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: September 25, 2019 01:30 PM Wednesday; Rod Welch

Doctor Tucker 11th PRP treatment left knee 8 injections.

1...Summary/Objective
2...Develope Scope of Work for 10th Regeneration PRP Injection Treatment
3...NSAID Pain Medication Paused 7 Days Before PRP Injections
4...Blood Draw for PRP Completed with One Needle Stick
5...Examination and Mark Injection Sites
6...Numbing Agent and Lidocane Injections Numb PRP Injection Sites
7...PRP Injections
........Left Shoulder Injections
........Right Elbow
........Trapezius right side
........Right Knee
........Left Knee
........Right Foot
........Left Foot
8...Progress Notes Doctor Tucker PRP Procedure on 190403

ACTION ITEMS.................. Click here to comment!

1...management from 4 to 6 months. Will ask VA to schedule synvisc 2 - 3

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 B6 0000. ref SDS A8 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040503 - Took shower to heat left arm for blood draw, and took oxycodone pill                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040504 - to manage pain from lidocane and PRP injections, then drove to Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040505 - Tucker's clinic in Novato. ref SDS 0 V54H  Discussed PRP treatment for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040506 - left knee based on correspondence reporting pain during hiking, since                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040507 - Half Dome on 190911.  Left knee seems worse than last year after Half                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040508 - Dome. ref SDS 0 SO4N  Main focus of PRP was left knee, including                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040509 - narrowing of patella joint space. ref SDS 0 YA4J  Blood was drawn from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040510 - left arm inner elbow.  Required only 1 stick. ref SDS 0 PS4K  Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040511 - Tucker palpated injuries.  She marked locations for injections, thenb                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040512 - sprayed sites with numbing agent.  Doctor Tucker injected lidocaine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040513 - into each site. ref SDS 0 O26N  PRP - 8 injections were made today,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040514 - all into left knee - well tolerated, because took oxycodone medication                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040515 - several hours before injections occurred. ref SDS 0 LO4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040517 -             ..
040518 -            [On 190926 1047 letter to Doctor Tucker reports more pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040519 -            and stiffness in left knee after PRP treatment today,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040520 -            compared with prior 10 PRP treatments. ref SDS C2 WZ9R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040522 -             ..
040523 -            [On 190926 1047 letter to Doctor Tucker confirms                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040524 -            considerations to delay adding synvisc to evaluate 2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040525 -            changes in treatment protocal today, of increasing amount                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040526 -            and frequency of injecting PRP to left knee. ref SDS C3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040527 -            WZ42                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040529 -             ..
040530 -            [On 190930 0932 letter reports left knee remains swollen 5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040531 -            days after PRP treatment on 190925, which is more than has                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040532 -            occurred for prior 10 PRP treatments. ref SDS C5 V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040534 -             ..
040535 -            [On 190930 0932 letter to Doctor Tucker asks for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040536 -            explanation of 2nd PRP treatment being "more intense, but                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040537 -            more effective." ref SDS C5 NY4L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040539 -             ..
040540 -            [On 191004 1116 letter requests progress notes for PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040541 -            treatment today on 190925. ref SDS C6 VH54                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
040543 -             ..
040544 -            [On 191005 1227 request for clarification on scope of PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040545 -            required. ref SDS C7 O552                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040546 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040547 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040548 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040549 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040550 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041327 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041329 -  ..
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0416 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041701 - Meeting...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041702 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041703 -        Doctor Gloria Tucker                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041704 -        250 Bel Marin Keys Boulevard #G1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041705 -        Novato, CA 94945                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
041706 -        415 506 4907                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041708 -  ..
041709 - On 190921 0947 letter to Doctor Tucker discussed scope and work plan                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041710 - for PRP treatment today, which will concentrate on left knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041711 - ref SDS C0 P740  Consider medical rationale for combining hyaluronic                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041712 - acid injections with PRP.  Review sequential or several months apart?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041714 -  ..
041715 - On 190923 0928 called Doctor Tucker's office and scheduled meeting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041716 - today, on 190925 1330, for 11th PRP treatment, 190923 0928,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041717 - ref SDS C1 V54H, as requested in the letter on 190921 0947.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041718 - ref SDS C0 P740  Meeting today, was confirmed in a letter from the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041719 - doctor's office on 190923 0928 at 1219. ref SDS C1 GH4M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041721 -  ..
041722 - Took oxycodone pill about (1130) 2 hours before schedule for PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041723 - injections at 1330, shown in case study on 190101 0730. ref SDS 64                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041724 - O64I per planning in the doctor's letter after the 8th PRP treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041725 - on 190515, reported on 190517 1139. ref SDS 96 V54H  This worked well                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041726 - to reduce pain from needle penetrations during 9th PRP on 190612 1130,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041727 - ref SDS A8 J478, and again for 10 PRP treatment on 190816 1100.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041728 - ref SDS B6 XS8M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041730 -  ..
041731 - Took shower and ran hot water over inner left arm at location the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041732 - doctor makes needle insertion for blood draws.  This improves vein                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041733 - flexibility for better blood flow, shown by experience setting IVs for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041734 - EGD procedures, most recenly a few days ago on 190813 0730.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
041735 - ref SDS B3 JA4N  Was effective for 9th PRP treatment on 190612 1130.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041736 - ref SDS A8 PS4K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041738 -  ..
041739 - Left the house about 1130, driving to the doctor's office in Novato,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041740 - implementing plan for 11th PRP treatment, scheduled in a call to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041741 - Doctor Tucker on 190923, and confirmed in a letter from the Doctor's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041742 - office later that day on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041743 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041744 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041745 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041747 -  ..
0418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0420 - 1245                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042101 - Arrived at Doctor Tucker's office.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042102 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042103 - Saw Paul getting out of his car.  He was returning from getting                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042104 - takeout for him and Gloria.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042106 -  ..
042107 - Went into the doctor's office.  Saw Doctor Tucker at a desk in her                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042108 - office.  She said that she and Paul will have lunch for about 20                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042109 - minutes, then she will begin PRP treatment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042111 -  ..
042112 - Previously, Doctor Tucker's credentials show she graduated from USC                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042113 - with honors, she got her degree in medicine from USC, and she is a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042114 - sports medicine specialits, reorted on 190816 1100. ref SDS B6 TY5M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042116 -  ..
042117 - Research available in the waiting room include published studies,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042118 - reported on 190816 1100. ref SDS B6 OJ4F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042120 -  ..
042121 - Previously on 180105 1630, Doctor Tuckor explained PRP repairs OA                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042122 - injuries, which then resolves knee pain, by increasing the body's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042123 - natural production of collagen, which transforms into and thereby                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042124 - repairs/regenrates ligaments, tendons, cartilage, muscle cells, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042125 - fat cells. ref SDS 30 T14I  Research found articles supporting this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042126 - analysis. ref SDS 30 I37N and ref SDS 30 6M8N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042128 -  ..
042129 - There is a report on professional basketball player, Steph Curry,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042130 - getting good results...  PRP, stem cell and Warriors G Steph Curry's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042131 - quick return from knee injury," also on 190816 1100. ref SDS B6 WU8O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042133 -  ..
042134 - Need articles or other source on PRP protocols treating athletes, who                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042135 - experience high stress to knees and feet, like Curry and others in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042136 - basketball, Nadal and Federer in tennis, guys in football, soccar,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042137 - baseball.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042138 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042139 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042140 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042142 -  ..
0422 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0423 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0424 - 1252                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0425 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042501 - Entered procedure room, removed shoes and socks for examination of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042502 - feet, knees and left elbow.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042506 -  ..
0426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0427 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0428 - 1318                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0429 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042901 - Develope Scope of Work for 10th Regeneration PRP Injection Treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042902 - 
042903 - Follow up ref SDS B6 SO4N, ref SDS A8 SO4N.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
042904 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042905 - Gloria came into the examination room.  We reviewed recent                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042906 - correspondence on 190921 0947, ref SDS C0 P740, and the day before on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042907 - 190920 1427, ref SDS B9 T53W, which transmitted a letter to Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042908 - Thuillier reporting left knee pain, and sent earlier the same day on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042909 - 190920 1342, ref SDS B8 V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042911 -  ..
042912 - The doctor noted that left knee osteoarthritis may have worsened after                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042913 - hiking 3,500 miles last year, and 2,000 so far this year, including                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042914 - Half Dome 2 weeks ago on 190911 0500. ref SDS B7 0001  This                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042915 - possibility is presented in the letter to Doctor Thuillier in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042916 - Orthopedics at the VA in San Francisco submitted on 190920 1342.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042917 - ref SDS B8 1T33                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042919 -  ..
042920 - Decided PRP treatment today, will concentrate on left knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
042921 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042923 -  ..
042924 - Discussed possible areas for PRP injections...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042925 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042926 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042927 -        1.  Shoulder left side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042929 -  ..
042930 - Decided not to inject left shoulder again today, because want to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042931 - concentrate on left knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042932 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042934 -             ..
042935 -        2.  Elbow right arm                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042937 -  ..
042938 - Decided not to inject right elbow today, because want to concentrate                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042939 - on left knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042940 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042942 -             ..
042943 -        3.  Left knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042944 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042945 -            Latest xray radiology study on 190607, found...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042947 -             ..
042948 -            Left knee:  unchanged medial and lateral femorotibial joint                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042949 -            space narrowing compatible with moderate osteoarthritis.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042950 -            No evidence of acute fracture.  Worsening lateral                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042951 -            subluxation of the patella with patellofemoral osteophytes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042952 -            Trace suprapatellar effusion.  New quadriceps insertional                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042953 -            enthesophyte. ref SDS A6 TB5V                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042954 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042956 -             ..
042957 -            Letter to Doctor Tucker reported PRP less effective this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042958 -            year, than it was last year after Half Dome, reported on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042959 -            190920.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042961 -             ..
042962 -            During hiking there is pain along left side of left knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042963 -            about where PRP injections are made.  There is also pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042964 -            below patella about where injections are made.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042966 -             ..
042967 -            Doctor Tucker letter asked about injecting hyaluronic acid                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042968 -            (also "hyaluronan) available as Synvisc at the VA, in left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042969 -            knee along with PRP, reported on 190920.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042971 -             ..
042972 -            Letter to Doctor Tucker on 190921, reported experience                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042973 -            injecting Synvisc (hyaluronic acid) currently, did not                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042974 -            extend effectivenss of PRP beyond 3 - 4 months.  Discusses                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042975 -            injecting PRP then 2 months later injecting hyaluronic                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042976 -            acid.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
042978 -  ..
042979 - Doctor Tucker commented that left knee may have been further injured                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042980 - during Half Dome Hike, following PRP injection on 190816 1100.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
042981 - ref SDS B6 0001  She cited the letter submitted on 190921, to her with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042982 - copy to Doctor Thuillier in Orthopedics at VAMCSF, saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
042983 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042984 -        I would be grateful if you could overbook me for PRP this week,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042985 -        as you say concentrating on the left knee.  Hiking Half Dome is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042986 -        an unusually high stress on an OA knee, especially coming down                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042987 -        the last 2 miles on the John Muir Trail.  Last year this had no                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
042988 -        significant impact on the knee, but this year seems to have.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
042990 -  ..
042991 - The doctor decided to focus PRP injections today, on treating left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042992 - knee, as requested in the letter to her with copy to Doctor Thuillier                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042993 - on 190921.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
042995 -  ..
042996 - All 6 or 7 cc of PRP produced from drawing 60 cc of blood, will be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042997 - injected into the left knee.  Doctor Tucker said this is the standard                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042998 - protocol treating knee osteoarthritis with PRP.  It will be an order                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
042999 - of magnitude increase injecting PRP into the left knee, compared with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043000 - prior 10 PRP treatments, which treated both knees and both feet, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043001 - once the left shoulder and once the right elbow.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043003 -  ..
043004 - Decided to do follow up PRP injection in left knee in 2 weeks.  Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043005 - Tucker explained this is another common protocol for treating knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043006 - osteoarthritis, which has not been applied in this case, because                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043007 - injecting less PRP and less frequently has been effective.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043008 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043009 -            [On 190927 1503 received letter from Doctor Tucker's office                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043010 -            scheduling 2nd PRP treatment on 191009 1500, following up                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043011 -            1st treatment 2 weeks ago on 190925. ref SDS C4 V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043013 -  ..
043014 - Considered adding synvisc (hyaluronic acid) to extend left knee pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043015 - management from 4 to 6 months.  Will ask VA to schedule synvisc 2 - 3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043016 - months after PRP treatment today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043018 -  ..
043019 - Another consideration is that since today, we are making 2 changes to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043020 - prior protocols, adding synvisc might be delayed until after this                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043021 - cycle, in order to evaluate results of the 2 changes.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043022 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043023 -            [On 190926 1047 letter to Doctor Tucker confirms                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043024 -            considerations to delay adding synvisc to evaluate 2                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043025 -            changes in treatment protocal today, of increasing amount                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043026 -            and frequency of injecting PRP to left knee. ref SDS C3                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
043027 -            WZ42                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043029 -  ..
043030 - Primary injection of PRP will be intra-articular.  Some will be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043031 - injected below and around the patella to treat express symptoms the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043032 - past few days.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
043034 -  ..
043035 - Doctor Tucker will inject the back of the knee, as well.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
043036 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043037 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043039 -             ..
043040 -        4.  Right knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043041 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043042 -            Has responded well to injections on 190403 1000,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
043043 -            ref SDS 79 GE9L, and to injections on 190612 1100, 190612                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043044 -            1130, ref SDS A8 GE9L, Interval hiking has revealed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043045 -            intermittant right knee pain.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
043047 -  ..
043048 - Radiologist's report for xray on 190607 0810, says in part...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043049 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043050 -            "Right knee:  Unchanged medial femorotibial joint space                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043051 -            narrowing with tricompartmental osteophytes compatible with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043052 -            moderate osteoarthritis.  No evidence of acute fractures.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043053 -            Heterotopic ossification of the medial joint line likely                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043054 -            sequela of prior ligamentous injury.  Trace suprapatellar                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043055 -            effusion.  Small quadriceps insertional enthesophyte.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043056 -            Surgical clips project over the posterior soft tissue."                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043057 -            ref SDS A5 TB47                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043059 -  ..
043060 - The doctor decided to focus PRP injections today, on treating left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043061 - knee today, per above, ref SDS 0 QG8N, so no injection into right                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043062 - knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043063 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043064 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043065 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043066 -        5.  Tailor's Bunion right foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043067 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043068 -            Was treated with PRP injection on 190403 1000. ref SDS 79                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043069 -            GE5H  Since then there has been some pain reported in case                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043070 -            study on 190101, on some hikes, e.g., on 190713.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
043071 -            ref SDS 64 VSSS  Since last PRP treatment on 190816 1100,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043072 -            ref SDS B6 GE5H, there has been no further pain in either                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043073 -            foot.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043075 -  ..
043076 - No injections to right foot Tailor's Bunion, because decided to focus                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043077 - PRP injections today, on treating left knee today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043078 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043079 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043081 -             ..
043082 -        6.  Tailor's Bunion left foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043083 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043084 -            Was treated with PRP injection 190403 1000. ref SDS 79 9G4I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043085 -            There was continuing pain in left foot Tailor's Bunion,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043086 -            while hiking, e.g., on 190419 shown in case study on 190101                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043087 -            0730. ref SDS 64 SVQX  On 190427 pain level 2 - 3 almost                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043088 -            entire hike. ref SDS 64 UPQT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043090 -             ..
043091 -            Was treated again with PRP on 190515 1400. ref SDS 93 Q35G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
043092 -            There was continuing pain in left foot Tailor's Bunion,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043093 -            while hiking, e.g., on 190522 shown in case study on 190101                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043094 -            0730. ref SDS 64 XWVY                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043096 -             ..
043097 -            On 190612 1130 the doctor injected left foot Tailor's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043098 -            Bunion with PRP using ultrasound guidance. ref SDS A8 Q35G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
043099 -            For a month after PRP injection on 190612, there were some                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043100 -            hikes when minor pain ( < 3 ) occurred during part of hike.
043101 -            For the past 4+ weeks there have no reports of pain in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043102 -            left foot Tailor's Bunion.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043104 -  ..
043105 - No injections to left foot Tailor's Bunion, because decided to focus                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043106 - PRP injections today, on treating left knee today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043107 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043108 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043109 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043111 -             ..
043112 -        7.  Metatarsalgia both feet                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043113 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043114 -            PRP was injected between all 5 metatartsals on 190403 1000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043115 -            ref SDS 79 9T4O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043117 -             ..
043118 -            Feet responded well with no metatarsalgia pain after PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043119 -            treatment on 190403, so there were no follow up injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043120 -            on 190515 1400. ref SDS 93 0108  There was continuing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043121 -            burning sensation bottom right foot, reported in the letter                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043122 -            to the doctor on 190513 1017. ref SDS 89 SB9M  This                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043123 -            occurred everyday after injections on 190403, with varying                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043124 -            intensity, e.g., on 190523, shown in case study on 190101                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043125 -            0730. ref SDS 64 QL4H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043127 -             ..
043128 -            PRP was injected between all 5 metatartsals on 190612 1130.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043129 -            ref SDS A8 0108                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043131 -             ..
043132 -            Feet have responded well to treatment on 190612, however,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043133 -            there have been some hikes when metatarsalgia pain occurs                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043134 -            in both feet, reported in case study on 190101, e.g., on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043135 -            190629, ref SDS 64 TTTU; again on 190630, ref SDS 64 TTYR,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043136 -            also on 190713, ref SDS 64 VSSS, on 190727, ref SDS 64                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043137 -            XSXV,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043139 -             ..
043140 -            Feet will experience severe stress hiking Half Dome on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043141 -            190912, especially coming down, explained in hike last year                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043142 -            on 180912 0545. ref SDS 50 VZ5G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043144 -  ..
043145 - No injections to metatarsals in both feet, because decided to focus                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043146 - PRP injections on treating left knee today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
043147 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043148 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043149 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043150 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043152 -  ..
043153 - NSAID Pain Medication Paused 7 Days Before PRP Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
043154 - 
043155 - Follow up ref SDS B6 JT6H, ref SDS A8 JT6H.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
043156 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043157 - Protocol for PRP treatment is to avoid NSAID drugs at least 7 days                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043158 - prior to getting PRP.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043160 -  ..
043161 - Advised Doctor Tucker that have not taken NSAID drugs since taking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043162 - naproxen on 190811, shown in case study on 190101 0730. ref SDS 64                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
043163 - PWYS                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043164 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043165 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043166 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043167 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043169 -  ..
0432 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0433 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0434 - 1340                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0435 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043501 - Blood Draw for PRP Completed with One Needle Stick                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043502 - 
043503 - Follow up ref SDS B6 PS4K, ref SDS A8 PS4K.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
043504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043505 - Put feet on the gurney and did 10 pushups to increase blood flow for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043506 - the IV blood draw.  Doctor Tucker asked about patient's age?                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043511 -  ..
043512 - The doctor drew blood from the left arm, again using the vein on the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043513 - inner elbow, which has been used previously, reported for the 10th PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043514 - treatment on 190816 1100. ref SDS B6 PS4K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043516 -  ..
043517 - Asked if Kathy can help, like she did for the previous blood draw on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043518 - 190816 1100. ref SDS B6 EL7N  Gloria said she can handle it alone                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
043519 - today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043521 -  ..
043522 - Doctor Tucker aligned the needle and pushed it into the vein, shown in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043523 - the film for the prior procedure...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043524 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043525 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043526 -              C:\sd\wl\pic\health\190816_PRP_procedure\20190816_122430.mp4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043527 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043529 -  ..
043530 - Gloria said there was good blood flow on the first stick, so nice did                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043531 - not need multiple needle sticks today.  Successful blood draw from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043532 - same vein 6 weeks ago, and 4 weeks before that, was aided with running                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043533 - hot water over this vein area while showering before leaving for the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043534 - doctor's office, reported above. ref SDS 0 TY9N  Blood draw was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043535 - further aided by pushups testing left shoulder and right elbow, also                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043536 - reported above. ref SDS 0 PS4K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
043538 -  ..
043539 - The doctor aspirated 3 viles containing 20 cc of blood for total PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043540 - blood draw of 60 cc's.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043542 -  ..
043543 - Actually, progress notes report the doctor aspirated 180 cc of blood                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
043544 - for PRP treatment today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
043546 -  ..
043547 - There was a delay, because somehow one of the vials dropped on the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043548 - floor.  The doctor was concerned about contamination.  Made a joke                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
043549 - that it is probably okay under the 5 second rule for picking up                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043550 - dropped food from the floor.  Doctor Tucker got another vial from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043551 - inventory and filled it from the IV still in the arm.  She disposed of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043552 - the dropped vial.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
043553 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043554 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043556 -  ..
043557 - Examination and Mark Injection Sites                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043558 - 
043559 - Follow up ref SDS B6 O26N, ref SDS A8 O26N.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
043560 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043561 - While PRP was being created using 2-spin Harvest centrifuge                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
043562 - processing, explained in the doctor's letter on 190419 1123,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
043563 - ref SDS 86 V54H, Doctor Tucker examined and palpated areas where                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
043564 - injections would be made.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
043565 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043567 -               ..
043569 -   
043570 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043571 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043572 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043573 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043574 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043576 -  ..
0436 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0437 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0438 - 1300                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0439 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
043901 - Numbing Agent and Lidocane Injections Numb PRP Injection Sites                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043902 - 
043903 - Follow up ref SDS B6 MN4K.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
043904 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043905 - Numbing agent was sprayed on injection sites, which were then further                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043906 - numbed with lidocaine injections...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043907 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043908 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043910 -               ..
043911 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043912 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043913 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043915 -               ..
043916 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043917 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043918 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043920 -               ..
043922 -   
043923 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043924 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043926 -               ..
043927 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043928 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043929 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043931 -               ..
043932 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043933 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043934 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043936 -               ..
043937 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
043938 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043939 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043941 -               ..
043943 -   
043944 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043945 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043947 -  ..
043948 - Antiseptic was applied at each injection site.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
043950 -  ..
043951 - Injecting lidocaine into the knees is about pain level 2 - noticable,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043952 - but easily tolerated.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
043953 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043954 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043955 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
043957 -  ..
0440 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0441 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0442 - 1316                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0443 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
044301 - PRP Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044302 - 
044303 - Follow up ref SDS B6 LO4O, ref SDS A8 LO4O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
044304 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044305 - After all sites were marked and numbed with spraying agent and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044306 - lidocane, and after the centrifuging process completed, the doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
044307 - made PRP injections.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
044309 -         ..
044310 -        Left Shoulder                                     Injections                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
044311 -        
044312 -        Follow up ref SDS B6 M23O, ref SDS A8 M23O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044313 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044314 -        Injections.........................................     0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044315 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044316 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044317 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044319 -         ..
044320 -        Right Elbow                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
044321 -        
044322 -        Follow up ref SDS B6 5M5I.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
044323 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044324 -        Injections.........................................     0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044325 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044326 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044328 -         ..
044329 -        Trapezius right side                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
044330 -        
044331 -        Follow up ref SDS B6 SB5J, ref SDS A8 SB5J.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044332 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044333 -        Injections.........................................     0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044334 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044335 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044336 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044338 -         ..
044339 -        Right Knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
044340 -        
044341 -        Follow up ref SDS B6 GE9L, ref SDS A8 GE9L.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044342 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044343 -        Knee joint............................................  0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044344 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044345 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044347 -         ..
044348 -        Left Knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
044349 -        
044350 -        Follow up ref SDS B6 TF4H, ref SDS A8 TF4H.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044351 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044352 -        Knee joint............................................  7                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044354 -  ..
044355 - The doctor seemed to make 4 injections on left side of left knee,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
044356 - including intra articular into the meniscus...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044357 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044358 -            [On 190926 1047 letter to Doctor Tucker reports more pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
044359 -            and stiffness in left knee after PRP treatment today,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044360 -            compared with prior 10 PRP treatments. ref SDS C2 WZ9R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
044362 -             ..
044363 -            [On 190930 0932 letter reports left knee remains swollen 5                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044364 -            days after PRP treatment on 190925, which is more than has                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
044365 -            occurred for prior 10 PRP treatments. ref SDS C5 V54H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
044366 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044367 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044368 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
044369 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044370 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044372 -               ..
044373 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
044374 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044376 -  ..
044377 - All pain level 0, except intra articular injection into lateral                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044378 - meniscus was pain level 5, seemed to be deeper into the joint today.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
044379 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044380 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044382 -  ..
044383 - Seemed to be 1 injections below patella on front of knee...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
044384 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044385 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044386 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044387 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
044388 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044389 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044391 -  ..
044392 - Another injection was on top of the knee cap.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
044393 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044394 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044395 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044396 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044398 -  ..
044399 - All pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
044400 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044402 -  ..
044403 - Seemed to be 3 intra articular injection into medial meniscus of left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
044404 - knee...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
044405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044407 -               ..
044408 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
044409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044410 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044412 -  ..
044413 - Pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
044414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044417 -        Back of knee ACL and PCL............................... 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044419 -            [On 190926 1047 letter to Doctor Tucker reports more pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
044420 -            and stiffness in left knee after PRP treatment today,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044421 -            compared with prior 10 PRP treatments. ref SDS C2 WZ9R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
044422 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044424 -               ..
044425 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
044426 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044428 -  ..
044429 - All pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
044431 -  ..
044432 - The next day on 190926, left knee was considerably swollen, more than                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
044433 - with prior PRP treatments for left knee...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
044434 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044435 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044436 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
044437 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044438 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044439 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044441 -         ..
044442 -        Right Foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
044443 -        
044444 -        Follow up ref SDS B6 0108, ref SDS A8 0108.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044445 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044446 -        Metatarsalgia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
044447 -        Between little toe and ring toe................. 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044448 -        Between ring toe and middle toe................. 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044449 -        Between middle and long toe..................... 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044450 -        Between long toe and big toe.................... 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044452 -  ..
044453 - All pain level 2.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
044454 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044456 -         ..
044457 -        Tailor's bunion................................. 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044459 -         ..
044460 -        Total right foot...............................  0      0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044461 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044462 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044464 -         ..
044465 -        Left Foot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
044466 -        
044467 -        Follow up ref SDS B6 YY3G, ref SDS A8 YY3G.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
044468 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044469 -        Metatarsalgia                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
044470 -        Between little toe and ring toe................. 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044471 -        Between ring toe and middle toe................. 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044472 -        Between middle and long toe..................... 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044473 -        Between long toe and big toe.................... 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044474 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044476 -  ..
044477 - All pain level 0.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
044478 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044479 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044481 -         ..
044482 -        Tailor's Bunion................................. 0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
044483 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044485 -         ..
044486 -        Total left foot................................  0      0                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044487 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044489 -         ..
044490 -        Total PRP injections..................................  8                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044491 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044492 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044493 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044513 -  ..
044514 - Next PRP treatment is scheduled on 191009 1500.  A 3rd treament is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
044515 - scheduled on 191021 1100, if needed.  Will confirm this based on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
044516 - results after the treatment on 191009.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
044517 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044518 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044519 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044542 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044543 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044544 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
044545 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0446 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

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 B6 JS8O, ref SDS A8 JS8O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050406 - Received letter from Doctor Tucker transmitting her Progress Notes for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050407 - the procedure today, reported a few weeks later reported on 191004                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050408 - 1116. ref SDS C6 GS7J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050410 -  ..
050411 - Stored Doctor Tucker's Progress Notes in...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
050412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050413 -              F:\05\00003\SM\CC\AGMJ\20190925-133000\rod_sep_2019.docx                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050415 -         ..
050416 -    1.  Gloria Tucker MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050417 -        Diplomatic American College of Sports Medicine                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050418 -        250 Bel Marin Keys Boulevard, Building G Suite 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050419 -        Novato, CA 94949                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050420 -        415 506 4907                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050421 -        NPI:1265516231                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050423 -         ..
050424 -        Rod Welch                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050426 -         ..
050427 -    2.  Date....................................... September, 25, 2019                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050429 -         ..
050430 -        S: Here for pain in his left knee.  1 month after treatment                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050431 -        with PRP, he hiked nearly to the top of Half  Dome.  And about                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050432 -        1 week after that, he began having pain in his left knee, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050433 -        for this pain he takes glucosamine/chondroitin sulfate, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050434 -        sometimes narcotic pain medication.  He says the pain is in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050435 -        the anterior knee and also deep in the knee and on the medial                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050436 -        side of the knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050437 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050438 -            [On 191005 1227 request for clarification on scope of PRP                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050439 -            required. ref SDS C7 O552                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
050441 -         ..
050442 -        Of note, he has no further pain in his feet since his last                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
050443 -        course of PRP.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050445 -         ..
050446 -    3.  Examination: Left knee: Minimal effusion, TTP at the posterior                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
050447 -        medial joint line, and although he is not in pain now his                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050448 -        typical pain is at the distal patellar pole, tibial tubercle,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050449 -        anterior knee, and lateral joint line.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050451 -         ..
050452 -        Bilateral feet are not tender at his MTPs.  Or his tailor's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050453 -        bunions.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050455 -         ..
050456 -        Review of his x-ray shows narrowing at the medial aspect of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050457 -        his left knee with mild to moderate osteoarthritis in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
050458 -        retropatellar region.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
050460 -         ..
050461 -    4.  Plan: PRP to his left knee only.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
050462 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050463 -        Gloria Tucker, MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050465 -         ..
050466 -    5.  Procedure: 180 cc of blood was aspirated from his left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050467 -        anti-cubital fossa.  This was centrifuged and buffered with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
050468 -        sodium bicarbonate and activated with calcium chloride .  After                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
050469 -        numbing the medial retinaculum entry sites, tibial tubercle,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050470 -        distal pole of the patella, anterior joint line, medial joint                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050471 -        line, intra-articular entry site, and posterior lateral joint                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
050472 -        line with 1% lidocaine, we then injected with PRP.  He                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
050473 -        tolerated the procedure well.  I will see him back in 3 to 4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
050474 -        weeks for a repeat round of injections to his left knee.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050476 -         ..
050477 -        Gloria Tucker, MD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
050478 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050479 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050480 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050481 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050482 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050483 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050484 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050485 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050486 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050487 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050488 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050489 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
050490 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
Distribution. . . . See "CONTACTS"