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 67 0000. ref SDS 66 0000.
040502 -
040503 - Meeting with Sara Edwards, MD, who specializes in sports medicine.
040504 - She has experience treating college and professional atheletes,
040505 - specializing in shoulders. She is on the staff at UCSF as assistant
040506 - adjunct professor of orthopedic surgery. The doctor provides care for
040507 - veterans at VAMCSF. ref SDS 0 V54H She was familiar with patient
040508 - history in this case using PRP for feet and knees. ref SDS 0 0Q4H She
040509 - ordered another PRP treatment for knees, which she will perform at
040510 - VAMCSF. ref SDS 0 9N6J On discussion, ordered PRP for feet to be
040511 - performed by Doctor Tucker at her private clinic in Marin. During the
040512 - meeting today, Doctor Edwards called Doctor Tucker's office to
040513 - collaborate on continuing PRP care. ref SDS 0 WC3J Examination of
040514 - shoulders found patient can continue pushups until current minor
040515 - affliction worsens. ref SDS 0 ML6H There was not enough time to
040516 - review "anxious legs" condition occurring 5+ hours after hikes 15+
040517 - miles. ref SDS 0 GG9L
040518 -
040519 - [On 190328 0926 letter to Doctor Tucker confirms
040520 - discussions at the VA for Doctor Edwards to perform PRP
040521 - injections to the knees and elbow. ref SDS 70 PD4H
040523 - ..
040524 - [On 190328 1000 letter thanks Gina for facilitating meeting
040525 - with Doctor Edwards today. ref SDS 71 WX5H
040527 - ..
040528 - [On 190328 1104 letter thanks to Doctor Thuillier notifying
040529 - Doctor Edwards ordered further PRP care. ref SDS 72 V54H
040531 - ..
040532 - [On 190328 1239 letter to Doctor Edwards confirms
040533 - understandings from meeting at VAMCSF, as shown in this
040534 - record. ref SDS 73 V54H
040535 -
040536 -
040537 -
040538 -
040540 - ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 170726 1600 1st PRP treatment - Doctor Tucker performed injections
040902 - to treat plantar plate tear right foot, ref SDS 8 HE4N; she also made
040903 - PRP injections treating metatarsalgia in both feet. ref SDS 8 EG7F
040904 - PRP was injected into the left knee, ref SDS 8 4Y8K,
040906 - ..
040907 - On 170816 1400 2nd PRP injection treatment regeneration therapy;
040908 - Doctor Tucker used pain management protocol similar to 1st phase, when
040909 - no pain was experience, but on this 2nd phase there was considerable
040910 - pain, because injections were deeper and more PRP was injected to
040911 - achieve benefits of regenerating (healing) plantar plate tear, which
040912 - were not achieved with 1st phase of treatment. ref SDS 10 S543 PRP was
040913 - injected into arch to repair Halux Valgus right foot. ref SDS 10 IM7N
040915 - ..
040916 - On 170817 0836 at 1207 letter from Doctor Tucker says hallux valgus is
040917 - symptom of weakening arch; injecting PRP to ligaments of the 1st mtp
040918 - (big toe) in association with treating the arch, we are hoping to help
040919 - heal that and more importantly, keep it from worsening. ref SDS 11
040920 - 9F5H
040922 - ..
040923 - On 171229 0745 MRI right knee regenerate cartelage compare left knee.
040924 - ref SDS 24 K05I
040926 - ..
040927 - On 171229 0900 MRI both feet evaluate PRP treatments. 171229 0900,
040928 - ref SDS 25 HQ5O
040930 - ..
040931 - On 180105 1630 3rd PRP treatment - Doctor Tucker performed PRP
040932 - injections, ref SDS 29 0001, for knees and feet including Tailor's
040933 - Bunions. ref SDS 29 VO3F
040935 - ..
040936 - On 180108 letter to Doctor Thuillier reported PRP treatment in both
040937 - feet and both knees on 180105 1630, ref SDS 29 HP5O, and related
040938 - research indicating PRP yields measurable increase in minisucs
040939 - cartilage over 6 months. ref SDS 29 JX67
040941 - ..
040942 - On 180110 1100 meeting Doctor Thuillier review MRI scans both feet and
040943 - both knees on 171229. ref SDS 31 JN9H The doctor cited finding in the
040944 - report from MRI on 171229, that cartilage has not further reduced
040945 - since prior study on 170412, reported on 160805. ref SDS 24 M75N He
040946 - feels this is significant that continuing patient hiking 11 miles per
040947 - day has not further degraded miniscus cartilage in both knees.
040949 - ..
040950 - On 180425 1145 meeting Doctor Thuillier review progress recover feet
040951 - and knee injuries using PRP injection treatments, ref SDS 34 V54H, and
040952 - order additional care. ref SDS 34 4J6H
040954 - ..
040955 - On 180516 1015 meeting Doctor Thuillier got name of "smartwool" socks.
040956 - ref SDS 39 GW5N The doctor suggested trying Doctor Scholl's Corn
040957 - Removers using Salicylic Acid to recover from Tailor's Bunion on left
040958 - side of left foot, and from calluses on both big toes. ref SDS 39 GW7M
040959 - Doctor Thuillier indicated PRP treatments have been strong remedies
040960 - for metatrsalgia, plantar plate tear, hallux valgus, and Tailor's
040961 - Bunion. He is investigating how VA can pay for the treatments.
040962 - ref SDS 39 GG6J
040964 - ..
040965 - On 180620 1530 4th PRP treatment to both feet and both knees.
040966 - ref SDS 43 VO3F
040968 - ..
040969 - On 180725 1145 meeting Doctor Thuillier about acetaminophen at
040970 - prescribed dose of 1000 mg per day taken over extended days, weeks and
040971 - months could accumulate into an "intoxination" condition that causes
040972 - liver damage and lowers HDL some 33%, ref SDS 46 155F, as reported in
040973 - the study reviewed on 180724 1645. ref SDS 45 EN4L Further considered
040974 - how long recovery might take to restore liver function after stopping
040975 - acetaminophen, particularly restoring elevated HDL levels? ref SDS 46
040976 - SV6H Dan said he has hiked Half Dome 4 times. ref SDS 46 G56K
040978 - ..
040979 - On 180824 1515 5th PRP treatment - meeting Doctor Tucker injection
040980 - treatment to protect feet and knees, enable training Half Dome.
040981 - ref SDS 48 0001
040983 - ..
040984 - On 180912 0545 hiked Half Dome in Yosemite Valley, total 28 miles that
040985 - day. ref SDS 49 0001
040987 - ..
040988 - On 181024 0752 sent letter to Doctor Thuillier, ref SDS 50 FC8M,
040989 - asking him to order Supartz injections for knees, hope to extend PRP
040990 - effectivenss to 6 months. ref SDS 50 OC44
040992 - ..
040993 - On 181025 0735 received letter from Doctor Thuillier advising that he
040994 - ordered Supartz for knees, which will be combined with PRP.
040995 - ref SDS 51 ZY9M
040997 - ..
040998 - On 181025 0735 at 0801 letter to Jane in Orthopedics Administration,
040999 - asking about coordinating schedule for Supartz injections. ref SDS 51
041000 - 7H7S
041002 - ..
041003 - On 181126 1130 1st of 3 Supartz injections - meeting with Gina at VA
041004 - Clinic in Santa Rosa performed 1st injection Supartz in both knees.
041005 - ref SDS 54 BK6H Gina is strong proponent for PRP at VA; she is
041006 - talking to Doctor Thuiller and Doctor Sara Edwards in Orthopedics at
041007 - VAMCSF, and hopes to get assignment for doing PRP injections.
041008 - ref SDS 54 375L
041010 - ..
041011 - On 181126 1127 meeting Doctor Gloria Tucker - received article on
041012 - favorable results combinging PRP with Supartz injections; and
041013 - scheduled next PRP treatment 2 days after last Supartz, which be done
041014 - on 181212. ref SDS 55 KJ5I
041016 - ..
041017 - On 181126 1547 at 1952 letter to Gina at VA Clinic in Santa Rosa, with
041018 - copy to Doctor Thuillier in Orthopedics at VAMCSF, and copy to Doctor
041019 - Tucker, and submitting to Gina and Doctor Thuiller article on study
041020 - combinging Supartz with PRP. ref SDS 54 VE46 Further report improved
041021 - hiking during 2018, with PRP treatments in feet and knees, reaching
041022 - 3,000 miles and HDL 83, an increase of nearly 300% after CABG x4
041023 - surgery 9 years ago. ref SDS 54 VE73
041025 - ..
041026 - On 181126 1547 receive results of Telomere test, ref SDS 56 ZD7J,
041027 - seeming to indicate have telomere length for average 77 year old,
041028 - reported in the record for the day of the blood draw on 181115 1037.
041029 - ref SDS 53 AY46
041031 - ..
041032 - On 181203 1030 2nd of 3 Supartz injections - meeting with Gina at VA
041033 - Clinic in Santa Rosa performed 2nd injection Supartz in both knees.
041034 - ref SDS 58 V54H
041036 - ..
041037 - On 181205 1045 meeting with Doctor Dan Thuillier at VAMCSF on
041038 - telomeres, ref SDS 59 V54H; collaborating with Doctor Sara Edwards on
041039 - adding PRP treatments at the VA. ref SDS 59 FN8M
041041 - ..
041042 - On 181210 1030 3rd of 3 Supartz injections - meeting with Gina at VA
041043 - Clinic in Santa Rosa; Gina made final injection of Supartz into both
041044 - knees to complete 3 injection series. ref SDS 60 CJ98
041046 - ..
041047 - On 181212 1600 6th PRP injection treatment - meeting Doctor Tucker
041048 - injected PRP into both feet and both knees. ref SDS 61 0001
041049 -
041050 -
041051 -
041052 -
041053 -
041055 - ..
0411 -
0412 -
0413 - Progress
0414 -
041401 - Meeting...
041402 -
041403 - Sara Edwards, MD
041404 - VA Medical Center San Francisco
041405 - Orthopedics Department
041406 - 4150 Clement Street
041407 - San Francisco, CA 94121
041408 - 415 221 4810
041409 - saraedwards1@va.gov
041411 - ..
041412 - Sara explained that she is on the staff at UCSF. Research found...
041413 -
041414 - UCSF Directory
041415 -
041416 - Sara Edwards, MD
041417 - Assistant Adjunct Professor
041418 - Orthopedic Surgery
041419 -
041420 - https://directory.ucsf.edu/people/search/id/24506
041422 - ..
041423 - Sara Edwards, MD
041424 - Email: Sara.Edwards@ucsf.edu
041426 - ..
041427 - Good biography of the doctor's education and extensive experience
041428 - treating college and professional athletes, shown at...
041429 -
041430 - http://www.southbaydocs.com/dr-sara-edwards/
041432 - ..
041433 - She trained with the Yankees team physician.
041435 - ..
041436 - Doctor Edwards has her own website...
041437 -
041438 - http://www.saraedwardsmd.com/
041440 - ..
041441 - Very well done, and says in part...
041442 -
041443 - Dr Edwards is a San Francisco Bay Area Orthopaedic Surgeon,
041444 - specializing in treatment of athletes of all ages. She practices
041445 - as a shoulder and sports medicine specialist, and serves a Team
041446 - Physician at University of San Francisco and City College of San
041447 - Francisco, a clinical instructor for UCSF's department of
041448 - Orthopaedic Surgery, and sees patients at the San Francisco VA,
041449 - CPMC, and Saint Mary's hospital.
041450 -
041451 -
041453 - ..
041454 - Agenda from letter sent yesterday, to Gina and to Doctor Thuillier
041455 - reported on 190325 0936. ref SDS 68 MB3I
041456 -
041457 - 1. Evaluate response to treatment with PRP combined with Supartz,
041458 - planned with Doctor Thuillier on 181025 0735. ref SDS 51 ZY5G
041459 - Discussed with Gina at VA Clinic in Santa Rosa on 181126 1030.
041460 - ref SDS 54 I66I
041462 - ..
041463 - Sara feels patient has had excellent response to PRP treatment
041464 - performed by Doctor Tucker, cited by Doctor Simpson in Cardiology
041465 - Progress Notes for examination on 181031 1000. ref SDS 52 BM86 and
041466 - ref SDS 52 625J, and evident from hiking extended miles the past 2
041467 - years, including Half Dome. Improved health is shown in spreadsheet
041468 - tracking exercise, vitals, diet and medication...
041469 -
041470 - F:\05\00003\SM\CC\BNKG\120216cc\130101cc\hiking_miles_3.xlsx
041472 - ..
041473 - [On 190328 1104 letter thanks to Doctor Thuillier notifying
041474 - Doctor Edwards ordered further PRP care. ref SDS 72 V54H
041476 - ..
041477 - [On 190328 1239 letter to Doctor Edwards confirms
041478 - understandings from meeting at VAMCSF, as shown in this
041479 - record. ref SDS 73 V54H
041480 -
041481 -
041483 - ..
041484 - 2. Guide PRP treatments, collaborate with Doctor Tucker.
041485 -
041486 - 1. Consider multiple treatments - see scope on 170816 1400.
041487 - ref SDS 10 VO3F
041488 -
041489 - This takes multiple blood draws to treat feet (metatarsals,
041490 - Tailor's bunions, Hallux Valgus), knees, elbows, shoulders.
041492 - ..
041493 - Sara searched for Doctor Tucker online. On finding a picture, she
041494 - commented that Doctor Tucker looks familiar. They may have met at a
041495 - Sports Medicine conference, maybe served on a panel, etc.
041497 - ..
041498 - Sara called Doctor Tucker's office, and left message for Gloria to
041499 - call about collaborating on PRP treatments in this case. The person
041500 - who answered said Doctor Tucker is very familiar with Rod, and that
041501 - Doctor Tucker will return Sara's call.
041502 -
041503 - [On 190328 0926 letter to Doctor Tucker confirms
041504 - discussions at the VA for Doctor Edwards to perform PRP
041505 - injections to the knees and elbow. ref SDS 70 PD4H
041506 -
041508 - ..
041509 - 2. Consider series of several PRP treatments weeks apart?
041510 -
041512 - ..
041513 - 3. Revise location injections - for example on 180824, Doctor
041514 - Tucker made a series of 4 injections into the left knee
041515 - just below knee cap. This seemed to work well until OA
041516 - 181212, i.e., about 4 months.
041518 - ..
041519 - On 181212, did not make the series of 4 injections below knee
041520 - cap, but seemed to make single injection on anterior of left
041521 - knee (see pictures).
041523 - ..
041524 - During the meeting today, Sara seemed to say that lateral PRP
041525 - injection should nominally be more effective than injecting below the
041526 - kneecap (anterior??).
041527 -
041528 -
041530 - ..
041531 - 3. Doctor Edwards may be able to order PRP treatment with Doctor
041532 - Tucker, similar to Doctor Patal reporting VAMCSF GI Clinic has
041533 - ordered fundoplication using gastroscope by outside medical
041534 - clinic, reported on 180627 1300. ref SDS 44 JX9F Doctor
041535 - Simpson reported in Progress Notes that "knees and feet much
041536 - better after PRP injections," shown on 181031 1000. ref SDS 52
041537 - 625J
041539 - ..
041540 - VA can test application to...
041541 -
041542 - Feet
041543 - Knees
041544 - Shoulders
041545 - Elbows
041547 - ..
041548 - Plantar Plate Tear completely healed
041550 - ..
041551 - Doctor Edwards looked at xray on the computer in the examination room,
041552 - which were done earlier this morning, reported on 190327 0730.
041553 - ref SDS 69 Y37F
041555 - ..
041556 - She commented that left knee is worse than right knee.
041558 - ..
041559 - Explained history of severe injury to left knee in 1973, falling 40'
041560 - into a pump station. At that time in 1973, the doctor performed
041561 - surgery to remove cartilage. This has caused degenerative arthritis
041562 - over all these years. Reviewed recent pain in knees reported in
041563 - letter to Gina submitted on 190325 0936. ref SDS 68 MB69
041565 - ..
041566 - Doctor Edwards offered to perform PRP injections to the knees at
041567 - VAMCSF. She does this work herself. Doctor Edwards said she does not
041568 - perform PRP treatment for feet, because they are very complex.
041570 - ..
041571 - Considered Doctor Thuillier doing PRP for feet, because feet are one
041572 - of his specialities. There was discussion that Dan has not
041573 - transitioned to perform PRP in his practice. Discussed Sara meeting
041574 - with Doctor Tang to discuss Podiatry training to provide PRP
041575 - injections to treat feet problems.
041576 -
041577 - [On 190328 1104 letter thanks to Doctor Thuillier notifying
041578 - Doctor Edwards ordered further PRP care. ref SDS 72 V54H
041580 - ..
041581 - Decided to continue with Doctor Tucker for feet PRP treatment. Doctor
041582 - Tucker has said she likes performing PRP injection treatments for
041583 - feet, because of the complex structure. Her care the past 2 years,
041584 - since 170726, enabled hiking mileage to double last year, including
041585 - reaching the top of Half Dome.
041587 - ..
041588 - Doctor Edwards entered an order in the computer for Doctor Tucker to
041589 - provide PRP treatments for the feet.
041591 - ..
041592 - Doctor Edwards entered an order for her to perform PRP here at VAMCSF
041593 - in both knees, and in the right elbow.
041595 - ..
041596 - The doctor indicated both treaments should be performed in about 4
041597 - weeks.
041599 - ..
041600 - Jane will call to schedule the date for PRP care at VAMCSF.
041601 -
041602 - [On 190328 1104 letter thanks to Doctor Thuillier notifying
041603 - Doctor Edwards ordered further PRP care. ref SDS 72 V54H
041604 -
041605 - [On 190328 1239 letter to Doctor Edwards confirms
041606 - understandings from meeting at VAMCSF, as shown in this
041607 - record. ref SDS 73 V54H
041609 - ..
041610 - [On 190329 0905 letter to Jane asks for earlier date for
041611 - PRP treatment if there is a cancellation. ref SDS 74 V54H
041613 - ..
041614 - Patient can coordinate with Doctor Tucker's office to schedule PRP
041615 - for feet.
041616 -
041617 - [On 190328 0926 letter to Doctor Tucker confirms
041618 - discussions for the VA to order and pay for Doctor Tucker
041619 - to continue providing PRP care to feet. ref SDS 70 HM6O
041620 -
041621 -
041623 - ..
041624 - 4. Shoulders and elbows
041625 -
041626 - Was doing pushups 30 reps 3 - 5 sets per day, 5 years ago.
041627 - Left elbow swelled up, so stopped.
041629 - ..
041630 - Last year on 180810, resumed pushups shown in case study on
041631 - 180101 0820, ref SDS 26 PY4K, to build strength for using
041632 - cables to reach top of Half Dome on 180912. Limited this to 20
041633 - reps 3 times a day, in order to avoid prior injury to left
041634 - elbow. After Half Dome, gradually increased to 5 sets per day.
041635 - On 190225, had to pause pushups again, because right elbow was
041636 - popping, and both shoulders had become very sore, e.g., pain
041637 - level 5 starting pushups, shown in case study on 190101 0730.
041638 - ref SDS 62 VRTQ
041640 - ..
041641 - Sara did physical examination of shoulders, which is one of her
041642 - specialties, per above. ref SDS 0 X86J She seemed to identify minor
041643 - rotator cuff shoulder injuries, but advised they are not severe enough
041644 - yet to prevent continuing pushups.
041646 - ..
041647 - Somehow this seems conflicting with pain level 5 starting to do
041648 - pushups, when for past 74 years there was never any pain.
041650 - ..
041651 - The doctor further noted studies have reported negative results using
041652 - PRP injections to treat shoulders.
041654 - ..
041655 - She will inject PRP into right elbow, at time knees are injected.
041656 -
041658 - ..
041659 - 5. Anesthesia pain management...
041660 -
041661 - PRP treatments into feet can be painful, reported on 170816
041662 - 1400. ref SDS 10 1H6M Excessive pain can limit adequate
041663 - treatment, reported by Doctor Jessica Della Valle performing
041664 - debridment of leg wound, on 150923 1530. ref SDS 2 QD5K
041666 - ..
041667 - Can treatments be done at VAMCSF, so Nancy and Marlyn Michela,
041668 - can provide anesthesia, as they did for Doctor Stewart on
041669 - 190204 1200. ref SDS 64 4U8K This will enable PRP injections
041670 - to be thorough.
041672 - ..
041673 - Sara said Doctor Tucker would have to become associated with the VA in
041674 - order to do PRP treatments at the VA. This administrative process can
041675 - take a year.
041677 - ..
041678 - The VA will pay for Doctor Tucker to provide anesthesia for VA
041679 - patients, as needed. This will require review of patient risks, and
041680 - formulating a work plan, as was done for the surgery on 190204. There
041681 - was a meeting on 190201 0800, with Doctor Choukalas to evaluate
041682 - anesthesia procedures, ref SDS 63 ZW6L, to be used for surgery on
041683 - 190204. The key point was to avoid versed for conscious sedation,
041684 - because of past problems getting stroke symptoms with versed 6 mg.
041685 -
041686 -
041688 - ..
041689 - 6. Post-PRP Recovery Process and Time
041690 -
041691 - 1st PRP treatment on 170726 1600. ref SDS 8 S93J
041693 - ..
041694 - Doctor Tucker wrapped both feet with loose gause and ace
041695 - bandages. She explained this helps hold injected plazma in
041696 - place. She further said to walk flat footed for a day or so,
041697 - to avoid pressure on metatarsals while regeneration of tissue
041698 - occurs.
041700 - ..
041701 - Patient should avoid hiking for 2 - 4 weeks. She would prefer
041702 - 6 weeks. ref SDS 8 RN6H
041704 - ..
041705 - On 170727 1747 Doctor Tucker called and said walking 1 mile 2
041706 - days after feet injections, and then slow for about 3 miles
041707 - helps distribute PRP in the feet. ref SDS 9 0W6V
041708 -
041710 - ..
041711 - 2nd PRP treatment on 170726 1600. ref SDS 8 S93J
041713 - ..
041714 - Doctor Tucker applied same post procedure protocol, per above.
041715 - ref SDS 0 PO6N
041717 - ..
041718 - This was not done for ensuing 4 PRP treatments.
041719 -
041721 - ..
041722 - 3rd PRP treatment on 180105 1630. ref SDS 29 NX5K
041724 - ..
041725 - Research found extensive pos-procedure protocols.
041727 - ..
041728 - Doctor Edwards will provide post-procedure protocols after providing
041729 - PRP treatment in 4 weeks.
041730 -
041732 - ..
041733 - 7. Anxious legs 5+ hours after hiking
041734 -
041735 - Past 6 months or so, about 5+ hours after long hikes 15+ miles,
041736 - legs become very "anxious", as if suffering withdrawal
041737 - symptoms. Just sitting suddenly realize I am turning
041738 - side-to-side, but this becomes insufficient. Taking Tramadol
041739 - quiets the legs in a few minutes. However, seem to have
041740 - adverse side effects taking Tramadol everyday, so had to stop
041741 - Tramadol last week. Cannot find anything online to explain nor
041742 - remedy this "anxious" condition. Seems like a Sports Medicine
041743 - issue, so Doctor Edwards may have a remedy.
041745 - ..
041746 - Did not discuss this subject.
041747 -
041748 - [On 190328 1239 letter to Doctor Edwards asks about
041749 - "anxious legs" issue that was planned for review, but not
041750 - actually discussed today. ref SDS 73 Z559
041751 -
041752 -
041753 -
041754 -
041755 -
041756 -
041757 -
041758 -
041759 -
041760 -
041761 -
041762 -
041763 -
041764 -
0418 -
Distribution. . . . See "CONTACTS"