CONTACTS
SUBJECTS
VA Notify Injury Hematoma Left Leg Symptoms Worsening Pain Need Crut
1403 -
1403 - ..
1404 - Summary/Objective
1405 -
140501 - Follow up ref SDS 27 0000. ref SDS 15 0000.
140502 -
140503 -
140504 -
140505 -
140507 - ..
1406 -
1407 -
1408 - Progress
1409 -
140901 - Meeting Primary Care VA Examin Injury Right Hip
140902 -
140903 - Follow up ref SDS 27 JN3J, ref SDS 15 499K.
140904 -
140905 - On, ref SDS 28 TS4N, 160504, met Lauren Rettberg, NP PA, in Primary
140906 - Care. Reported loss of balance that caused fall on 160501,
140907 - ref SDS 27 JN3J, shown in case study on 140101 0600. ref SDS 4 O85F
140908 - Lauren performed a neurological test, passed this including Romberg's
140909 - balance test. ref SDS 27 WZ50
140911 - ..
140912 - Agenda....
140913 -
140914 - 1. Drinking more water.
140915 -
140916 - 2. Diet was going well until yesterday.
140918 - ..
140919 - 3. Referral Wound Clinic review acute lower leg wounds and
140920 - prescribe refills on
140921 -
140922 - 1. Hydrofera Blue Bacteriostatic dressing
140923 - 2. Antiseptic spray
140924 - 3. Coban self-adhering tape
140925 - 4. Tape Micropore RX #610165 0 Refills
140926 -
140928 - ..
140929 - 4. Referral Neurology for...
140930 -
140931 - 1. Order radiology study for calcium crystals (called
140932 - "otoconia") moving from vestibular chamber into one or more
140933 - semicircular canals causing loss of balance due to sway
140934 - that further causes falling, reviewed on 160505 0753,
140935 - ref SDS 28 S43G, and cited in a letter to the medical team
140936 - on 160505 1715. ref SDS 29 J080
140938 - ..
140939 - 2. Perform Sway study using software technology to rate
140940 - balance fitness for routine hiking, e.g., Half Dome.
140942 - ..
140943 - 3. Develop remedies to improve balance fitness, if warranted.
140944 -
140946 - ..
140947 - 5. Progress Notes...
140948 -
140949 - 1. Interim events..... 160504 1030, ref SDS 27 8I3J
140950 -
140951 - 1. On 130918 patient at age 68, hiked to top of Half Dome in
140952 - Yosemite, and 9 mile hike and climbing 1 mile up; round
140953 - trip 18 miles. ref SDS 3 0001
140955 - ..
140956 - 2. On 150809 patient paused statin treatments to recover from
140957 - side effects - liver damage shown by elevated bilirubin
140958 - that caused dehydration through frequent urination,
140959 - resulting in cracked, peeling, bleeding feet, and to enable
140960 - training for Half Dome in September, reported in case study
140961 - on 140101. ref SDS 4 GH3G
140963 - ..
140964 - 3. On 150914 patient fell attempting another Half Dome hike,
140965 - suffering mild injuries, hematoma lower left leg, that was
140966 - treated with brief hospitalization at VAMCSF, and follow
140967 - up in Wound Care Clinic.
140969 - ..
140970 - 4. On 151019 VA performed CCTA, ref SDS 22 NV5I, and found no
140971 - evident atherosclerotic plaques in active circulatory
140972 - system. ref SDS 22 SU4L
140974 - ..
140975 - 5. On 151028, patient resumed Atorvastatin 10 mg and Ezetimibe
140976 - 10 mg.
140978 - ..
140979 - 6. On 160131 patient increased HDL 30 at time of CABG on
140980 - 091022, to HDL 73. ref SDS 23 W25L Increasing HDL 143%
140981 - occurred hiking 10,000 miles in past 4 years.
140983 - ..
140984 - 7. On 160203, Doctor Simpson reduced statin drugs 50% based on
140985 - CCTA showing no evidence atherosclerosis, and patient HDL
140986 - 73. 160203 1000, ref SDS 24 NR81
140987 -
140989 - ..
140990 - 2. Computerized Problem List.... 160504 1030, ref SDS 27 8I65
140991 -
140992 - Consideration to add...
140994 - ..
140995 - Metatarsalgia
140996 - Urination frequency improved reduced statins and Omeprazole
140997 - Shoulder left myopathy nearly healed reduced statins
140998 - Wrist right fracture nearly healed
140999 - Knee right pain (MRI pending evaluation MCL tear)
141000 - Knee left chronic degenerative arthritis - continual pain
141001 - Feet chronic injuries hiking to lower CVD risk by raising HDL
141002 - Fall sway balance - bruise right hip
141003 - LLG Hematoma
141004 - Cellulitis
141005 - Weight - need more hiking/recover from injuries
141006 -
141008 - ..
141009 - 3. Active Outpatient Medications: updated 5.4.16, ref SDS 27
141010 - 8I7L,
141012 - ..
141013 - This is an excellent list.
141014 -
141016 - ..
141017 - 4. SH: (from cards note)....... ref SDS 27 8I87
141018 -
141019 - Listing good reproduction of Cardiology understanding.
141021 - ..
141022 - Doctor Rao spot checked daily record of exercise, diet,
141023 - vitals, and medications, see for example day before meeting
141024 - on 160503, shown in case study on 140101 0600. ref SDS 4
141025 - EF5M
141027 - ..
141028 - See Doctor Rao's Progress Notes for 141024 0900,
141029 - ref SDS 6 IO6J
141030 -
141032 - ..
141033 - PE......................... ref SDS 27 8I4U
141035 - ..
141036 - Bruise 7" x 6" right hip from fall on 160501
141038 - ..
141039 - Lauren reviewed photograph during the meeting.
141040 -
141042 - ..
141043 - 5. A/P.................... ref SDS 27 8J3Q
141044 -
141045 - Falls...
141046 -
141047 - Reassuring that neuro exam today wnl.
141048 -
141049 - What does "Wnl" mean"
141051 - ..
141052 - Consider referral to gait and balance PT clinic if falls
141053 - persist, ref SDS 27 BZ5K
141055 - ..
141056 - Hoping referral to Neurology to correct sway balance
141057 - problems occurs to prevent another fall, rather than
141058 - wait for another fall, which may be the last.
141059 -
141060 -
141061 -
141062 -
141063 -
141064 -
141065 -