CONTACTS
0201 - Doctor Gloria Tucker
020101 - Dr. Gloria Tucker
020103 - Medical Offices
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 24 0000. ref SDS 23 0000.
040502 -
040503 - Good work today, injecting right knee, both feet, including Tailor's
040504 - Bunions, and rest into left knee. ref SDS 0 VO3F Reviewed findings in
040505 - MRI on 171229. ref SDS 0 9J8N Got better insight into how PRP
040506 - resolves pain by regenerating soft tissue. Post procedure research
040507 - found support for PRP increasing collagen, ligaments, etc. ref SDS 0
040508 - T14I Another article in PMC relates research finding PRP increases
040509 - cartilage at 6 months. This indicates subsequent measurements in
040510 - Welch, may yield comparable findings. ref SDS 0 JX67 Scope of
040511 - treatment today, was limited by lack of driver. ref SDS 0 HP5O As a
040512 - result, only 12 injections were made. ref SDS 0 VO3F Doctor Tucker
040513 - injected right knee for first time, and with full protocol amount.
040514 - ref SDS 0 K65M
040515 -
040516 -
040517 -
040518 -
040520 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Arrived OA 1500, so worked for 90 minutes in one of the spare
040902 - offices. This was helpful to review the record preparing for
040903 - productive meeting.
040905 - ..
040906 - The 3nd PRP treatment performed today, was scheduled with Connie
040907 - earlier this morning, during a call intended to schedule treatment on
040908 - 180221, reported on 180105 1118. ref SDS 40 5P4L
040910 - ..
040911 - During this 90-minute period, a patient took ill in the waiting room.
040912 - She was with her husband. He coordinated with Jane, and partly with
040913 - Doctor Tucker to provide interim care until they could drive to a
040914 - hospital. At one point, Doctor Tucker authorized the patient to lie
040915 - down on an examination table to recover. Turned out this patient did
040916 - not receive PRP treatment today, so her illness was unrelated.
040918 - ..
040919 - Doctor Tucker's other patients required care until about 1650.
040920 -
040922 - ..
0410 -
0411 -
0412 - 1700
0413 -
041301 - Jane came and said a treatment room is ready, so stopped working, and
041302 - went into the procedure room. Removed shoes and waited for the
041303 - doctor. Within a few minutes she came into the room.
041304 -
041341 - ..
041342 - Discussed scope of treatment today, presented in a letter to Doctor
041343 - Tucker on 171208 1242. ref SDS 34 CJ60
041345 - ..
041346 - Scope was reviewed again in another letter on 171227. ref SDS 38 FN52
041348 - ..
041349 - On 171227 1300, Doctor Thuillier in VA Orthotpedics ordered MRI
041350 - studies on both feet and both knees, to find changes in anatomy that
041351 - reconcile clinical improvement reducing severe osteoarthritis pain.
041352 - 171227 0915, ref SDS 37 E54H
041354 - ..
041355 - On 171229 0615 went to Radiology at VAMCSF. Jonus did MRI scans on
041356 - both knees to evaluate recovery osteoarthritis. ref SDS 39 FZ5L
041358 - ..
041359 - Doctor Tucker said earlier today, she read the MRI findings on left
041360 - knee shown in the record on 171229 0745, ref SDS 39 ZG6H, and
041361 - referenced in the copy she received of the letter sent to Doctor
041362 - Thuiller earlier today on 180105 1321. ref SDS 41 O46F
041364 - ..
041365 - The doctor said there is not a lot of reporting on MRI studies finding
041366 - regeneration of cartiage in joints. This aligns with results of MRI
041367 - on 171229 0745, ref SDS 39 PSWR, which says in part...
041368 -
041369 - Unchanged complete degenerative tearing of the medial
041370 - meniscus and partial tearing of the lateral meniscus with
041371 - extrusion of the body with intrasubstance degeneration.
041373 - ..
041374 - This finding indicates PRP did not regnerate cartilage. Why then has
041375 - there been no pain in the left knee? The right knee was treated with
041376 - Supartz on 170731 1500, ref SDS 20 0001, 5 days after PRP treatment on
041377 - 170726. It's known that hyaluronic acid in Supartz lubricates the
041378 - joint to reduce pain. This worked well in the right knee for about 4
041379 - months, then pain began to recur, so Glucosamine Chondroitin has been
041380 - taken to continue lubricating the right knee joint for pain
041381 - management. Since PRP does not inject hyaluronic acid, how has it
041382 - prevented pain in the left knee for over 5 months and counting?
041384 - ..
041385 - Doctor Tucker seemed to say PRP eliminated pain hiking 630 miles since
041386 - injections on 170726, cited in the letter to Doctor Thuillier on
041387 - 180105 1321, ref SDS 41 I48O, by regenerating (healing??) soft tissue.
041388 - The doctor mentioned specifically collagen, ligaments, muscles, and
041389 - further indicated MRI technology cannot assess these soft tissue
041390 - improvements.
041392 - ..
041393 - After the meeting, research found on the Internet...
041394 -
041395 - Arthritis-Health
041397 - ..
041398 - Platelet-Rich Plasma (PRP) Therapy for Arthritis
041399 -
041400 - By John J Wilson, MD, MS
041401 - Updated................................ 2014 01 07 | Peer Reviewed
041402 -
041403 - https://www.arthritis-health.com/treatment/injections/platelet-rich-plasma-prp-therapy-arthritis
041405 - ..
041406 - The article says in part...
041407 -
041408 - PRP injections are formulated from your own immune system's
041409 - platelets, which are extracted from a blood sample, then
041410 - concentrated to make the injection. This seems to stimulate
041411 - healing through the production of collagen and to alter pain
041412 - receptors, which reduces pain.
041414 - ..
041415 - This seems to support Doctor Tucker's theory, per above. ref SDS 0
041416 - T14I Would be helpful to have study measuring collagen before and
041417 - after PRP treatment. What signals increased collagen?
041419 - ..
041420 - Article continues...
041421 -
041422 - What Does Platelet-Rich Plasma Therapy Do?
041424 - ..
041425 - Experts are unsure exactly how PRP therapy may alleviate
041426 - symptoms for certain orthopedic conditions. Doctors who use
041427 - PRP therapy to treat osteoarthritis theorize that the
041428 - platelet-rich plasma might:
041429 -
041430 - 1. Inhibit inflammation and slow down the progression of
041431 - osteoarthritis1
041433 - ..
041434 - MRI study may support this explanation.
041436 - ..
041437 - Article continues...
041438 -
041439 - 2. Stimulate the formation of new cartilage2
041441 - ..
041442 - MRI study seems not to support this explanation.
041444 - ..
041445 - Article continues...
041446 -
041447 - 3. Increase the production of natural lubricating fluid in the
041448 - joint, thereby easing painful joint friction3
041450 - ..
041451 - MRI study seems silent on this.
041453 - ..
041454 - Article continues...
041455 -
041456 - 4. Contain proteins that alter a patient's pain receptors and
041457 - reduce pain sensation
041459 - ..
041460 - It could be that platelet-rich plasma does all of these things,
041461 - or none.5 More large-scale, high-quality clinical studies are
041462 - needed before scientists can know.
041463 -
041465 - ..
041466 - Pubmed article sounds promising...
041467 -
041468 - NCBI
041469 - PMC
041470 - US National Library of Medicine
041471 - National Institutes of Health (NIH)
041473 - ..
041474 - Cartilage
041475 - Cartilage: 2013 Oct, 4 (4) 295-312
041477 - ..
041478 - PMCID: PCM4297162
041479 - doi: 10.1177/1947603513497553
041481 - ..
041482 - Application of Platelet-Rich Plasma to Disorders of the Knee Joint
041483 -
041484 - Omitted - authors and copyright and license information
041485 -
041486 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297162/
041488 - ..
041489 - Abstract
041491 - ..
041492 - Importance. The promising therapeutic potential and
041493 - regenerative properties of platelet-rich plasma (PRP) have
041494 - rapidly led to its widespread clinical use in musculoskeletal
041495 - injury and disease. Although the basic scientific rationale
041496 - surrounding PRP products is compelling, the clinical
041497 - application has outpaced the research.
041499 - ..
041500 - Objective. The purpose of this article is to examine the
041501 - current concepts around the basic science of PRP application,
041502 - different preparation systems, and clinical application of PRP
041503 - in disorders in the knee.
041505 - ..
041506 - Many articles mention varying results based on "different preparation
041507 - systems, as here. In this case, where results seem favorable after
041508 - only 5 months on the left knee, and both feet, specifications on
041509 - "preparation" and "product composition" should be reported to evaluate
041510 - repetitive results.
041512 - ..
041513 - Article continues...
041514 -
041515 - Basic Scientific Rationale of Platelet-Rich Plasma Use in
041516 - Articular Cartilage Degradation and Repair
041518 - ..
041519 - On a molecular level, results have indicated a beneficial
041520 - effect of PRP on chondrocytes and mesenchymal stem cells.
041521 - Increased cell proliferation and synthesis of proteoglycans and
041522 - collagen type II has been demonstrated when cell cultures of
041523 - chondrocytes56,57 and mesenchymal stem cells58 are treated with
041524 - PRP compared with controls treated with platelet-poor plasma or
041525 - fetal bovine serum.
041527 - ..
041528 - This seems to align with Doctor Tucker's explanation that PRP
041529 - increases collagen, per above. ref SDS 0 T14I
041531 - ..
041532 - Article continues...
041533 -
041534 - Clinical Application of Platelet-Rich Plasma Use in Articular
041535 - Cartilage Degradation and Repair in the Knee
041537 - ..
041538 - Osteoarthritis
041540 - ..
041541 - In an uncontrolled prospective study, 14 patients with knee OA
041542 - were treated with PRP produced using anticoagulated blood
041543 - processed in the GPS III system.61 These authors reported
041544 - reduced pain and improved functional outcome after a series of
041545 - injections with PRP.
041547 - ..
041548 - This aligns with Welch case on left knee.
041550 - ..
041551 - Article continues...
041552 -
041553 - They also reported improvement in the ultrasonographic
041554 - measurement of femoral articular cartilage thickness in 6 out
041555 - of 13 patients at 6 months and in the satisfaction survey at
041556 - the 1-year follow-up examination, 8 of 13 patients reached
041557 - their goals at 1 year (Table 3).
041559 - ..
041560 - There is no evidence of cartilage thickness improvement in Welch,
041561 - after 5 months, at least using measurements applied by radiologists
041562 - for MRI study on 171229. Conceivably, more refined measurement
041563 - methodology might register either increase or decrease in cartilage of
041564 - left knee joint. Since PRP injected on 170726, was deminimus, i.e.,
041565 - less than protocol, per Doctor Tucker below, ref SDS 0 TR68, perhaps
041566 - another MRI in 6 months after treatment today, will show increased
041567 - miniscus. If so, this would further reconcile clinical improvement
041568 - feeling no pain in left knee hiking 630 miles between MRI on 170726,
041569 - and recent follow up MRI on 171229.
041570 -
041571 -
041573 - ..
041574 - Develope Scope of Work for Regeneration PRP Injection Treatments
041575 -
041576 - Follow up ref SDS 24 PPVQ.
041577 -
041578 - Doctor Tucker asked about pain medication. How long since taking
041579 - NSAID drugs? She said these should have been stopped for at least
041580 - the past 7 days.
041582 - ..
041583 - Cited letter to the medical team (including Doctor Tucker) on 171103,
041584 - reported all pain medication was stopped 4 weeks earlier ref SDS 33
041585 - S273 Ending pain medication actually began on 171018, shown in diary
041586 - listing daily exercise, diet, vitals and medication in case study
041587 - beginning on 160101 0700. ref SDS 9 PM5F
041589 - ..
041590 - Based on understanding for rational basis that PRP in left knee
041591 - reduced pain through improving multiple joint deficits, made
041592 - following decisions...
041593 -
041594 - Because the meeting today, was scheduled ad hoc from a call
041595 - this morning, reported on 180105 1118, ref SDS 40 GO9L, it was
041596 - not possible to have a driver.
041598 - ..
041599 - Driver is needed when injections require strong medication to
041600 - manage pain, which then impairs ability to drive, based on
041601 - prior care, reported on 170816 1400, ref SDS 24 J97M On that
041602 - occasion, the body suffered severe side effects from
041603 - post-procedure pain medication. ref SDS 24 RN5H
041605 - ..
041606 - Without driver, should not do deep injections to left and right
041607 - feet plantar plate tears, nor to arches, which both caused
041608 - severe pain and so required pain medication for prior PRP
041609 - injections on 170816 1400. ref SDS 24 1H6M
041611 - ..
041612 - Doctor Tucker agreed to defer injections into the arch today,
041613 - but noted efficacy to relieve hallus valgus in both feet.
041615 - ..
041616 - We noted simple procedure of placing felt pad spreaders between
041617 - toes has been successful preventing feet pain and increased
041618 - blisters caused by hallus valgus injuries, as recommended by
041619 - Doctor Thuillier during the meeting at the VA on 171227 0915.
041620 - ref SDS 37 3B3H This reduces urgency for injecting hallus
041621 - valgus today, so that PRP can be injected in left knee.
041623 - ..
041624 - Will consider PRP injecting hallus valgus during subsequent
041625 - treatments, when a driver is available and/or conscious
041626 - sedation can be performed.
041628 - ..
041629 - Primary PRP injection objective is right knee, presented in the
041630 - letter on 171208 1242, ref SDS 34 YM3I, and to achieve pain
041631 - relief comparable to total relief experienced with left knee
041632 - during hiking, reported in the letter to the medical team on
041633 - 171103 1141, ref SDS 33 S293, further presented in the letter
041634 - to Doctor Tucker on 171208 1242. ref SDS 34 CK36 This was
041635 - confirmed in recent letter on 171227 1328. ref SDS 38 FN52
041637 - ..
041638 - Next inject both feet metatarsals only, and not inject bottom
041639 - of feet to specifically treat plantar plate. These seem
041640 - largely healed. Injecting metatartsals today, may also
041641 - additonally treat plantar plate area without direct injections.
041643 - ..
041644 - Tailor's bunion inject PRP on both feet.
041646 - ..
041647 - Remaining PRP plasma, if any, can be injected into left knee.
041649 - ..
041650 - Doctor Tucker said she was surprised the left knee responded so well
041651 - to PRP injection on 170726, which used less than standard protocol for
041652 - knee injections. She explained this occurred, because at that time,
041653 - the left knee was injected last with only what remained after
041654 - injecting both feet metatarsals and plantar plate tear on bottom of
041655 - right foot.
041657 - ..
041658 - Longevity of recovery was discussed.
041660 - ..
041661 - Doctor Tucker seemed to say the single injections into both feet and
041662 - left knee could last 1 - 5 years.
041664 - ..
041665 - Discussed research indicating some patients get injections every 6
041666 - months or at least annually.
041668 - ..
041669 - The doctor seemed to say that properly applied PRP injection
041670 - treatments should last at least multiple years.
041672 - ..
041673 - Since the left knee did not receive a full amount of PRP injection,
041674 - supplementing the first injection today, is good insurance for longer
041675 - results.
041677 - ..
041678 - Finally, most patients don't hike 2,500 miles per year, with running
041679 - and sprinting included.
041681 - ..
041682 - The doctor seemed to indicate that running and sprinting in particular
041683 - reduce longevity of PRP care. She recommended agains it. This
041684 - conflicts with reporting that many professional atheltes are extending
041685 - their careers by getting PRP injections, cited in the letter to Doctor
041686 - Tucker on 171212 1657. ref SDS 35 RX52 These athletes run and sprint,
041687 - endemic to tennis, baseball, et al.
041689 - ..
041690 - As a result, multiple PRP injections to feet and knees are required to
041691 - achieve longevity normally expected for patients who receive only
041692 - single injections. Hopefully, injections today, will last 2 - 5
041693 - years.
041694 -
041696 - ..
041697 - PRP Treatment Layout Injection Sites
041698 -
041699 - Follow up ref SDS 24 VO3F, ref SDS 17 PP4N.
041700 -
041701 - In procedure room laying on treatment table, Doctor Tucker again
041702 - marked locations on both feet and both knees to be injected.
041704 - ..
041705 - Right Leg Injections
041706 -
041707 - Knee joint........................................... 1
041708 -
041710 - ..
041711 - Left Leg
041712 -
041713 - Knee joint........................................... 1
041714 -
041716 - ..
041717 - Right Foot
041718 -
041719 - Follow up ref SDS 24 0108.
041720 -
041721 - Metatarsalgia
041722 - Between little toe and ring toe................. 1
041723 - Between ring toe and middle toe................. 1
041724 - Between middle and long toe..................... 1
041725 - Between long toe and big toe.................... 1
041727 - ..
041728 - Tailor's bunion................................. 1
041730 - ..
041731 - Total right foot............................... 5 5
041733 - ..
041734 - Left Foot
041735 -
041736 - Follow up ref SDS 24 YY3G.
041737 -
041738 - Metatarsalgia
041739 - Between little toe and ring toe................. 1
041740 - Between ring toe and middle toe................. 1
041741 - Between middle and long toe..................... 1
041742 - Between long toe and big toe.................... 1
041744 - ..
041745 - Tailor's Bunion................................. 1
041747 - ..
041748 - Total right foot............................... 5 5
041750 - ..
041751 - Total injections...................................... 12
041752 -
041754 - ..
041755 - Blood Draw for PRP Completed with One Needle Stick
041756 -
041757 - Follow up ref SDS 24 YY6N, ref SDS 17 FG7F.
041758 -
041759 - Doctor Tucker drew blood for PRP platelet extraction. She used outer
041760 - side of left arm inner elbow, which was successful for prior treatment
041761 - on 170816 1400, ref SDS 24 YY6N, and previously on 170726 1600.
041762 - ref SDS 17 TZ8N
041764 - ..
041765 - This took only 1 stick today.
041766 -
041768 - ..
041769 - PRP Injections Mostly Pain Free
041770 -
041771 - Follow up ref SDS 24 K65M, ref SDS 17 GU6N.
041772 -
041773 - Doctor Tucker initially, marked all locations for PRP injections.
041774 - She sprayed numbing agent on each location.
041776 - ..
041777 - The doctor made markings around the knee caps to consider possible
041778 - multiple injection points. However, she ultimately made only 1
041779 - injection, and advised this is a standard protocol location for knees.
041781 - ..
041782 - Doctor Tucker injected each location with lidocain to further numb
041783 - needle penetrations.
041785 - ..
041786 - Right knee - after waiting mintutes for lidocain to take effect, PRP
041787 - was injected into the right knee joint, using standard protocol
041788 - amount, discussed above. ref SDS 0 059O
041790 - ..
041791 - This was completely pain free.
041793 - ..
041794 - Right foot - PRP was next injected into 4 locations on top of right
041795 - foot metatarsals. The outer 2 injections were pain free. The middle
041796 - injections caused severe pain. The doctor noted this reflected these
041797 - middle toes have been worn down by hiking, running and sprinting.
041799 - ..
041800 - Tailor's bunion right foot was injected with small amount.
041802 - ..
041803 - Left foot - same scenario as right foot, with considerable pain
041804 - injecting middle metatarsals.
041806 - ..
041807 - Pain was only at moments of needle penetration, similar but less
041808 - severe than prior procedure on 170816 1400. ref SDS 24 1A3I
041810 - ..
041811 - Tailor's bunion left foot was injected with small amount.
041812 -
041813 - [On 180315 shown in case study on 160101 0700 tailor's
041814 - bunion on left foot now requires dressing to relieve shoe
041815 - pressure during hikes. Tailor's bunion right foot does not
041816 - require dressing. ref SDS 10 4B6L
041818 - ..
041819 - Left knee - remainting PRP was injected into left knee. This was
041820 - completely pain free.
041821 -
041822 -
041824 - ..
041825 - Follow Up Treatments Might be Needed
041826 - Discharge Instructions and Payment
041827 -
041828 - Follow up ref SDS 24 WV5I, ref SDS 17 S93J.
041829 -
041830 - Doctor Tucker cleaned forefeet which had leaked blood slightly.
041832 - ..
041833 - On standing up from the treatment table, there was mild pain at level
041834 - 1 - 2 in the feet where injections were made. This was much less
041835 - severe than after deep injections to plantar plate and arches done on
041836 - 170816 1400. ref SDS 24 J97T As a result, pain medication was not
041837 - needed today.
041839 - ..
041840 - Doctor Tucker said not to hike for a week, then follow prior protocol.
041841 - On 170727 1747 Doctor Tucker called and said walking 1 mile 2 days
041842 - after feet injections stimulates PRP healing (regeneration) processes,
041843 - and then slow for about 3 miles helps distribute PRP in the feet.
041844 - ref SDS 18 0W6V
041846 - ..
041847 - After treatment today, research found...
041848 -
041849 - The Stemcell Orthopedic Institute of Texas
041850 - Call 210 293 3136
041852 - ..
041853 - PRP POST INJECTION GUIDELINES AND EXERCISES
041854 -
041855 -
041856 - https://stemcellorthopedicinstituteoftexas.com/platelet-rich-plasma-therapy-prp/after-prp-therapy/
041857 -
041858 - 1. Medication Guidelines
041859 -
041860 - For a minimum of two weeks post-injection, it is important
041861 - for the efficacy of the treatment that all
041862 - anti-inflammatory medications (NSAIDS) are discontinued.
041863 - You can take Tylenol (Acetaminophen) and Celebrex, but we
041864 - ask that you avoid other NSAIDS such as aspirin, Naproxen
041865 - (Aleve) and Ibuprofen (Advil, Motrin) because they will
041866 - inhibit platelet function. Other prescription medication
041867 - should be reviewed with your procedure physician.
041869 - ..
041870 - Apply moist heat to treated area for the first 24 hours.
041872 - ..
041873 - 2. Activity Guidelines
041874 -
041875 - FIRST WEEK&Treated areas should remain immobile. For the
041876 - first two weeks, we encourage you to resume normal day-to
041877 - day activities&BUT NO exercise of the treated extremity.
041879 - ..
041880 - SECOND WEEK& light exercises and progressively build back
041881 - to normal exercise after 4 weeks. Controlled and moderate
041882 - movement is important for the proper stimulation of tissue
041883 - to rebuild in a linear and physiologic fashion. However,
041884 - we strongly advise that you avoid heavy lifting or high
041885 - exercise levels because these activities will compromise
041886 - the progress we are trying to make
041888 - ..
041889 - AFTER TWO WEEKS&you are cleared by your physician to resume
041890 - exercising the area. However, we ask that you gradually
041891 - increase the intensity of your workouts so as not to
041892 - re-injure the tissue. Use pain in the area of injection as
041893 - a guide to how far you push yourself. This is not like
041894 - physical therapy after surgery. We do not want you to push
041895 - through the pain. Instead, ease off the intensity if the
041896 - pain persists.
041898 - ..
041899 - The question is whether damaged tissue heals, i.e., regenerates, e.g.,
041900 - miniscus cartilage, ligaments. How long does this take? 1 week,
041901 - month, 6 months, a year. Once healed, how long will "healed" miniscus
041902 - cartilage, metatarsal cartilage last hiking 11 - 15 miles per day?
041904 - ..
041905 - Article continues...
041906 -
041907 - If you feel any of the following symptoms immediately
041908 - contact our office: prolonged redness, swelling, fevers,
041909 - chills, muscle weakness as well as numbness and/or
041910 - tingling.
041911 -
041913 - ..
041914 - The doctor also cautioned against using NSAID pain medications for 2
041915 - weeks after injections, since NSAID drugs block/reduce blood flow
041916 - needed for PRP healing process.
041918 - ..
041919 - Thanked Doctor Tucker for great work.
041920 -
041921 -
041923 - ..
0420 -
0421 -
0422 - 1842
0423 -
042301 - Jane had already left, so Doctor Tucker prepared the bill...
042302 -
042303 - $900
042304 -
042312 -
042313 -
042315 - ..
0424 -
0425 -
0426 - 1613
0427 -
042701 - Driving from Novato to Concord
042702 -
042703 - Follow up ref SDS 24 VJ3G.
042704 -
042705 - After leaving the doctor's office traffic was okay on 101 for the 5
042706 - miles to highway 37 off ramp.
042708 - ..
042709 - Traffic moved well for 2 or 3 miles on highway 37 with 2 lanes in
042710 - both directions.
042712 - ..
042713 - Fortunately, traffic speed remained normal all the way to Vallejo.
042715 - ..
042716 - Made it to Vallejo and transitioned onto US 80 toward San Francisco.
042717 - There was moderate rain, and in the dark took wrong turn off, so
042718 - missed highway 780 to Benecia- Martinez bridge. Was fortunate to
042719 - quickly find an onramp for highway 80 West to Sacramento. Took this
042720 - to 680, and then to Benecia-Martinez bridge and home.
042721 -
042723 - ..
0428 -
0429 -
0430 - 2010
0431 -
043101 - Arrived home, and transferred the record from c23 to c22.
043102 -
043103 - Began writing up the record meeting with Doctor Tucker.
043104 -
043105 -
043106 -
043107 -
043108 -
043109 -
043110 -
043111 -
043112 -
043113 -
043114 -
043115 -
0432 -
Distribution. . . . See "CONTACTS"