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: October 10, 1988 10:00 AM .......; Rod Welch

Meeting Dr. Glick re operation for knee.

1...Summary/Objective
2...Knee Joint Compressed; Anthroscopic Survery May Improve Condition
3...Favorable Experience with Procedure and Jim Glick
4...Set operation for tomorrow 0930 - will cost about $4,100


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CONTACTS 
0201 - Pacific Orthopaedic Medical Group                                                                                                                                  
020101 - Dr. James M. Glick                                                                                                                                               

SUBJECTS
Personal, Rod Welch                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
Knee Operation                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
0404 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0404 -    ..
0405 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040601 - Follow up ref SDS 1 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040602 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040603 - Examination shows knee joint is compressed, because cartilage has                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040604 - worn.  Jim suggests surgery and provided reference on past work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040605 - Reference indicated Jim's work was fairly successful.  Scheduled                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040606 - operation for tomorrow.  Cost is about $4,100.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040607 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040608 -     [On 881011 operation prformed. ref SDS 2 0001]                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040609 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
040611 -  ..
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041001 -  ..
041002 - Knee Joint Compressed; Anthroscopic Survery May Improve Condition                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041003 - 
041004 - X-Rays showed left leg knee joint is compressed with calcium build up                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041005 - on the bone where the cartilage was removed.  There is a wide (normal)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041006 - gap on the outside, but the upper bone is angled down to nearly                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041007 - touching the lower bone on the inside of the knee joint.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
041008 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041009 -      [On 990910 xray looks very similar. ref SDS 3 7388]                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041011 -       ..
041012 -      [On 000124 Doctor Vincent Yamomoto in Orthopedics                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041013 -      Department at Kaiser in Walnut Creek diagnosed left knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041014 -      degenerative arthritis will continue to worsen, and require                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041015 -      knee replacement in 5 years. ref SDS 4 HU5O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041017 -       ..
041018 -      [On 151216 1130 new xray of left leg seems to show even gap                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041019 -      between the upper and lower leg bones, indicating the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041020 -      cartelage has repaired from regimen hiking 11 miles per day                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041021 -      (10,000 miles past 4 years), with Glucosamine Chondroitine.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041022 -      ref SDS 5 GO5K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041024 -  ..
041025 - Jim advised my understanding on this was incorrect (I had thought                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041026 - there was a calcium buildup on the lower bone which closed the joint,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041027 - based upon discussion with the guys at St Francis Sports Med Center).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
041029 -  ..
041030 - Jim explained that compression is causing the smooth surface of the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041031 - bone to wear away.  Apparently this is the nature of degenerative                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041032 - arthritus, rather than a build up of calcium.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041034 -  ..
041035 - He advised that more complete diagnostics is accomplished during the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041036 - operation.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041037 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041038 -     [On 881011 operation prformed. ref SDS 2 0001]                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041039 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041041 -  ..
0411 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0413 - Arthroscopic surgery                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041401 - Jim indicated there is a 60% to 70% chance of success.  This is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041402 - not a laser technology.  Uses a light and camera to show the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041403 - surgeon the condition.  A mechanical instrument is used to "clean                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041404 - the area."                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
041405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041408 -  ..
041409 - Favorable Experience with Procedure and Jim Glick                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041410 - 
041411 - Jim gave me Bill Dunlop's name as a reference for this work.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
041412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041413 - Jim operated on him in 1983  and again a year or so ago.  Bill is back                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
041414 - playing tennis.  Jim and Bill are friends, who used to play tennis                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041415 - together.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041417 -  ..
041418 - Bill's phone number:  H 415 957 1137; W 346 3525                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
041419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0417 - 1334 called Bill                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
0418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041802 -  ..
041803 - Talked to Bill about 1410 this afternoon.  He called me back.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
041805 -  ..
041806 - Bill had the surgery in 1983.  He is playing a little differently                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041807 - due to a number of operations he has had.  He feels the surgery was                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041808 - in the main successful relative to his expectations.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
041810 -  ..
041811 - His experience is that the body generally heals itself pretty well.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041813 -  ..
041814 - In his case, he indicated he has no cartilage in his knees, yet he                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
041815 - is still able to get around without pain in his knees.  He cannot                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041816 - accelerate using a driving motion like I do from the toes. Bill did                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
041817 - not attribute all of this to the knee operation, since he has had                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
041818 - foot, ankle, and back operations as well as knee surgery.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
041819 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041820 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
041822 -  ..
0419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0420 - 1354 called Jim back                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
0421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042101 - Set operation for tomorrow 0930 - will cost about $4,100                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042102 - 
042103 - Initially set the operation for Thursday.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
042104 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042105 - Jim indicated I should be able to return to Montana for light duty on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042106 - Monday.  He has an opening for tomorrow due to a cancellation, and so                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042107 - asked if I would take that time slot.  I said no, but he wanted to do                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042108 - it tomorrow, so finally I agreed.  This will provide a little more                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042109 - time to recuperate before returning to the job.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042111 -  ..
042112 - Jim took preliminary data for operation (pulse, blood pressure,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042113 - medical history).                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042115 -  ..
042116 - May need crutches.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042118 -  ..
042119 - Need Millie to bring me home.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
042121 -  ..
042122 - Called her at work and set it up.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
042124 -  ..
042125 - Will cost from $2,000 to $2,500 plus $1,600 for hospital services.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
042127 -  ..
042128 - Have to pay hospital $800 in advance, this afternoon.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
042130 -  ..
042131 - Jim said we could work out reasonable terms for payment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
042132 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042133 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042134 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042135 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042136 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
042137 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
0422 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
Distribution. . . . See "CONTACTS"