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: May 14, 2014 09:50 AM Wednesday;
Rod Welch
VA lab with lipid panel test cholesterol aligns with Labcorp results.
1...Summary/Objective
2...CBC WBC 9.5 Increased 50% After Several Years Stable
3...Blood Tests Evaluate Health 5 Years After CABG x4 Surgery
.............................CBC PANEL
4...Urinalysis Ketones Trace Abnormal Sp Gravity Above Range
.............................URINALYSIS PANEL
5...T Bili 2.2 Hyperbilirubinemia Worse Atorvastatin Ezetimibe
6...Potasium K 5.6 Elevated Increased Electrical Problems Heart
7...Bun/Creatinine Ratio Elevated Slightly
.............................ELECTROLYTES - CHEM PROFILE
8...Notes on Electrolytes Lab Hyperbilirubinemia Potassium Heart Problems
9...Hyperbilirubinemia Potassium Heart Problems Notes on Electrolytes Lab
10...Potassium Heart Problems Hyperbilirubinemia Notes on Electrolytes Lab
11...LDL-C 83 LDL-P 851 HDL 67 Hike 1000 Miles Weight Maintain 170
.............................LIPID PANEL
12...Lipid History Trend Analysis
13...Coronary CTA or IVUS Test Athereosclerosis Plaque 4 Years After CABG
14...Athereosclerosis Plaque 4 Years After CABG Coronary CTA or IVUS Test
15...Myopathy Muscle Pain Side Effects Simvistatin Decline
.............................CARDIAC ENZYMES
16...HGBA1c Diabetes Blood Test A1c
17...A1c Diabetes Blood Test HGBA1c
18...Diabetes HGBA1c A1c Blood Test
.............................Endocrine IV - HGBA1c - A1c
19...Cardiology Meeting on Radiology Test Regrission Atherosclerosis Plaque
20...Regrission Atherosclerosis Plaque Meeting Cardiology on Radiology Test
21...Atherosclerosis Plaque Regrission Meeting Cardiology on Radiology Test
..............
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CONTACTS
SUBJECTS
CBC Lab WBC VA No Results
2403 -
2403 - ..
2404 - Summary/Objective
2405 -
240501 - Follow up ref SDS 54 0000. ref SDS 47 0000.
240502 -
240503 - Lipids improved again with LDL-P 851 falling from 861, well below
240504 - 1000, the low end of the range. VA and Labcorp align reporting HDL 67
240505 - increased from 61, and Triglycerides 59 fell from 68. ref SDS 0 U45J
240506 - This indicates response to VA healthcare plan for regression of
240507 - artherosclerotic plaque through medication, diet and exercise.
240508 - ref SDS 0 I17G VA lab today omits CBC, so cannot cross check elevated
240509 - WBC in Labcorp test last week. ref SDS 0 RP4N Need further review of
240510 - Urinalysis finding ketones Trace Abnormal, and Specific Gravity
240511 - elevated. ref SDS 0 MT4L Electrolytes (Chem Profile) need cross check
240512 - of elevated Glucose, Sodium, and Potassium. ref SDS 0 ZG5O T Bili 2.2
240513 - 80% above range may affect liver function, and align with recent new,
240514 - mild episodes of peripheral neuropathy right foot. ref SDS 0 G34G
240515 - Elevated Potassium 5.6 may risk "electrical problems with the heart."
240516 - ref SDS 0 TN3M Elevated Chem labs (electrolytes) might be caused by
240517 - dehydration from increased urination associated with taking statin
240518 - medication, and compounded by extended hiking. ref SDS 0 KZ5O
240519 -
240520 - [On 140515 2043 VA notified consolidated test results show
240521 - progress lowering CVD risk with improved lipid management.
240522 - ref SDS 56 IM9N
240523 -
240524 -
240525 -
240526 -
240527 -
240529 - ..
2406 -
2407 -
2408 - Background
2409 -
240901 - On 131016 1632 submit letter for agenda meeting to review lab results
240902 - scheduled 131017 1000. ref SDS 36 X45G
240904 - ..
240905 - On 140131 0815 ordered another lab - cbc, electrolytes, lipid with NMR
240906 - - from Labcor to get LDL-P. ref SDS 45 X45G
240908 - ..
240909 - On 140201 1159 had full lab with NMR lipid panel drawn at John Muir
240910 - Hospital on Treat, and by Labcorp. ref SDS 46 RP4N
240912 - ..
240913 - On 140203 1147 had partial lab drawn at VA in Martinez. ref SDS 47
240914 - KK9M
240916 - ..
240917 - On 140507 0857 ordered another full lab from Labcorp with NMR lipid
240918 - panel. ref SDS 53 OO5G
240920 - ..
240921 - On 140508 1133 lab blood daw at Labcorp with John Muir Medical Center
240922 - on Treat Blvd in Concord. ref SDS 54 445G
240924 - ..
240925 - On 140514 0950 VA partial lab at Medical Center in San Francisco.
240926 - ref SDS 0 X45G
240927 -
240928 -
240929 -
240930 -
240932 - ..
2410 -
2411 -
2412 - Progress
2413 -
241301 - Blood draw today at VA health care facility for meeting at VA with
241302 - Doctor Alba on 140519, planned during prior meeting on 140213 0830.
241303 - ref SDS 50 MQ5U On 140204 1236 letter from VA says to get blood draw
241304 - at VA San Francisco Medical Center (SFMC) in order to included LDL
241305 - direct, ref SDS 48 PT3M, responding to inquiry in letter to VA on
241306 - 140128. ref SDS 44 TZ96 Letter to the VA on 140211 submitting agenda
241307 - for meeting on 140213, noted VA request for blood draw at Medical
241308 - Center in San Francisco, and presented plan to implement VA request
241309 - for next lab. ref SDS 49 HY6O
241311 - ..
241312 - Blood draw today is stored on CD pdf file stored in...
241313 -
241314 - F:\05\00003\SM\CC\AGMJ\20140514-101603\WELCH_0144_5 14 14.pdf
241315 -
241316 - F:\05\00441\CG\GG\HMC\20140514-101603\WELCH_0144_5 14 14.pdf
241317 -
241318 - F:\05\00441\SM\BGMC\20140514-101603\WELCH_0144_5 14 14.pdf
241320 - ..
241321 - See directory structure for medical records on 140320 1125.
241322 - ref SDS 51 4M5I
241324 - ..
241325 - Blood draw today compliments test 6 days ago with Labcorp to perform
241326 - NMR lipid analysis, reported on 140508 1133. ref SDS 54 445G
241328 - ..
241329 - Blood draw today follows up previous VA partial lab on 140203 1147.
241330 - ref SDS 47 ZG5O
241332 - ..
241333 - Last full VA lab was on 130529 0818. ref SDS 33 RP4N
241335 - ..
241336 - Prior full lab was on 121130 0846, ref SDS 26 RP4N, 120831 1400.
241337 - ref SDS 22 RP4N, following up 120509 1108, ref SDS 21 X45G; and before
241338 - that on 110727 1238, ref SDS 11 RP4N, and this was to prepare for
241339 - meeting in Primary Care a few weeks later on 110803 1400. ref SDS 12
241340 - U24I
241342 - ..
241343 - Partial lab to resolve skewed results from dehydration was on 121212
241344 - 0941. ref SDS 28 KK9M
241346 - ..
241347 - Went to 2nd floor for blood draw. Used right arm, no problems.
241348 -
241349 -
241351 - ..
241352 - CBC WBC 9.5 Increased 50% After Several Years Stable
241353 - Blood Tests Evaluate Health 5 Years After CABG x4 Surgery
241354 -
241355 - Follow up ref SDS 54 RP4N, ref SDS 47 RP4N.
241356 -
241357 - Prior VA CBC on 120509 1108. ref SDS 21 RP4N
241358 - Prior VA CBC on 120831 1524. ref SDS 22 RP4N
241359 - Prior VA CBC on 121130 1001. ref SDS 26 RP4N
241360 - Prior VA CBC on 130529 0818. ref SDS 33 RP4N
241361 - Prior Labcorp CBC on 140201 1159. ref SDS 46 RP4N
241362 - VA did not order CBC for lab on 140203 1147. ref SDS 47 YX8K
241363 - Prior Labcorp CBC on 140508 1149. ref SDS 54 RP4N
241365 - ..
241366 - CBC PANEL
241367 - ..
241368 - Dates......... 2014 05 14 1016 140508 140203 140201 130529
241369 - VA Labcorp VA Labcorp VA VA Labcorp
241370 - Blood Results Results Results Results Results Units Range Range
241371 - WBC 9.5 6.2 7.4 K/cmm 4.8 - 10.8 3.4 - 10.8
241372 - RBC 5.21 5.13 5.09 M/cmm 4.7 - 6.1 4.14 - 5.80
241373 - HGB 15.1 15.2 15.0 g/dL 14 - 18 12.6 - 17.7
241374 - HCT 47.0 44.2 46.2 % 42 - 52 37.5 - 51.0
241375 - MCV 90.0 86.0 90.7 fL 80 - 99 79.0 - 97.0
241376 - MCH 29.0 29.6 29.5 uug 27 - 34 26.6 - 33.0
241377 - MCHC 32.1 34.4 32.5 gm/dL 32 - 35.2 31.5 - 35.7
241378 - RDW 13.8 13.7 14.4 % 11.5 - 14.5 12.3 - 15.4
241379 - PLT 329 303 279 K/cmm 130 - 400 155.0 - 379.0
241380 - MPV 8.8 fL 7 - 10.4
241381 - NEUT % 70 69 69.9 % 40 - 80 40.0 - 74.0
241382 - LYMPH % 20 21 L 19.7 % 20 - 51 14.0 - 46.0
241383 - MONO % 8 8 7.8 % 2 - 13 4.0 - 12.0
241384 - EOS % 1 1 1.9 % .5 - 7 0.0 - 5.0
241385 - BASO % 1 1 0.7 % 0 - 2 0.0 - 3.0
241386 - NEUT # 6.7 4.3 5.2 K/cmm 1.5 - 7.9 1.4 - 7.0
241387 - LYMPH # 1.9 1.3 1.5 K/cmm 1.2 - 3.4 0.7 - 3.1
241388 - MONO # 0.7 0.5 0.6 K/cmm .2 - 1.2 0.1 - 0.9
241389 - EOS # 0.1 0.1 0.1 K/cmm .1 - .5 0.0 - 0.4
241390 - BASO # 0.1 0.1 0.1 K/cmm 0 - .2 0.0 - 0.2
241391 - ESRmVES mm/hr 0 - 10
241392 - ESRxCYT mm/hr 2 - 10
241393 - RETIC % % .66 - 2.85
241394 - RETIC # k/uL 27.9 - 121.6
241395 - Immature Granulocytes 0.0 0.0 % 0.0 - 2.0
241396 - Immature Grans (Abs) 0.0 0.0 % 0.0 - 0.1
241398 - ..
241399 - Comments:
241400 -
241401 - a. Test not performed at VA today.
241403 - ..
241404 - VA does not report results for CBC, so cannot cross check Labcorp
241405 - finding WBC 9.5 increase 50% in blood test on 140508 1133. ref SDS 54
241406 - FK6I
241408 - ..
241409 - Increased exercise explained below, ref SDS 0 I17G, may have
241410 - stimulated bone marrow to produce more new blood that increased WBC
241411 - 50% in Labcorp blood test on 140508, per above, ref SDS 0 FK6I,
241412 - explained by Doctor Johnson during a meeting at Kaiser on 030606.
241413 - ref SDS 1 JP7G
241414 -
241415 -
241416 -
241417 -
241418 -
2415 -
SUBJECTS
Urinalysis Lab VA No Results
3903 -
390401 - ..
390402 - Urinalysis Ketones Trace Abnormal Sp Gravity Above Range
390403 -
390404 - Follow up ref SDS 54 0X72, ref SDS 47 0X72.
390405 -
390406 - Prior Urinalysis test on 101207 0906. ref SDS 10 0X72
390407 - Prior Urinalysis test on 120509 1108. ref SDS 21 0X72
390408 - Prior Urinalysis test on 140201 1159. ref SDS 46 0X72
390409 - VA did not order urinalysis for lab on 140203 1147. ref SDS 47 0X72
390410 - Prior Labcorp CBC on 140508 1149. ref SDS 54 0X72
390412 - ..
390413 - URINALYSIS PANEL
390414 -
390415 - Dates..........2014 05 14 1016 140203 140201 120509
390416 - VA Labcorp VA Labcorp VA VA Labcorp
390417 - Results Results Results Results Results Units Range Range
390418 - PH 5.5 5.5 6.0 5 - 9 5.0 - 7.5
390419 - PROTEIN NEG NEG NEG mg/dL NEG - TRACE NEG - TRACE
390420 - GLUCOSE NEG NEG NEG mg/dL Ref: NEG NEG
390421 - KETONES Trace Abnormal NEG NEG mg/dL Ref: NEG NEG
390422 - BILI NEG NEG NEG Ref: NEG NEG
390423 - BILIcnf Ref: NEG
390424 - BLOOD TRACE TRACE TRACE Ref: NEG
390425 - NITRITE, URINE NEG NEG NEG Ref: NEG NEG
390426 - UROBILI 0.2 0.2 0.2 EU/dL .2 - 1 0.0 - 1.9
390427 - LEU EST NEG Ref: NEG
390428 - SP.GRAV H 1.036 1.026 1.025 1.003- 1.035 1.005 - 1.030
390429 - COLOR YELLOW YELLOW YELLOW
390430 - APPEAR CLEAR CLEAR CLEAR
390431 - WBC ESTERASE NEG NEG
390432 - OCCULT BLOOD NEG NEG NEG
390434 - ..
390435 - Comments:
390436 -
390437 - a. Test not performed at VA today.
390439 - ..
390440 - VA does not report results for Urinalysis, so cannot cross check
390441 - Labcorp adverse findings in blood test on 140508 1133. ref SDS 54 FK6I
390442 -
390443 -
390444 -
390445 -
390446 -
390447 -
390448 -
3905 -
SUBJECTS
Lab Electrolytes Chem Profile Glucose 97 Sodium NA 144 Potasium K 5.
5603 -
560401 - ..
560402 - T Bili 2.2 Hyperbilirubinemia Worse Atorvastatin Ezetimibe
560403 - Potasium K 5.6 Elevated Increased Electrical Problems Heart
560404 - Bun/Creatinine Ratio Elevated Slightly
560405 -
560406 - Follow up ref SDS 54 KK9M, ref SDS 47 KK9M.
560407 -
560408 - Prior CHEM PROFILE on 120509 1108. ref SDS 21 KK9M
560409 - Prior CHEM PROFILE on 120831 1524. ref SDS 22 KK9M
560410 - Prior CHEM PROFILE on 130228 1140. ref SDS 31 KK9M
560411 - Prior CHEM PROFILE on 130529 0818. ref SDS 33 KK9M
560412 - Prior CHEM PROFILE on 131015 0724. ref SDS 35 KK9M
560413 - Prior CHEM PROFILE Labcorp on 140201 1159. ref SDS 46 KK9M
560414 - Prior CHEM PROFILE on 140203 1147. ref SDS 47 KK9M
560415 - Prior CHEM PROFILE Labcorp on 140508 1149. ref SDS 54 KK9M
560417 - ..
560418 - ELECTROLYTES - CHEM PROFILE
560420 - ..
560421 - Dates..........2014 05 14 1016 140508 140203 140201 131015 130529
560422 - VA Labcorp VA Labcorp VA VA VA Labcorp
560423 - PLASMA Results Results Results Results Results Results Units Range Range
560424 - GLUCOSE 97 103 98 108 H 120 mg/dL 74 - 118 65.0 - 99.0
560425 - GLUfast mg/dL Ref: <=99
560426 - NA (salt) 144 140 140 139 139 mmol/L 136 - 144 134.0 - 144.0
560427 - K (potasium) H 5.6 H 5.4 4.8 4.3 H 4.9 mmol/L 3.4 - 4.8 3.5 - 5.2
560428 - CL 105 103 102 105 105 mmol/L 98 - 106 97.0 - 108.0
560429 - CO2 30.0 37.0 30.0 mmol/L 23 - 33
560430 - BUN/Creati Ratio H 23 17 20 24 18 mg/dL 8 - 26 10.0 - 22.0
560431 - CREAT 0.97 0.82 0.81 0.83 0.83 mg/dL .5 - 1.1 0.76 - 1.27
560432 - eGFR INA 79 >60 91 >60 >60 mL/min Ref: >=60 >59
560433 - eGFR IA 92 106 mL/min >59
560434 - CALCIUM 9.5 9.3 9.4 9.2 9.2 mg/dL 8.7 - 10.2 8.6 - 10.2
560435 - CA CORR mg/dL 8.7 - 10.2
560436 - PO4 mg/dL 2.4 - 4.5
560437 - MG 85 mg/dL 1.8 - 2.5
560438 - ALK PHO 100 105 84 87 IntUnits/L 37 - 107 39.0 - 117.0
560439 - ..
560440 - T. BIL H 2.2 H 1.3 H 2.1 H 1.6 H 1.7 H 1.3 mg/dL .1 - 1.2 0.0 - 1.2
560441 - D. BILI 0.2 0.32 0.3 0.34 < 0.1 mg/dL .1 - .5 0.00 - 0.40
560442 - Bilirubin, Indir 0.98 1.26 H mg/dL 0.10 - 0.80
560443 - AST 26 23 21 20 22 IntUnits/L 8 - 42 0.0 - 40.0
560444 - ALT 17 21 19 17 19 IntUnits/L 5 - 55 0.0 - 44.0
560445 - ALBUMIN 4.6 4.6 4.1 4.4 3.9 4.0 g/dL 3.3 - 5.2 3.6 - 4.8
560446 - PROTEIN 7.5 6.6 6.7 6.5 7.1 7.2 g/dL 6.0 - 8.5 6.0 - 8.5
560447 - Globulin, Total 2.0 2.1 g/dL 1.4 - 4.5
560448 - A/G Ratio 2.3 2.1 1.1 - 2.5
560449 - LDH 200.0 180.0 IntUnits/L 90 - 208 0.0 - 225.0
560450 - GGT 11.0 9.0 IU/L 0.0 - 65.0
560451 - Iron, Serum 100.0 114.0 ug/dL 40.0 - 155.0
560452 - AMYLASE Units/L 28 - 100
560453 - LIPASE Units/L 7 - 58
560454 - NH3 mcmol/L 15 - 56
560455 - URIC AC 5.6 mg/dL 4.8 - 8.7 3.7 - 8.6
560456 - Cholesterol, Total 164.0 162.0 mg/dL 100.0 - 199.0
560457 - Triglycerides 55.0 64.0 mg/dL 0.0 - 149.0
560458 -
560460 - ..
560461 - a. SLIGHTLY ICTERIC SPECIMEN /HN
560463 - ..
560464 - b. Ordering Provider: Diana Alba
560465 - Report Released..: May 14, 2014@11:29
560466 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
560467 - 4150 CLEMENT STREET
560468 - SAN FRANCISCO, CA 94121-1545
560469 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
560470 -
560471 -
560472 -
560474 - ..
560475 - Notes on Electrolytes Lab Hyperbilirubinemia Potassium Heart Problems
560476 - Hyperbilirubinemia Potassium Heart Problems Notes on Electrolytes Lab
560477 - Potassium Heart Problems Hyperbilirubinemia Notes on Electrolytes Lab
560478 -
560479 - Follow up ref SDS 54 G34G, ref SDS 47 G34G.
560480 -
560481 - 1. T Bilirubin 2.2................. ref SDS 0 015M
560482 -
560483 - Bilirubin 2.2 in lab today, elevated 80% above range after
560484 - ending Rosuvastatin 17 months ago on 121206 0900, ref SDS 27
560485 - OS5L, - with continuing side effects of poor liver function
560486 - that may align with new, recent mild episodes peripheral
560487 - neuropathy in right foot, reported on 140510, shown in case
560488 - study on 120101 0900. ref SDS 16 TV6I Until then there had
560489 - been no symptoms for past 9 months, since 130614, reported in
560490 - case study on 120101 0900. ref SDS 16 TSUY Prior to 130614,
560491 - there were no episodes for several months reported on 130402,
560492 - ref SDS 16 RURT, until episode occurred on 130210. ref SDS 16
560493 - PV8I Major peripheral neuopathy both feet on 130107.
560494 - ref SDS 16 8H5F
560495 -
560496 - [On 140520 0732 follow up lab at VA shows T Bili 1.2,
560497 - falling dramatically to within range, ref SDS 59 G34G, from
560498 - being elevated at 2.2 recorded in test today on 140514, per
560499 - above. ref SDS 0 015M
560501 - ..
560502 - Background on Rosuvastatin causing elevated T Bilirubin with
560503 - associated severe side effects is reported on 121206 0900,
560504 - ref SDS 27 NI9L, and further explained in the record on 121130
560505 - 0846. ref SDS 26 ER4K
560507 - ..
560508 - On 131017 1000 Doctor Egan explained patient history of
560509 - intermittant and mild peripheral neuropathy that correlates
560510 - with persistent elevated T Bilirubin in lab on 131015,
560511 - ref SDS 35 015M, and further reported with vitals, diet and
560512 - exercise since prior meeting at VA on 130603, see case study on
560513 - 120101 0900, ref SDS 16 X14N, suggests intervention is not
560514 - required at this time to improve recovery from side effects
560515 - taking Rosuvastatin. ref SDS 37 LV5J
560517 - ..
560518 - On 131017 1000 VA medical chart Progress Notes assessment
560519 - report doctor concerned about chronic hyperbilirubinemia.
560520 - ref SDS 37 PSXT
560522 - ..
560523 - 2. Potasium K 5.6 Elevated above range......... ref SDS 54 ZG5O
560524 -
560525 - Labcorp blood test last week on 140508 reported potassium 5.6
560526 - increased from 4.8 on prior Labcorp lab and 5.4 on VA lab from
560527 - 3 months ago, shown on 140203 1147. ref SDS 47 ZG5O VA lab did
560528 - not report results for Potassium today. ref SDS 0 ZG5O
560530 - ..
560531 - Doctor Egan, referring cardiology physician at Martinez VA,
560532 - noted in a recent letter that meeting at VA Medical Center in
560533 - San Francisco on 140213 0830, ref SDS 50 GT7G, did not address
560534 - elevated potassium in labs performed by Labcorp and VA, shown
560535 - on 140203 1147. ref SDS 47 ZG5O Doctor Egan again notifies
560536 - that this condition of elevated potassium represents exposure
560537 - to "electrical problems" with the heart, reported on 140430.
560538 - ref SDS 52 UV5I
560539 -
560540 - [On 140515 2043 letter submits agenda for meeting on
560541 - 140519, and notifies VA Medical Center in San Francisco
560542 - that glucose, sodium and potassium are elevated above
560543 - expected levels in Labcorp Lab on 140508, and reminds that
560544 - Doctor Egan issued request for re-lab because elevated
560545 - potassium presents electrical problems for the heart, which
560546 - is at risk in this case based on CABG +4 on 091022.
560547 - ref SDS 56 YM75
560549 - ..
560550 - Doctor Egan was concerned last year about potasium (K) rising
560551 - above range for good health. He explained potasium effects
560552 - electrical signals to the heart, and so has significance for
560553 - CVD, reported during meeting at VA on 121206 0900. ref SDS 27
560554 - 6K56
560556 - ..
560557 - At that time on 121206, the doctor cited medication conflicts
560558 - as possibly causing elevated potasium. ref SDS 27 FI7L Doctor
560559 - Egan further considered dehydration (urination) caused by
560560 - Rosuvastatin may have skewed lab results for electrolytes on
560561 - 121130, and so ordered re-test. ref SDS 27 6K4J
560563 - ..
560564 - On 121212 0941 re-test lab reported Glucose 111, sodium 139,
560565 - and potasium (K) 4.6, all within range, ref SDS 28 KK9M,
560566 - correcting errors noted by Doctor Egan during meeting at VA on
560567 - 121206 0900. ref SDS 27 6K4J
560569 - ..
560570 - At this time, dehydration from increased urination, possibly
560571 - caused by statin medication, and combined with hiking 22 miles
560572 - yesterday, and another 11 miles this moring before the blood
560573 - draw, reported in case study on 120101 0900, ref SDS 16 4G5I,
560574 - might reconcile elevated potasium (K 5.6).
560576 - ..
560577 - 3. Glucose 97...................... ref SDS 0 ZG5O
560578 -
560579 - Glucose near upper range 99 of Labcorp blood test last week on
560580 - 140508, presents risk diabetes, see above. ref SDS 0 ZG5O Like
560581 - potassium, ref SDS 0 KZ5O, glucose may be elevated by
560582 - dehydration taking statin medication, and by hiking 22 miles
560583 - yesterday and 11 miles this morning before the lab, reported in
560584 - case study on 120101 0900. ref SDS 15 4G5I
560585 -
560586 - [...below on 140514 0950 VA lab today for HGBA1c 5.6 within
560587 - range 4 - 6, seems to indicate no evident exposure for
560588 - diabetes. ref SDS 0 H66G
560589 -
560590 -
560591 -
560592 -
560593 -
560594 -
560595 -
560596 -
560597 -
560598 -
5606 -
SUBJECTS
VA Lab Lipid Cholesterol 164 with Medication Hiking 1000 Miles Weigh
7603 -
760401 - ..
760402 - LDL-C 83 LDL-P 851 HDL 67 Hike 1000 Miles Weight Maintain 170
760403 -
760404 - Follow up ref SDS 54 IM9N, ref SDS 47 IM9N.
760405 -
760406 - Excellent VA results today align with Labcorp blood test using NMR
760407 - technology reported last week on 140508 1133. ref SDS 54 5C7M This
760408 - reflects increased hiking and weight control past 3.5 months, reported
760409 - in case study on 120101 0900, ref SDS 16 PYXR, and supported with low
760410 - carb diet (including orange juice) and low dose medication, reported
760411 - on 140513, in the same study. ref SDS 16 ZU5G
760412 -
760413 - [On 140515 2043 VA notified consolidated test results show
760414 - progress lowering CVD risk with improved lipid management.
760415 - ref SDS 56 IM9N
760417 - ..
760418 - [On 140520 0732 letter to VA notifies Doctor Alba confirm
760419 - work plan to continue statin medication with Atorvastatin
760420 - 10 mg and Ezetimibe 10 mg despite rising peripheral
760421 - neuropathy because symptoms at this time are mild, and
760422 - lipid results are favorable. ref SDS 58 4U4F
760424 - ..
760425 - Prior LIPID PANEL 120509 1108. ref SDS 21 IM9N
760426 - Prior LIPID PANEL 120831 1525. ref SDS 22 IM9N
760427 - Prior LIPID PANEL 130228 1140. ref SDS 31 IM9N
760428 - Prior LIPID PANEL 130529 0818. ref SDS 33 IM9N
760429 - Prior LIPID PANEL 131015 0724, ref SDS 35 IM9N
760430 - Prior LIPID PANEL Labcorp, 140201 1159, ref SDS 46 IM9N
760431 - Prior LIPID PANEL, 140203 1147, ref SDS 47 IM9N
760432 - Prior CHEM PROFILE Labcorp on 140508 1149. ref SDS 54 IM9N
760434 - ..
760435 - LIPID PANEL
760437 - ..
760438 - Dates..........2014 05 14 1016 140508 140203 140201 131015 130529
760439 - VA Labcorp VA Labcorp VA VA VA Labcorp
760440 - NMR LipoProfile Results Results Results Results Results Results Units Range Range
760441 - LDL Particle Number
760442 - LDL-P 851.0 861.0 nmol/L < 1000
760443 - <ow < 1000
760444 - Moderate 1000 - 1299
760445 - Borderline High 1300 - 1599
760446 - High 1600 - 2000
760447 - Very High > 2000
760449 - ..
760450 - Lipids
760451 - CHOL (a) 164 162 160 156 321 H 307 mg/dL 100 - 240 < 200
760452 - (b) 169
760453 - TRIGLYC (a) 58 59 47 68 109 85 mg/dL 10 - 190 < 150
760454 - (b) 59
760455 - HDL-C (a) 66 67 58 61 50 50 mg/dL Ref: >=35 >= 40
760456 - (b) 67
760457 - LDL-C (a) 87 83 93 81 249 H 240 mg/dL Ref: <=131 < 100
760458 - (b) 90
760459 - ** LDL Dir 93 mg/dL 0 - 130
760460 - TRIG NF mg/dL Ref: <=150
760462 - ..
760463 - TG/HDL ratio (a).... 0.88 0.88 0.81 1.11 < 2.0
760464 - (b).... 0.88
760466 - ..
760467 - Comments
760468 -
760469 - a. Format and scope VA lab report changed by adding multiple
760470 - (a and b) values for several elements; changed ranges.
760471 - HDL target lowered from 40 to 35.
760472 -
760473 - A and B values not clear in the record.
760475 - ..
760476 - These multiple values for each blood element may indicate the VA did a
760477 - second test to verify initial exceptionally good results that "seem
760478 - too good to be true" - particularly HDL 67 increasing 34% in 6 months
760479 - since October 2013. In this case, VA results align (i.e., are nearly
760480 - identical) with Labcorp test a few days earlier. ref SDS 0 5C7M
760481 -
760482 - [On 140515 2043 notified VA lab reporting multiple values
760483 - is a new format. ref SDS 56 YM6T
760485 - ..
760486 - VA Lipid Panel report continues...
760487 -
760488 - b. SLIGHTLY Hemolyzed specimen /HN
760489 - Evaluation for HDL:
760490 - HDL <35 is associated with increased risk of CAD.
760491 - Evaluation for LDL CHO:
760492 - Desired LDL: <130 mg/dL; evaluate in light of CHD risk factors.
760494 - ..
760495 - ** c. Evaluation for DLDL:
760496 - DLDL ref.range: <100 mg/dL = Optimal; 100-129 mg/dL = Near
760497 - Optimal; 130-159 mg/dL = Borderline High; >/=160 mg/dL =
760498 - High.
760500 - ..
760501 - Ordering Provider: Diana Alba
760502 - Report Released..: May 14, 2014@11:30
760503 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
760504 - 4150 CLEMENT STREET
760505 - SAN FRANCISCO, CA 94121-1545
760506 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
760507 - 4150 CLEMENT STREET
760508 - SAN FRANCISCO, CA 94121-1545
760510 - ..
760511 - c. SLIGHTLY ICTERIC SPECIMEN /HN
760512 -
760513 - Ordering Provider: Diana Alba
760514 - Report Released..: May 14, 2014@11:30
760515 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
760516 - 4150 CLEMENT STREET
760517 - SAN FRANCISCO, CA 94121-1545
760518 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
760519 - 4150 CLEMENT STREET
760520 - SAN FRANCISCO, CA 94121-1545
760521 -
760523 - ..
760524 - Analysis....
760525 -
760526 - 1. LDL-P 851, ref SDS 54 U45J, represents lower CVD risk and
760527 - improving lipid management. LDL-C 83 increased 2 points from
760528 - prior lab on 140201. It remains low concordant with LDL-P, but
760529 - moving toward discordance. Research indicates healthiest
760530 - cardiovascular condition occurs with lowest risk for CVD, when
760531 - lipids are discordant, with LDL-P low and LDL-C high, shown in
760532 - the record on 131125 0005. ref SDS 41 FI3G
760534 - ..
760535 - VA published goal LDL-C <= 131; Labcorp published goal LCL-C <
760536 - 100. ref SDS 0 5C7M New AHA guidelines show LDL-C < 190,
760537 - reported on 131112 1422. ref SDS 39 HT87
760539 - ..
760540 - VA lowering goal to HDL > 35 from > 40 seems conflicting with
760541 - patient history of CABG +4 on 091022 0700. ref SDS 3 PQWU
760542 - Since HDL 30 was found at that time (see Lipid history below,
760543 - ref SDS 0 W25L, setting the bar at HDL 35 has little tolerance
760544 - for genetic variation to avoid and repair endothelium lesions
760545 - causing atheriosclerotic plaque.
760547 - ..
760548 - NMR test lists LDL-P < 1600 for "borderline" CVD high risk, and
760549 - that below 1000, is "low," risk for CVD. ref SDS 47 U45J Thus,
760550 - LDL-P 851 presents low risk for CVD. Research on 131125, lists
760551 - LDL-P < 700 may be a better target to manage CVD risk.
760552 - ref SDS 41 WY9H The same research also cites LDL-P < 1000 for
760553 - evaluating CVD risk, similar to NMR test today. ref SDS 41 OQ9N
760555 - ..
760556 - When can patients be confident LDL-P < 700, 600, 200 - is low
760557 - enough to work on other aspects of daily life?
760559 - ..
760560 - EPC and CTA with calcium score standard of care to test for
760561 - regression of atheroclerosis, reported in research on 131125
760562 - 0005. ref SDS 41 RA7K
760564 - ..
760565 - 2. LDL-P 851 in Labcorp test today on 140508, correlates with
760566 - TG/HDL ratio 59/67 = 0.88. ref SDS 54 5C7M Research indicates
760567 - TG/HDL ratio correlates to LDL-P vaulations produced by NMR
760568 - testing, reported on 131125 0005. ref SDS 41 666G
760570 - ..
760571 - 3. Resting heart rate getting up in the morings has fallen below
760572 - 50. Blood pressure varies - averages about 115 65. After
760573 - hikes about 105 55. Systalic on occassion falls below 100.
760574 - Dystalic has fallen below 50 - e.g., see Monday 140428 reported
760575 - in case study on 120101 0900. ref SDS 16 CB6N
760577 - ..
760578 - 4. LDL-P 851 and HDL 67 and Triglycerides 59 on 140508, indicate
760579 - low risk for CVD, per above analysis, ref SDS 54 RV5M, and may
760580 - align with hiking 22 miles yesterday on 140507, and 11 miles
760581 - this morning at 0400 (see again case study - ref SDS 16 4G5I),
760582 - before doing the blood draw later this morning at 1149.
760583 - ref SDS 54 U45J
760585 - ..
760586 - 5. Lipid favorable results in NMR test on 140508, and follow up
760587 - test at VA on 140514, particularly increase HDL
760588 - occurred concurrent with...
760589 -
760590 - [On 140520 0732 letter notifies Doctor Alba at VA
760591 - getting good labs through prescribed care integrating
760592 - diet, exercise, and medications. ref SDS 57 4U46
760594 - ..
760595 - a. Hiking 955 miles since prior lab on 140203, reported in
760596 - case study 120101 0900, ref SDS 16 P36G, and recommended in
760597 - research on 131125 0005. ref SDS 41 QP9F including regular
760598 - aerobic exercise to lower triglycerides, ref SDS 41 U44L,
760599 - and raise HDL, ref SDS 41 SH50, and raise EPC production
760600 - toward regression of atherosclerosis plaque. ref SDS 41
760601 - 6O9M
760602 -
760603 - [On 140529 0942 letter asks VA to present record of care
760604 - that includes extended training exercise that yielded
760605 - significantly improved lipid labs. ref SDS 60 QF67
760607 - ..
760608 - b. Weight - hit 163 yesterday on 140513, shown in case study
760609 - on 120101 0900. ref SDS 16 ZU5G This is lowest is about 30
760610 - years. On 140420 was able to hold 165 for 3 days.
760611 - ref SDS 16 TO6O This is continuing challenge bouncing
760612 - around from over 200 in 2011, but varied significantly.
760613 - Daily weight remains generally between 170 - 175.
760615 - ..
760616 - c. Low-carbohydrate diet lowers triglycerides (TG 59 in
760617 - Labcorp and VA tests, per above, ref SDS 0 5C7M), which
760618 - together with higher HDL 67 (TG/HDL ratio .88 < 2,
760619 - ref SDS 0 5X5G, combine to lower LDL-P, cited in research
760620 - on 131125 0005. ref SDS 41 QP9F
760622 - ..
760623 - d. Chia seeds added to diet on 131125, reported in case study
760624 - on 120101 0900, ref SDS 16 746M, and recommended by Karen
760625 - at VA on 131121 0930. ref SDS 40 NQ37
760627 - ..
760628 - e. Orange juice 1 gallon (3786 ML) per week (541 ML/day) added
760629 - to diet on 131125, based on study indicating HDL increased
760630 - 21% over 4 weeks with 750 ml per day (i.e., 1.4 gal per
760631 - week), ref SDS 41 R48K, as reported to VA in letter on
760632 - 140114 0845. ref SDS 43 218O Some research also indicates
760633 - grape juice increases HDL; however, no studies have
760634 - quantified this effect. Patient consumes combination of
760635 - lemon juice, orange juice, and grape juice in large
760636 - quantities to hydrate after hiking 11 miles per day.
760638 - ..
760639 - HDL 50 increased to HDL 67 = 34% rise in 6 months from Dec
760640 - 2013 - May 2014, shown in patient history below.
760641 - ref SDS 0 W25L This is approximately 7% for each 4 week
760642 - period, which may reflect taking 541 ML of orange juice
760643 - rather than 750 ML per day found effective in research
760644 - study shown in the record on 131125 0005. ref SDS 41 K34L
760645 - Raising HDL consistently 7% over 4 weeks for 6 months
760646 - taking only 541 ML in this case, presents improved results
760647 - compared to study results finding 500 ML of orange juice
760648 - for 4 weeks had no effect on HDL levels. Improved results
760649 - in this case may indicate that orange juice at 540 ML/day
760650 - combined with hiking 11 miles per day, explained above (see
760651 - para a), ref SDS 0 I17G, provides a direct path to improve
760652 - lipid profiles toward avoiding and regressing
760653 - atherosclerosis plaque.
760655 - ..
760656 - f. Atorvastatin 10 mg with Ezetimibe 10 begun on 131230,
760657 - reported in case study on 120101. ref SDS 16 6A6H
760659 - ..
760660 - Research studies report Atorvastatin 10 mg + Ezetimibe 10
760661 - mg achieves LDL < 70, and favorably changes triglycerides
760662 - and HDL by 5%, reported on 131125 0005. ref SDS 41 CO45
760663 - While low LDL < 70 conflicts with goal of "discordance"
760664 - that lowers health risk for arterialsclorosis and CVD when
760665 - LDL-P low and LDL-C high, shown in research on 131125 0005,
760666 - ref SDS 41 FI3G, even "concordant" results today are good
760667 - news.
760669 - ..
760670 - Since prior lab on 140201, until lab at VA today on 140508,
760671 - case study shows on 120101, ref SDS 16 E47L, patient has
760672 - taken...
760673 -
760674 - 1. Atorvastatin............... 900 mg
760675 - 2. Ezetimibe.................. 900 mg
760676 -
760678 - ..
760679 - Lipid History Trend Analysis
760680 -
760681 - Follow up ref SDS 54 W25L, ref SDS 26 W25L.
760682 -
760683 - Small LDL LP-IR
760684 - Collection DT CHOL TRIGL HDL LDL-C LDL-P HDL-P LDL-P SIZE SCORE LDL-D
760685 - 05/14/2014 10:16 164 58 67 87 .................................... 93.. ref SDS 0 5C7M
760686 - 05/08/2014 11:49 162 59 67 83 851 38.1 < 90 21.2 < 25 ..... ref SDS 54 BE6O
760687 - 02/03/2014 12:28 160 H 47 58 93 ......................................... ref SDS 47 BE6O
760688 - 02/01/2014 12:31 156 68 61 81 861 31.4 < 90 21.3 < 25 ..... ref SDS 46 BE6O
760689 - 10/15/2013 08:25 321 H 109 50 249 H ......................................... ref SDS 35 BE6O
760690 - 05/29/2013 08:18 307 H 85 50 240 H ......................................... ref SDS 31 BE6O
760691 - 02/28/2013 08:39 310 H 73 47 248 H ......................................... ref SDS 31 BE6O
760692 - 11/30/2012 10:01 173 53 57 105 ......................................... ref SDS 26 BE6O
760693 - 08/31/2012 15:25 176 94 47 110 ......................................... ref SDS 22 U89N
760694 - 05/09/2012 11:24 158 76 49 94 ......................................... ref SDS 21 U89N
760695 - 02/09/2012 11:18 285 82 41 228 H ......................................... ref SDS 17 2A4G
760696 - 11/17/2011 14:27 260 84 43 200 H ......................................... ref SDS 15 2A4G
760697 - 07/27/2011 12:58 163 81 45 102 ......................................... ref SDS 11 E19L
760698 - 12/07/2010 09:17 151 41 47 96 ......................................... ref SDS 10 E19L
760699 - 07/21/2010 08:54 261 H 87 35 L 209 H ......................................... ref SDS 6 E19L
760700 - 06/10/2010 10:33 217 H 83 36 L 164 H ......................................... ref SDS 5 QV4F
760701 - * 12/14/2009 11:10 241 H 136 44 170 H ......................................... 100928 0706, ref SDS 7 VW6J
760702 - 08/13/2009 15:09 233 H 118 30 L 179 H ......................................... 100610 1046, ref SDS 5 U45G
760703 - 06/16/2006 10:59 238 H 68 32 L 192 H ......................................... 091002 0900, ref SDS 2 LJ5H
760704 -
760705 - * Lab at VA San Francisco Medical Center reported on 100928 0706.
760706 - ref SDS 7 VW6J
760708 - ..
760709 - Research on cholesterol reported on 091002 0900. ref SDS 2 2F8K
760711 - ..
760712 - On 131125 0005 research found ezetimibe (zetia) mg added to
760713 - Atorvastatin 20 mg yielded after 6 weeks significantly greater changes
760714 - to lipids than taking Atorvastatin in higher doses, e.g., 20 or 40 mg.
760715 - ref SDS 41 CO56
760717 - ..
760718 - On 131125 0005 research found discordance LDL-P low and LDL-C high
760719 - lipid panel HDL 65 TG 77 healthy patient profile with LDL 246.
760720 - ref SDS 41 MN98 Discordance with LDL-P low and LDL-C high is lowest
760721 - risk for CVD, arterialsclorosis. ref SDS 41 FI3G
760722 -
760723 -
760725 - ..
760726 - Coronary CTA or IVUS Test Athereosclerosis Plaque 4 Years After CABG
760727 - Athereosclerosis Plaque 4 Years After CABG Coronary CTA or IVUS Test
760728 -
760729 - On 131125 0005 research further found radiology imaging tests can
760730 - evaluate level of plaque build up resulting from elevated cholesterol.
760731 - ref SDS 41 N73K Radiology imaging technologies are Coronary CT
760732 - angiography - CTA - and Intravascular ultrasound - IVUS. ref SDS 41
760733 - KZ8O
760735 - ..
760736 - Lipid history and particularly the past 6 months with HDL > 60 and
760737 - Triglycerides < 100, ref SDS 54 W25L, indicates patient may have change
760738 - body chemestry sufficient to cause rapid regression of atherosclerosis
760739 - plaque, cited in research on 131125 0005. ref SDS 41 RA7K Research
760740 - indicates that favorable lipid profile, weight loss, and production of
760741 - EPC in the bone marrow, all stimulated by exercise, drives regression
760742 - of plaque. ref SDS 41 XY7L
760744 - ..
760745 - The next step monitoring results of medical, diet, and exercise
760746 - interventions the past 4 years, since CABG +4 on 091022 0700,
760747 - ref SDS 3 PQWU, is to perform radiology imaging study with coronary CT
760748 - angiography or IVUS to assess regression of atherosclerosis plaque,
760749 - which previously required major surgery to fix.
760751 - ..
760752 - This step is supported by patient history using CT radiology imaging
760753 - to assess regression of esophageal bubble after 4 years of medical
760754 - interventions, reported favorable by Doctor Stewart, Chief General
760755 - Surgery at VA on 130122 1330. ref SDS 29 03H6
760756 -
760757 -
760758 -
760759 -
760760 -
760761 -
7608 -
SUBJECTS
VA Lab Cardiac Enzymnes Creatine Kinase CK also CPK Creatine Phospho
8403 -
840401 - ..
840402 - Myopathy Muscle Pain Side Effects Simvistatin Decline
840403 -
840404 - Follow up ref SDS 54 D26G, ref SDS 47 D26G.
840405 -
840406 - Prior Cardiac Enzymes Profile on 120209 1118. ref SDS 17 D26G
840407 - Prior Cardiac Enzymes Profile on 120509 1108. ref SDS 21 D26G
840408 - Prior Cardiac Enzymes, 131015 0724, ref SDS 35 D26G
840409 - Prior Cardiac Enzymes Profile VA on 140203 1147. ref SDS 47 NX6G
840411 - ..
840412 - This test not performed by Labcorp with blood draw on 140508...
840413 -
840414 - CARDIAC ENZYMES
840415 -
840416 - Dates 2014 05 14 1016 140508 140203 131015 120509
840417 - VA Labcorp VA VA VA
840418 - PLASMA Results Results Results Results Results Units Range
840419 - CPK (CK) 192 149 110 152 U/L 30 - 235
840420 - TRPONIN ng/ml 0 - 0.07
840421 - CK-MB ng/ml 0.6 - 3.5
840422 - MYOGLOB ng/ml 20 - 82
840424 - ..
840425 - a. CPK/CK test not performed by Labcorp
840427 - ..
840428 - b. SLIGHTLY ICTERIC SPECIMEN /HN
840430 - ..
840431 - c. Ordering Provider: Diana Alba
840432 - Report Released..: May 14, 2014@11:29
840433 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
840434 - 4150 CLEMENT STREET
840435 - SAN FRANCISCO, CA 94121-1545
840436 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
840438 - ..
840439 - CKP and CK are the same thing - creatine phosphokinase (CPK) also
840440 - called creatine kinase (CK).
840441 -
840442 - http://www.scai.org/SecondsCount/Resources/Detail.aspx?cid=ed385473-d4e8-491e-9ce0-a7c984fe6f8e#.U3b_BfldWi8
840444 - ..
840445 - Research on 111013 explains Creatine Kinase CK, relates to muscle
840446 - disorders caused by cholesterol medications with statins. 111013 1404,
840447 - ref SDS 14 J54K
840449 - ..
840450 - CK lab may align with reduced side effects of muscle pain in left
840451 - shoulder.
840452 -
840453 -
840454 -
840455 -
840456 -
840457 -
8405 -
SUBJECTS
HGBA1C 5.4 Range 4.0-6.0 Diabetes Negative Laboratory Blood Test Cro
A103 -
A10401 - ..
A10402 - HGBA1c Diabetes Blood Test A1c
A10403 - A1c Diabetes Blood Test HGBA1c
A10404 - Diabetes HGBA1c A1c Blood Test
A10405 -
A10406 - Follow up ref SDS 54 9F4O, ref SDS 47 9F4O.
A10407 -
A10408 - Prior HGBA1c Profile on 100721 0800. ref SDS 6 IL4N
A10409 - Prior HGBA1c Profile on 101207 0906. ref SDS 10 IL4N
A10410 - Prior HGBA1c Profile on 131015 0724. ref SDS 35 9F4O
A10411 - Prior HGBA1c Profile on 140203 1147. ref SDS 47 9F4O
A10413 - ..
A10414 - This test not performed by Labcorp with blood draw on 140508...
A10416 - ..
A10417 - Endocrine IV - HGBA1c - A1c
A10418 -
A10419 - Dates..........2014 05 14 1016 140508 140203 131015 101207
A10420 - VA Labcorp VA VA VA
A10421 - BLOOD Results Results Results Results Results Units Range
A10422 - HGBA1c 5.4 5.5 5.5 5.7 % 4.0 - 6.0
A10423 - eAG 111 111 mg/dL 74.0 - 118
A10425 - ..
A10426 - Comments:
A10427 -
A10428 - a. Labcorp did not perform HGBA1c lab
A10429 -
A10430 - b. Ordering Provider: Diana Alba
A10431 - Report Released..: May 14, 2014@11:29
A10432 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
A10433 - 4150 CLEMENT STREET
A10434 - SAN FRANCISCO, CA 94121-1545
A10435 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
A10437 - ..
A10438 - This test for diabetes was ordered by Doctor Abrams during a meeting
A10439 - at the San Francisco VA Medical Center on 130227 0930. ref SDS 30 8T5L
A10440 - However, it is not reported for the lab performed the next day on
A10441 - 130228 1140, ref SDS 31 RP4N, nor in the follow up lab 3 months later
A10442 - on 130529 0818. ref SDS 33 RP4N
A10444 - ..
A10445 - HGBA1c was performed previously on 101207 0906, ref SDS 10 IL4N, and 5
A10446 - months earlier on 100721 0800. ref SDS 6 IL4N
A10448 - ..
A10449 - Labcorp test showing LP-IR Score < 25.0, indicating very low risk of
A10450 - diabetes, reported on 140508. ref SDS 54 TU6L
A10452 - ..
A10453 - Glucose 97 near upper range 79 99, Labcorp electrolyte panel last week
A10454 - on 140508, per above, ref SDS 0 ZG5O, indicates potential diabetes
A10455 - risk, but may be elevated by dehydration from statin medication and
A10456 - hiking 22 miles the day before the lab and 11 miles the morning before
A10457 - getting the blood draw, reported on 140508 1133. ref SDS 54 QW6K
A10458 -
A10459 -
A10460 -
A105 -
SUBJECTS
Default Null Subject Account for Blank Record
A203 -
A20401 - ..
A20402 - Cardiology Meeting on Radiology Test Regrission Atherosclerosis Plaque
A20403 - Regrission Atherosclerosis Plaque Meeting Cardiology on Radiology Test
A20404 - Atherosclerosis Plaque Regrission Meeting Cardiology on Radiology Test
A20405 -
A20406 - After getting the blood draw, went across the street and met with
A20407 - Karen in the Cardiology Cath Lab Scheduling and Administration
A20408 - Department.
A20410 - ..
A20411 - Karen was pleased to hear that lipid profile has improved dramatically
A20412 - since CABG +4 in 2009, shown by history above. ref SDS 0 W25L
A20413 - Explained implementing her suggestion on chia seeds, when we met on
A20414 - 131121 0930, ref SDS 40 NQ37, cited in analysis on improving lipid
A20415 - profile, above. ref SDS 0 419M
A20416 -
A20417 -
A20418 -
A20419 -
A20420 -
A20421 -
A20422 -
A20423 -
A20424 -
A20425 -
A20426 -
A20427 -
A20428 -