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: March 10, 2014 09:39 AM Monday; Rod Welch

VA letter Progress Notes meeting on 13Feb2014 available VA system email.

1...Summary/Objective
2...Progress Notes Meeting 140213 Transmitted VA System Email
3...VA System Email Transmitted Progress Notes Meeting 140213
4...Email Send Medical Records Waive HIPAA Restrictions
5...Waive HIPAA Restrictions Sending Medical Records Public Domain Email
6...Public Domain Email Waive HIPAA Restrictions Sending Medical Records
7...Medical Records Transmit Public Domain Email Waive HIPAA Restrictions
8...Sickness Relapse Possible Side Effects Atorvastatin Ezetimibe
9...Atorvastatin Ezetimibe Prescription Delayed 1 Week Cancel and Reorder
10...CT Evaluate Regression Atherosclerosis Plaque CVD 4 Years After CABG


..............
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CONTACTS 

SUBJECTS
VA Pharmacy Ezetimibe Order Refill Treat Cholesterol LDL 249 Prescri                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
5703 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5703 -    ..
5704 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
5705 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
570501 - Follow up ref SDS A3 0000. ref SDS A2 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
570502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
570503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
570504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
570506 -  ..
5706 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5707 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5708 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5709 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
570901 - EGD on 101210, seems to show progress recovering from esophagitis; the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
570902 - doctor dilated the LESV from 11 to 14 cm, reported on 101210 0930,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
570903 - ref SDS 49 XG6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570905 -  ..
570906 - Follow up EGD planned for February, ref SDS 49 L94L.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
570908 -  ..
570909 - Doctor Lee prescribed doubling dose of Omeprazole to increse recover                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
570910 - from esophagitis, reported on 101210 0930. ref SDS 49 ZN4M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
570912 -  ..
570913 - On 101216 appears Doctor Lee ordered refill for omeprazole. ref SDS 51                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
570914 - 8785                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
570916 -  ..
570917 - On 110320 0750 ordered refill Omeprazole to treat Achalasia,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
570918 - ref SDS 58 5N3O,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
570920 -  ..
570921 - On 110626 0721 ordered refill Omeprazole to treat Achalasia.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
570922 - ref SDS 62 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570924 -  ..
570925 - On 110913 2238 ordered refill Omeprazole to treat Achalasia,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
570926 - ref SDS 63 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570928 -  ..
570929 - On 120326 1549 ordered refill Omeprazole to treat Achalasia,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
570930 - ref SDS 70 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570932 -  ..
570933 - On 120330 1439 received refill Omeprazole to treat Achalasia.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
570934 - ref SDS 71 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570936 -  ..
570937 - On 120906 1100 Doctor Egan reduced dose Omeprazole 20 mg from 40 mg,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
570938 - which increased effective treatments with current prescription.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
570939 - ref SDS 74 W165                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570941 -  ..
570942 - On 120925 1300 Doctor Lee increased dose Omeprazole 40 mg from 20 mg,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570943 - which decreases effective treatments under current prescription.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
570944 - ref SDS 75 K37G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570946 -  ..
570947 - On 120927 1214 could not order refill prescription for Omeprazole.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
570948 - ref SDS 76 3Z4M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570950 -  ..
570951 - On 121001 0820 VA ordered new prescription Omeprazole with 3 remaining                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
570952 - refills, ref SDS 78 5N3O, VA also ordered Fluconazole 200 mg, which is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
570953 - not explained in the record, ref SDS 78 EO5H, and further which                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570954 - increases side effects for Rosuvastatin, ref SDS 78 0450, but on plus                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
570955 - side Fluconazole resolves electrolytes abnormalites, in this case                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
570956 - Total Bilirubin is nearly 100% over healthy range, causing peripheral                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570957 - neuropathy. ref SDS 78 ZH6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
570959 -  ..
570960 - On 121003 1438 received in the mail Omeprazole with incorrect dose                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
570961 - prescription. ref SDS 79 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
570963 -  ..
570964 - On 121003 1438 received in the mail RX # 10864663B which conflicts                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
570965 - with RX #10864663A, ref SDS 78 5N3O and dose instructions to take 2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
570966 - pills twice a day, ref SDS 78 MH65, conflict with the doctor's order                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
570967 - to take 1 pill twice per day.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
570969 -  ..
570970 - On 130416 1100 Doctor Lee reported the VA placed hold that prevented                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
570971 - patient from ordering any of 3 refills of Omeprazole; the doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
570972 - cancelled the prior order and placed new order for current                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
570973 - prescription with 3 refills of Omeprazole. ref SDS 82 RG9K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
570975 -  ..
570976 - On 130423 1140 received refill for Omeprazole. ref SDS 84 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
570978 -  ..
570979 - On 131115 0800 meeting Doctor Lee EGD Dilation, continued prescription                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
570980 - for Omeprazole to aid digestion. ref SDS 87 R74M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
570982 -  ..
570983 - On 131121 1604 ordered refill for Omeprazole. ref SDS 89 AG9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
570985 -  ..
570986 - On 131205 1448 received prescription for Atorvastatin 20 MG,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
570987 - ref SDS 92 5N3O, ordered by Doctor Alba during the meeting at the VA                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
570988 - on 131121 0930. ref SDS 88 6H6K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
570990 -  ..
570991 - On 131219 0930 Doctor Alba ordered Ezetimibe 10 mg to take with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
570992 - Atorvastatin 10 mg, during meeting at VA. ref SDS 93 6H6K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
570994 -  ..
570995 - On 131230 1450 received Ezetimibe from VA to combine with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
570996 - Atorvastatin. ref SDS 94 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
570998 -  ..
570999 - On 140127 1821 ordered refill Ezetimibe from VA. ref SDS 95 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
571001 -  ..
571002 - On 140201 1353 received refill Ezetimibe from VA.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
571004 -  ..
571005 - On 140226 2035 only have 4 pills for Atorvastatin and Ezetimibe, so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
571006 - ordered refills. ref SDS 99 4P5M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
571007 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571008 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571009 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571010 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571012 -  ..
5711 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5712 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5713 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5714 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
571401 - Progress Notes Meeting 140213 Transmitted VA System Email                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
571402 - VA System Email Transmitted Progress Notes Meeting 140213                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
571403 - 
571404 - Follow up ref SDS A3 5N3O, ref SDS A2 4V4H.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
571405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571406 - Received letter this morning from the VA saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
571407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571408 -    1.  Subject:  Re: Progress Notes Meeting 13 Feb 2014, Thanks                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571409 -        Date:  2014-03-10 09:02                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
571416 -         ..
571417 -    2.  I just sent you the note again using the VA email. If you don't                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
571418 -        receive it, please let me know and I'll send it to you using                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
571419 -        this account.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
571421 -  ..
571422 - VA responds to the letter discussing transmission of Progress Notes,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
571423 - shown on 140308 0956, ref SDS A3 4I6G, for the meeting on 140213,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
571424 - which requested assistance getting "set up" for VA system email, or                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
571425 - alternatively, transmitting with public domain email, reported on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
571426 - 140307 1509. ref SDS A2 HW9I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
571427 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571428 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571430 -  ..
5715 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5716 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
5717 - 1018                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
5718 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
571801 - Sent letter to VA saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
571802 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571803 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571804 -    1.  Subject:  Progress Notes, Re-order Prescriptions, CT Evaluate Regression Atherosclerosis Plaque                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
571805 -        Date:  2014-03-10 10:35                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
571812 -         ..
571813 -    2.  Have still not received your VA system email transmission, sent                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
571814 -        this morning at 0902, shown above. ref SDS 0 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
571815 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571817 -  ..
571818 - Email Send Medical Records Waive HIPAA Restrictions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
571819 - Waive HIPAA Restrictions Sending Medical Records Public Domain Email                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
571820 - Public Domain Email Waive HIPAA Restrictions Sending Medical Records                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
571821 - Medical Records Transmit Public Domain Email Waive HIPAA Restrictions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
571822 - 
571823 - Follow up ref SDS A3 II80.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
571824 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571825 - Letter to VA continues...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
571827 -         ..
571828 -    3.  Please transmit Progress Notes with email account.  I don't                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
571829 -        mind driving over to the VA today and getting the Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
571830 -        Notes on a CD, if that is easier for you.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
571832 -  ..
571833 - Respond to VA letter earlier this morning requesting notice, if                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571834 - Progress Notes have not been received following transmission using "VA                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
571835 - system email," per above. ref SDS 0 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
571836 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571837 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
571838 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5719 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
5803 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
580401 -  ..
580402 - Sickness Relapse Possible Side Effects Atorvastatin Ezetimibe                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
580403 - 
580404 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
580405 - Letter to VA continues...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
580406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
580407 -    4.  Have been sick (relapse) with mild symptoms the past 5 days.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
580408 -        Mostly feel weak, sore throat in the morning, and voice/hearing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
580409 -        slightly amiss.  Eyes seem heavy or something, hard to describe                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
580410 -        - vision is okay.  Since last treatment with Atorvastatin and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
580411 -        Ezetimibe was on 140302, may weaken the case that side effects                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
580412 -        are driving current maladies.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
580414 -         ..
580415 -    5.  Have not gone out hiking since last Tuesday - probably needed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
580416 -        time off anyway.  Of course weight has trended higher.  Will                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
580417 -        start hiking today, and get back into the exercise, diet,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
580418 -        weight loss thing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
580419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
580420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5805 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
5903 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
590401 -  ..
590402 - Atorvastatin Ezetimibe Prescription Delayed 1 Week Cancel and Reorder                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
590403 - 
590404 - Follow up ref SDS A3 IE7I, ref SDS A2 5N3O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
590405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
590406 -    6.  Previously, when delay occurred getting Omeprazole, Doctor Lee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
590407 -        in EGD, Sacramento VA at Mather, cancelled the current                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
590408 -        prescription and entered a new one, reported on 130416 (see                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
590409 -        line 451701. ref SDS 82 RG9K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
590411 -         ..
590412 -    7.  Maybe that is the solution in this case to continue                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
590413 -        prescriptions for Atorvastatin and Ezetimibe.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
590414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
590415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
5905 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
6003 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
600401 -  ..
600402 - CT Evaluate Regression Atherosclerosis Plaque CVD 4 Years After CABG                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
600403 - 
600404 - Follow up ref SDS A1 WY3X, ref SDS 98 JR99.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
600405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600406 -    8.  Notice as well in the same record, report of CT test showing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
600407 -        resolution on 130122, of long-standing achalasia swallowing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
600408 -        problem about 4 years after Heller Myotomy surgery on 091216,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
600409 -        and referencing meeting at VA in San Francisco with Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
600410 -        Stewart, Chief General Surgery (see line 380502. ref SDS 80                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
600411 -        03H6                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
600413 -         ..
600414 -    9.  Would be helpful to get similar resolution of atherosclerosis                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
600415 -        plaque, now nearing 5 years after CABG +4, discussed during our                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
600416 -        meeting on 140213 (see para 8 line 430402. ref SDS 97 JZ4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
600417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600424 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600425 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600427 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600428 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600430 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600431 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600432 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600433 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600434 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600435 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600436 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
600437 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
6005 -