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: July 31, 2017 03:00 PM Monday; Rod Welch

VA Orthopedics meeting Joan for Supartz treatment on right knee.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 35 0001, ref SDS 34 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 - Joan was excellent today, injecting right knee for another treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040504 - with Supartz that maintains pain-free function for next 6 months.  She                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040505 - initially reviewed the record of prior work to verify objectives and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040506 - scope, and for any issues that might have occurred which normally                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040507 - would not be expected. ref SDS 0 DS94  Joan was aware that work today                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040508 - is only for the right knee, after having left knee injected with PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040509 - by Doctor Tucker last week. ref SDS 0 F245  Actual injection process                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040510 - went flawlessly - timely, professional and totally pain free.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040511 - ref SDS 0 S456  Next injection is scheduled a week from today for next                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040512 - Monday on 170807. ref SDS 0 3W8N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040513 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040514 -            [On 170802 0742 submitted letter to Joan with the record on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040515 -            Supartz injection for left knee; attached only 2 of 13                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040516 -            pictures, because Samsung s8 camera high resolution                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040517 -            produces large files, so only 2 passed VA email limits.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040518 -            ref SDS 37 4G5J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040520 -             ..
040521 -            [On 170804 1622 received letter from Joan with appreciation                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040522 -            for the record injecting Supartz, and including pictures.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040523 -            ref SDS 38 4G5J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040524 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040525 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040526 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040527 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040529 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - Arrived at VA OA 1300, after hiking a few miles at Lafayette Reservoir                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040902 - on the way to the City.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040904 -  ..
040905 - Checked in at Module #2, and gave cellphone number for Joan to call,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040906 - if she wants to start before 1500.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040908 -  ..
040909 - Next went to Pharmacy down the hall, and received Supartz treatments                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040910 - for 3 injections.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040912 -  ..
040913 - Went to cafeteria and worked for 90 minutes or so.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040914 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040915 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040916 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040918 -  ..
0410 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0412 - 1425                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041301 - Received call from nurse in module #2.  She said Joan can do the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041302 - procedure 30 minutes ahead of schedule.  Explained it will take 10                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041303 - minutes to close shop in the cafeteria, and store the computer in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041304 - car, then walk back to Module 2.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041305 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041306 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041307 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041309 -  ..
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0416 - 1437                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041701 - Arrived in Module 2.  A nurse said Joan took another patient ahead of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041702 - me, and I will be next in about 15 minutes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041704 -  ..
041705 - Waited in lobby reading today's paper, and other materials.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041707 -  ..
041708 - Nurses came out continually and called patients.  Several patients                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041709 - were elderly and complained of long wait to see the doctor.  One was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041710 - waiting for Joan.  When the nurse came and called my name, said to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041711 - take the other patient, since he has been waiting a long time.  The                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041712 - patient was relieved and said thanks.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041714 -  ..
041715 - There were a lot of patients in difficult circumstance, many with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041716 - walkers, and motorized wheelchairs.  One was on a gurney, and so was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041717 - pushed by two attendants.  Turned out he was a Wound Care patient.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041718 - Christy Burns was the provider today.  She came along pushing her                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041719 - mobile workstation.  Christy said hello, and that she is filling in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041720 - for Lana, still on vacation.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041721 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041723 -  ..
0418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0420 - 1538                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042101 - Joan came into the waiting area and called for the procedure.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042102 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042103 - Walked into the care area, and to the procedure room at the end of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042104 - the hall, where Lana usually gives Wound Care.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042106 -  ..
042107 - On the way down the hall, asked Anna if she would take pictures                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042108 - today.  She smiled and said sure.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042110 -  ..
042111 - In the procedure room, Joan read Gina's progress notes from the last                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042112 - injection on 170206 1240. ref SDS 5 RN5K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042113 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042114 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042115 -   
042116 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042118 -  ..
042119 - Joan asked about Gina's report on patient hiking 11 - 15 miles per                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042120 - day.  Explained these are the usual routes.  Joan asked how the right                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042121 - knee injected by Gina 6 months ago has held up with this level of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042122 - stress?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042124 -  ..
042125 - Explained Supartz has worked well, until the past few weeks, and so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042126 - requested another phase of injection treatment.  On 170619, Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042127 - Thuillier ordered this treatment.  At that time, the doctor ordered                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042128 - injections for both knee. ref SDS 33 U76F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042130 -  ..
042131 - Joan was aware that scope of work was changed from both knees to only                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042132 - the right knee, because the left knee was treated experimentally with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042133 - platelet rich plasma (PRP) by Doctor Tucker last Wednesday on 170726                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042134 - 1600. ref SDS 36 0001                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042135 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042136 -              https://www.google.ca/imgres?imgurl=https://embed.widencdn.net/img/veritas/8niw4d0qto/600px/knee-injection.jpg%3Fquality%3D80%26u%3Dat8tiu%26use%3Dthpzr&imgrefurl=https://www.arthritis-health.com/treatment/injections/efficacy-platelet-rich-plasma-injections&h=338&w=600&tbnid=dDg1VNCMwG1QjM:&tbnh=160&tbnw=284&usg=__6FL_HsZM1_28AuiTzIYy91j1W0M=&vet=10ahUKEwjG_-OcjbnVAhXIv1QKHYqICMYQ9QEIODAA..i&docid=4Mde7CuwlVcBzM&sa=X&ve           d=0a                                                                                                   
042137 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042138 -              https://www.spinemd.com/treatments/platelet-rich-plasma                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042139 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042141 -  ..
042142 - Joan was generally aware of PRP, and that the VA does not support                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042143 - this line of care at this time.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042145 -  ..
042146 - Signed consent statement.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042148 -  ..
042149 - Joan setup the injection table...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042150 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042151 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042152 -   
042153 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042154 -   
042155 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042157 -  ..
042158 - She then called for Anna to take pictures.  She asked if Gina took                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042159 - pictures previously.  Explained we took pictures for the 1st of the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042160 - 3-injections, on 170123 1530. ref SDS 4 VG6M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042162 -  ..
042163 - Joan requested copies of piectures taken today, to send to her                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042164 - parents, so they can see her work.  She said they have no idea what                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042165 - she does.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042166 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042167 -            [...below on 170731 1500 at 1031 received Joan's letter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042168 -            requesting pictures. ref SDS 0 9Q8N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042170 -             ..
042171 -            [On 170802 0742 submitted letter to Joan with the record on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042172 -            Supartz injection for left knee; attached only 2 of 13                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042173 -            pictures, because Samsung s8 camera high resolution                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042174 -            produces large files, so only 2 passed VA email limits.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042175 -            ref SDS 37 4G5J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042177 -  ..
042178 - Joan prepared materials for numbing injection area...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042179 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042180 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042181 -   
042182 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042184 -  ..
042185 - Joan palpated the knee to determine precise location for making the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042186 - injection...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042187 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042188 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042189 -   
042190 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042192 -  ..
042193 - She used the syrenge for marking where to make the injection...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042194 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042195 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042196 -   
042198 -  ..
042199 - Next, she applied numbing agent...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042200 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042201 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042202 -   
042204 -  ..
042205 - After initial site numbing of the skin, Joan injected lidocane to numb                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042206 - the area inside knee where Supartz will be injected...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042207 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042208 -   
042209 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042211 -  ..
042212 - Finally, Joan injected Supartz...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042213 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042214 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042215 -   
042216 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042217 -   
042218 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042220 -  ..
042221 - She removed the needle, and applied bandaid to protect wound...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042222 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042223 -   
042224 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042225 -   
042226 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042227 -   
042228 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042230 -  ..
042231 - Thanked Joan for great work.  Did not feel anything from the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042232 - injections - everything pain free.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042234 -  ..
042235 - Joan said to take the remaining 2 boxes of Supartz for the next                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042236 - injections over the next 2 weeks, on Monday.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042237 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042238 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042240 -  ..
0423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0424 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0425 - 1841                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042601 - After the procedure, Joan sent a letter to facilitate submitting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042602 - pictures taken today, to her, per above. ref SDS 0 486J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042604 -  ..
042605 - Received Joan's letter saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042606 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042607 -    1.  Subject:  Hello                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042608 -        Date:  2017-07-31 16:10                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042612 -         ..
042613 -    2.  Hi Rod,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042615 -         ..
042616 -    3.  Great working w/ you and I look forward to the pics.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042618 -         ..
042619 -    4.  Take care,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042621 -         ..
042622 -    5.  Joan                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042623 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042624 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042625 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042626 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042627 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042628 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042629 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042630 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042631 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042632 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042633 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042634 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042635 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042636 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042637 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042638 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042639 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0427 -