  ..
041004 - Bob noted that he has never in his life had to rest in bed during the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041005 - day, like today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041007 -  ..
041008 - We considered that this level of fatigue, could present dangers to him                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041009 - and others driving a car.  Bob feels he got home without incident, so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041010 - everything is okay.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041012 -  ..
041013 - Mentioned that low blood counts may cause fatigue, along with simply                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041014 - being tired recovering from knee surgery.  Doctor Fow was worried                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041015 - about low blood counts in the call on 111111 0802. ref SDS 11 WT4G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041017 -  ..
041018 - Bob said that Robin also mentioned that he needs more than normal rest                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041019 - because recovering from surgery causes fatigue.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041021 -  ..
041022 - Asked Bob this evening about pain management?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041024 -  ..
041025 - Bob said he is out of medication.  He is using other medication on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041026 - hand in the house.  He is using more than the normal amount until he                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041027 - can get more prescribed medication.  Bob said he will reorder a refill                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041028 - tomorrow.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041030 -  ..
041031 - Asked if Bob has talked to Shari lately, who visited, along with her                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041032 - friend, Rick, to welcome Bob home from the hospital last week on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041033 - 111119 0933. ref SDS 19 EH6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041035 -  ..
041036 - Bob said he talked to Shari today, and she has agreed to come over and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041037 - clean the house tomorrow, because he is too tired to take care of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041038 - things the way he thought he could last week, when he decided not to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041039 - continue having Terreas help him, reported on 111123 1847. ref SDS 21                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041040 - FM62                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041042 -  ..
041043 - Wonderful hearing Bob has agreed to get help with the house, after                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041044 - saying last Tuesday, that he had an disagreement with Terreas, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041045 - that he really didn't need help, reported on 111123 1847. ref SDS 21                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041046 - FM56                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041048 -  ..
041049 - We discussed Bob going to the gym and using the treadmill as a walker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041050 - at a very slow pace to exercise his leg standing vertically, as he was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041051 - doing on 111119 0933. ref SDS 19 1O7F  This might be more effective,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041052 - and less stressful than using the cane, evidently noted by the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041053 - physical therapist last week on 111123 1847, ref SDS 21 IL4J, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041054 - again yesterday, per above. ref SDS 0 4V53                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041056 -  ..
041057 - Bob plans to discuss this with Doctor Fow, the knee surgeon, at a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041058 - meeting on Wednesday.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041060 -  ..
041061 - Asked Bob if he has had a CBC lab to assess blood counts, which were                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041062 - too low in his last blood reported on 111114 0715. ref SDS 13 B868                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041064 -  ..
041065 - Bob seemed to say he had a blood draw last week.  He doesn't know the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041066 - scope.  He assumes everything is okay, because he hasn't heard from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041067 - anybody.  Bob indicated he has a follow up meeting with primary care,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041068 - but is not sure when.  Bob said he will ask Doctor Fow about results                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041069 - of his blood test last week, when they meet next Wednesday.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041071 -  ..
041072 - Bob is worried about being so tired.  He's glad Shari is coming                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041073 - tomorrow.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041074 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041075 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041076 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041077 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041079 -  ..
0411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0413 - 1957                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041401 - Called Shari.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041402 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041403 -              805 929 8299                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041405 -  ..
041406 - Left message thanking Shari for arranging to help Bob tomorrow.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041408 -  ..
041409 - Mentioned that Bob sounds very tired tonight, and said he went                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041410 - grocery shopping, and became very tired.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041415 -  ..
0415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0417 - 2001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041801 - Called Robin.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041802 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041803 - Left message on Bob getting tired going to the store, and possibility                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041804 - that his blood counts are down.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041805 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041806 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041807 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041808 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041809 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041810 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041811 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0419 -