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 18, 2018 08:09 AM Wednesday; Rod Welch

VA Audiology Balance letter to Bethany requests examination BPPV on 180718 0800.

1...Summary/Objective


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CONTACTS 

SUBJECTS
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0403 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 25 0000. ref SDS 24 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040508 -  ..
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - On 171201 1300 visited Audiology and Balance for treatment scheduled                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040902 - with Doctor Wiseman at the end of the meeting last week on 171121                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040903 - 0800. ref SDS 17 9X3J  Met with Bethany Wiseman, MD...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040905 -  ..
040906 - On 171207 1833 sent letter to Bethany reporting BPPV dizziness                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040907 - symptoms were resolved. ref SDS 19 GG5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040909 -  ..
040910 - On 180514 0829 letter requests VA Audiology and Balance Department                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040911 - examination and treatment for initial symptoms of dizziness                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040912 - recurrance. ref SDS 20 038J  Bethany responded saying the VA can                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040913 - provide treatment anyday this week. ref SDS 20 X65O  Notified would                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040914 - appear for treatment this morning at 0830. ref SDS 20 4F5F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040916 -  ..
040917 - On 180516, meeting with Bethany.  She performed Dix Hallpike maneuver                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040918 - and diagnosed BPPV.  Symptoms did not include common spinning                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040919 - sensation.  There is a "floating", wobbly, and "disorientation"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040920 - feeling that precedes the "spinning room" sensation. ref SDS 21 GT6K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040921 - Bethany explained recurrence of mild BPPV symptoms is common because,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040922 - after a patient suffers BPPV, then relapse occurs more easily.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040923 - ref SDS 21 TR6N  The doctor performed Epley and other treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040924 - maneuvers. ref SDS 21 R54O  On the last attempt, the patient rolls                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040925 - onto the stomach with both arms bent under the chest to support the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040926 - upper body.  In this position with the head extended over the end of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040927 - the examination table, Bethany shook the head up and down several                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040928 - times very quickly. ref SDS 21 AE7H  This line of care was effective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040929 - during treatment on 160707 0900. ref SDS 3 414G  Bethany said to let                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040930 - her know if symptoms return. ref SDS 21 QN9G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040932 -  ..
040933 - On 180517 1713 favorable report to Doctor Wiseman saying BPPV symptoms                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040934 - seem fully resolved. ref SDS 22 005U                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040936 -  ..
040937 - On 180707 0852 report BPPV recurred - little wobbly - for past week,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040938 - and on 180707 recurred strongly. ref SDS 23 RS5F  Letter to Bethany at                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040939 - VAMCSF Audiology and Balance requests examination for BPPV recurrence                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040940 - and treatment. ref SDS 23 U13F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040942 -  ..
040943 - On 180712 1526 letter from Bethany at VAMCSF proposes meeting on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040944 - Wednesday morning early for examination BPPV. ref SDS 24 RS5F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040946 -  ..
040947 - On 180716 0835 letter to Bethany saying will stop by office on 180718                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040948 - 0800 for BPPV examination, if she has time.  Mention hiking Half Dome.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040949 - ref SDS 25 RS5F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040950 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040951 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040952 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040953 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040954 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040956 -  ..
0410 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0412 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041301 - Sent letter to Bethany saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041302 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041303 -    1.  Subject:  Re: [EXTERNAL] SECURE BPPV Symptoms Recurred                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041304 -        Date:  2018-07-18 08:13                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041308 -         ..
041309 -    2.  Dear Bethany,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041311 -         ..
041312 -    3.  Very sorry cannot visit your office this morning.  Had some                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041313 -        plumbing problems with the house.  The plumber was here                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041314 -        yesterday for repairs, which should have been completed.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041315 -        Encountered complications that will take more time this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
041316 -        morning.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041318 -         ..
041319 -    4.  Can we shoot for next Wednesday morning early, on 180725??                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041321 -         ..
041322 -    5.  Will also call to let you know about today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041323 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041332 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041333 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041335 -  ..
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0416 - 0816                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041701 - Called Audiology & Balance for Bethany.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041702 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041703 -            415 750 2225                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041705 -  ..
041706 - Talked to receptionist.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041708 -  ..
041709 - She said Doctor Wiseman is in the office this morning.  She will tell                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041710 - the doctor I called to confirm notice in the letter sent earlier this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041711 - morning, that cannot meet today, per above. ref SDS 0 RS5F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041712 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041713 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041715 -  ..
0418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0420 - 1419                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042101 - Received a letter from Doctor Weisman saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042102 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042103 -    1.  Subject:  RE: [EXTERNAL] SECURE BPPV Symptoms Recurred                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042104 -        Date:  2018-07-18 11:57                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042108 -         ..
042109 -    2.  Hello Rod,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042111 -         ..
042112 -    3.  I'm sorry to hear about the plumbing problems, hopfully                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042113 -        everything is taken care of. Yes, lets plan for 8am on 7/25.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042115 -         ..
042116 -    4.  Bethany                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042117 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042118 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042119 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042120 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042121 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0422 -