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: June 12, 2019 11:30 AM Wednesday; Rod Welch

Doctor Tucker 9th PRP injection treatment feet and knees,

1...Summary/Objective
2...Develope Scope of Work for 9th Regeneration PRP Injection Treatment
3...NSAID Pain Medication Paused More than 7 Days Before PRP Injections
4...Blood Draw for PRP Completed with One Needle Stick
5...Identify Injection Sites Numbing Agent and Lidocaine
6...PRP Injections
........Left Shoulder Injections
........Trapezius right side
........Right Leg
........Left Leg
........Right Foot
........Left Foot
7...Progress Notes Doctor Tucker PRP Procedure on 190403


..............
Click here to comment!

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 93 0000. ref SDS 79 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 - Doctor Tucker provided effective, comprehensive PRP treatment to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040504 - recover from multiple feet and knee injuries.  Her office called this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040505 - morning, and requested meeting at 1130, rather than 1300.  Drove to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040506 - the doctor's office in Novato.  Took hydrocodone pill before leaving                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040507 - from Concord, so it will be effective for optimum pain management                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040508 - during PRP injections. ref SDS 0 V54H  Discussed scope of work based                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040509 - on xray performed by the VA last week on 190607. ref SDS 0 SO4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040510 - Decided main focus of PRP will be left knee, and narrowing of patella                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040511 - joint space. ref SDS 0 WS4I  The doctor drew blood from left arm inner                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040512 - elbow.  Kathy assisted getting full compliment of blood required for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040513 - centrifuge process, and requiring only 1 stick. ref SDS 0 PS4K  Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040514 - Tucker palpated prospective sites, and marked locations for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040515 - injections.  Kathy sprayed sites with numbing agent.  Doctor Tucker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040516 - injected lidocaine into each site. ref SDS 0 O26N  PRP injections were                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040517 - well tolerated today, because patient took hydrocodone several hours                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040518 - before injections occurred. ref SDS 0 LO4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040519 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040520 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040521 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040522 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041277 -  ..
0413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0415 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041601 - Meeting...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041602 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041603 -        Doctor Gloria Tucker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041604 -        250 Bel Marin Keys Boulevard #G1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041605 -        Novato, CA 94945                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041606 -        415 506 4907                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041608 -  ..
041609 - Paul called this morning responding to the letter yesterday,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041610 - confirming plans for PRP treatment today, reported on 190611 1442.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041611 - ref SDS A6 V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041613 -  ..
041614 - Took hydrocodone pill (actually Norco) about 2 hours before leaving                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041615 - for the doctor's office, per planning the doctor's letter after the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041616 - previous PRP treatment on 190515, reported on 190517 1139. ref SDS 96                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041617 - V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041618 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041619 -            [On 190614 0938 letter notifies Doctor Tucker that taking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041620 -            hydrocodone (actually Norco) 2 hours before PRP injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041621 -            was effective reducing pain. ref SDS A7 R590                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041623 -  ..
041624 - Took shower and ran hot water over inner left arm at location the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041625 - doctor typically makes needle insertion for blood draws.  This will                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041626 - improve flexibility for better blood flow, shown by experience setting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041627 - IVs for EGD procedures, most recenly a few weeks ago on 190521 0930.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041628 - ref SDS 97 JA4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041629 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041630 -            [...below on 190612 1130 at 1200 good blood flow drawing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041631 -            from same vein continuously, aided by running hot water                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041632 -            over vein injection site, and by pushups. ref SDS 0 G13F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041634 -  ..
041635 - Implement planning in call from Connie on 190510 1015, ref SDS 87                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041636 - V54H, scheduling PRP treatment with Doctor Tucker today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041638 -  ..
041639 - Arrived at Doctor Tucker's office.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041641 -  ..
041642 - Paul was at the front desk, and said Doctor Tucker will be available                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041643 - shortly.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041644 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041645 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041646 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041647 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041649 -  ..
0417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0419 - 1135                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042001 - Entered procedure room, removed shoes and socks, and shirt for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042002 - examination of feet and shoulders.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042004 -  ..
042005 - Setup c23 opened to the xray file, which was performed at VAMCSF on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042006 - 190607 0810. ref SDS A5 SQ51                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042007 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042008 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042009 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042010 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042012 -  ..
042013 - Develope Scope of Work for 9th Regeneration PRP Injection Treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042014 - 
042015 - Follow up ref SDS 93 SO4N, ref SDS 79 SO4N.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042016 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042017 - Gloria asked for scope of work for 9th PRP treatment?  Submitted CD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042018 - with radiology files and radiologist's analysis for xray performed at                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042019 - VAMCSF on 190607 0810. ref SDS A5 SQ51                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042021 -  ..
042022 - Reviewed letter to the doctor explaining scope, submitted yesterday on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042023 - 190611 1442. ref SDS A6 V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042024 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042025 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042026 -        1.  Left shoulder                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042027 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042028 -            Placed feet on gurney and did 10 pushups to test recovery                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042029 -            since ultrasound guided PRP injections on 190515 1400.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042030 -            ref SDS 93 M23O  Pushups were done much easier today, than                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042031 -            previously.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042033 -  ..
042034 - Decided not to inject left shoulder again today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042035 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042036 -               [...below on 190612 1130 at 1200 good blood flow drawing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042037 -               from same vein continuously, aided by pushups.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042038 -               ref SDS 0 G13F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042039 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042041 -             ..
042042 -        2.  Left knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042043 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042044 -            There is no longer sensation that femur bone is slipping                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042045 -            forward off the meniscus, when hiking downhill.  This                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042046 -            indicates 3 PRP injections to front of the knee below the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042047 -            knee cap (patella) performed on 190515 1400. ref SDS 93                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042048 -            TF4H, were effective, reported in the letter on 190524                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042049 -            1048. ref SDS 98 CY62                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042051 -  ..
042052 - Decided not to inject front of left knee today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042053 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042054 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042055 -            Pain in back of left knee has subsided after 3 PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042056 -            injections on 190515 1400. ref SDS 93 TQ7K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042058 -  ..
042059 - Doctor Tucker used a medical mockup of the knee to show crossing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042060 - anterior (lateral) cruciate ligament (ACL) and posterior (medial)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042061 - cruciate liament (PCL) help maintain alignment of femur and tibia leg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042062 - bones.  She was pleased that PRP she injected on 190515, relieved                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042063 - prior pain in the bac of left knee. ref SDS 93 TQ7K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042065 -  ..
042066 - Decided not to inject back of left knee today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042067 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042069 -             ..
042070 -            Current continuing pain seems internal to knee, indicating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042071 -            degenerating meniscus, despite 1 lateral prp injection and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042072 -            2 medial injections on 190403 1000, ref SDS 79 TF4H, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042073 -            further indicated by buckling of the knee, reported in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042074 -            letter on 190611 1442. ref SDS A6 3360  Buckling left knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042075 -            is reported continuously, e.g., on 190529 in case study on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042076 -            190101 0730. ref SDS 64 YXSQ                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042078 -  ..
042079 - Doctor Tucker used c23 to view xray study performed by VAMCSF on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042080 - 190607 0810. ref SDS A5 5T5L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042082 -  ..
042083 - Xray files are stored in...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042084 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042085 -              F:\05\00003\SM\CC\AGMJ\20190607-091600\xray_knees\MediaViewerLauncher.EXE                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042087 -  ..
042088 - The doctor pointed out narrowing joint space at lateral meniscus, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042089 - she noted narrowing of patella joint space.  Radiologist's report for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042090 - xray on 190607 0810, says in part...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042091 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042092 -            "Left knee:  Unchanged medial and lateral femorotibial                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042093 -            joint space narrowing compatible with moderate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042094 -            osteoarthritis.  No evidence of acute fracture.  Worsening                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042095 -            lateral subluxation of the patella with patellofemoral                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042096 -            osteophytes.  Trace suprapatellar effusion.  New quadriceps                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042097 -            insertional enthesophyte." ref SDS A5 TB5V                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042099 -  ..
042100 - The doctor decided to focus PRP injections today, on treating left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042101 - knee deficits.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042102 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042104 -             ..
042105 -        3.  Right knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042106 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042107 -            Has responded well to 2 lateral PRP injections on 190403                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042108 -            1000. ref SDS 79 GE9L  Interval hiking has revealed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042109 -            intermittant right knee pain.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042111 -  ..
042112 - Radiologist's report for xray on 190607 0810, says in part...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042113 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042114 -            "Right knee:  Unchanged medial femorotibial joint space                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042115 -            narrowing with tricompartmental osteophytes compatible with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042116 -            moderate osteoarthritis.  No evidence of acute fractures.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042117 -            Heterotopic ossification of the medial joint line likely                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042118 -            sequela of prior ligamentous injury.  Trace suprapatellar                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042119 -            effusion.  Small quadriceps insertional enthesophyte.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042120 -            Surgical clips project over the posterior soft tissue."                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042121 -            ref SDS A5 TB47                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042123 -  ..
042124 - The doctor decided to assign right knee lowest priority for PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042125 - injections today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042126 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042127 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042128 -        4.  Tailor's Bunion right foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042129 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042130 -            Was treated with PRP injection on 190403 1000. ref SDS 79                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042131 -            GE5H  Since then there are no reports of pain, so no                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042132 -            reason to inject again today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042133 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042134 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042136 -             ..
042137 -        5.  Tailor's Bunion left foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042138 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042139 -            Was treated with PRP injection 190403 1000. ref SDS 79 9G4I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042140 -            There was continuing pain in left foot Tailor's Bunion,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042141 -            while hiking, e.g., on 190419 shown in case study on 190101                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042142 -            0730. ref SDS 64 SVQX  On 190427 pain level 2 - 3 almost                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042143 -            entire hike. ref SDS 64 UPQT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042145 -             ..
042146 -            Was treated again with PRP on 190515 1400. ref SDS 93 Q35G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042147 -            There was continuing pain in left foot Tailor's Bunion,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042148 -            while hiking, e.g., on 190522 shown in case study on 190101                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042149 -            0730. ref SDS 64 XWVY                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042151 -             ..
042152 -            Doctor Tucker commented that pain in left foot Tailor's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042153 -            Bunion and no pain in right foot Tailor's Bunion may                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042154 -            reflect more severe left knee deficits compared to right                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042155 -            knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042157 -  ..
042158 - The doctor decided to inject left foot Tailor's Bunion with PRP using                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042159 - ultrasound guidance, and commented this requires integrated PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042160 - treatment for left knee today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042161 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042162 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042164 -             ..
042165 -        6.  Metatarsalgia both feet                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042166 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042167 -            Treated with PRP injections on 190403 1000. ref SDS 79 9T4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042169 -             ..
042170 -            Feet responded well to treatment, so there were no follow                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042171 -            up injections on 190515 1400. ref SDS 93 0108  However,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042172 -            there has been continuing burning sensation bottom right                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042173 -            foot, reported in the letter to the doctor on 190513 1017.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042174 -            ref SDS 89 SB9M  This has occurred everyday since last                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042175 -            injections on 190403, with varying intensity, e.g., on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042176 -            190523, shown in case study on 190101 0730. ref SDS 64 XWPW                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042178 -             ..
042179 -            There was discussion that injections today, may maintain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042180 -            hiking without metatarsalgia injuries through training and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042181 -            Half Dome scheduled on 190911.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042183 -  ..
042184 - The doctor will inject small amount of PRP initially in feet, to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042185 - preserve increased treatment for left knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042186 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042188 -             ..
042189 -        7.  Elbow left arm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042190 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042191 -            Injured from doing pushups.  Past 60 days has improved,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042192 -            because reduced pushups while recovering from left shoulder                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042193 -            injury, per above. ref SDS 0 JK4K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042195 -  ..
042196 - Doctor Tucker will monitor progress recovering and consider treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042197 - with PRP at future time.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042198 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042199 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042201 -             ..
042202 -        8.  Right side trapezius muscle injured in car crash on 170905                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042203 -            2230. ref SDS 13 0001  It recovered considerably for 18                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042204 -            months.  About 6 months ago seemed to relapse while hiking.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042205 -            Seems like it should respond similarly to ligaments and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042206 -            tendons.  This has improved considerably again the past 60                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042207 -            days.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042209 -  ..
042210 - Doctor Tucker will monitor progress recovering and consider treating                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042211 - with PRP at future time.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042212 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042213 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042215 -  ..
042216 - NSAID Pain Medication Paused More than 7 Days Before PRP Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042217 - 
042218 - Doctor Tucker asked how long since taking NSAID drugs?  She said these                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042219 - should have been stopped for at least the past 7 days.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042221 -  ..
042222 - Reviewed the letter submitted to Doctor Tucker yesterday on 190611                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042223 - 1442, and saying in part...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042224 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042225 -        Have not taken naproxen nor other NSAID for over a week, per                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042226 -        PRP protocol. ref SDS A6 JH7M  See case study showing history                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042227 -        taking pain medication past 2 weeks, reported on 190101 0730.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042228 -        ref SDS 64 H69K.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042229 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042230 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042231 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042232 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042234 -  ..
0423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0424 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0425 - 1200                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042601 - Blood Draw for PRP Completed with One Needle Stick                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042602 - 
042603 - Follow up ref SDS 93 PS4K, ref SDS 79 PS4K.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042604 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042605 - The doctor drew blood from the left arm, again using the vein on the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042606 - inside of the elbow, which she has used previously, reported on 180824                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042607 - 1515. ref SDS 49 YY6N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042609 -  ..
042610 - Kathy assisted, holding the container for the blood draw, and clamping                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042611 - the line to change vials.  Doctor Tucker aligned the needle and pushed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042612 - it into the vein.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042614 -  ..
042615 - Gloria said there was good blood flow.  After 20 seconds or so, they                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042616 - had the 60cc of blood needed for spinning down into 6 or 7 cc of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042617 - platlet rich plasma (PRP).  Successful blood draw from same vein 3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042618 - weeks ago, and 4 weeks before that, was aided with running hot water                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042619 - over this vein area taking shower before leaving for the doctor's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042620 - office, reported above. ref SDS 0 TY9N  Blood draw was further aided                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042621 - by pushups testing left shoulder response to treatment, also reported                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042622 - above. ref SDS 0 SO4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042623 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042624 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042626 -  ..
042627 - Identify Injection Sites Numbing Agent and Lidocaine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042628 - 
042629 - Follow up ref SDS 93 O26N, ref SDS 79 O26N.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042630 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042631 - While PRP was being created using 2-spin Harvest centrifuge                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042632 - processing, explained in the doctor's letter on 190419 1123,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042633 - ref SDS 86 V54H, the doctor examined and palpated areas where                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042634 - injections would be made.  She marked examination findings...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042635 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042637 -               ..
042639 -   
042640 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042642 -               ..
042644 -   
042645 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042647 -               ..
042649 -   
042650 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042652 -               ..
042654 -   
042655 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042657 -  ..
042658 - Doctor Tucker used ultrasound radiology to guide PRP injections for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042659 - left foot Tailor's Bunion...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042660 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042661 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042662 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042663 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042664 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042666 -   
042667 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042669 -  ..
042670 - Both feet were marked between metatarsals...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042671 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042672 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042674 -   
042675 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042677 -  ..
042678 - Numbing agent was sprayed on injection sites, which were then further                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042679 - numbed with lidocaine injections...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042686 -  ..
042687 - Antiseptic was applied at each injection site...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042688 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042690 -   
042691 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042693 -  ..
042694 - Injecting lidocaine into the knees is about pain level 2 - noticable,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042695 - but easily tolerated.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042697 -  ..
042698 - Injecting lidocaine into Tailor's Bunions on the fore-edge of the foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042699 - has been pain level 8+ on prior PRP treatments, but today, was only                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042700 - about pain level 4, because took hydrodocone 2 hours before treatment,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042701 - per above. ref SDS 0 XS8M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042702 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042703 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042704 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042706 -  ..
042707 - PRP Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042708 - 
042709 - Follow up ref SDS 93 LO4O, ref SDS 79 LO4O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042710 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042711 - After all sites were marked and numbed with spraying agent and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042712 - lidocane, and after the centrifuging process completed, the doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042713 - made PRP injections.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042715 -         ..
042716 -        Left Shoulder                                     Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042717 -        
042718 -        Follow up ref SDS 93 M23O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042719 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042720 -        Injections.........................................    0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042721 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042722 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042724 -         ..
042725 -        Trapezius right side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042726 -        
042727 -        Follow up ref SDS 93 SB5J.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042728 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042729 -        Injections.........................................    0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042730 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042731 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042732 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042734 -         ..
042735 -        Right Leg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042736 -        
042737 -        Follow up ref SDS 93 GE9L, ref SDS 79 GE9L.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042738 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042739 -        Knee joint............................................  1 - 2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042741 -  ..
042742 - The doctor seemed to make 1 and possibly 2 injections on lateral side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042743 - of right knee...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042744 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042745 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042747 -   
042748 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042749 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042751 -   
042753 -  ..
042754 - All pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042755 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042756 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042758 -         ..
042759 -        Left Leg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042760 -        
042761 -        Follow up ref SDS 93 TF4H, ref SDS 79 TF4H.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042762 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042763 -        Knee joint............................................  3 - 5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042765 -  ..
042766 - The doctor seemed to make 2 and possibly 3 injections on lateral side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042767 - of left knee...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042768 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042770 -   
042771 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042772 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042774 -   
042775 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042777 -  ..
042778 - The doctor seemed to make 1 and possibly 2 injections on medial side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042779 - of left knee...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042780 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042782 -   
042784 -  ..
042785 - All pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042786 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042787 -        Back of knee ACL and PCL............................... 0 - 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042788 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042789 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042791 -         ..
042792 -        Right Foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042793 -        
042794 -        Follow up ref SDS 93 0108, ref SDS 79 0108.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042795 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042796 -        Metatarsalgia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042797 -        Between little toe and ring toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042798 -        Between ring toe and middle toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042799 -        Between middle and long toe..................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042800 -        Between long toe and big toe.................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042801 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042802 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042804 -   
042805 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042807 -               ..
042809 -   
042810 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042812 -               ..
042814 -   
042815 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042817 -         ..
042818 -        Tailor's bunion................................. 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042820 -  ..
042821 - Pain increases as PRP is injected to level 3+.  Much easier to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042822 - tolerate today, after taking hydrocodone 2 hours before injections,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042823 - per above. ref SDS 0 XS8M  Additionally, injections today, may have                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042824 - been shallower and with less PRP, in order to preserve PRP for left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042825 - knee, per above. ref SDS 0 WS4I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042827 -         ..
042828 -        Total right foot...............................  4      4   4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042829 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042831 -         ..
042832 -        Left Foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042833 -        
042834 -        Follow up ref SDS 93 YY3G, ref SDS 79 YY3G.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042835 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042836 -        Metatarsalgia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042837 -        Between little toe and ring toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042838 -        Between ring toe and middle toe................. 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042839 -        Between middle and long toe..................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042840 -        Between long toe and big toe.................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042841 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042842 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042844 -   
042845 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042847 -  ..
042848 - She then injected the Tailor's Bunion on the left foot.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042850 -         ..
042851 -        Tailor's Bunion................................. 1 - 3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042852 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042853 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042855 -   
042856 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042857 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042859 -  ..
042860 - Pain increases as PRP is injected to level 8+, and so challenging to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042861 - tolerate.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042862 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042863 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042864 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042865 -        Medial side left foot for Tailor's Bunion.....   1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042866 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042867 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042869 -   
042870 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042871 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042873 -   
042874 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042876 -         ..
042877 -        Instep left foot for Tailor's Bunbion.........   1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042878 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042879 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042881 -   
042882 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042883 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042885 -   
042886 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042888 -         ..
042889 -        Total left foot................................  7 - 9  7 - 9                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042890 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042892 -         ..
042893 -        Total injections...................................... 15 - 20                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042894 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042896 -  ..
042897 - How long wait before doing pushups?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042899 -  ..
042900 - The doctor said to buildup gradually over several weeks, rather than                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042901 - starting out dong 20 or 30 pushups.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042918 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042922 -  ..
042923 - Before leaving the office, scheduled PRP on....                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042924 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042925 -                190816 1100                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042926 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042927 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042928 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042929 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042930 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042931 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042932 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042933 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042934 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042935 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0430 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Default Null Subject Account for Blank Record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050401 -  ..
050402 - Progress Notes Doctor Tucker PRP Procedure on 190403                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050403 - 
050404 - Follow up ref SDS 93 JS8O, ref SDS 79 JS8O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050406 - Received letter from Doctor Tucker transmitting her Progress Notes                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050407 - for the procedure today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050409 -  ..
050410 - Stored Doctor Tucker's Progress Notes in...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050412 -              F:\05\00003\SM\CC\AGMJ\20190612-113000\20190612_prp_prog_notes.docx                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050414 -         ..
050415 -    1.  Gloria Tucker MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050416 -        Diplomatic American College of Sports Medicine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050417 -        250 Bel Marin Keys Boulevard, Building G Suite 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050418 -        Novato, CA 94949                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050419 -        415 506 4907                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050421 -         ..
050422 -        Rod Welch                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050424 -         ..
050425 -    2.  Date....................................... June 12, 2019                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050427 -         ..
050428 -        S: Return visit for swelling and soreness in his left knee but                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050429 -        no persistent pain.  He also reports that the sensation of his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050430 -        femur moving forward on his tibia has stopped.  Since the last                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050431 -        set of injections.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
050433 -  ..
050434 - Aligns with understandings during the meeting, per above. ref SDS 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050435 - WS4I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050437 -  ..
050438 - Doctor Tucker's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050439 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050440 -        Right knee: He reports the right knee is 95% better and would                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050441 -        like an intra-articular injection into his right knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050443 -  ..
050444 - Aligns with understandings during the meeting, per above. ref SDS 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050445 - LX6F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050446 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050448 -  ..
050449 - Doctor Tucker's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050450 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050451 -        Left foot: He reports persistent soreness in his metatarsals as                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050452 -        well as his fifth MTP joint.  Despite having an injection to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050453 -        his tailor's bunion in May, the pain persists.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050455 -  ..
050456 - Aligns with understandings during the meeting, per above. ref SDS 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050457 - DC9N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050459 -  ..
050460 - Doctor Tucker's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050461 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050462 -        Right foot: Persistent soreness in his metatarsals.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
050463 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050465 -         ..
050466 -        Examination:  Left knee:  Minimal effusion, TTP  along his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050467 -        lateral and medial joint line, also on the superior aspect of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050468 -        his patella.  Negative Lachman, negative grind, negative sag                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050469 -        test                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050471 -         ..
050472 -        Left foot:  Mild pes planus:  An TTP in his spring ligament,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050473 -        sinus tarsus, but tender at the metatarsals 1 through 5 and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050474 -        that his fifth metatarsal joint.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050476 -         ..
050477 -        Right knee: TTP along the metatarsals 1 through 5.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
050479 -         ..
050480 -        Right knee: Nontender.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050481 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050483 -         ..
050484 -        X-ray:  Bilateral knees:  Some narrowing of his joint space                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050485 -        with most pronounced narrowing in his left medial aspect also                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050486 -        he has retropatellar osteoarthritis bilaterally.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050488 -  ..
050489 - Reflects review xray performed on 190607 at VAMCSF, discussed during                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050490 - the meeting, per above. ref SDS 0 4O6F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050491 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050493 -  ..
050494 - Doctor Tucker's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050495 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050496 -        Plan:  Discussed the possibility of a medial offloading brace                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050497 -        to his left knee.  He reports having used this in the past with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050498 -        no benefit.  We will try treatment with PRP.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050500 -  ..
050501 - Planning PRP injections today, shown above. ref SDS 0 O26N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
050503 -  ..
050504 - Doctor Tucker's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050506 -        Gloria Tucker, MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050507 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050509 -         ..
050510 -        Procedure:  Patient is aware of the risks and benefits.  After                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050511 -        aspirating 60 cc of blood from his left brachium.  We spun this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050512 -        down to PRP and buffered it with sodium bicarbonate and calcium                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050513 -        chloride.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050515 -         ..
050516 -        We then injected the above areas of his left knee including                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050517 -        intra-articularly, his patellar retinaculum, medial and lateral                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050518 -        joint lines, and the superior aspect of his patella, after                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050519 -        pretreating with 1% lidocaine.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050521 -  ..
050522 - Aligns with report showing left knee injections, per above.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050523 - ref SDS 0 TF4H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050525 -  ..
050526 - Photographs unclear on exact number of injections.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050528 -  ..
050529 - Doctor Tucker's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050530 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050531 -        Using ultrasound guidance, I injected his left fifth MTP joint,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050533 -  ..
050534 - Aligns with record of injections and using ultrasound, per above.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050535 - ref SDS 0 FI45                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050537 -  ..
050538 - Doctor Tucker's Progress Notes continue...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
050539 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050540 -        his bilateral MTP joints 1 through 5, his left sinus tarsus,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050541 -        and his left spring ligament.  Lastly I injected 1 cc of PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050542 -        intra-articularly to his right knee.  He tolerated the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050543 -        procedure well.  RTC 6 to 8 weeks.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
050544 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050545 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050546 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050547 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050548 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050549 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050550 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050551 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050552 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050553 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050554 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050555 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
Distribution. . . . See "CONTACTS"