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 42 0000. ref SDS 40 0000.
040502 -
040503 -
040504 -
040505 - [On 190411 1056 letter to Doctor Tucker requests progress
040506 - notes for PRP treatment on 181212. ref SDS 47 0350
040507 -
040508 -
040509 -
040510 -
040512 - ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 180105 1118 Jane called and advised of cancellation, so ordered PRP
040902 - treatment in feet and knees by Doctor Gloria Tucker. ref SDS 24 O46F
040904 - ..
040905 - On 180105 1321 letter to Doctor Thuillier in VA Orthopedics notified
040906 - have been unable to download radiologist report on MRI of both feet
040907 - performed on 171229. ref SDS 25 O46F Further explained plan on
040908 - driving to VAMCSF to get the report from VA Release of Information
040909 - (ROI). ref SDS 25 I492 Also planned to schedule meeting with Doctor
040910 - Thuillier for review results of MRI studies on feet and knees. 180105
040911 - 1321, ref SDS 25 I495
040913 - ..
040914 - On 180105 1630 Doctor Tucker performed 3rd PRP injection treatment for
040915 - feet and knees again. ref SDS 26 0001
040917 - ..
040918 - On 180108 letter to Doctor Thuillier reported PRP treatment in both
040919 - feet and both knees on 180105 1630, ref SDS 26 HP5O, and related
040920 - research indicating PRP yields measurable increase in minisucs
040921 - cartilage over 6 months. ref SDS 26 JX67
040923 - ..
040924 - On 180110 1100 meeting Doctor Thuillier. ref SDS 28 JN9H
040926 - ..
040927 - On 180423 0908 called Jane and scheduled meeting with Doctor Thuillier
040928 - on 180425 1145. ref SDS 30 OL9L
040930 - ..
040931 - On 180425 1145 meeting Doctor Thuillier review progress recover feet
040932 - and knee injuries using PRP injection treatments, ref SDS 31 V54H, and
040933 - order additional care. ref SDS 31 4J6H
040935 - ..
040936 - On 180427 0458 letter to Doctor Thuillier confirm understandings from
040937 - meeting on 180425. ref SDS 32 V54H
040939 - ..
040940 - On 180516 1015 meeting Doctor Thuillier got name of "smartwool" socks.
040941 - ref SDS 36 GW5N The doctor suggested trying Doctor Scholl's Corn
040942 - Removers using Salicylic Acid to recover from Tailor's Bunion on left
040943 - side of left foot, and from calluses on both big toes. ref SDS 36 GW7M
040944 - Doctor Thuillier indicated PRP treatments have been strong remedies
040945 - for metatrsalgia, plantar plate tear, hallux valgus, and Tailor's
040946 - Bunion. He is investigating how VA can pay for the treatments.
040947 - ref SDS 36 GG6J
040949 - ..
040950 - On 180521 1045 called Connie in Doctor Tucker's office, and she
040951 - scheduled PRP treatment on 180620 1530. ref SDS 37 V54H Connie
040952 - submitted letter confirming work plan. ref SDS 37 PQ6J She included
040953 - directions to new office location. ref SDS 37 P58O
040955 - ..
040956 - On 180522 2318 submitted letter to Doctor Tucker confirming PRP
040957 - treatment on 180620 1530, and setting scope for care. ref SDS 38 E476
040959 - ..
040960 - On 180620 1530 received 4th PRP treatment. ref SDS 40 V54H
040962 - ..
040963 - On 180820 1039 scheduled follow up with 5th PRP treatment on 180824
040964 - 1515. ref SDS 41 E27M
040966 - ..
040967 - On 181126 1030 meeting with Gina at VA Santa Rosa receive 1st Supartz
040968 - injection both knees. ref SDS 43 BK6H Gina is strong advocate for
040969 - PRP, and is working with Doctor Sara Edwards and Doctor Thuillier at
040970 - VAMCSF to get approval. ref SDS 43 T35F
040972 - ..
040973 - On 181126 1127 met Doctor Tucker; received article on combining
040974 - Supartz with PRP. ref SDS 44 T66V Doctor Tucker scheduled next PRP
040975 - treatment on 191212, 2 days after 3rd Supartz injections at VA.
040976 - ref SDS 44 GF4J Submitted $1,000 retainer payment for consulting on
040977 - PRP and Sports Medicine. Received prescription for Tramadol.
040978 - ref SDS 44 LU6M
040980 - ..
040981 - On 181203 1030 meeting with Gina at VA Santa Rosa receive 2nd Supartz
040982 - injection both knees. ref SDS 45 CJ98
040984 - ..
040985 - On 181210 0800 meeting with Gina at VA Clinic in Santa Rosa; she
040986 - injected both knees with Supartz. ref SDS 46 V54H
040988 - ..
040989 - On 181212 1600 Doctor Tucker performed 6th PRP injection treatment on
040990 - both feet and both feet. ref SDS 0 V54H
040991 -
040992 -
040993 -
040994 -
040995 -
040997 - ..
0410 -
0411 -
0412 - Progress
0413 -
041301 - Arrived OA 1330. Checked in and met Paul, the doctor's husband. He
041302 - said the doctor just left and will return at 1530 for the treatment.
041304 - ..
041305 - Kathy and I went to the Pachacho Mall and walked around. Finally
041306 - bought a sandwich at Subway for lunch. Returned to the doctor's
041307 - office at 1500. Paul said the doctor still has not arrived. Went
041308 - for a walk until 1530.
041310 - ..
041311 - The 4th PRP treatment performed today, was scheduled with Connie on
041312 - 180521 1045. ref SDS 37 V54H Letter to the doctor the next day
041313 - explained priority for PRP injection treatment, reported on 180522
041314 - 2318, ref SDS 38 E476 The letter cites scope for prior treatment on
041315 - 180105 1630. ref SDS 26 VO3F
041317 - ..
041318 - Doctor Tucker requested priority for treatment today?
041320 - ..
041321 - Explained that when treatment was ordered on 180522, needed PRP
041322 - injections to cure Tailor's Bunion on left foot. ref SDS 38 E476
041324 - ..
041325 - Subsequently, Podiatry treatment at the VA has improved condition of
041326 - left foot Tailor's Bunion using Ammonium Lactate 12% lotion, reported
041327 - in a letter to Doctor Tang at VAMCSF on 180611 1052. ref SDS 39 VL4U
041328 -
041329 - [On 180820 1039 scheduled follow up with 5th PRP treatment
041330 - on 180825 1515. ref SDS 41 E27M
041331 -
041332 -
041334 - ..
041335 - Discussed scope of treatment today, presented in a letter to Doctor
041336 - Tucker on 171208 1242. ref SDS 34 CJ60
041338 - ..
041339 - Scope was reviewed again in another letter on 171227. ref SDS 38 FN52
041341 - ..
041342 - On 171227 1300, Doctor Thuillier in VA Orthotpedics ordered MRI
041343 - studies on both feet and both knees, to find changes in anatomy that
041344 - reconcile clinical improvement reducing severe osteoarthritis pain.
041345 - 171227 0915, ref SDS 37 E54H
041347 - ..
041348 - On 171229 0615 went to Radiology at VAMCSF. Jonus did MRI scans on
041349 - both knees to evaluate recovery osteoarthritis. ref SDS 39 FZ5L
041351 - ..
041352 - Doctor Tucker said earlier today, she read the MRI findings on left
041353 - knee shown in the record on 171229 0745, ref SDS 39 ZG6H, and
041354 - referenced in the copy she received of the letter sent to Doctor
041355 - Thuiller earlier today on 180105 1321. ref SDS 25~O46F
041357 - ..
041358 - The doctor said there is not a lot of reporting on MRI studies finding
041359 - regeneration of cartiage in joints. This aligns with results of MRI
041360 - on 171229 0745, ref SDS 39 PSWR, which says in part...
041361 -
041362 - Unchanged complete degenerative tearing of the medial
041363 - meniscus and partial tearing of the lateral meniscus with
041364 - extrusion of the body with intrasubstance degeneration.
041366 - ..
041367 - This finding indicates PRP did not regnerate cartilage. Why then has
041368 - there been no pain in the left knee? The right knee was treated with
041369 - Supartz on 170731 1500, ref SDS 20 0001, 5 days after PRP treatment on
041370 - 170726. It's known that hyaluronic acid in Supartz lubricates the
041371 - joint to reduce pain. This worked well in the right knee for about 4
041372 - months, then pain began to recur, so Glucosamine Chondroitin has been
041373 - taken to continue lubricating the right knee joint for pain
041374 - management. Since PRP does not inject hyaluronic acid, how has it
041375 - prevented pain in the left knee for over 5 months and counting?
041377 - ..
041378 - Doctor Tucker seemed to say PRP eliminated pain hiking 630 miles since
041379 - injections on 170726, cited in the letter to Doctor Thuillier on
041380 - 180105 1321, ref SDS 25 I48O, by regenerating (healing??) soft tissue.
041381 - The doctor mentioned specifically collagen, ligaments, muscles, and
041382 - further indicated MRI technology cannot assess these soft tissue
041383 - improvements.
041385 - ..
041386 - After the meeting, research found on the Internet...
041387 -
041388 - Arthritis-Health
041390 - ..
041391 - Platelet-Rich Plasma (PRP) Therapy for Arthritis
041392 -
041393 - Follow up ref SDS 42 8Z6M, ref SDS 40 8Z6M.
041394 -
041395 - By John J Wilson, MD, MS
041396 - Updated................................ 2014 01 07 | Peer Reviewed
041397 -
041398 - https://www.arthritis-health.com/treatment/injections/platelet-rich-plasma-prp-therapy-arthritis
041400 - ..
041401 - The article says in part...
041402 -
041403 - PRP injections are formulated from your own immune system's
041404 - platelets, which are extracted from a blood sample, then
041405 - concentrated to make the injection. This seems to stimulate
041406 - healing through the production of collagen and to alter pain
041407 - receptors, which reduces pain.
041409 - ..
041410 - This seems to support Doctor Tucker's theory, per above. ref SDS 40
041411 - T14I Would be helpful to have study measuring collagen before and
041412 - after PRP treatment. What signals increased collagen?
041414 - ..
041415 - Article continues...
041416 -
041417 - What Does Platelet-Rich Plasma Therapy Do?
041419 - ..
041420 - Experts are unsure exactly how PRP therapy may alleviate
041421 - symptoms for certain orthopedic conditions. Doctors who use
041422 - PRP therapy to treat osteoarthritis theorize that the
041423 - platelet-rich plasma might:
041424 -
041425 - 1. Inhibit inflammation and slow down the progression of
041426 - osteoarthritis1
041428 - ..
041429 - MRI study may support this explanation.
041431 - ..
041432 - Article continues...
041433 -
041434 - 2. Stimulate the formation of new cartilage2
041436 - ..
041437 - MRI study seems not to support this explanation.
041439 - ..
041440 - Article continues...
041441 -
041442 - 3. Increase the production of natural lubricating fluid in the
041443 - joint, thereby easing painful joint friction3
041445 - ..
041446 - MRI study seems silent on this.
041448 - ..
041449 - Article continues...
041450 -
041451 - 4. Contain proteins that alter a patient's pain receptors and
041452 - reduce pain sensation
041454 - ..
041455 - It could be that platelet-rich plasma does all of these things,
041456 - or none.5 More large-scale, high-quality clinical studies are
041457 - needed before scientists can know.
041458 -
041460 - ..
041461 - Pubmed article sounds promising...
041462 -
041463 - NCBI
041464 - PMC
041465 - US National Library of Medicine
041466 - National Institutes of Health (NIH)
041468 - ..
041469 - Cartilage
041470 - Cartilage: 2013 Oct, 4 (4) 295-312
041472 - ..
041473 - PMCID: PCM4297162
041474 - doi: 10.1177/1947603513497553
041476 - ..
041477 - Application of Platelet-Rich Plasma to Disorders of the Knee Joint
041478 -
041479 - Follow up ref SDS 42 JH4L, ref SDS 40 JH4L.
041480 -
041481 - Omitted - authors and copyright and license information
041482 -
041483 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4297162/
041485 - ..
041486 - Abstract
041488 - ..
041489 - Importance. The promising therapeutic potential and
041490 - regenerative properties of platelet-rich plasma (PRP) have
041491 - rapidly led to its widespread clinical use in musculoskeletal
041492 - injury and disease. Although the basic scientific rationale
041493 - surrounding PRP products is compelling, the clinical
041494 - application has outpaced the research.
041496 - ..
041497 - Objective. The purpose of this article is to examine the
041498 - current concepts around the basic science of PRP application,
041499 - different preparation systems, and clinical application of PRP
041500 - in disorders in the knee.
041502 - ..
041503 - Many articles mention varying results based on "different preparation
041504 - systems, as here. In this case, where results seem favorable after
041505 - only 5 months on the left knee, and both feet, specifications on
041506 - "preparation" and "product composition" should be reported to evaluate
041507 - repetitive results.
041509 - ..
041510 - Article continues...
041511 -
041512 - Basic Scientific Rationale of Platelet-Rich Plasma Use in
041513 - Articular Cartilage Degradation and Repair
041515 - ..
041516 - On a molecular level, results have indicated a beneficial
041517 - effect of PRP on chondrocytes and mesenchymal stem cells.
041518 - Increased cell proliferation and synthesis of proteoglycans and
041519 - collagen type II has been demonstrated when cell cultures of
041520 - chondrocytes56,57 and mesenchymal stem cells58 are treated with
041521 - PRP compared with controls treated with platelet-poor plasma or
041522 - fetal bovine serum.
041524 - ..
041525 - This seems to align with Doctor Tucker's explanation that PRP
041526 - increases collagen, per above. ref SDS 40 T14I
041528 - ..
041529 - Article continues...
041530 -
041531 - Clinical Application of Platelet-Rich Plasma Use in Articular
041532 - Cartilage Degradation and Repair in the Knee
041534 - ..
041535 - Osteoarthritis
041537 - ..
041538 - In an uncontrolled prospective study, 14 patients with knee OA
041539 - were treated with PRP produced using anticoagulated blood
041540 - processed in the GPS III system.61 These authors reported
041541 - reduced pain and improved functional outcome after a series of
041542 - injections with PRP.
041544 - ..
041545 - This aligns with Welch case on left knee.
041547 - ..
041548 - Article continues...
041549 -
041550 - They also reported improvement in the ultrasonographic
041551 - measurement of femoral articular cartilage thickness in 6 out
041552 - of 13 patients at 6 months and in the satisfaction survey at
041553 - the 1-year follow-up examination, 8 of 13 patients reached
041554 - their goals at 1 year (Table 3).
041556 - ..
041557 - There is no evidence of cartilage thickness improvement in Welch,
041558 - after 5 months, at least using measurements applied by radiologists
041559 - for MRI study on 171229. Conceivably, more refined measurement
041560 - methodology might register either increase or decrease in cartilage of
041561 - left knee joint. Since PRP injected on 170726, was deminimus, i.e.,
041562 - less than protocol, per Doctor Tucker below, ref SDS 40 TR68, perhaps
041563 - another MRI in 6 months after treatment today, will show increased
041564 - miniscus. If so, this would further reconcile clinical improvement
041565 - feeling no pain in left knee hiking 630 miles between MRI on 170726,
041566 - and recent follow up MRI on 171229.
041567 -
041568 -
041570 - ..
041571 - Develope Scope of Work for Regeneration PRP Injection Treatments
041572 -
041573 - Follow up ref SDS 42 HP5O, ref SDS 40 HP5O.
041574 -
041575 - Doctor Tucker asked about pain medication. How long since taking
041576 - NSAID drugs? She said these should have been stopped for at least
041577 - the past 7 days.
041579 - ..
041580 - Cited letter to the medical team (including Doctor Tucker) on 171103,
041581 - reported all pain medication was stopped 4 weeks earlier ref SDS 33
041582 - S273 Ending pain medication actually began on 171018, shown in diary
041583 - listing daily exercise, diet, vitals and medication in case study
041584 - beginning on 160101 0700. ref SDS 9 PM5F
041586 - ..
041587 - Based on understanding for rational basis that PRP in left knee
041588 - reduced pain through improving multiple joint deficits, made
041589 - following decisions...
041590 -
041591 - Because the meeting today, was scheduled ad hoc from a call
041592 - this morning, reported on 180105 1118, ref SDS 26 GO9L, it was
041593 - not possible to have a driver.
041595 - ..
041596 - Driver is needed when injections require strong medication to
041597 - manage pain, which then impairs ability to drive, based on
041598 - prior care, reported on 170816 1400, ref SDS 24 J97M On that
041599 - occasion, the body suffered severe side effects from
041600 - post-procedure pain medication. ref SDS 24 RN5H
041602 - ..
041603 - Without driver, should not do deep injections to left and right
041604 - feet plantar plate tears, nor to arches, which both caused
041605 - severe pain and so required pain medication for prior PRP
041606 - injections on 170816 1400. ref SDS 24 1H6M
041608 - ..
041609 - Doctor Tucker agreed to defer injections into the arch today,
041610 - but noted efficacy to relieve hallus valgus in both feet.
041612 - ..
041613 - We noted simple procedure of placing felt pad spreaders between
041614 - toes has been successful preventing feet pain and increased
041615 - blisters caused by hallus valgus injuries, as recommended by
041616 - Doctor Thuillier during the meeting at the VA on 171227 0915.
041617 - ref SDS 37 3B3H This reduces urgency for injecting hallus
041618 - valgus today, so that PRP can be injected in left knee.
041620 - ..
041621 - Will consider PRP injecting hallus valgus during subsequent
041622 - treatments, when a driver is available and/or conscious
041623 - sedation can be performed.
041625 - ..
041626 - Primary PRP injection objective is right knee, presented in the
041627 - letter on 171208 1242, ref SDS 34 YM3I, and to achieve pain
041628 - relief comparable to total relief experienced with left knee
041629 - during hiking, reported in the letter to the medical team on
041630 - 171103 1141, ref SDS 33 S293, further presented in the letter
041631 - to Doctor Tucker on 171208 1242. ref SDS 34 CK36 This was
041632 - confirmed in recent letter on 171227 1328. ref SDS 38 FN52
041634 - ..
041635 - Next inject both feet metatarsals only, and not inject bottom
041636 - of feet to specifically treat plantar plate. These seem
041637 - largely healed. Injecting metatartsals today, may also
041638 - additonally treat plantar plate area without direct injections.
041640 - ..
041641 - Tailor's bunion inject PRP on both feet.
041643 - ..
041644 - Remaining PRP plasma, if any, can be injected into left knee.
041646 - ..
041647 - Doctor Tucker said she was surprised the left knee responded so well
041648 - to PRP injection on 170726, which used less than standard protocol for
041649 - knee injections. She explained this occurred, because at that time,
041650 - the left knee was injected last with only what remained after
041651 - injecting both feet metatarsals and plantar plate tear on bottom of
041652 - right foot.
041654 - ..
041655 - Longevity of recovery was discussed.
041657 - ..
041658 - Doctor Tucker seemed to say the single injections into both feet and
041659 - left knee could last 1 - 5 years.
041661 - ..
041662 - Discussed research indicating some patients get injections every 6
041663 - months or at least annually.
041665 - ..
041666 - The doctor seemed to say that properly applied PRP injection
041667 - treatments should last at least multiple years.
041669 - ..
041670 - Since the left knee did not receive a full amount of PRP injection,
041671 - supplementing the first injection today, is good insurance for longer
041672 - results.
041674 - ..
041675 - Finally, most patients don't hike 2,500 miles per year, with running
041676 - and sprinting included.
041678 - ..
041679 - The doctor seemed to indicate that running and sprinting in particular
041680 - reduce longevity of PRP care. She recommended against it. This
041681 - conflicts with reporting that many professional atheltes are extending
041682 - their careers by getting PRP injections, cited in the letter to Doctor
041683 - Tucker on 171212 1657. ref SDS 35 RX52 These athletes run and sprint,
041684 - endemic to tennis, baseball, et al.
041686 - ..
041687 - As a result, multiple PRP injections to feet and knees are required to
041688 - achieve longevity normally expected for patients who receive only
041689 - single injections. Hopefully, injections today, will last 2 - 5
041690 - years.
041691 -
041693 - ..
041694 - PRP Treatment Layout Injection Sites
041695 -
041696 - Follow up ref SDS 42 VO3F, ref SDS 40 VO3F.
041697 -
041698 - In procedure room laying on treatment table, Doctor Tucker again
041699 - marked locations on both feet and both knees to be injected.
041701 - ..
041702 - Right Leg Injections
041703 -
041704 - Follow up ref SDS 42 GE9L, ref SDS 40 GE9L.
041705 -
041706 - Knee joint........................................... 3
041707 -
041708 - left side, middle and right side well below patella.
041709 -
041711 - ..
041712 - Left Leg
041713 -
041714 - Follow up ref SDS 42 TF4H, ref SDS 40 TF4H.
041715 -
041716 - Knee joint........................................... 3
041717 -
041718 - left side, middle and right side well below patella.
041719 -
041721 - ..
041722 - Right Foot
041723 -
041724 - Follow up ref SDS 42 0108, ref SDS 40 0108.
041725 -
041726 - Metatarsalgia
041727 - Between little toe and ring toe................. 1
041728 - Between ring toe and middle toe................. 1
041729 - Between middle and long toe..................... 1
041730 - Between long toe and big toe.................... 1
041732 - ..
041733 - Tailor's bunion................................. 0
041735 - ..
041736 - Total right foot............................... 4 4
041738 - ..
041739 - Left Foot
041740 -
041741 - Follow up ref SDS 42 YY3G, ref SDS 40 YY3G.
041742 -
041743 - Metatarsalgia
041744 - Between little toe and ring toe................. 1
041745 - Between ring toe and middle toe................. 1
041746 - Between middle and long toe..................... 1
041747 - Between long toe and big toe.................... 1
041749 - ..
041750 - Tailor's Bunion................................. 0
041752 - ..
041753 - Total right foot............................... 4 4
041755 - ..
041756 - Total injections...................................... 14
041757 -
041759 - ..
041760 - Blood Draw for PRP Completed with One Needle Stick
041761 -
041762 - Follow up ref SDS 42 YY6N, ref SDS 40 YY6N.
041763 -
041764 - Doctor Tucker drew blood for PRP platelet extraction. She again used
041765 - outer side of left arm inner elbow, which was successful for prior
041766 - treatment on 180620 1530. ref SDS 40 YY6N 170816 1400, ref SDS 24
041767 - YY6N, and previously on 170726 1600. ref SDS 17 TZ8N
041769 - ..
041770 - This took only 1 stick today.
041771 -
041773 - ..
041774 - PRP Injections Mostly Pain Free
041775 -
041776 - Follow up ref SDS 42 K65M, ref SDS 40 K65M.
041777 -
041778 - Doctor Tucker initially, marked all locations for PRP injections.
041780 - ..
041781 - She sprayed numbing agent on each location. Seems like today, she
041782 - sprayed more numbing agent.
041784 - ..
041785 - The doctor made markings around the knee caps to consider possible
041786 - multiple injection points. However, she ultimately made only 1
041787 - injection, and advised this is a standard protocol location for knees.
041789 - ..
041790 - Doctor Tucker injected each location with lidocain to further numb
041791 - needle penetrations.
041793 - ..
041794 - Right knee - after waiting mintutes for lidocain to take effect, PRP
041795 - was injected into the right knee joint, using standard protocol
041796 - amount, discussed above. ref SDS 40 059O
041798 - ..
041799 - This was completely pain free.
041801 - ..
041802 - Right foot - PRP was next injected into 4 locations on top of right
041803 - foot metatarsals. The outer 2 injections were pain free. The middle
041804 - injections caused severe pain. The doctor noted this reflected these
041805 - middle toes have been worn down by hiking, running and sprinting.
041807 - ..
041808 - Tailor's bunion right foot was injected with small amount.
041810 - ..
041811 - Left foot - same scenario as right foot, with considerable pain
041812 - injecting middle metatarsals.
041814 - ..
041815 - Pain was only at moments of needle penetration, similar but less
041816 - severe than prior procedure on 170816 1400. ref SDS 24 1A3I
041818 - ..
041819 - Tailor's bunion left foot was injected with small amount.
041820 -
041821 - [On 180315 shown in case study on 160101 0700 tailor's
041822 - bunion on left foot now requires dressing to relieve shoe
041823 - pressure during hikes. Tailor's bunion right foot does not
041824 - require dressing. ref SDS 10 4B6L
041826 - ..
041827 - Left knee - remainting PRP was injected into left knee. This was
041828 - completely pain free.
041829 -
041830 -
041832 - ..
041833 - Follow Up Treatments Might be Needed
041834 - Discharge Instructions and Payment
041835 -
041836 - Follow up ref SDS 42 WV5I, ref SDS 40 WV5I.
041837 -
041838 - Doctor Tucker cleaned forefeet which had leaked blood slightly.
041840 - ..
041841 - On standing up from the treatment table, there was mild pain at level
041842 - 1 - 2 in the feet where injections were made. This was much less
041843 - severe than after deep injections to plantar plate and arches done on
041844 - 170816 1400. ref SDS 24 J97T As a result, pain medication was not
041845 - needed today.
041847 - ..
041848 - Doctor Tucker said not to hike for a week, then follow prior protocol.
041849 - On 170727 1747 Doctor Tucker called and said walking 1 mile 2 days
041850 - after feet injections stimulates PRP healing (regeneration) processes,
041851 - and then slow for about 3 miles helps distribute PRP in the feet.
041852 - ref SDS 18 0W6V
041854 - ..
041855 - After treatment today, research found...
041856 -
041857 - The Stemcell Orthopedic Institute of Texas
041858 - Call 210 293 3136
041860 - ..
041861 - PRP - POST INJECTION GUIDELINES AND EXERCISES
041862 -
041863 - Follow up ref SDS 42 NX6F, ref SDS 40 NX6F.
041864 -
041865 - https://stemcellorthopedicinstituteoftexas.com/platelet-rich-plasma-therapy-prp/after-prp-therapy/
041866 -
041867 - 1. Medication Guidelines
041868 -
041869 - For a minimum of two weeks post-injection, it is important
041870 - for the efficacy of the treatment that all
041871 - anti-inflammatory medications (NSAIDS) are discontinued.
041872 - You can take Tylenol (Acetaminophen) and Celebrex, but we
041873 - ask that you avoid other NSAIDS such as aspirin, Naproxen
041874 - (Aleve) and Ibuprofen (Advil, Motrin) because they will
041875 - inhibit platelet function. Other prescription medication
041876 - should be reviewed with your procedure physician.
041878 - ..
041879 - Apply moist heat to treated area for the first 24 hours.
041881 - ..
041882 - 2. Activity Guidelines
041883 -
041884 - FIRST WEEK&Treated areas should remain immobile. For the
041885 - first two weeks, we encourage you to resume normal day-to
041886 - day activities&BUT NO exercise of the treated extremity.
041888 - ..
041889 - SECOND WEEK& light exercises and progressively build back
041890 - to normal exercise after 4 weeks. Controlled and moderate
041891 - movement is important for the proper stimulation of tissue
041892 - to rebuild in a linear and physiologic fashion. However,
041893 - we strongly advise that you avoid heavy lifting or high
041894 - exercise levels because these activities will compromise
041895 - the progress we are trying to make
041897 - ..
041898 - AFTER TWO WEEKS&you are cleared by your physician to resume
041899 - exercising the area. However, we ask that you gradually
041900 - increase the intensity of your workouts so as not to
041901 - re-injure the tissue. Use pain in the area of injection as
041902 - a guide to how far you push yourself. This is not like
041903 - physical therapy after surgery. We do not want you to push
041904 - through the pain. Instead, ease off the intensity if the
041905 - pain persists.
041907 - ..
041908 - The question is whether damaged tissue heals, i.e., regenerates, e.g.,
041909 - miniscus cartilage, ligaments. How long does this take? 1 week,
041910 - month, 6 months, a year. Once healed, how long will "healed" miniscus
041911 - cartilage, metatarsal cartilage last hiking 11 - 15 miles per day?
041913 - ..
041914 - Article continues...
041915 -
041916 - If you feel any of the following symptoms immediately
041917 - contact our office: prolonged redness, swelling, fevers,
041918 - chills, muscle weakness as well as numbness and/or
041919 - tingling.
041920 -
041922 - ..
041923 - The doctor also cautioned against using NSAID pain medications for 2
041924 - weeks after injections, since NSAID drugs block/reduce blood flow
041925 - needed for PRP healing process.
041927 - ..
041928 - Thanked Doctor Tucker for great work.
041929 -
041930 -
041932 - ..
0420 -
0421 -
0422 - 1842
0423 -
042301 - Doctor Tucker prepared the bill...
042302 -
042303 - $1,200
042305 - ..
042306 - She sai her prices are going up for any follow up treatments.
042307 -
042315 -
042316 -
042318 - ..
0424 -
0425 -
0426 - 1613
0427 -
042701 - Driving from Novato to Concord
042702 -
042703 - Follow up ref SDS 42 VJ3G, ref SDS 40 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 -
0432 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - Progress Notes Doctor Tucker PRP Procedure on 181212
050403 -
050404 - Follow up ref SDS 42 4G9J. ref SDS 40 U45M.
050405 -
050406 - [On 190411 1056 letter to Doctor Tucker requests progress
050407 - notes for PRP treatment on 181212. ref SDS 47 0350
050408 -
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0505 -
Distribution. . . . See "CONTACTS"