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: February 21, 2020 08:00 AM Friday;
Rod Welch
VA Orthopedics meeting Doctor Thuillier on VA paying for PRP using evidence from IVUS report.
1...Summary/Objective
2...Orthopedics Progress Notes Meeting Doctor Thuillier
..............
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CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS C6 0000. ref SDS C2 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040507 -
040509 - ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 170726 1600 1st PRP treatment - Doctor Tucker performed injections
040902 - to treat plantar plate tear right foot, ref SDS 15 HE4N; she also made
040903 - PRP injections treating metatarsalgia in both feet. ref SDS 15 EG7F
040904 - PRP was injected into the left knee, ref SDS 15 4Y8K,
040906 - ..
040907 - On 170816 1400 2nd PRP injection treatment regeneration therapy;
040908 - Doctor Tucker used pain management protocol similar to 1st phase, when
040909 - no pain was experience, but on this 2nd phase there was considerable
040910 - pain, because injections were deeper and more PRP was injected to
040911 - achieve benefits of regenerating (healing) plantar plate tear, which
040912 - were not achieved with 1st phase of treatment. ref SDS 17 S543 PRP was
040913 - injected into arch to repair Halux Valgus right foot. ref SDS 17 IM7N
040915 - ..
040916 - On 170817 0836 at 1207 letter from Doctor Tucker says hallux valgus is
040917 - symptom of weakening arch; injecting PRP to ligaments of the 1st mtp
040918 - (big toe) in association with treating the arch, we are hoping to help
040919 - heal that and more importantly, keep it from worsening. ref SDS 18
040920 - 9F5H
040922 - ..
040923 - On 171229 0745 MRI right knee regenerate cartelage compare left knee.
040924 - ref SDS 31 K05I
040926 - ..
040927 - On 171229 0900 MRI both feet evaluate PRP treatments. 171229 0900,
040928 - ref SDS 32 HQ5O
040930 - ..
040931 - On 180105 1630 3rd PRP treatment - Doctor Tucker performed PRP
040932 - injections, ref SDS 36 0001, for knees and feet including Tailor's
040933 - Bunions. ref SDS 36 VO3F
040935 - ..
040936 - On 180108 letter to Doctor Thuillier reported PRP treatment in both
040937 - feet and both knees on 180105 1630, ref SDS 36 HP5O, and related
040938 - research indicating PRP yields measurable increase in minisucs
040939 - cartilage over 6 months. ref SDS 36 JX67
040941 - ..
040942 - On 180110 1100 meeting Doctor Thuillier review MRI scans both feet and
040943 - both knees on 171229. ref SDS 38 JN9H The doctor cited finding in the
040944 - report from MRI on 171229, that cartilage has not further reduced
040945 - since prior study on 170412, reported on 160805. ref SDS 31 M75N He
040946 - feels this is significant that continuing patient hiking 11 miles per
040947 - day has not further degraded miniscus cartilage in both knees.
040949 - ..
040950 - On 180425 1145 meeting Doctor Thuillier review progress recover feet
040951 - and knee injuries using PRP injection treatments, ref SDS 41 V54H, and
040952 - order additional care. ref SDS 41 4J6H
040954 - ..
040955 - On 180516 1015 meeting Doctor Thuillier got name of "smartwool" socks.
040956 - ref SDS 46 GW5N The doctor suggested trying Doctor Scholl's Corn
040957 - Removers using Salicylic Acid to recover from Tailor's Bunion on left
040958 - side of left foot, and from calluses on both big toes. ref SDS 46 GW7M
040959 - Doctor Thuillier indicated PRP treatments have been strong remedies
040960 - for metatrsalgia, plantar plate tear, hallux valgus, and Tailor's
040961 - Bunion. He is investigating how VA can pay for the treatments.
040962 - ref SDS 46 GG6J
040964 - ..
040965 - On 180620 1530 4th PRP treatment to both feet and both knees.
040966 - ref SDS 50 VO3F
040968 - ..
040969 - On 180725 1145 meeting Doctor Thuillier about acetaminophen at
040970 - prescribed dose of 1000 mg per day taken over extended days, weeks and
040971 - months could accumulate into an "intoxination" condition that causes
040972 - liver damage and lowers HDL some 33%, ref SDS 53 155F, as reported in
040973 - the study reviewed on 180724 1645. ref SDS 52 EN4L Further considered
040974 - how long recovery might take to restore liver function after stopping
040975 - acetaminophen, particularly restoring elevated HDL levels? ref SDS 53
040976 - SV6H Dan said he has hiked Half Dome 4 times. ref SDS 53 G56K
040978 - ..
040979 - On 180824 1515 5th PRP treatment - meeting Doctor Tucker injection
040980 - treatment to protect feet and knees, enable training Half Dome.
040981 - ref SDS 55 0001
040983 - ..
040984 - On 180912 0545 hiked Half Dome in Yosemite Valley, total 28 miles that
040985 - day. ref SDS 56 0001
040987 - ..
040988 - On 181024 0752 sent letter to Doctor Thuillier, ref SDS 57 FC8M,
040989 - asking him to order Supartz injections for knees, hope to extend PRP
040990 - effectivenss to 6 months. ref SDS 57 OC44
040992 - ..
040993 - On 181025 0735 received letter from Doctor Thuillier advising that he
040994 - ordered Supartz for knees, which will be combined with PRP.
040995 - ref SDS 58 ZY9M
040997 - ..
040998 - On 181025 0735 at 0801 letter to Jane in Orthopedics Administration,
040999 - asking about coordinating schedule for Supartz injections. ref SDS 58
041000 - 7H7S
041002 - ..
041003 - On 181126 1130 1st of 3 Supartz injections - meeting with Gina at VA
041004 - Clinic in Santa Rosa performed 1st injection Supartz in both knees.
041005 - ref SDS 61 BK6H Gina is strong proponent for PRP at VA; she is
041006 - talking to Doctor Thuiller and Doctor Sara Edwards in Orthopedics at
041007 - VAMCSF, and hopes to get assignment for doing PRP injections.
041008 - ref SDS 61 375L
041010 - ..
041011 - On 181126 1127 meeting Doctor Gloria Tucker - received article on
041012 - favorable results combinging PRP with Supartz injections; and
041013 - scheduled next PRP treatment 2 days after last Supartz, which be done
041014 - on 181212. ref SDS 62 KJ5I
041016 - ..
041017 - On 181126 1547 at 1952 letter to Gina at VA Clinic in Santa Rosa, with
041018 - copy to Doctor Thuillier in Orthopedics at VAMCSF, and copy to Doctor
041019 - Tucker, and submitting to Gina and Doctor Thuiller article on study
041020 - combinging Supartz with PRP. ref SDS 61 VE46 Further report improved
041021 - hiking during 2018, with PRP treatments in feet and knees, reaching
041022 - 3,000 miles and HDL 83, an increase of nearly 300% after CABG x4
041023 - surgery 9 years ago. ref SDS 61 VE73
041025 - ..
041026 - On 181126 1547 receive results of Telomere test, ref SDS 63 ZD7J,
041027 - seeming to indicate have telomere length for average 77 year old,
041028 - reported in the record for the day of the blood draw on 181115 1037.
041029 - ref SDS 60 AY46
041031 - ..
041032 - On 181203 1030 2nd of 3 Supartz injections - meeting with Gina at VA
041033 - Clinic in Santa Rosa performed 2nd injection Supartz in both knees.
041034 - ref SDS 65 V54H
041036 - ..
041037 - On 181205 1045 meeting with Doctor Dan Thuillier at VAMCSF on
041038 - telomeres, ref SDS 66 V54H; collaborating with Doctor Sara Edwards on
041039 - adding PRP treatments at the VA. ref SDS 66 FN8M
041041 - ..
041042 - On 181210 1030 3rd of 3 Supartz injections - meeting with Gina at VA
041043 - Clinic in Santa Rosa; Gina made final injection of Supartz into both
041044 - knees to complete 3 injection series. ref SDS 67 CJ98
041046 - ..
041047 - On 181212 1600 6th PRP injection treatment - meeting Doctor Tucker
041048 - injected PRP into both feet and both knees. ref SDS 68 0001
041050 - ..
041051 - On 190327 0915 meeting at VAMCSF Doctor Sara Edwards offered to
041052 - perform PRP injection treatment for both knees and right elbow.
041053 - ref SDS 77 YM90 Expect work to be performed in about 4 weeks.
041054 - ref SDS 77 T13O
041056 - ..
041057 - On 190329 0905 letter to Jane asks for earlier date for PRP treatment
041058 - if there is a cancellation. ref SDS 82 V54H
041060 - ..
041061 - On 190329 0905 at 1127 letter from Jane saying she forwarded the
041062 - letter to Lance, who schedules PRP procedures. ref SDS 82 VN3H
041064 - ..
041065 - On 190403 1000 Doctor Tucker has not received documentation of an
041066 - order for PRP care, nor establishing payment process, so paid for 7th
041067 - PRP set of injections, by cash. ref SDS 83 V66K
041069 - ..
041070 - On 190411 130912 VA Orthopedics visit Lance to schedule PRP ordered by
041071 - Doctor Edwards on 190327. ref SDS 84 V54H
041073 - ..
041074 - On 190418 150449 VA Orthopedics letter to Lance requesting time and
041075 - location for PRP on 190425. ref SDS 85 V54H Received response from
041076 - Lance saying ASU will call on 190424 OA 1400 to advise instructions on
041077 - reporting for PRP treatment the next day. ref SDS 85 3A6N
041079 - ..
041080 - On 190423 0931 received call from Rachael in VAMCSF Orthopedics
041081 - scheduling post-procedure review of PRP on 190425, with Doctor Edwards
041082 - on 190522 0900. 190423 0931, ref SDS 87 JL4J
041084 - ..
041085 - On 190424 1515 Lance called with VAMCSF Orthopedics, and said PRP
041086 - scheduled tomorrow on 190425, was cancelled in a staff meeting the day
041087 - before on 190423, by Chiefs of Orthopedics and Surgery, ref SDS 88
041088 - V54H, who were unfamiliar with "science" of PRP, and were unfamiliar
041089 - with patient strong response to treatment with PRP the past 2 years.
041090 - ref SDS 88 E647
041092 - ..
041093 - On 190424 1515 at 1531 called Jane - she scheduled meeting with Doctor
041094 - Edwards on 190517 0845. ref SDS 88 E66G
041096 - ..
041097 - On 190425 0844 letter to Doctor Edwards confirms understanding that
041098 - PRP treatment she schedule for today, was cancelled. ref SDS 89 V54H
041099 - Radiology history with MRI studies show significant injuries to feet
041100 - and knees, which responded well to treatment with PRP injection
041101 - therapy. ref SDS 89 NQ6X
041103 - ..
041104 - On 190513 1017 letter to Doctor Tucker on scope PRP treatment
041105 - scheduled for 190517. 190513 1017, ref SDS 91 6N6L
041107 - ..
041108 - On 190514 1043 received call from Joseph in Orthopedics at VAMCSF - he
041109 - changed schedule for meeting Doctor Edwards from 190515, to 190529
041110 - 0900. ref SDS 92 JL4J Later Jane called and after discussion
041111 - confirmed meeting with Doctor Edwards on 190529 0900; she said it was
041112 - a doublebook, so there may be some wait. ref SDS 92 NY6J
041114 - ..
041115 - On 190515 1400 Doctor Tucker provided 8th PRP treatment for left feet,
041116 - left knee, left shoulder. ref SDS 94 LO4O
041118 - ..
041119 - On 190517 0845 meeting Doctor Thuillier discussed referral to Doctor
041120 - Tucker through Veterans Choice for PRP treatment injured right
041121 - trapezius. ref SDS 96 SV8H Doctor will issue request for Patient
041122 - Choice to order PRP treament for knee. ref SDS 96 O45N Doctor
041123 - Thuillier will coordinate with Doctor Edwards on having Patient Choice
041124 - issue order for Doctor Tucker to perform PRP on feet, since Doctor
041125 - Tang in Podietry referred feet care to Doctor Thuillier. ref SDS 96
041126 - CH7M
041128 - ..
041129 - On 190524 1048 letter to Doctor Tucker transmit letter to Doctor
041130 - Thuillier on requirement for VA to order PRP treatment based on record
041131 - of favorable outcome reported by Doctor Simpson. ref SDS 99 V54H
041133 - ..
041134 - On 190529 1040 met with Doctor Sara Edwards in Module 2, VAMCSF.
041135 - ref SDS A0 V54H
041137 - ..
041138 - On 190610 0910 visited Jane in Orthopedics - she will notify Doctor
041139 - Edwards to make referral for meeting with Doctor Chu at VAMC Palo Alto
041140 - on clinical trial for PRP and stem cells. ref SDS A7 V54H
041142 - ..
041143 - On 190612 0910 received letter from Jane saying referral has been
041144 - entered for meeting to consult with Docto Chu at VAMC Palo Alto on
041145 - entering clinical trial for PRP and/or stem cell knee treatments.
041146 - ref SDS A9 V54H
041148 - ..
041149 - On 190621 0916 letter asks Jane in Orthopedics about status Doctor
041150 - Edwards' referral to clinical trial PRP knee treatment. ref SDS B0 V54H
041152 - ..
041153 - On 190621 0916 at 0953 call from Jane saying referral for PRP
041154 - treatment denied, recommend patient get VA support for PRP through
041155 - Veterans Choice. ref SDS B0 OH5G
041157 - ..
041158 - On 190621 0916 at 1034 letter asks Jane to schedule meeting with
041159 - Doctor Edwards. ref SDS B0 7X6I
041161 - ..
041162 - On 190621 0916 at 1500 received letter from Jane scheduling meeting
041163 - with Doctor Edwards on 190626 0945. ref SDS B0 PH4H
041165 - ..
041166 - On 190621 0916 at 1507 letter thanks Jane for assistance scheduling
041167 - meeting with Sara. ref SDS B0 MJ7K
041169 - ..
041170 - On 190630 1000 letter to Doctor Thuiller with copy to Doctor Tang
041171 - notifying results PRP treatment on 190612, ref SDS B2 V54H, and request
041172 - meeting on 190705, to review results of xray on 190607. ref SDS B2 NZ98
041173 - Advised PRP care has resolved burning sensation in bottom right foot.
041174 - ref SDS B2 NZ8K PRP resolved left knee buckling. ref SDS B2 NZ8Y
041176 - ..
041177 - On 190701 0952 Jane scheduled meeting with Doctor Thuillier on 190719
041178 - 0900. ref SDS B3 V54H
041180 - ..
041181 - On 191018 1345 meeting Doctor Thuillier in Orthopedics at VAMCSF need
041182 - to submit progress notes for PRP on 190815, 4 weeks before Half Dome.
041183 - ref SDS C1 W57I Dan showed how to apply Rock Tape to protect left
041184 - knee patella and hamstring tendon injuries. ref SDS C1 K18J The
041185 - doctor explained electrical shocks in toes during hiking is common
041186 - repetitive stress injury for athletes. ref SDS C1 W37O Left knee
041187 - buckling because hamstring tendon weakened from hiking many miles that
041188 - stretches the tendon sending signal to brain, which then sends message
041189 - to rest tendon by buckling the knee. The doctor provided 2 types of
041190 - knee braces to test for protecting left knee hamstring tendon.
041191 - ref SDS C1 EN8F After meeting called Jane to remind Doctor Thuillier
041192 - to order MRI for feet and knees, and she will schedule meeting with
041193 - Doctor Kim to get progress on contacting Doctor Connie Chow at
041194 - Stanford Medical Center treating patient with PRP in clinical trial at
041195 - VAMC Palo Alto; Jane called later and scheduled meeting on 191218
041196 - 1330. ref SDS C1 PTWV
041198 - ..
041199 - On 191220 0800 meeting Doctor Thuillier ordered MRI studies both feet
041200 - and knees. ref SDS C2 C65O
041202 - ..
041203 - On 200219 0933 met with Jane and she scheduled meeting with Dan on
041204 - 200221 0800. ref SDS C6 V54H
041206 - ..
041207 - On 200221 025451 letter to Doctor Thuillier in Orthopedics
041208 - transmitting letter to Doctor Pellegrini in Cardilology on
041209 - collaboration to order PRP that maintains hiking to treat
041210 - atherosclerosis. ref SDS C9 V54H
041212 - ..
041213 - On 200221 080014 meeting with Doctor Thuillier in Orthopedics
041214 - reporting care past 5 months for paroxysmal atrial fibrillation.
041215 - ref SDS 0 VG5J IVUS angiogram found blood vessels completely clear of
041216 - atherosclerotic plaque, showing hiking that raised HDL 30 at time of
041217 - CABG x4 11 years ago, to HDL 83 on 181112, was effective. ref SDS 0
041218 - 8557 Letter notified Primary Care Department that PRP prevented pain
041219 - so that hiking that raised HDL can continue without pain medications.
041220 - ref SDS 0 8558 Doctor Thuillier noted PRP reduces pain in feet and
041221 - knees by preventing inflammation. ref SDS 0 WY8H The doctor will make
041222 - referral to Doctor Chu at VAMCPA for consideration to order PRP with
041223 - Veterans Choice. ref SDS 0 8Y4L and, ref SDS 0 6I7I Switched from
041224 - oxycodone (opioid) to naproxen (NSAID); combined with gabapentin
041225 - supresses feet and knee pain to enable long hikes. ref SDS 0 MZ5N
041226 - Doctor Pellegrini wants to end naproxen, because NSAIDs inhibit
041227 - Apixaban for blood thinner to prevent strokes while paroxysmal atrial
041228 - fibrillation is active. Doctor Thuillier agrees cannot switch to
041229 - acetaminophen because it lowers HDL; PRP solves the problem.
041230 - ref SDS 0 IZ6J No pain in right knee since PRP last September. Left
041231 - knee doing better than expected with naproxen and gabapentin. Feels
041232 - like continuing recovery from PRP on 191009. Doctor Thuillier
041233 - indicated straight hiking should be theraputic for restoring over time
041234 - diminished miniscus cartelage, and healing other ligament and tendon
041235 - knee injuries. ref SDS 0 E94L Feet doing better with double-ply
041236 - "Wrightsocks" Hiking has come back after 1 month layoff. ref SDS 0
041237 - E955
041238 -
041239 -
041240 -
041241 -
041242 -
041243 -
041245 - ..
0413 -
0414 -
0415 - Progress
0416 -
041601 - Doctor Thuillier advised that he received the letter sent this
041602 - morning, reported in another record on 200221 0254, ref SDS C9 V54H
041603 - and transmitting an earlier letter confirming understandings from
041604 - meeting with Doctor Pellegrini on new cardilolgy problems, submitted
041605 - on 200219 2117. ref SDS C8 9C9M During the meeting the doctor seemed
041606 - familiar with the record.
041608 - ..
041609 - Agenda
041610 -
041611 - 1. Paroxysmal atrial fibrillation (PAF and AF) emerged in December
041612 - from increasing hiking to 20 miles per day in order to raise
041613 - HDL. Felt chest pain hiking up long, steep hills, reported on
041614 - 191210 shown in case study on 190101 0730. ref SDS 69 YTWS A
041615 - 2-week Zio XT heart monitor test reported 15% PAF, reported on
041616 - 191229 1517. ref SDS C3 I69J
041618 - ..
041619 - HDL failed to increase, then actually dropped despite
041620 - significantly increased hiking. Seemed like major conflict;
041621 - but, reconciled by research finding AF lowers HDL, reported on
041622 - 200103 0700. ref SDS C4 PW5J
041623 -
041625 - ..
041626 - 2. AF good news - Doctor Simpson ordered IVUS examination that
041627 - found hiking that raised HDL and EPCs past 5 years has
041628 - completely cleared atherosclerotic plaque from blood vessels,
041629 - reported on 200124 0705, ref SDS C5 ME8G; see also progress
041630 - notes finding 0% stenosis. ref SDS C5 5G59
041631 -
041633 - ..
041634 - 3. Letter to PCP, Lauren, on 200204, saying PRP has prevented
041635 - injuries from worsening shown by MRI studies on 200109
041636 - compared to 171229, indicating no change, i.e., stable,
041637 - conditions.
041639 - ..
041640 - 4. Pain medications using opioids and NSAIDs have not been needed
041641 - for months after PRP treatments. This seems to indicate PRP is
041642 - curing feet and knee injuries, shown in VA pharmacy history
041643 - providing medications, and SDS records reporting hiking
041644 - distance and feet and knee injury pain levels.
041646 - ..
041647 - Doctor Thuillier advised that PRP injecting concentrated platelets
041648 - resolves inflammation that occurs with feet and knee injuries. That
041649 - is why pain medications are not needed during hikes for months after
041650 - PRP treatments.
041651 -
041652 - [On 210415 0900 article published in January 2019, by
041653 - Doctor Feingold and Doctor Grunfeld in Endocrinology
041654 - reports inflammation (e.g., from painful feet and knee
041655 - injuries during hiking) blocks the liver from producing
041656 - HDL. ref SDS D2 SX4N
041658 - ..
041659 - [On 210705 1100 13th PRP treatment to resolve inflammation
041660 - from feet and knee injuries so hiking will raise HDL.
041661 - ref SDS D3 764F
041663 - ..
041664 - [On 210705 2228 letter to Doctor Rolnik appreciation
041665 - providing PRP that will prevent inflammation from new feet
041666 - injuries, so HDL will rise again when hiking. ref SDS D4
041667 - H56H
041669 - ..
041670 - Dan seemed to say this is a weak scientific argument, but is good
041671 - medical reason for prescribing care that has enabled hiking to regress
041672 - atherosclerosis, found by Doctor Tietjens during IVUS angiogram on
041673 - 200124 0705. ref SDS C5 ME8G The doctor's comments today, align with
041674 - Doctor Pellegrini's analysis on continuing PRP in order to continue
041675 - hiking, required to treat cardiopulmonary issues, presented during the
041676 - meeting on 200219 1150. ref SDS C7 TR7K
041678 - ..
041679 - He will investigatge making referral to Doctor Chu at Stanford Medical
041680 - to discuss PRP, since she is running a clinical trial on PRP, and so
041681 - may be willing to make referral under Veterans Choice, based on
041682 - background indicating she recommended the patient get PRP through
041683 - Veterans Choice, shown in the record meeting with Doctor Pellegini on
041684 - 200219 1150. ref SDS C7 EL3O
041685 -
041686 - [On 200226 1956 letter notifies Lauren, PCP about Doctor
041687 - Thuillier making referral to Doctor Chu for meeting at
041688 - VAMCPA to get PRP care through Veterans Choice. ref SDS D0
041689 - HQ7O
041691 - ..
041692 - Agenda continues...
041693 -
041694 - 5. Switched from oxycodone (opioid) to naproxen (NSAID). Combined
041695 - with gabapentin this works well to supress feet and knee pain
041696 - to enable long hikes.
041698 - ..
041699 - 6. Meeting on Wednesday, with Doctor Pellegrini. She wants to end
041700 - treatment with naproxen, because it is an NSAID that inhibits
041701 - effect of Apixaban for blood thinner to prevent strokes while
041702 - paroxysmal atrial fibrillation is active.
041704 - ..
041705 - Cannot switch to acetaminophen because it lowers HDL.
041707 - ..
041708 - PRP solves the problem.
041710 - ..
041711 - Dan agrees with this.
041713 - ..
041714 - Agenda continues...
041715 -
041716 - 7. Orthopedic good news...
041717 -
041718 - No pain in right knee since PRP last September.
041720 - ..
041721 - Left knee doing better than expected with naproxen and
041722 - gabapentin. Feels like continuing recovery from PRP on 191009.
041724 - ..
041725 - Dan indicated straight hiking should be theraputic for restoring over
041726 - time diminished miniscus cartelage, and healing other ligament and
041727 - tendon knee injuries.
041729 - ..
041730 - Agenda continues...
041731 -
041732 - Feet doing better with double-ply "Wrightsocks"
041734 - ..
041735 - Hiking has come back after 1 month layoff.
041737 - ..
041738 - Dan will investigate making referral to Doctor Chew at Stanford
041739 - Medical Center for discussing PRP, and perhaps she can order care with
041740 - Doctor Tucker through Veterans Choice.
041741 -
041742 -
041743 -
041744 -
041745 -
041746 -
0418 -
SUBJECTS
Default Null Subject Account for Blank Record
0503 -
050401 - ..
050402 - Orthopedics Progress Notes Meeting Doctor Thuillier
050403 -
050404 - Request records on CD from ROI for this medical encounter due to
050405 - continual difficulties downloading medical records from VA website
050406 - at...
050407 -
050408 - https://www.myhealth.va.gov/mhv-portal-web/track-health
050409 -
050416 - ..
050417 - On 200124 Kathy went to ROI at Sacramento VA Mather Field, and
050418 - received from Tracy CD with progress notes.
050420 - ..
050421 - Stored Progess Notes for procedure on 190813 at location...
050422 -
050423 - F:\05\00003\SM\CC\AGMJ\20200221-080000\mhv_WELCH_20200422_1233.txt
050424 -
050425 -
050426 - Date/Time: 21 Feb 2020 @ 1020
050427 - Note Title: ORTHO ATTENDING CLINIC NOTE (SURG)
050428 - Location: San Francisco CA VAMC
050429 - Signed By: THUILLIER,DANIEL U
050430 - Co-signed By: THUILLIER,DANIEL U
050431 - Date/Time Signed: 21 Feb 2020 @ 1024
050432 - -------------------------------------------------------------------------
050434 - ..
050435 - LOCAL TITLE: ORTHO ATTENDING CLINIC NOTE (SURG)
050436 - STANDARD TITLE: ORTHOPEDIC SURGERY ATTENDING NOTE
050437 - DATE OF NOTE: FEB 21, 2020@10:20 ENTRY DATE: FEB 21, 2020@10:20:58
050438 - AUTHOR: THUILLIER,DANIEL U EXP COSIGNER:
050439 - URGENCY: STATUS: COMPLETED
050440 -
050441 - 73 yo man with bilateral moderate knee arthritis and bilateral hallux
050442 - valgus
050443 - and 2nd plantar plate partial tear
050445 - ..
050446 - Events since last appointment:
050447 - no new
050449 - ..
050450 - Subjective:
050452 - ..
050453 - Rod reports that he is overall doing a lot better. Both of his
050454 - knees are not hurting him or hurting him a lot less. he did
050455 - back off of his activity for a little while in January when he
050456 - had his arrythmia but has since increased his activity back to
050457 - where it was
050459 - ..
050460 - A/P
050462 - ..
050463 - 73 yo man bilateral moderate knee arthritis and bilateral
050464 - hallux valgus and 2nd plantar plate partial tear
050466 - ..
050467 - He continues to get improvements with the PRP injections into
050468 - his knees and occasionally into his feet. Overall this seems
050469 - to be helping a great deal with his pain. It is currently
050470 - allowing him to refrain from narcotic medications. he has been
050471 - taking NSAIDs but they would like him to get off of the NSAIDs
050472 - given his other issues this may be valuable.
050474 - ..
050475 - I will see about putting in another request to see Dr Chu at
050476 - Stanford to discuss this further.
050477 -
050478 - /es/ DANIEL U THUILLIER, MD
050479 - Assistant Professor of Clinical Orthopae UC# 68428
050480 - Signed: 02/21/2020 10:24
050481 -
050482 -
050483 -
050484 -
050485 -
050486 -
050487 -
050488 -
050489 -
050490 -
050491 -
050492 -
050493 -
050494 -
050495 -
0505 -