CONTACTS
SUBJECTS
VA Prescribe Atorvastin 10 MG Trial 4 Weeks Evaluate Side Effects In
6003 -
6003 - ..
6004 - Summary/Objective
6005 -
600501 - Follow up ref SDS 56 0000. ref SDS 45 0000.
600502 -
600503 -
600504 -
600505 -
600506 -
600507 -
600508 -
600510 - ..
6006 -
6007 -
6008 - Background
6009 -
6010 -
601001 - Lab on 131015, showing cholesterol remained high, 131015 0724,
601002 - ref SDS 32 BE6O, conflict with increased exercise and weight loss,
601003 - discussed in the letter to the medical team yesterday on 131016 1632.
601004 - ref SDS 33 IW57
601006 - ..
601007 - On 131017 1000 VA medical chart Progress Notes assessment report
601008 - patient status CAD stable, asymptomatic. hyperlipidemia not
601009 - controlled. ref SDS 34 T24N
601011 - ..
601012 - On 131017 1000 Doctor Egan proposed referring patient for clinical
601013 - trial to reduce cholesterol with new "targeted" drugs. ref SDS 34 179N
601015 - ..
601016 - On 131017 1000 VA medical chart Progress Notes assessment report
601017 - patient status hyperlipidemia not controlled, ref SDS 34 PSXT; Doctor
601018 - Egan makes referral to SF VA Medical Center for consult on
601019 - participation clinical trials, ref SDS 34 EU9F, with experimental
601020 - agents such as AMG 145 and REGN 727 to resolve multiple statin
601021 - intolerances. ref SDS 34 CN4H
601023 - ..
601024 - On 131103 received letter from VA SF Medical Center scheduling meeting
601025 - on 131121 1000, to consider clinical trial for lowering cholesteral.
601026 - ref SDS 36 YT4N
601028 - ..
601029 - On 131112 New York Times published several articles reporting that the
601030 - day before on 131113, American Heart Association published new
601031 - guidelines for treating CAD patients that expand use of statin
601032 - medication regardless of cholesterol levels, ref SDS 37 0001, and
601033 - further raise the LDL 70 to LDL 190, as a target for cardiovascular
601034 - risk. ref SDS 37 CW6H
601036 - ..
601037 - On 131114 New York Times published several articles reporting that the
601038 - day before on 131113, American Heart Association published new
601039 - guidelines for treating CAD patients. ref SDS 38 SH6G
601041 - ..
601042 - On 131121 1604 meeting with Doctor Alba at San Francisco Medical
601043 - Center - prescribed Atorvastatin 20 mg 4-week trial and evaluate
601044 - adding Zetia 10 mg, schedule follow up on 131219 0930. ref SDS 39 6H6K
601046 - ..
601047 - On 131121 1604 in another record later today, VA prescription RX #
601048 - 5674471 for Atorvastatin 20 mg has been ordered. ref SDS 40 GH5M
601050 - ..
601051 - On 131125 0005 letter from Karen reports VA work plan to take statin
601052 - drug low dose Atvorstatin 10 mg for 4 weeks, then add Zetia 10 mg in
601053 - clinical trial for lowering cholesterol. ref SDS 42 V154
601055 - ..
601056 - On 131125 0005 research seems to indicate this clincial trial of low
601057 - dose Atorvasatatin 10 mg with Zeitia 10 mg has lowered cholesterol LDL
601058 - 70.
601060 - ..
601061 - On 131205 1448 received new prescription for Atvorstatin 20 mg,
601062 - ordered by Doctor Alba today for 4-week trial to assess side effects
601063 - for adding 2nd drug, Zetia 10 mg to lower LDL 249. ref SDS 43 GH5M
601065 - ..
601066 - On 131216 0028 letter to Doctor Alba submit agenda for meeting at VA
601067 - SFMC on 131219. ref SDS 44 HY6O
601069 - ..
601070 - On 131219 0930 meeting Doctor Alba at San Francisco VA Medical Center
601071 - ordered Ezedimibe 10 mg prescription for adding to Atorvastatin, and
601072 - ordered blood test to evaluate changes in lipid profile. 131219 0930,
601073 - ref SDS 45 NJ6G
601075 - ..
601076 - On 131230 1450, received Ezetimibe in US mail, ref SDS 46 5N3O,
601077 - ordered by Doctor Alba on 131219, 131219 0930, ref SDS 45 6H6K; begin
601078 - trial to manage cholesterol with Atorvastatin 10 mg and Ezetimibe 10
601079 - mg, planned during meeting at VA on 131121 0930. ref SDS 39 6H6K
601081 - ..
601082 - On 140114 0845 letter to Diana request Progress Notes meeting 131219,
601083 - ref SDS 47 HY6O, and ask about expanding scope pending lab to include
601084 - LDL-P. ref SDS 47 2140
601086 - ..
601087 - On 140115 1842 letter Diana will look for Progress Notes meeting
601088 - 131219, ref SDS 48 HY6O; investigating prospects for ordering lab test
601089 - LDL-P, ref SDS 48 CE80; VA claims patient cholesterol and LDL are above
601090 - target. ref SDS 48 CE91 VA further claims testing LDL-P not effective
601091 - in this case because LDL-C is not optimal. ref SDS 48 FF4H
601093 - ..
601094 - On 140116 0814 letter thanks Doctor Alba for investigting to find
601095 - Progress Notes for meeting at VA on 131219. ref SDS 49 HY6O Cite
601096 - research indicating patient with discordant LDL-C high and LDL-P low,
601097 - shown in patient lab on 131015, constitutes least risk for
601098 - arterialsclorosis disorder, CVD, mycardial infarction. ref SDS 49 735Y
601100 - ..
601101 - On 140128 1327 letter asks again about Progress Notes meeting 131219,
601102 - ref SDS 50 HY6O; report hiking 11 miles per day continued, weight hit
601103 - 165, ref SDS 50 TZ8U; ask where to get lab at VA Martinez, in San
601104 - Francisco, or at UCSF. ref SDS 50 TZ96 No side effects from
601105 - Atorvastatin and Ezetimibe. ref SDS 50 TZ99
601107 - ..
601108 - On 140131 0815 have not received instructions from VA on getting lab
601109 - to test LDL-P, so ordered test. ref SDS 51 OO5G lab blood draw at
601110 - Labcorp in Walnut Creek on Ygnacio Valley Road. ref SDS 51 NT6T
601112 - ..
601113 - On 140201 1159 obtained blood draw for Lipid NMR test at Labcor on
601114 - Health Testing Centers order # 27716, ref SDS 52 KQ4L, showing
601115 - "concordance" LDL-P 861, LDL-C 81, HDL 61, TG 68, LDL (pattern A) size
601116 - = large bouyant protective. ref SDS 52 IM9N
601118 - ..
601119 - On 140203 1147 since have not received instructions from VA, obtained
601120 - blood draw at VA in Martinez to cross check Labcorp blood test. 140203
601121 - 1147, ref SDS 53 KK9M, showing LDL-C 93, HDL 58, TG 47, ref SDS 53
601122 - IM9N, indicating "concordance" LDL-P 626, LDL (pattern A) size = large
601123 - bouyant protective. ref SDS 53 QV5G
601125 - ..
601126 - On 140204 1236 letter from VA today, notifies that Progress Notes for
601127 - meeting on 131219, have been posted and are available for customer to
601128 - receive from ROI department. ref SDS 54 HY6O Cause for 6-weeks delay
601129 - issuing Progress Notes not clear in the record. ref SDS 54 V44F VA
601130 - Progress Notes for meeting on 131219, are comprehensive and helpful.
601131 - ref SDS 54 MR3G Progress Notes have many minor grammatical errors
601132 - likely due to limited time, ref SDS 54 MZ5H, VA does not support NMR
601133 - lipid tests to determine LDL-P and discordance with LDL-C; patient can
601134 - obtain test from another lab. ref SDS 54 CE80 VA letter today
601135 - maintains discordance with low LDL-P and high LDL-C is "unhealthy" -
601136 - submits no evidence from medical literature supporting this
601137 - proposition, nor to address literature submitted to the VA stating
601138 - discordance is the healthiest condition for CVD patients. ref SDS 54
601139 - 6U4L VA concurs that lowering weight toward BMI standards aids
601140 - resolving hyperlipidemia. ref SDS 54 8N9H VA maintains lifestyle
601141 - through exercise and diet to control weight and hyperlipidemia require
601142 - support taking statin medications, e.g., Atorvastatin and Ezetimibe.
601143 - ref SDS 54 GT5F VA letter today says patient mis-reads literature on
601144 - discordance between LDL-P and LDL-C, and proposes discussions to
601145 - clarify this matter during meeting scheduled on 140213. ref SDS 54 HU5M
601146 - VA prefers patient get labs drawn at San Francisco VA Medical Center.
601147 - ref SDS 54 PT3M
601149 - ..
601150 - On 140213 0830 meeting VA San Francisco, ref SDS 56 195I, report good
601151 - progress lowering risks of recurrant CVD based on concordant low LDL-P
601152 - 861 with low LDL-C 81. shown by lab NMR lipid panal. ref SDS 56 TB6J
601153 - Medical team excellent results collaborating doctor/patient
601154 - partnership. ref SDS 56 1L7M Atorvastatin 40 mg started 131121, and
601155 - then changed to Atorvastatin 10 mg with Ezetimibe 10 mg started
601156 - 131230. ref SDS 56 IE7F No side effects taking medication past 6
601157 - weeks. ref SDS 56 333L Objectives and ramifications of discordance
601158 - between LDL-P and LDL-C discussed. ref SDS 56 WM8J Regression of
601159 - atherosclerosis plaque can be assessed with CT and IVUS modalities to
601160 - evaluate recovery from prior acute condition that required surgery in
601161 - 2009. ref SDS 56 JZ4O Will continue medication, diet, exercise and
601162 - weight loss protocols, and test lipid panal again in 3 months on
601163 - 140519 0800. ref SDS 56 8X5O Did not discuss today elevated potasium
601164 - and bilirubin. ref SDS 56 GT7G
601166 - ..
601167 - On 140226 1332 letter to VA transmits notes of meeting on 140213.
601168 - ref SDS 0 HY6O Report possible cold symptoms side effects taking
601169 - Atorvastatin with Ezetimibe. ref SDS 0 JY8K Request consideration
601170 - order CT radiology assess regression atherosclerosis. ref SDS 0 JR99
601171 - Request Progress Notes meeting on 140213. ref SDS 0 JY4M
601173 - ..
601174 - On 140305 1117 letter to VA follows up asking about work plan in
601175 - Progress Notes doing CTA and other testing to evaluate regression of
601176 - atheroscleroisis, ref SDS 61 WY3X, since CABG x4 surgery on 091022
601177 - 0700. ref SDS 3 PQWU
601179 - ..
601180 - On 140312 1720 letter to VA asks about adding consideration in
601181 - Progress Notes of CT and other image testing to evaluate regression of
601182 - atherosclerosis plaque after significant increase in LDL-C in lab last
601183 - year on 131015. ref SDS 62 PSXX
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601192 - ..
6012 -
6013 -
6014 - Progress
6015 -
601501 - Hyperlipidemia Cholesterol Controlled Exercise Diet Medication
601502 - Cholesterol Managed Clinical Trial Exercise Diet Medication
601503 - Clinical Trial Considered Lower Cholesterol Without Statin Drugs
601504 -
601505 - Follow up ref SDS 56 HY6O, ref SDS 45 HY6O.
601506 -
601507 - Sent letter to San Francisco VA Medical Center saying...
601508 -
601509 - 1. Subject: Meeting 13 Feb Good Lipid Lab Continue Protocol
601510 - Date: 2014-02-26 13:51
601519 - ..
601520 - 2. Here are notes on our meeting with Doctor Feingold in your
601521 - office at the VA on 140213 (see line 601534, beginning para 4.
601522 - ref SDS 56 TB6J
601524 - ..
601525 - 3. Notice para 6 reporting possible side effects taking
601526 - Atorvastatin 10 mg with Ezetimibe 10 mg, may have started some
601527 - days after our meeting. Symptoms could result from catching a
601528 - cold or the flu. I have not had a cold nor the flu in more
601529 - than 10 years. Received flu vaccination from the VA on 131209.
601530 - Still, it is possible I have a cold or the flu.
601531 -
601532 - [On 140303 1644 letter notifies VA side effects have
601533 - subsided. ref SDS 60 HY6O
601535 - ..
601536 - 4. If you have time to check the record cited in the case study,
601537 - note symptoms seem to subside everyday about 1000, and the
601538 - resume after 2000 hours. [...see case study record on 120101,
601539 - for Tuesday, 140225. ref SDS 11 WB6F...].
601540 -
601541 - [On 140227 1007 Sally reported getting cold/flu after
601542 - visiting her daughter's family in Seattle last week; says
601543 - the virus is going around Seattle area. ref SDS 59 SV6F
601545 - ..
601546 - Might be possible that heightened exposure to cold flu epidemic
601547 - overcomes normal resistance lowered taking Atorvastatin and Ezetimibe.
601549 - ..
601550 - Letter to VA continues...
601551 -
601552 - 5. This somewhat aligns with taking the medication about 1900, but
601553 - could be a coincidence. Symptoms prevented hiking for 4 days
601554 - last week, after hiking 22 days in a row. Yesterday, I did the
601555 - 11 mile hike and was okay. However, symptoms resumed again
601556 - last night and continued until OA 1000 this morning. Feel okay
601557 - now, so will do another hike in a few minutes.
601559 - ..
601560 - 6. Might there be a vaccination of some kind to treat persistent
601561 - symptoms while taking Atorvastatin and Ezetimibe?
601563 - ..
601564 - 7. In any case, at this time symptoms are not sufficiently
601565 - debilitating to discontinue Atorvastatin and Ezetimibe, at
601566 - least for another few weeks to do another lab and test for
601567 - results. Patient history shows lipids improved significantly
601568 - after starting Simvistatin and Rosuvastatin; but, after the
601569 - first cycle, favorable lipids worsened, i.e., LDL-C increased.
601570 - Would like to see if we can maintain favorable results through
601571 - 2 cycles. [see lab report on 140203 1147. ref SDS 53 W25L...].
601573 - ..
601574 - 8. If feasible, please comment in Progress Notes on doing CT test
601575 - for regression of atherosclerosis plaque, as discussed in the
601576 - record para 11 (line 601771 - [...report meeting on 140213
601577 - 0830, ref SDS 56 JZ4O...]
601578 -
601579 - [On 140305 1117 letter to VA follows up asking about
601580 - doing CT and other testing to evaluate regression of
601581 - atheroscleroisis, ref SDS 61 WY3X, since CABG x4 surgery
601582 - on 091022 0700. ref SDS 3 PQWU
601584 - ..
601585 - 9. Look forward to seeing Progress Notes.
601586 -
601587 - [On 140303 1644 letter requests submission of Progress
601588 - Notes for meeting on 140213. ref SDS 60 E792
601590 - ..
601591 - 10. Thanks very much for taking good care of me.
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