CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 3 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Consider doing another CCTA to assess progression of atherosclerosis.
040902 -
040903 - Doctor Simpson seemed to feel the patient is despondent worrying about
040904 - prospects of cardiology failure, based on inquires in the letter on
040905 - 160927, ref SDS 7 XJ6S, and including. ref SDS 7 XJ8G
040907 - ..
040908 - He said the patient suffers atherosclerosis, based on having CABG x4
040909 - on 091022.
040911 - ..
040912 - The doctor said he is worried patent LDL-C increased to 170 this
040913 - cycle. He wants to add aspirin and increase Atorvastatin from 10 mg
040914 - every other day, to 80 mg per day.
040915 -
040916 - [On 170412 1000 Doctor Simpson recommends increasing
040917 - statins to lowere LDL < 50. ref SDS 11 OP5M
040919 - ..
040920 - [On 170726 1600 Doctor Tucker drew blood for PRP injection
040921 - therapy to recover from plantar plate tear, metatarsalgia,
040922 - and left knee osteoarthritis; she found thicker than
040923 - expected blood, and so recommended patient take Baby
040924 - Aspirin to thin the blood that helps prevent coronary
040925 - events. ref SDS 12 TZ99
040927 - ..
040928 - We reviewed the record of the CCTA on 151019, showing the patient has
040929 - no evidence of atherosclerosis, as set out in the addendum.
040930 - ref SDS 2 SU62
040932 - ..
040933 - Doctor Simpson seemed to say there could be a lot of soft material
040934 - building up in the blood vessels which was not identified in the CCTA,
040935 - because the resolution is not small enough to recognize soft material.
040937 - ..
040938 - Asked about doing an MRI on the cornary artery system, as was done on
040939 - the brain?
040941 - ..
040942 - The doctor seemed to say there is no technology that can identify
040943 - atherosclerosis better than CCTA.
040945 - ..
040946 - This indicates that the best evidence possible shows there is no
040947 - atherosclerosis in the patient blood vessel system.
040949 - ..
040950 - Doctor Simposon concurred, but indicated there could still be the
040951 - beginnings of atherosclerosis advancing because of elevated LDL,
040952 - shown in blood test yesterday.
040954 - ..
040955 - We considered benefits of elevated HDL > 60 and assumed elevated EPCs
040956 - both generated by hiking 11 - 15 miles per day. These favorable
040957 - CVD/CAD diagnostics may fully resolve any temporary elevations in LDL
040958 - particles.
040960 - ..
040961 - Should research radiology options for evaluating atherosclerosis
040962 - better than CCTA; should be listed on 131125 0005. ref SDS 1 0001
040964 - ..
040965 - Asked about the rate of advance of atherosclerosis that takes 50 years
040966 - to reach a point of disease that threatens patient health.
040968 - ..
040969 - The patient protection against the advance of atherosclerosis is not
040970 - to slow the growth by lowering LDL, but to stop and regress
040971 - atheroclerosis to 0 by raising HDL > 60, shown in the lab yesterday.
040973 - ..
040974 - Doctor Simpson submitted research he had done with passages
040975 - highlighted showing patients who have had CABG surgery do best with
040976 - LDL 100 achieved by taking statin drugs.
040978 - ..
040979 - Asked for research on patients who raise HDL >= 60?
040981 - ..
040982 - Doctor Simpson said he found no research on this solution for
040983 - patients who have had CABG surgery.
040985 - ..
040986 - He advised that patient clinical results hiking 15 miles per day, and
040987 - recently hiking Half Dome on 160914 0530. ref SDS 6 0001 show
040988 - excellent coronary health.
040990 - ..
040991 - Doctor Simpson urged the patient to continue current conduct,
040992 - saying...
040993 -
040994 - "You are the best patient I have ever had."
040996 - ..
040997 - Thanked the doctor for confidence in patient practice managing health
040998 - care.
040999 -
041000 - [On 170412 1000 Doctor Simpson again related benefits of
041001 - hiking that increased HDL 30 to 72 for past 5 years.
041002 - ref SDS 10 3L8I
041004 - ..
041005 - The doctor was complimentary on coordinating resolution of erroneous
041006 - stroke diagnosis last June on 160618 1348, ref SDS 4 WK7K, between
041007 - Neurology, his office in Cardiology, and the GI Department in
041008 - Sacramento.
041010 - ..
041011 - Explained Doctor Stewart in General Surgery offered helpful guidance,
041012 - as well.
041014 - ..
041015 - Doctor Simpson chuckled and said that was an amazing job, including
041016 - 2nd opinion from Stanford finding no stroke occurred.
041018 - ..
041019 - This referenced letter dated 160802, from Stanford Neuroscience
041020 - received on 160820 0940. ref SDS 5 OE7M
041022 - ..
041023 - Discussed emphasis in the cardiology community on lowering LDL-C and
041024 - the opportunity for raising HDL to totally resolve atherosclerosis
041025 - indicated in this case, present interesting challenges.
041027 - ..
041028 - The doctor said we will continue this discussion at the next meeting.
041029 - For now, the patient is doing well.
041031 - ..
041032 - Scheduled the next meeting for February.
041034 - ..
041035 - After the meeting, met with Module #1 attendant. She said the VA
041036 - computer will not accept scheduling meetings for Cardiology more than
041037 - 3 months ahead. The VA will send the patient notice in December to
041038 - call Cardiology and schedule the meeting with Doctor Simpson in
041039 - February.
041041 - ..
041042 - [On 170123 1315 tried to schedule next meeting for late
041043 - February, but nothing was availble until 170412, so settled
041044 - on that date. ref SDS 8 JY6J
041046 - ..
041047 - [On 170123 1315 VA Cardiology Module #1 clerk advised that
041048 - Cardiology can schedule meetins 12 months ahead.
041049 - ref SDS 9 L97M
041050 -
041051 -
041052 -
041053 -
041054 -
041055 -
041056 -
041057 -
041058 -
041059 -
041060 -
0411 -