CONTACTS
SUBJECTS
CBC Lab WBC 12.8 Elevated Blister Big Toe Left Foot VA for Meeting D
2903 -
2903 - ..
2904 - Summary/Objective
2905 -
290501 - Follow up ref SDS 78 0000. ref SDS 76 0000.
290502 -
290503 -
290504 -
290506 - ..
2906 -
2907 -
2908 - Background
2909 -
290901 - On 131016 1632 submit letter for agenda meeting to review lab results
290902 - scheduled 131017 1000. ref SDS 41 X45G
290904 - ..
290905 - On 140131 0815 ordered another lab - cbc, electrolytes, lipid with NMR
290906 - - from Labcor to get LDL-P. ref SDS 50 X45G
290908 - ..
290909 - On 140201 1159 had full lab with NMR lipid panel drawn at John Muir
290910 - Hospital on Treat, and by Labcorp. ref SDS 51 RP4N
290912 - ..
290913 - On 140203 1147 had partial lab drawn at VA in Martinez. ref SDS 52
290914 - KK9M
290916 - ..
290917 - On 140507 0857 ordered another full lab from Labcorp with NMR lipid
290918 - panel. ref SDS 58 OO5G
290920 - ..
290921 - On 140508 1133 lab blood daw at Labcorp with John Muir Medical Center
290922 - on Treat Blvd in Concord. ref SDS 59 445G
290924 - ..
290925 - On 140514 0950 VA partial lab at Medical Center in San Francisco.
290926 - ref SDS 62 X45G
290928 - ..
290929 - On 140814 1530 VA full lab at Clinic in Martinez. ref SDS 69 X45G
290931 - ..
290932 - On 140827 1422 VA partial lab CBC only at Clinic in Martinez re-check
290933 - elevated WBC. ref SDS 73 X45G
290935 - ..
290936 - On 141020 1025 Labcorp partial lab CBC Electrolytes Urinalysis, but
290937 - mistakenly omitted NMP lipid panel. ref SDS 74 X45G
290939 - ..
290940 - On 141021 1009 Labcorp NMR Lipid panel, ref SDS 76 U45J, and
290941 - Homocyst(e)ine. ref SDS 76 CM6J
290943 - ..
290944 - On 141021 1150 VA labs electrolytes, ref SDS 76 ZG5O, and lipids.
290945 - ref SDS 76 U45J
290946 -
290947 -
290949 - ..
2910 -
2911 -
2912 - Progress
2913 -
291301 - See directory structure for medical records on 140320 1125.
291302 - ref SDS 56 4M5I
291303 -
291304 -
291306 - ..
291307 - Blood Tests Evaluate Health 5 Years After CABG x4 Surgery
291308 - CBC WBC 11.2 Slightly Elevated Resolve Achalasia Aligns Increased Hiking
291309 -
291310 - Follow up ref SDS 78 RP4N, ref SDS 76 RP4N.
291311 -
291312 - Prior VA CBC on 120509 1108. ref SDS 26 RP4N
291313 - Prior VA CBC on 120831 1524. ref SDS 27 RP4N
291314 - Prior VA CBC on 121130 1001. ref SDS 31 RP4N
291315 - Prior VA CBC on 130529 0818. ref SDS 38 RP4N
291316 - Prior Labcorp CBC on 140201 1159. ref SDS 51 RP4N
291317 - VA did not order CBC for lab on 140203 1147. ref SDS 52 YX8K
291318 - Prior Labcorp CBC on 140508 1149. ref SDS 59 RP4N
291319 - VA did not order CBC for lab on 140514 0950. ref SDS 62 RP4N
291320 - Prior VA CBC on 140814 1530. ref SDS 69 RP4N
291321 - Prior VA CBC on 140827 1413. ref SDS 73 RP4N
291322 - Prior Labcorp CBC on 141020 1025. ref SDS 74 RP4N
291323 - Prior Labcorp CBC on 141201 0850. ref SDS 0 RP4N
291325 - ..
291326 - Liposcience lab report stored in...
291327 -
291328 - F:\05\00003\SM\CC\AGMJ\20141201-084000\ROD_WELCH.pdf
291330 - ..
291331 - Labcorp Telephone 954 485 3322
291332 - Patient Report
291333 - Rte............................. 28
291338 - ..
291339 - Health Testing Centers
291340 - 2760 W. OAKLAND PARK BLVD.
291341 - FORT LAUDERDALE FL 33311
291342 -
291356 - ..
291357 - Specimen Details
291358 - Date collected.................. 12/01/2014 0840 Local
291359 - Date entered.................... 12/01/2014
291360 - Date reported................... 12/03/2014 1411 ET
291362 - ..
291363 - Physician Details
291364 - Ordering......................... F AN
291365 - Referring:
291366 - ID............................... 1558345843
291367 - NPI.............................. 1558345843
291369 - ..
291371 - Total Volume..................... Not Provided
291372 - Alternate Patient ID............. Not Provided
291374 - ..
291375 - Ordered Items
291376 - NMR LipoProfile;
291377 - Venipuncture
291378 - Fasting.......................... Yes
291380 - ..
291381 - CBC PANEL
291382 - ..
291383 - Dates......... 2014 12 01 0840 141020 140827 140814 140514 140508 140203 140201 130529
291384 - Labcorp Labcorp VA VA VA Labcorp VA Labcorp VA VA Labcorp
291385 - Blood Results Results Results Results Results Results Results Results Results Units Range Range
291386 - WBC 11.2 H 13.3 H 13.8 H 12.8 H 9.5 6.2 7.4 K/cmm 4.8 - 10.8 3.4 - 10.8
291387 - RBC 5.24 5.64 5.56 5.44 5.21 5.13 5.09 M/cmm 4.7 - 6.1 4.14 - 5.80
291388 - HGB 15.7 16.5 16.4 16.2 15.1 15.2 15.0 g/dL 14 - 18 12.6 - 17.7
291389 - HCT 47.4 50.1 48.8 48.3 47.0 44.2 46.2 % 42 - 52 37.5 - 51.0
291390 - MCV 91.0 89.0 87.8 88.7 90.0 86.0 90.7 fL 80 - 99 79.0 - 97.0
291391 - MCH 30.0 29.3 29.5 29.8 29.0 29.6 29.5 uug 27 - 34 26.6 - 33.0
291392 - MCHC 33.1 32.9 33.6 33.6 32.1 34.4 32.5 gm/dL 32 - 35.2 31.5 - 35.7
291393 - RDW 13.9 14.3 13.9 13.9 13.8 13.7 14.4 % 11.5 - 14.5 12.3 - 15.4
291394 - PLT 314.0 341.0 322.0 295.0 329 303 279 K/cmm 130 - 400 155.0 - 379.0
291395 - MPV 9.1 8.3 8.8 fL 7 - 10.4
291396 - NEUT % 82.0 80.0 74.2 78.1 70 69 69.9 % 40 - 80 40.0 - 74.0
291397 - LYMPH % 12.0 13.0 14.9 L 13.6 L 20 21 L 19.7 % 20 - 51 14.0 - 46.0
291398 - MONO % 5.0 7.0 9.8 7.6 8 8 7.8 % 2 - 13 4.0 - 12.0
291399 - EOS % 1.0 0.0 0.3 L 0.4 L 1 1 1.9 % .5 - 7 0.0 - 5.0
291400 - BASO % 0.0 0.9 0.8 0.3 1 1 0.7 % 0 - 2 0.0 - 3.0
291401 - NEUT # 9.1 H 10.5 H 10.3 H 10.0 H 6.7 4.3 5.2 K/cmm 1.5 - 7.9 1.4 - 7.0
291402 - LYMPH # 1.4 1.7 2.1 1.7 1.9 1.3 1.5 K/cmm 1.2 - 3.4 0.7 - 3.1
291403 - MONO # 0.6 0.9 1.3 H 1.0 0.7 0.5 0.6 K/cmm .2 - 1.2 0.1 - 0.9
291404 - EOS # 0.1 0.0 0.9 L 0.1 0.1 0.1 0.1 K/cmm .1 - .5 0.0 - 0.4
291405 - BASO # 0.1 0.0 0.1 0.0 0.1 0.1 0.1 K/cmm 0 - .2 0.0 - 0.2
291406 - ESRmVES mm/hr 0 - 10
291407 - ESRxCYT mm/hr 2 - 10
291408 - RETIC % % .66 - 2.85
291409 - RETIC # k/uL 27.9 - 121.6
291410 - Immature Granulocytes 0.0 0.0 0.0 0.0 % 0.0 - 2.0
291411 - Immature Grans (Abs) 0.0 0.0 0.0 0.0 % 0.0 - 0.1
291413 - ..
291414 - Comments:
291415 -
291416 - a. Test Performed at...
291417 - Health Testing Centers
291418 - 2760 W. OAKLAND PARK BLVD.
291419 - FORT LAUDERDALE FL 33311
291420 -
291422 - ..
291423 - Background Elevated WBC
291424 -
291425 - Follow up ref SDS 78 EC5L, ref SDS 76 EC5L.
291426 -
291427 - WBC has declined significantly from persistently elevated WBC > 12, to
291428 - now only slightly elevated WBC 11.2, ref SDS 0 FK6I, just .4 units
291429 - above the range 3.4 - 10.8.
291431 - ..
291432 - Decline in WBC may reflect emergency (exigent) care in Podiatry to
291433 - resolve infectious blisters on 141021 1411. ref SDS 77 DR9G
291435 - ..
291436 - Decline may further result in part from EGD dilation on 141107, that
291437 - resolved swallowing stricture in LESV. ref SDS 79 VV6N Prior to
291438 - Heller Myotomy surgery to recover from achalasia on 091216 0600,
291439 - ref SDS 8 KE9U, WBC was elevated for several years. On 050816, Doctor
291440 - Sandhu reported WBC elevated and ordered retest. ref SDS 2 G540 CBC
291441 - retest was ordered and WBC remained high on 050818, so the doctor
291442 - prescribed antibiotics. ref SDS 3 BM8O Initial diagnosis of achalasia
291443 - cited persistent elevated WBC part of patient profile, reported on
291444 - 051202 1430. ref SDS 4 H26M
291446 - ..
291447 - Increased exercise the past month or so, may have stimulated bone
291448 - marrow to produce more new blood cells that maintain slightly elevated
291449 - WBC, explained by Doctor Johnson during a meeting at Kaiser on 030606.
291450 - ref SDS 1 JP7G WBC 9.5 was slighly below the high end of the range
291451 - for the lab on 140508. ref SDS 59 RP4N Over the past 4 weeks, hiking
291452 - has increased above the former level of 300 miles per month. This
291453 - past week, hiked over 100 miles and hiked 33 miles the past 2 days,
291454 - reported in case study of patient history on 120101 0900. ref SDS 21
291455 - SRTP
291456 -
291457 -
291458 -
291459 -
291460 -
291461 -
291462 -
2915 -
SUBJECTS
Urinalysis Lab VA No Results
4403 -
440401 - ..
440402 - Urinalysis Ketones Trace Abnormal Sp Gravity Above Range
440403 -
440404 - Follow up ref SDS 78 0X72, ref SDS 76 0X72.
440405 -
440406 - Prior Urinalysis test on 101207 0906. ref SDS 15 0X72
440407 - Prior Urinalysis test on 120509 1108. ref SDS 26 0X72
440408 - Prior Urinalysis test on 140201 1159. ref SDS 51 0X72
440409 - VA did not order urinalysis for lab on 140203 1147. ref SDS 52 0X72
440410 - Prior Urinalysis Labcorp test on 140508 1149. ref SDS 59 0X72
440411 - Prior Urinalysis test on 140814 1530. ref SDS 69 0X72
440412 - Prior Urinalysis Labcorp test on 141020 1025. ref SDS 74 0X72
440413 - Prior Urinalysis Labcorp test on 141201 0850. ref SDS 0 0X72
440414 -
440416 - ..
440417 - URINALYSIS PANEL
440418 - ..
440419 - Dates.......... 2014 12 01 0840 141020 140814 140514 140203 140201 120509
440420 - Labcorp Labcorp VA VA Labcorp VA Labcorp VA VA Labcorp
440421 - Results Results Results Results Results Results Results Results Units Range Range
440422 - PH 5.5 6.0 6.0 5.5 5.5 6.0 5 - 9 5.0 - 7.5
440423 - PROTEIN Trace Trace NEG NEG NEG NEG mg/dL NEG - TRACE NEG - TRACE
440424 - GLUCOSE NEG NEG NEG NEG NEG NEG mg/dL Ref: NEG NEG
440425 - KETONES 1+ Abnormal Trace Abnormal 15 Trace Abnormal NEG NEG mg/dL Ref: NEG NEG
440426 - BILI NEG NEG NEG NEG NEG NEG Ref: NEG NEG
440427 - BILIcnf Ref: NEG
440428 - BLOOD TRACE TRACE TRACE TRACE Ref: NEG
440429 - NITRITE, URINE NEG NEG NEG NEG NEG NEG Ref: NEG NEG
440430 - UROBILI 0.2 0.2 0.2 0.2 0.2 0.2 EU/dL .2 - 1 0.0 - 1.9
440431 - LEU EST NEG NEG Ref: NEG
440432 - SP.GRAV 1.035 H 1.030 >=1.030 H 1.036 1.026 1.025 1.003- 1.035 1.005 - 1.030
440433 - COLOR YELLOW YELLOW YELLOW YELLOW YELLOW YELLOW
440434 - APPEAR CLEAR CLEAR CLEAR CLEAR CLEAR CLEAR
440435 - WBC 0-5 /hpf 0 - 5
440436 - WBC ESTERASE NEG NEG NEG NEG
440437 - RBC 0-2 /hpf 0 - 2
440438 - OCCULT BLOOD NEG NEG NEG NEG NEG
440439 - HAYALINE CASTS NORM(0-1) per lpf 0 - 1
440440 - GRANULAR CASTS None per lpf Ref: None
440441 - CELLULAR CASTS None per lpf Ref: None
440442 - RBC/HPF NORM(0-3) per lpf 0 - 3
440443 - BACTERIA None seen 0 - 1 None seen / Few
440444 - EPITHELIAL CELLS 0-10 NORM(0-1) /hpf 0 - 10
440445 - RENAL EPITHELIAL CELLS None per lpf Ref: None
440446 - CALCIUM OXILATE CRYST Present Abnormal N/A
440447 - URIC ACID CRYSTALS NORM(0-1) per lpf 0 - 1
440448 - TRIPLE PHOSPHATE CRYST NORM(0-1) per lpf 0 - 1
440449 - AMORPHOUS SEDIMENT None per lpf Ref: None
440450 - MUCOUS Present Not Established
440451 - TRICHOMONAS None per lpf Ref: None
440452 - YEAST None per lpf Ref: None
440453 - CULTURE REFLEXED No
440454 - TR EPTH None per lpf Ref: None
440455 - Urobilinogen, Semi-On 0.2 0.2
440456 - NITRITE, URINE NEG NEG
440457 -
440459 - ..
440460 - Comments:
440461 -
440462 - a. Test Performed at...
440463 - Health Testing Centers
440464 - 2760 W. OAKLAND PARK BLVD.
440465 - FORT LAUDERDALE FL 33311
440467 - ..
440468 - Ketones trace abnormal signals elevated physical activity, in this
440469 - case hiking over 100 miles the past week, and hiking 33 miles
440470 - yesterday and this morning; continues recent labs Ketones 15 review by
440471 - VA, follow up prior lab showning Ketones trace abnormal, reported on
440472 - 140514 0950. ref SDS 62 MT4L
440473 -
440474 -
440475 -
440476 -
440477 -
440478 -
4405 -
SUBJECTS
Lab Electrolytes Chem Profile Glucose 97 Sodium NA 144 Potasium K 5.
6103 -
610401 - ..
610402 - T Bili 1.9 Hyperbilirubinemia Worse Atorvastatin Ezetimibe
610403 - Potasium K 5.6 Elevated Increased Electrical Problems Heart
610404 - Bun/Creatinine Ratio Elevated Slightly
610405 -
610406 - Follow up ref SDS 78 KK9M, ref SDS 76 KK9M.
610407 -
610408 - Prior CHEM PROFILE on 120509 1108. ref SDS 26 KK9M
610409 - Prior CHEM PROFILE on 120831 1524. ref SDS 27 KK9M
610410 - Prior CHEM PROFILE on 130228 1140. ref SDS 36 KK9M
610411 - Prior CHEM PROFILE on 130529 0818. ref SDS 38 KK9M
610412 - Prior CHEM PROFILE on 131015 0724. ref SDS 40 KK9M
610413 - Prior CHEM PROFILE Labcorp on 140201 1159. ref SDS 51 KK9M
610414 - Prior CHEM PROFILE on 140203 1147. ref SDS 52 KK9M
610415 - Prior CHEM PROFILE Labcorp on 140508 1149. ref SDS 59 KK9M
610416 - Prior CHEM PROFILE on 140520 0732. ref SDS 65 KK9M
610417 - Prior CHEM PROFILE on 140814 1530. ref SDS 69 KK9M
610418 - Prior CHEM PROFILE Labcorp on 141020 1025. ref SDS 74 KK9M
610419 - Prior CHEM PROFILE on 141021 11150 ref SDS 76 KK9M
610420 - Prior CHEM PROFILE on 141201 0840. ref SDS 0 KK9M
610421 -
610423 - ..
610424 - ELECTROLYTES - CHEM PROFILE
610426 - ..
610427 - Dates..........2014 12 01 0840 141021 141020 140814 140520 140514 140508 140203 140201 131015 130529
610428 - Labcorp VA Labcorp VA VA VA Labcorp VA Labcorp VA VA VA Labcorp
610429 - PLASMA Results Results Results Results Results Results Results Results Results Results Results Units Range Range
610430 - GLUCOSE 104 H 110 H 105 98 98 97 103 98 108 H 120 mg/dL 74 - 118 65.0 - 99.0
610431 - GLUfast mg/dL Ref: <=99
610432 - NA (salt) 147 H 138 144 144 139 144 140 140 139 139 mmol/L 136 - 144 134.0 - 144.0
610433 - K (potasium) 5.6 H 4.4 4.3 4.3 H 5.2 H 5.6 H 5.4 4.8 4.3 H 4.9 mmol/L 3.4 - 4.8 3.5 - 5.2
610434 - CL 106 103 H 108 H 108 102 105 103 102 105 105 mmol/L 98 - 106 97.0 - 108.0
610435 - CO2 28 29 29 29.0 30.0 37.0 30.0 mmol/L 23 - 33
610436 - AGAP 7.0 8.0 mmol/L 5 - 20
610437 - BUN 28 H mg/dL 8 - 26 8.0 - 27.0
610438 - BUN/Creati Ratio 24 H 22 H 28 19 H 23 17 20 24 18 10.0 - 22.0
610439 - CREAT 1.16 0.8 1.13 1.03 0.80 0.97 0.82 0.81 0.83 0.83 mg/dL .5 - 1.1 0.76 - 1.27
610440 - eGFR INA 64 91 66 >60 102 79 >60 91 >60 >60 mL/min Ref: >=60 >59
610441 - eGFR IA 74 76 92 106 mL/min >59
610442 - CALCIUM 10.0 8.8 9.9 9.1 8.9 9.5 9.3 9.4 9.2 9.2 mg/dL 8.7 - 10.2 8.6 - 10.2
610443 - CA CORR mg/dL 8.7 - 10.2
610444 - PO4 mg/dL 2.4 - 4.5
610445 - MG 85 mg/dL 1.8 - 2.5
610446 - ALK PHO 96 107 85 86 100 105 84 87 U/L 40 - 125 39.0 - 117.0
610447 - SGOT 27 U/L 5 - 35
610448 - SGPT 28 U/L 7 - 56
610450 - ..
610451 - T. BIL 1.9 H H 2.0 H 2.5 1.2 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
610452 - D. BILI 0.38 0.38 0.3 0.2 0.2 0.32 0.3 0.34 < 0.1 mg/dL .1 - .5 0.00 - 0.40
610453 - Bilirubin, Indir 1.52 H 1.62 0.98 1.26 H mg/dL 0.10 - 0.80
610454 - AST (SGOT) 26 31 25 23 26 23 21 20 22 IntUnits/L 8 - 42 0.0 - 40.0
610455 - ALT (SGPT) 23 30 21 21 17 21 19 17 19 IntUnits/L 5 - 55 0.0 - 44.0
610456 - ALBUMIN 4.7 4.8 4.3 3.9 4.6 4.6 4.1 4.4 3.9 4.0 g/dL 3.3 - 5.2 3.6 - 4.8
610457 - PROTEIN 6.6 6.9 7.2 6.5 7.5 6.6 6.7 6.5 7.1 7.2 g/dL 6.0 - 8.5 6.0 - 8.5
610458 - Globulin, Total 1.9 2.1 2.0 2.1 g/dL 1.4 - 4.5
610459 - A/G Ratio 2.5 2.3 2.3 2.1 1.1 - 2.5
610460 - LDH 241 H 223 200.0 180.0 IntUnits/L 90 - 208 0.0 - 225.0
610461 - GGT 13 11.0 9.0 IU/L 0.0 - 65.0
610462 - Iron, Serum 101 146 100.0 114.0 ug/dL 40.0 - 155.0
610463 - AMYLASE Units/L 28 - 100
610464 - LIPASE Units/L 7 - 58
610465 - NH3 mcmol/L 15 - 56
610466 - URIC AC 5.3 6.9 5.6 mg/dL 4.8 - 8.7 3.7 - 8.6
610467 - ..
610468 - Cholesterol, Total 161 174 164.0 162.0 mg/dL 100.0 - 199.0
610469 - Triglycerides 66 79 55.0 64.0 mg/dL 0.0 - 149.0
610470 - HDL Cholesterol 67 61 > 39
610471 - LDL Cholesterol 81 96 0 - 99
610472 - T Chol/HDL ratio 2.8 0.0 - 5.0
610474 - ..
610475 - TG/HDL ratio .98 1.3
610477 - ..
610478 - Comments VA test 141021...
610479 -
610480 - a. Ordering Provider: Diana Alba
610481 - Report Released..: Oct 21, 2014@12:33
610482 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
610483 - 4150 CLEMENT STREET
610484 - SAN FRANCISCO, CA 94121-1545
610485 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
610486 -
610488 - ..
610489 - Comments Labcorp test 141020...
610490 -
610491 - a. Test Performed at...
610492 - Jenny Galloway, MD
610493 - LabCorp San Diego
610494 - 13112 Evening Creek Dr So Ste 200, San Diego, CA 92128-4108
610496 - ..
610497 - For inquiries, the physician may contact Branch:
610498 - 800-762-4344 Lab: 858-668-3700
610500 - ..
610501 - b. Please Note:
610502 -
610503 - T Chol/HDL Ratio Men Women
610504 -
610505 - 1/2 Avg Risk 3.4 3.3
610506 - Avg Risk 5.0 4.4
610507 - 2x Avg Risk 9.6 7.1
610508 - 3x Avg Risk 23.4 11.0
610510 - ..
610511 - Estimated CHD Risk <0.5 times avg 0.0 - 1.0
610512 -
610514 - ..
610515 - The CHD Risk is based on the T Chol/HDL ratio.
610516 - Other factors affect CHD Risk such as hypertension,
610517 - smoking, diabetes, severe obesity, and family history
610518 - of premature CHD.
610519 -
610521 - ..
610522 - Notes on Electrolytes Lab Hyperbilirubinemia Potassium Heart Problems
610523 - Hyperbilirubinemia Potassium Heart Problems Notes on Electrolytes Lab
610524 - Potassium Heart Problems Hyperbilirubinemia Notes on Electrolytes Lab
610525 -
610526 - Follow up ref SDS 78 G34G, ref SDS 76 G34G.
610527 -
610528 - 1. T Bilirubin 1.9................. ref SDS 0 015M
610530 - ..
610531 - Collection DT T Bili Range Source
610532 - 01/12/2014 08:40 1.9 H...0.3 - 1.2.. ref SDS 0 015M
610533 - 20/10/2014 10:60 2.0 H...0.3 - 1.2.. ref SDS 74 015M
610534 - 14/08/2014 15:28 2.5 H...0.3 - 1.2.. ref SDS 69 WJ5H
610535 - 20/05/2014 10:20 1.2 ....0.3 - 1.2.. ref SDS 65 015M
610536 - 08/05/2014 11:49 1.3 H...0.0 - 1.2.. ref SDS 59 015M
610537 - 03/02/2014 09:52 2.1 H...0.3 - 1.2.. ref SDS 52 015M
610538 - 01/02/2014 12:28 1.6 H...0.0 - 1.2.. ref SDS 51 015M
610539 - 15/10/2013 08:25 1.7 H...0.3 - 1.2.. ref SDS 40 015M
610540 - 29/05/2013 08:18 1.3 H...0.3 - 1.2.. ref SDS 38 1Y9G
610541 - 28/02/2013 08:36 1.3 H...0.3 - 1.2.. ref SDS 36 6S4F
610542 - 31/08/2012 15:24 2.3 H...0.3 - 1.2.. ref SDS 27 NV9M
610543 - 09/05/2012 11:24 2.5 H...0.3 - 1.2.. ref SDS 26 O46K
610544 - 09/02/2012 11:18 1.8 H...0.3 - 1.2.. ref SDS 22 KK9M
610545 - 17/11/2011 14:27 1.3 H.............. ref SDS 20 KK9M
610546 - 13/10/2011 14:35 1.3 H.............. ref SDS 19 GM65
610547 - 27/07/2011 12:58 2.0 H.............. ref SDS 16 GM65
610548 - 07/12/2010 09:17 1.0 ............... ref SDS 15 GM65
610549 - 21/07/2010 08:54 1.3 H.............. ref SDS 11 GM65
610550 - 14/12/2009 1.3 H ............. ref DRP 1 DE4O
610551 - 02/11/2009 0.9 ............... ref DRP 1 LG4L
610552 - 13/08/2009 15:09 1.7 H.............. ref SDS 5 VG8R
610554 - ..
610555 - On 131017 1000 VA medical chart Progress Notes assessment
610556 - reports Doctor Egan diagnosed chronic hyperbilirubinemia.
610557 - ref SDS 42 PSXT
610559 - ..
610560 - Bilirubin 2.5 elevated 110% above range shows dramatic increase
610561 - from 1.2 in lab at VA San Francisco Medical Center on 140520.
610562 - ref SDS 65 015M This is highest result for T Bili in patient
610563 - history, may demonstrate chronic side effects statin
610564 - medications causing poor liver function, as reviewed previously
610565 - on prior lab on 140514 0950. ref SDS 62 G34G Side effects of
610566 - peripheral neuropathy in right foot have ebbed and flowed,
610567 - reported on 140510, shown in case study on 120101 0900.
610568 - ref SDS 21 TV6I
610570 - ..
610571 - On 140819 0800 during meeting with Doctor Sandhu in Primary
610572 - Care VA Clinic in Martinez, there was no review of chronic
610573 - hyperbilirubinemia, with T Bilirubin 2.5 rising 110% above
610574 - range, ref SDS 71 9K7I, shown in lab ordered by the doctor on
610575 - 140814. ref SDS 69 015M
610577 - ..
610578 - Background on Rosuvastatin causing elevated T Bilirubin with
610579 - associated severe side effects is reported on 121206 0900,
610580 - ref SDS 32 NI9L, and further explained in the record on 121130
610581 - 0846. ref SDS 31 ER4K
610583 - ..
610584 - On 131017 1000 Doctor Egan explained patient history of
610585 - intermittant and mild peripheral neuropathy that correlates
610586 - with persistent elevated T Bilirubin in lab on 131015,
610587 - ref SDS 40 015M, and further reported with vitals, diet and
610588 - exercise since prior meeting at VA on 130603, see case study on
610589 - 120101 0900, ref SDS 21 X14N, suggests intervention is not
610590 - required at this time to improve recovery from side effects
610591 - taking Rosuvastatin. ref SDS 42 LV5J
610592 -
610594 - ..
610595 - 2. Potasium K 5.6 within range................. ref SDS 0 ZG5O
610597 - ..
610598 - Doctor Egan, referring cardiology physician at Martinez VA,
610599 - noted in a recent letter that meeting at VA Medical Center in
610600 - San Francisco on 140213 0830, ref SDS 55 GT7G, did not address
610601 - elevated potassium in labs performed by Labcorp and VA, shown
610602 - on 140203 1147. ref SDS 52 ZG5O Doctor Egan again notifies
610603 - that this condition of elevated potassium represents exposure
610604 - to "electrical problems" with the heart, reported on 140430.
610605 - ref SDS 57 UV5I
610607 - ..
610608 - Doctor Egan was concerned last year about potasium (K) rising
610609 - above range for good health. He explained potasium effects
610610 - electrical signals to the heart, and so has significance for
610611 - CVD, reported during meeting at VA on 121206 0900. ref SDS 32
610612 - 6K56
610614 - ..
610615 - At that time on 121206, the doctor cited medication conflicts
610616 - as possibly causing elevated potasium. ref SDS 32 FI7L Doctor
610617 - Egan further considered dehydration (urination) caused by
610618 - Rosuvastatin may have skewed lab results for electrolytes on
610619 - 121130, and so ordered re-test. ref SDS 32 6K4J
610621 - ..
610622 - On 121212 0941 re-test lab reported Glucose 111, sodium 139,
610623 - and potasium (K) 4.6, all within range, ref SDS 33 KK9M,
610624 - correcting errors noted by Doctor Egan during meeting at VA on
610625 - 121206 0900. ref SDS 32 6K4J
610627 - ..
610628 - Dramatic decline in hiking during 6 weeks, shown in case study
610629 - on 120101 0900, ref SDS 21 7718, and reported on the agenda for
610630 - meeting with Doctor Sandhu in Primary Care, which was submitted
610631 - on 140814 2227. ref SDS 70 K098, may correlate with potassium
610632 - falling back within range, at that time.
610634 - ..
610635 - Potassium 5.6 rising above range may equally reflect recent
610636 - dramatic increased hiking over 100 miles the past week, and 33
610637 - miles between yesterday and this morning before the lab.
610638 -
610640 - ..
610641 - 3. Glucose 104....65 - 99.......... ref SDS 0 ZG5O
610642 -
610643 - VA lab on 141021 shows glucose 110 within range; Labcorp test
610644 - the day before on 141020 shows glucose 105 above their range;
610645 - on 140814, Doctor Sandhu VA in Martinez ordered tests showing
610646 - glucose 98 within range, so results are unclear.
610648 - ..
610649 - Diabetes concern from reduced hiking due to metatarsalgia side
610650 - effects, causing weight to increase at times above 180; this
610651 - has subisded the past month, because hiking increased above
610652 - 300 miles per month.
610654 - ..
610655 - On 140814 VA Martinez lab reported HGBA1c 5.6 within range 4 -
610656 - 6, seems to indicate no evident exposure for diabetes.
610657 - ref SDS 76 H66G
610659 - ..
610660 - On 140514 0950 VA lab for HGBA1c 5.4 within range 4 - 6, seems
610661 - to indicate no evident exposure for diabetes. ref SDS 62 H66G
610663 - ..
610664 - Glucose 104 rising above range may reflect recent dramatic
610665 - increased hiking over 100 miles the past week, and 33 miles
610666 - between yesterday and this morning before the lab.
610667 -
610669 - ..
610670 - 4. Salt NA 147..................... ref SDS 0 WJ5H
610671 -
610672 - NA salt 147 rising above range may reflect recent dramatic
610673 - increased hiking over 100 miles the past week, and 33 miles
610674 - between yesterday and this morning before the lab.
610676 - ..
610677 - 5. LDH 241......................... ref SDS 0 015M
610678 -
610679 - LDH 241 rising above range may reflect recent dramatic
610680 - increased hiking over 100 miles the past week, and 33 miles
610681 - between yesterday and this morning before the lab.
610682 -
610683 -
610684 -
610685 -
610686 -
610687 -
610688 -
6107 -
SUBJECTS
VA Lab Lipid Cholesterol 164 with Medication Hiking 1000 Miles Weigh
8103 -
810401 - ..
810402 - LDL-C 79 LDL-P 656 HDL 63 Hike 250 Miles in 3 Weeks
810403 -
810404 - Follow up ref SDS 78 IM9N, ref SDS 76 IM9N.
810405 -
810406 - Improved LDL-P declined 33% and HDL increased 20% nominally represent
810407 - significantly lower CVD risk.
810409 - ..
810410 - Prior LIPID PANEL 120509 1108. ref SDS 26 IM9N
810411 - Prior LIPID PANEL 120831 1525. ref SDS 27 IM9N
810412 - Prior LIPID PANEL 130228 1140. ref SDS 36 IM9N
810413 - Prior LIPID PANEL 130529 0818. ref SDS 38 IM9N
810414 - Prior LIPID PANEL 131015 0724, ref SDS 40 IM9N
810415 - Prior LIPID PANEL Labcorp, 140201 1159, ref SDS 51 IM9N
810416 - Prior LIPID PANEL, 140203 1147, ref SDS 52 IM9N
810417 - Prior LIPID PANEL Labcorp, 140508 1149. ref SDS 59 IM9N
810418 - Prior LIPID PANEL, 140814 1530, ref SDS 69 IM9N
810419 - Prior LIPID PANEL Labcorp, 141021 1009. ref SDS 75 IM9N
810420 - Prior LIPID PANEL, 141021 1150, ref SDS 76 IM9N
810421 - Prior LIPID PANEL Labcorp, 141106 0630, ref SDS 78 IM9N
810422 -
810424 - ..
810425 - LIPID PANEL
810427 - ..
810428 - Dates..........2014 12 01 0840 141106 0714 141021 1148 141021 1021 140814 140514 140508 140203 140201 131015 130529
810429 - Labcorp Labcorp VA Labcorp VA VA Labcorp VA Labcorp VA VA VA Labcorp
810430 - NMR LipoProfile Results Results Results Results Results Results Results Results Results Results Results Units Range Range
810431 - LDL Particle Number
810432 - LDL P 656 997 H 1586 851 861 nmol/L Low < 1000
810433 - Moderate 1000 - 1299
810434 - Borderline High 1300 - 1599
810435 - High 1600 - 2000
810436 - Very High > 2000
810438 - ..
810439 - Lipids
810440 - CHOL 157 137 159 157 161 (a) 164 162 160 156 321 H 307 mg/dL 100 - 240 < 200
810441 - (b) 169
810442 - TRIGLYC 73 85 65 80 72 (a) 58 59 47 68 109 85 mg/dL 10 - 190 < 150
810443 - (b) 59
810444 - HDL-C 63 53 57 55 55 (a) 66 67 58 61 50 50 mg/dL Ref: >=35 >= 40
810445 - (b) 67
810446 - LDL-C 79 67 90 86 92 (a) 87 83 93 81 249 H 240 mg/dL Ref: <=131 < 160
810447 - (b) 90
810448 - ** LDL Dir 93 mg/dL 0 - 130
810449 - TRIG NF mg/dL Ref: <=150
810451 - ..
810452 - TG/HDL ratio 1.16 1.60 1.14 1.46 1.31 (a) 0.88 0.88 0.81 1.11 < 2.0
810453 - TC/HDL ratio 2.49 2.58 2.79 2.85 2.93 2.48 2.42 2.76 2.56
810455 - ..
810456 - LDL and HDL Particles s
810457 - HDL-P (Total) 38.9 35.2 36.4 38.1 31.4 umol/L >= 30.5
810458 - Small LDL-P 310 387 H 1277.0 < 90.0 < 90.0 umol/L <=527.0
810459 - LDL Size 20.4 Low 20.8 L 19.7 21.2 21.3 nm > 20.5
810461 - ..
810462 - --------------------------------------------------------
810463 - ** INTERPRETATIVE INFORMATION**
810464 - PARTICLE CONCENTRATION AND SIZE
810466 - ..
810467 - LDL AND HDL PARTICLES Percentile in Reference Population
810468 - HDL-P (total) High 75th 50th 25th Low
810469 - >34.9 34.9 30.5 26.7 <25.7
810470 - ..
810471 - Small LDL-P Low 25th 50th 75th High
810472 - <117 117 527 839 >839
810474 - ..
810475 - LDL Size <- Large (Pattern A)-> <- (Pattern B) ->
810476 - 23.0 20.6 20.5 19.0
810478 - ..
810479 - --------------------------------------------------------
810480 - Insulin Resistance/Diab. Risk
810481 - Large VLDL-P < 0.8 nmol/L <= 2.7
810482 - Small LDL-P < 90.0 nmol/L < 527
810483 - Large HDL-P 9.4 umol/L >= 4.8
810485 - ..
810486 - VLDL Size NOTES
810487 -
810488 - VLDL concentration too low to allow determination of VLDL
810489 - Size. Low VLDL concentration contributes minimally to the
810490 - LP-IR score.
810492 - ..
810493 - LDL Size 21.2 >= 20.8
810494 - HDL Size 9.8 >= 9.2
810495 -
810496 - Small LDL-P, LDL Particle Size, Large HDL-P VLDL Size, HDL
810497 - Size, HDL Particle, and LP-IR Score have been validated by
810498 - LipoScience but not cleared by US FDA; the clinical
810499 - utility of these tests has not been fully established.
810501 - ..
810502 - Insulin Resistance Score
810503 - LP-IR Score < 25 H 46.0 < 25.0 < 25.0 <= 45.0
810505 - ..
810506 - LP-IR Score is inaccurate if patient is non-fasting. The
810507 - LP-IR Score combines the information from Large VLDL-P,
810508 - Small LDL-P, Large HDL-P, VLDL Size, LDL Size and HDL Size
810509 - to give improved assessment of insulin resistance and
810510 - diabetes risk.
810512 - ..
810513 - INSULIN RESISTANCE MARKER
810514 -
810515 - <--Insulin Sensitive Insulin Resistant-->
810516 - Percentile in Reference Population
810517 -
810518 - Large VLDL-P Low 25th 50th 75th High
810519 - <0.9 0.9 2.7 6.9 >6.9
810521 - ..
810522 - Small LDL-P Low 25th 50th 75th High
810523 - <117 117 527 839 >839
810525 - ..
810526 - Large HDL-P High 75th 50th 25th Low
810527 - >7.3 7.3 4.8 3.1 <3.1
810529 - ..
810530 - VLDL Size Small 25th 50th 75th Large
810531 - <42.4 42.4 46.6 52.5 >52.5
810533 - ..
810534 - LDL Size Large 75th 50th 25th Small
810535 - >21.2 21.2 20.8 20.4 <20.4
810537 - ..
810538 - HDL Size Large 75th 50th 25th Small
810539 - > 9.6 9.6 9.2 8.9 < 8.9
810541 - ..
810542 - Insulin Resistance Score
810543 - LP-IR Score Low 25th 50th 75th High
810544 - <27 27 45 63 >63
810545 -
810547 - ..
810548 - Final Report
810550 - ..
810551 - Date Issued: 12/03/14 1424 ET
810553 - ..
810554 - This document contains private and confidential health
810555 - information protected by state and federal law.
810556 - If you have received this document in error, please call
810557 - 858-668-3700
810558 -
810559 - 1995-2014 Laboratory Corporation of America® Holdings
810560 - All Rights Reserved - Enterprise Report Version 1.00
810562 - ..
810563 - 01 S7 Deanna Franke, PhD
810564 - Liposcience Inc
810565 - 2500 Sumner Blvd, Raleigh, NC 27616-3235
810566 - 877 547 6837
810567 -
810568 - customer.service@liposcience.com
810570 - ..
810571 - 02 SO Jenny Galloway, MD
810572 - Labcorp San Diego
810573 - 13112 Evening Creek Dr So Ste 200 San Diego, CA
810574 - 92128-4108
810576 - ..
810577 - For inquiries, the physician may contact Branch: 800 762 4344
810578 - Lab: 858 668 3700
810579 -
810580 -
810581 -
810583 - ..
810584 - Lipid History Trend Analysis
810585 -
810586 - Follow up ref SDS 78 W25L, ref SDS 76 W25L.
810587 -
810588 - Small LDL LP-IR
810589 - Collection DT CHOL TRIGL HDL LDL-C LDL-P HDL-P LDL-P SIZE SCORE LDL-D
810590 - 12/01/2014 08:40 157 73 63 79 ..656....38.9...310...20.4....< 25....... ref SDS 0 BE6O
810591 - 12/01/2014 08:40 161 66 67 81 ......................................... ref SDS 0 1O6N
810592 - 11/06/2014 07:14 137 85 53 67 ..997....35.2...387...20.8......30....... ref SDS 78 BE6O
810593 - 10/21/2014 11:48 159 65 57 90 ......................................... ref SDS 76 BE6O
810594 - 10/21/2014 10:21 157 80 55 86 .1586....36.4..1277...19.7......46....... ref SDS 75 BE6O
810595 - 10/20/2014 10:50 174 79 61 96 ......................................... ref SDS 74 IN5N
810596 - 08/14/2014 15:28 161 72 55 92 ......................................... ref SDS 69 BE6O
810597 - 05/14/2014 10:16 164 58 66 87 .................................... 93.. ref SDS 62 BE6O
810598 - 05/08/2014 11:49 162 59 67 83 851 38.1 < 90 21.2 < 25 ..... ref SDS 59 BE6O
810599 - 02/03/2014 12:28 160 47 58 93 ......................................... ref SDS 52 BE6O
810600 - 02/01/2014 12:31 156 68 61 81 861 31.4 < 90 21.3 < 25 ..... ref SDS 51 BE6O
810601 - 10/15/2013 08:25 321 H 109 50 249 H ......................................... ref SDS 40 BE6O
810602 - 05/29/2013 08:18 307 H 85 50 240 H ......................................... ref SDS 36 BE6O
810603 - 02/28/2013 08:39 310 H 73 47 248 H ......................................... ref SDS 36 BE6O
810604 - 11/30/2012 10:01 173 53 57 105 ......................................... ref SDS 31 BE6O
810605 - 08/31/2012 15:25 176 94 47 110 ......................................... ref SDS 27 U89N
810606 - 05/09/2012 11:24 158 76 49 94 ......................................... ref SDS 26 U89N
810607 - 02/09/2012 11:18 285 82 41 228 H ......................................... ref SDS 22 2A4G
810608 - 11/17/2011 14:27 260 84 43 200 H ......................................... ref SDS 20 2A4G
810609 - 07/27/2011 12:58 163 81 45 102 ......................................... ref SDS 16 E19L
810610 - 12/07/2010 09:17 151 41 47 96 ......................................... ref SDS 15 E19L
810611 - 07/21/2010 08:54 261 H 87 35 L 209 H ......................................... ref SDS 11 E19L
810612 - 06/10/2010 10:33 217 H 83 36 L 164 H ......................................... ref SDS 10 QV4F
810613 - * 12/14/2009 11:10 241 H 136 44 170 H ......................................... 100928 0706, ref SDS 12 VW6J
810614 - 08/13/2009 15:09 233 H 118 30 L 179 H ......................................... 100610 1046, ref SDS 10 U45G
810615 - 06/16/2006 10:59 238 H 68 32 L 192 H ......................................... 091002 0900, ref SDS 6 LJ5H
810616 -
810617 - * Lab at VA San Francisco Medical Center reported on 100928 0706.
810618 - ref SDS 12 VW6J
810620 - ..
810621 - Research on cholesterol reported on 091002 0900. ref SDS 6 2F8K
810623 - ..
810624 - On 131125 0005 research found ezetimibe (zetia) mg added to
810625 - Atorvastatin 20 mg yielded after 6 weeks significantly greater changes
810626 - to lipids than taking Atorvastatin in higher doses, e.g., 20 or 40 mg.
810627 - ref SDS 46 CO56
810629 - ..
810630 - On 131125 0005 research found discordance LDL-P low and LDL-C high
810631 - lipid panel HDL 65 TG 77 healthy patient profile with LDL 246.
810632 - ref SDS 46 MN98 Discordance with LDL-P low and LDL-C high is lowest
810633 - risk for CVD, arterialsclorosis. ref SDS 46 FI3G
810634 -
810636 - ..
810637 - Analysis....
810638 -
810639 - 1. NMR LDL-P 656 reported in lipid re-test today on 141201,
810640 - ref SDS 0 U45J, is remarkably 33% better than prior test 3
810641 - weeks ago; yet, still aligns with prior lab LDL-P 994, better
810642 - than the earlier lab on 101021 reported LDL-P 1586 in relation
810643 - to prior labs. ref SDS 76 U45J If correct, it reflects
810644 - increased physical activity and improved condition, explained
810645 - below.
810647 - ..
810648 - The test today provides a baseline at high levels of physical
810649 - activity in relation to patient history, which may never be
810650 - replicated: hiking 11 miles in < 170 minutes for 21 days in a
810651 - row, including the best time ever, 158 minutes. This is a
810652 - breakthrough in conditioning that exceeds prior levels, since
810653 - the longest period hiking < 170 minutes for 11 miles was only 6
810654 - days in a row. As recently as a month ago, conditioning had
810655 - deteriorated to doing 11 miles in 192 minutes on 141011, shown
810656 - in case study on 120101 0900. ref SDS 21 PUWT
810658 - ..
810659 - 2. VA advised LDL-P can be "assumed" from TG/HDL ratio, reported
810660 - during the meeting at the Medical Center in San Francisco on
810661 - 140213 0830. ref SDS 55 WQ8L This aligns with research on
810662 - 131125, ref SDS 46 338N, and in PubMed article. ref SDS 46 VR5N
810663 - Assumption of LDL-P from TG/HDL ratio implies stable
810664 - calculation, otherwise "assumptions" are not reliable. In
810665 - this case, the record shows...
810667 - ..
810668 - Testing Agency Date
810669 - Labcorp TG/HDL ratio 141201 73/63 = 1.16 ..... ref SDS 0 5C7M
810670 - Labcorp Electrolyte panel TG/HDL ratio 141201 66/67 = 0.98 ..... ref SDS 0 1O6N
810671 - Labcorp TG/HDL ratio 141106 85/53 = 1.60 ..... ref SDS 0 5C7M
810672 - Labcorp TG/HDL ratio 141021 80/55 = 1.46 ..... ref SDS 0 5C7M
810673 - VA TG/HDL ratio 141021 65/57 = 1.14 ..... ref SDS 0 5C7M
810674 - Labcorp Electrolyte panel TG/HDL ratio 141021 79/61 = 1.30 ..... ref SDS 0 1O6N
810676 - ..
810677 - What research supports "assuming" LDL-P from TG/HDL ratio?
810679 - ..
810680 - 3. Research indicates healthiest cardiovascular condition occurs
810681 - with lowest risk for CVD, when lipids are discordant, with
810682 - LDL-P low and LDL-C high. However, greatest risk for CVD is
810683 - LDL-P high and LDL-C low, shown in the record on 131125 0005.
810684 - ref SDS 46 FI3G
810686 - ..
810687 - VA published goal LDL-C <= 131; Labcorp published goal LCL-C <
810688 - 100. ref SDS 62 5C7M New AHA guidelines show LDL-C < 190,
810689 - reported on 131112 1422. ref SDS 44 HT87
810691 - ..
810692 - VA lowering goal to HDL > 35 from > 40 seems conflicting with
810693 - patient history of CABG +4 on 091022 0700. ref SDS 7 PQWU
810694 - Since HDL 30 was found at that time (see Lipid history below,
810695 - ref SDS 62 W25L, setting the bar at HDL 35 has little tolerance
810696 - for genetic variation to avoid and repair endothelium lesions
810697 - causing atheriosclerotic plaque.
810699 - ..
810700 - 4. Resting heart rate getting up in the mornings remains slightly
810701 - above 50, though sometimes falls below 50. Blood pressure
810702 - averages about 120 65; however, Diastolic often falls below 60.
810703 - After 11 mile hikes blood pressure drops to about 105 55.
810704 - Systolic on occassion falls below 90. Dystalic has fallen
810705 - below 50 - e.g., see Saturday, 141018, reported in case study
810706 - on 120101 0900, ref SDS 21 V83O Heart rate now recovers well
810707 - after strenuous exercise, often falling back below 60 within 20
810708 - minutes or so.
810710 - ..
810711 - 5. NMR Lipid results on 141106 show...
810712 -
810713 - Cholesterol................... 157................ ref SDS 0 U45J
810715 - ..
810716 - 20 unit increase of cholesterol from prior test just 3 weeks
810717 - ago on 141106, appears conflicting with patient history showing
810718 - Cholesterol has been steady taking Atorvastatin 10 mg and
810719 - Ezetimibe 10 mg for 12 months, varying between 157 - 174.
810720 - ref SDS 78 W25L Sudden, unexplained rise of cholesterol
810721 - resulted in...
810723 - ..
810724 - LDL-C......................... 79................ ref SDS 0 U45J
810726 - ..
810727 - 12 unit rise of LDL-C from prior Liposcience test on 141106,
810728 - aligns testing with patient history consistently 10 - 20 units
810729 - above VA goal to lower LDL-C < 70 reported in Progress Notes on
810730 - 140519 0800. ref SDS 64 OW3K Since LDL-C is calculated and so
810731 - can be "assumed" from the Friedwald equation...Cholesterol -
810732 - HDL - TG/5 (reported on 140213 0830. ref SDS 55 Z37L), the 20
810733 - unit rise in cholesterol, results in 12 unit rise in LDL-C,
810734 - because TG and HDL remain relatively stable.
810736 - ..
810737 - 6. NMR Lipid results on 141201 show...
810738 -
810739 - Triglycerices (TG)............ 73................ ref SDS 0 U45J
810740 - HDL........................... 63................ ref SDS 0 U45J
810742 - ..
810743 - These improvements along with LDL-P 656 reflect...
810745 - ..
810746 - a. Physical activity prescribed by the VA on 140213,
810747 - ref SDS 55 E34O, has finally reached, after a pause of 7
810748 - months to recover from side effects, and now exceeds prior
810749 - levels of hiking 300+ miles per month...
810751 - ..
810752 - Mileage 2014
810753 -
810754 - Follow up ref SDS 78 ZY7M, ref SDS 76 ZY7M.
810755 -
810756 - 131103....Oct................. 373 5757 ...... ref SDS 21 6F9N
810757 - 131201....Nov................. 172 2899 ...... ref SDS 21 XRPV
810758 - 131229....Dec................. 234 3324 ...... ref SDS 21 XXQY
810759 - 140202....Jan................. 347 5393 ...... ref SDS 21 YWST
810760 - 140302....Feb................. 234 3681 ...... ref SDS 21 PYWS
810761 - 140330....Mar................. 207 3313 ...... ref SDS 21 RXPR
810762 - 140427....Apr................. 310 4402 ...... ref SDS 21 RXVV
810763 - 140601....May................. 322 5338 ...... ref SDS 21 SXWV
810764 - 140629....Jun................. 156 2337 ...... ref SDS 21 ZW4N
810765 - 140803....Jul................. 81 1023 ...... ref SDS 21 I37G
810766 - 140831....Aug................. 140 1998 ...... ref SDS 21 236I
810767 - 140928....Sep................. 136 2855 ...... ref SDS 21 XWUY
810768 - 141102....Oct................. 215 3540 ...... ref SDS 21 F56L
810769 - 141130....Nov................. 319 4840 ...... ref SDS 21 ST5L
810771 - ..
810772 - b. Weight - 173 on 141201, ref SDS 21 1N4I, declined from 186
810773 - on 141011, ref SDS 21 PUWT, but still above 163 on 140513,
810774 - shown in case study on 120101 0900. ref SDS 21 ZU5G Hiking
810775 - has a positive effect on weight both consuming calories and
810776 - triglycerides, and reducing time and interest for eating.
810778 - ..
810779 - Week ending 121130, hiked 106 miles the most in patient
810780 - history for 1 week. ref SDS 21 ST5L
810782 - ..
810783 - On 141123 hiked 11 miles in 158 minutes, fastest pace in
810784 - patient history. ref SDS 21 OI6N
810786 - ..
810787 - Hiked 11 miles < 170 minutes for 20 days in a row; hiking
810788 - 14 - 15 minute miles every day reflects order of magnitude
810789 - improvement in body condition; previous best was only 6
810790 - days in a row. This change in body condition may
810791 - reconcile 33% decline in LDL-P 656, and 20% better than
810792 - prior best lipid report before side effect injuries that
810793 - caused hiking to decline 70%, leading to poor Lipids.
810795 - ..
810796 - c. Low-carbohydrate diet works best in this case with
810797 - elevated physical activity.
810799 - ..
810800 - d. Chia seeds added to diet on 131125, reported in case study
810801 - on 120101 0900, ref SDS 21 746M, and recommended for
810802 - sustained energy hiking by Karen at VA on 131121 0930.
810803 - ref SDS 45 NQ37
810805 - ..
810806 - e. Orange juice remained constant, likely contributing to HDL
810807 - rising 20% along with increased physical activity, and as
810808 - explained in the prior lab analysis on 140514 0950.
810809 - ref SDS 62 LO4J
810811 - ..
810812 - f. Atorvastatin 10 mg with Ezetimibe 10 begun on 131230,
810813 - reported in case study on 120101, ref SDS 21 6A6H, and
810814 - continued through current cycle.
810816 - ..
810817 - Research studies report Atorvastatin 10 mg + Ezetimibe 10
810818 - mg achieves LDL < 70, and favorably changes triglycerides
810819 - and HDL by 5%, reported on 131125 0005. ref SDS 46 CO45
810820 - While low LDL < 70 conflicts with goal of "discordance"
810821 - that lowers health risk for arterialsclorosis and CVD when
810822 - LDL-P low and LDL-C high, shown in research on 131125 0005,
810823 - ref SDS 46 FI3G, even "concordant" results today are good
810824 - news.
810825 -
810826 -
810828 - ..
810829 - Coronary CTA or IVUS Test Athereosclerosis Plaque 4 Years After CABG
810830 - Athereosclerosis Plaque 4 Years After CABG Coronary CTA or IVUS Test
810831 -
810832 - Follow up ref SDS 78 QA4M, ref SDS 76 QA4M.
810833 -
810834 - On 131125 0005 research further found radiology imaging tests can
810835 - evaluate level of plaque build up resulting from elevated cholesterol.
810836 - ref SDS 46 N73K Radiology imaging technologies are Coronary CT
810837 - angiography - CTA - and Intravascular ultrasound - IVUS. ref SDS 46
810838 - KZ8O
810840 - ..
810841 - Lipid history and particularly the past 3 weeks with HDL > 60 and
810842 - Triglycerides < 100, ref SDS 0 5C7M, indicates body chemestry may be
810843 - sufficient again to cause rapid regression of atherosclerosis plaque,
810844 - cited in research on 131125 0005. ref SDS 46 RA7K Research indicates
810845 - that favorable lipid profile, weight loss, and production of EPC in
810846 - the bone marrow, all stimulated by exercise, drives regression of
810847 - plaque. ref SDS 46 XY7L
810849 - ..
810850 - The next step monitoring results of medical, diet, and exercise
810851 - interventions the past 4 years, since CABG +4 on 091022 0700,
810852 - ref SDS 7 PQWU, is to perform radiology imaging study with coronary CT
810853 - angiography or IVUS to assess regression of atherosclerosis plaque,
810854 - which previously required major surgery to fix.
810856 - ..
810857 - This step is supported by patient history using CT radiology imaging
810858 - to assess regression of esophageal bubble after 4 years of medical
810859 - interventions, reported favorable by Doctor Stewart, Chief General
810860 - Surgery at VA on 130122 1330. ref SDS 34 03H6
810861 -
810862 -
810863 -
810864 -
810865 -
810866 -
8109 -
SUBJECTS
VA Lab Cardiac Enzymnes Creatine Kinase CK also CPK Creatine Phospho
8903 -
890401 - ..
890402 - Myopathy Muscle Pain Side Effects Simvistatin Decline
890403 -
890404 - Follow up ref SDS 78 D26G, ref SDS 76 D26G.
890405 -
890406 - Prior Cardiac Enzymes Profile on 120209 1118. ref SDS 22 D26G
890407 - Prior Cardiac Enzymes Profile on 120509 1108. ref SDS 26 D26G
890408 - Prior Cardiac Enzymes, 131015 0724, ref SDS 40 D26G
890409 - Prior Cardiac Enzymes Profile VA on 140203 1147. ref SDS 52 NX6G
890411 - ..
890412 - This test not performed by Labcorp with blood draw on 141201...
890413 -
890414 - CARDIAC ENZYMES
890415 -
890416 - Dates 2014 05 14 1016 140508 140203 131015 120509
890417 - VA Labcorp VA VA VA
890418 - PLASMA Results Results Results Results Results Units Range
890419 - CPK (CK) 192 149 110 152 U/L 30 - 235
890420 - TRPONIN ng/ml 0 - 0.07
890421 - CK-MB ng/ml 0.6 - 3.5
890422 - MYOGLOB ng/ml 20 - 82
890424 - ..
890425 - a. CPK/CK test not performed by Labcorp
890427 - ..
890428 - b. SLIGHTLY ICTERIC SPECIMEN /HN
890430 - ..
890431 - c. Ordering Provider: Diana Alba
890432 - Report Released..: May 14, 2014@11:29
890433 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
890434 - 4150 CLEMENT STREET
890435 - SAN FRANCISCO, CA 94121-1545
890436 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
890438 - ..
890439 - CKP and CK are the same thing - creatine phosphokinase (CPK) also
890440 - called creatine kinase (CK).
890441 -
890442 - http://www.scai.org/SecondsCount/Resources/Detail.aspx?cid=ed385473-d4e8-491e-9ce0-a7c984fe6f8e#.U3b_BfldWi8
890444 - ..
890445 - Research on 111013 explains Creatine Kinase CK, relates to muscle
890446 - disorders caused by cholesterol medications with statins. 111013 1404,
890447 - ref SDS 19 J54K
890449 - ..
890450 - CK lab may align with reduced side effects of muscle pain in left
890451 - shoulder.
890452 -
890453 -
890454 -
890455 -
890456 -
890457 -
8905 -
SUBJECTS
HGBA1C 5.4 Range 4.0-6.0 Diabetes Negative Laboratory Blood Test Cro
A603 -
A60401 - ..
A60402 - HGBA1c Diabetes Blood Test A1c
A60403 - A1c Diabetes Blood Test HGBA1c
A60404 - Diabetes HGBA1c A1c Blood Test
A60405 -
A60406 - Follow up ref SDS 78 9F4O, ref SDS 76 9F4O.
A60407 -
A60408 - Prior HGBA1c Profile on 100721 0800. ref SDS 11 IL4N
A60409 - Prior HGBA1c Profile on 101207 0906. ref SDS 15 IL4N
A60410 - Prior HGBA1c Profile on 131015 0724. ref SDS 40 9F4O
A60411 - Prior HGBA1c Profile on 140203 1147. ref SDS 52 9F4O
A60413 - ..
A60414 - This test not performed by Labcorp with blood draw on 141201...
A60416 - ..
A60417 - Endocrine IV - HGBA1c - A1c
A60418 -
A60419 - Dates..........2014 08 14 1528 140514 140508 140203 131015 101207
A60420 - VA VA Labcorp VA VA VA
A60421 - BLOOD Results Results Results Results Results Results Units Range
A60422 - HGBA1c 5.6 5.4 5.5 5.5 5.7 % 4.0 - 6.0
A60423 - eAG 114 111 111 mg/dL 74.0 - 118
A60425 - ..
A60426 - Comments:
A60427 -
A60428 - a. Labcorp did not perform HGBA1c lab
A60429 -
A60430 - b. Ordering Provider: Diana Alba
A60431 - Report Released..: May 14, 2014@11:29
A60432 - Reporting Lab....: SAN FRANCISCO VAMC [CLIA# 05D0988226]
A60433 - 4150 CLEMENT STREET
A60434 - SAN FRANCISCO, CA 94121-1545
A60435 - Performing Lab...: SAN FRANCISCO VAMC [CLIA# 05D0988226]
A60437 - ..
A60438 - This test for diabetes was ordered by Doctor Abrams during a meeting
A60439 - at the San Francisco VA Medical Center on 130227 0930. ref SDS 35 8T5L
A60440 - However, it is not reported for the lab performed the next day on
A60441 - 130228 1140, ref SDS 36 RP4N, nor in the follow up lab 3 months later
A60442 - on 130529 0818. ref SDS 38 RP4N
A60444 - ..
A60445 - HGBA1c was performed previously on 101207 0906, ref SDS 15 IL4N, and 5
A60446 - months earlier on 100721 0800. ref SDS 11 IL4N
A60448 - ..
A60449 - Labcorp test showing LP-IR Score < 25.0, indicating very low risk of
A60450 - diabetes. ref SDS 0 TU6L
A60452 - ..
A60453 - Glucose 104 above range 79 99, Labcorp electrolyte panel reported
A60454 - today, per above, ref SDS 0 ZG5O, indicates potential diabetes risk,
A60455 - but may be elevated by dehydration from statin medication and hiking
A60456 - 22 miles the day before the lab and 11 miles the morning before
A60457 - getting the blood draw, reported above. ref SDS 0 QW6K
A60458 -
A60459 -
A60460 -
A60461 -
A60462 -
A60463 -
A60464 -
A60465 -
A60466 -
A60467 -
A605 -