THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com


S U M M A R Y


DIARY: December 12, 2012 09:41 AM Wednesday; Rod Welch

VA lab retest for potasium (K), glucose and salt.

1...Summary/Objective
2...Potassium Glucose Sodium Reduced after Ending Rosuvastation Dehydration
3...Salt Glucose Potassium Lower End Rosuvastatin Reduce Dehydration
4...Rosuvastatin Dehydration Lower Glucose Salt Potassium Reduce Good Health
5...BUN Elevated 60% Impaired Kidney Function Dehydration Rosuvastatin


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 22 0000. ref SDS 18 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040507 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - Blood draw today ordered by Doctor Egan to test glucose, sodium, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040902 - potasium (K), after ending Rosuvastatin which should reduce                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040903 - dehydration and thereby show valid labs, reported during meeting at VA                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040904 - on 121206 0900. ref SDS 23 6K4J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040906 -  ..
040907 - Last full lab was on 121130 0846, ref SDS 22 PQRS, and listing prior                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040908 - lab history. ref SDS 22 SG6N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040910 -  ..
040911 - Blood draw at VA in Martinez.  There was no wait today.  On arrival                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040912 - OA 1010, was taken into the lab within 5 minutes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040914 -  ..
040915 - Fasted since last night OA 2200.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040917 -  ..
040918 - Patient history of exercise diet and medication past week since ending                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040919 - Rosuvastatin is shown in case study on 101010 0744. ref SDS 6 GC6N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040921 -  ..
040922 - Potassium Glucose Sodium Reduced after Ending Rosuvastation Dehydration                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040923 - Salt Glucose Potassium Lower End Rosuvastatin Reduce Dehydration                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040924 - Rosuvastatin Dehydration Lower Glucose Salt Potassium Reduce Good Health                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040925 - BUN Elevated 60% Impaired Kidney Function Dehydration Rosuvastatin                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040926 - 
040927 - Follow up ref SDS 22 KK9M, ref SDS 18 KK9M.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040928 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040929 - Prior CHEM PROFILE on 120509 1108. ref SDS 17 KK9M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040930 - Prior CHEM PROFILE on 120831 1524. ref SDS 18 KK9M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040931 - Prior CHEM PROFILE on 121130 0846. ref SDS 22 KK9M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040932 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040933 -                           ELECTROLYTES                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040935 -         ..
040936 -        CHEM PROFILE... 2012 12 12 1013   121130       120831                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040937 -        PLASMA                Results      Results     Results     Units            Range                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040938 -        GLUCOSE                111          115           113       mg/dL       74     -  118                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040939 -        GLUfast                                                     mg/dL       Ref: <=99
040940 -        NA (salt)              139          144           141       mmol/L     136     -  144                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040941 -        K (potasium)             4.6   H      5.2           3.8     mmol/L       3.4   -    4.8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040942 -        CL                     105     H    107      H    109       mmol/L      98     -  106                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040943 -        CO2                     27           28.7          24       mmol/L      23     -   33                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040944 -        BUN (urea nitrate)      25           21            16       mg/dL        8     -   26                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040945 -        CREAT                    1.03         0.84          1.02    mg/dL         .5   -    1.1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040946 -        eGFR                      >60       >60           >60       mL/min      Ref: >=60                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040947 -        CALCIUM                  8.9          9.3           9.1     mg/dL        8.7   -   10.2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040948 -        CA CORR                                                     mg/dL        8.7   -   10.2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040949 -        PO4                                                         mg/dL        2.4   -    4.5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040950 -        MG                                                          mg/dL        1.8   -    2.5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040951 -        ALK PHO                              80            93       IntUnits/L  37     -  107                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040952 -        T. BIL                         H      1.6           2.3     mg/dL         .3   -    1.2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040953 -        D. BILI                               0.2           0.3     mg/dL         .1   -     .4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040954 -        AST                                  22            33       IntUnits/L   8     -   42                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040955 -        ALT                                  21            35       IntUnits/L   5     -   55                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040956 -        ALBUMIN                               4.1           4.3     g/dL         3.3   -    4.8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040957 -        PROTEIN                               6.8           7.5     g/dL         6.5   -    8.1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040958 -        LDH                                                         IntUnits/L  90     -  208                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040959 -        AMYLASE                                                     Units/L     28     -  100                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040960 -        LIPASE                                                      Units/L      7     -   58                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040961 -        NH3                                                         mcmol/L     15     -   56                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040962 -        URIC AC                                                     mg/dL        4.8   -    8.7                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040963 -        Comments:                 a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040965 -                  ..
040966 -             a.  TEST PERFORMED BY VA MARTINEZ, 150 MUIR ROAD, MARTINEZ CA.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040968 -                  ..
040969 -             b.  Evaluation for CREAT:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040970 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040971 -                 Effective 7/2/08, new standardized method for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040972 -                 creatinine in place.  Note reference range change.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040973 -                 Previous range 0.5-1.2 mg/dL.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040975 -                  ..
040976 -             c.  Evaluation for ALK PHO:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040977 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040978 -                 The normal range is for an adult population less than                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040979 -                 50 years old. Alk Phos increases with age over 50 to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040980 -                 about 60% higher values by ages greater than 75 years                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040981 -                 old.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040983 -                  ..
040984 -             d.  Evaluation for eGFR:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040985 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040986 -                 eGFR Units = mL/min/1.73 square meters                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040988 -  ..
040989 - Rosuvastatin ended on 121206, to reduce dehydration, and so glucose,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040990 - sodium, and potassium (K) all declined, as Doctor Egan expected during                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040991 - the meeting on 121206 0900. ref SDS 23 6K4J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040993 -  ..
040994 - Correcting errors in electrolytes lab on 121130, may indicated that                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040995 - HDL and LDL cholesterol labs were also impacted by dehydration, and so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040996 - were equally reduced by ending Rosuvastatin, discussed in the record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040997 - meeting with Doctor Egan on 121206 0900. ref SDS 23 QG6F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040999 -  ..
041000 - BUN (urea nitrate) has increased 60% along with creatinine rising a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041001 - lessor amount toward high end of health range.  This may be due to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041002 - dehydration that can impair kidney function, caused by Rosuvastatin.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041003 - Hopefully, this can be reversed as dehydration declines after ending                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041004 - Rosuvastatin on 121206.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041005 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041006 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041007 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041008 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041009 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041010 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041011 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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041013 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041014 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041015 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041016 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0411 -