THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700


S U M M A R Y


DIARY: June 28, 1994 10:00 AM Tuesday; Rod Welch

Visited Kaiser for physical exam.

1...Summary/Objective
2...Dizziness
3...Chest Pains
4...Sleep/Dizziness
5...Prostrate Cancer
6...Physical Examination Required 20 Minutes
7...Rosacea Prescrption Medication Received at Pharmacy
8...Received following document
........................Retail Price Your Price
9...Medication Instructions
......Possible Side Effects


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

CONTACTS 
0201 - Kaiser Medical Center              415 929 4000
020101 - Dr. George Matula, GP; =415 202 2220; Internal Medicine, 2nd Floor

SUBJECTS
Prostrate Cancer Testing
Sleep, Dizzyness, Chest Pains
Physical Exam on 940628

1005 -    ..
1006 - Summary/Objective
1007 -
100701 - Follow up ref SDS 3 0893.
100702 -
100703 - Had to wait an hour to see the doctor.
100704 -
100705 - Nothing apparent was discovered from preliminary exam.
100706 -
100707 - Will do hearing exam, and blood tests tomorrow, then need report from
100708 - George on results.
100709 -
100710 -     [On 940629 submitted letter requesting feedback. ref SDS 5 0001]
100711 -
100712 -     [On 990722 doctor said tests were normal, refused to submit
100713 -     written report. ref SDS 9 2409]
100714 -
100715 -  ..
1008 -
1009 -
1010 - Symptoms
1011 -
101101 - Dizziness
101102 -
101103 - About 3 weeks ago, I experienced a period of about a week where when I
101104 - layed down I would feel mildly dizzy.  The same would occur when I got
101105 - up.  As best I recall, this did not occur when I sat down, only when I
101106 - layed down, so I was changing the horizontal orientation of my head
101107 - relative to the ground.
101108 -
101109 - Seems to have lasted about a week or so, and has now gone away.
101110 -
101111 -     [On 940724 problem returned, notified George. ref SDS 10 0001]
101112 -
101113 -
101114 - Chest Pains
101115 -
101116 - We did not discuss this point.  Millie mentioned it when I later
101117 - called her to advise nothing apparent emerged from the exam.  So I am
101118 - setting it out here. I did indicate on a history form in advance of
101119 - the exam, having been hospitalized in 1976 with chest pains, so
101120 - presumably George had this information for the exam, although since he
101121 - noted the file folder he was given for me had incorrect documents,
101122 - possibly he was unaware of this matter.  He did not ask about it.
101123 -
101124 -
101125 - About every 3 months or so, sometimes more often, sometimes at greater
101126 - intervals (it is random), I will have chest pains.  These can be
101127 - relatively severe.  I believe this first occurred in 1976, at age 31.
101128 - I woke up in the morning about 6 am, and drove to the emergency room
101129 - at the hospital in Sacramento.  They kept me for about 2 days, I later
101130 - saw an internist, and he attributed it to a possible tension arising
101131 - from business situation, litigation etc.
101132 -
101133 - About 2 years later I recall a similar condition occurring, while
101134 - playing volleyball on the beach in Santa Cruz.  I was not hospitalized.
101135 - Just layed down for awhile.  It took several hours on that occasion
101136 - for the problem to cease.
101137 -
101138 - Within the past 5 years, a similar condition began occurring with the
101139 - frequency described above.  However, somewhere along the line I
101140 - learned the pressure can be relieved by forced burping, essentially
101141 - expelling the pressure.  This can take 5 - 30 minutes, before the
101142 - symptom is fully dissipated.  I have read in recent years that chest
101143 - pains similar to a heart problem can occur from indigestion. At this
101144 - time, based on the above record, I assume the difficulties described
101145 - here have been digestion disorders, rather than heart related.
101146 -
101147 -
101148 -
101149 -
101150 -
1012 -
1013 -
1014 - Administration
1015 -
101501 - The record of the dermatology exam, and diagnosis of rosacea were in
101502 - the medical record, so George was aware of that information.
101503 -
101504 - The Dr. said there were other documents on another patient, that were
101505 - incorrectly included in the file folder for my record, i.e., the
101506 - hospital's records were mixed up.
101507 -
101508 -
101509 -
101510 -
1016 -
1017 -
1018 - Analysis
1019 -
101901 - My weight was checked, and it looks like I am about 170.  Would like
101902 - to be closer to 155 - 160, but the 170 is better than I expected.
101903 -
101904 -
101905 -  ..
101906 - Sleep/Dizziness
101907 -
101908 - In connection with the dizziness, I explained having worked some long
101909 - hours lately (e.g., 36).  The Dr. indicated this is "pushing the
101910 - envelope."  He said the mind begins reacting a little when there is
101911 - not enough sleep.  This is consistent with the lecture on sleep
101912 - presented at the IBM conference, ref SDS 6 line 99.
101913 -
101914 - My hours are not much different than in past years. Maybe once a month
101915 - or so, when the need arises, or I am working on something interesting,
101916 - I just keep going.  Normally I get from 4 - 6 hours sleep.  After
101917 - working extended hours, I can sleep 10 to 12 hours.
101918 -
101919 - He checked my ears, and observed nothing indicating a disorder that
101920 - explains the dizziness.
101921 -
101922 - George checked my blood pressure, and said it is normal.
101923 -
101924 - He is a tennis player, so we chatted about the relative value of
101925 - tennis as an exercise regimens.  He sounds like a good player.
101926 -
101927 - George submitted a document for a hearing test at another location,
101928 - and another document specifying a variety of blood tests.
101929 -
101930 -      [On 990707 hearing test performed. ref SDS 7 0001]
101931 -
101932 -      [On 990718 requested results of tests. ref SDS 8 0001]
101933 -
101934 -
101935 -  ..
101936 - Prostrate Cancer
101937 -
101938 - I asked about prostrate PSA exam per discussion with Bill Palmer on
101939 - 940621. ref SDS 3 0893
101940 -
101941 - George said that condition is generally not evaluated until about age
101942 - 55.
101943 -
101944 - I requested that this test be performed.
101945 -
101946 - George checked "PSA" on the blood test document to schedule the test.
101947 -
101948 - After meeting with George, I went to the labatory for PSA tests.
101949 -
101950 - There was a long line, so I will come back tomorrow at 0700.
101951 -
101952 -     [On 990629 performed PSA blood test. ref SDS 5 0001]
101953 -
101954 -
101955 -
101956 - Physical Examination Required 20 Minutes
101957 -
101958 - This seemed like a cursory exam.  The entire discussion took about 20
101959 - minutes, and part of that was on POIMS.
101960 -
101961 - I asked if he knew of anyone interested in the biology of the brain
101962 - that relates to the distinction between "information" which essen-
101963 - tially is sensory, and "knowledge" which seems to be "processed"
101964 - information.
101965 -
101966 - George said his nephew is working in this area.
101967 -
101968 - I will submit the POIMS paper and ask him to pass it along to his
101969 - nephew for comments.
101970 -
101971 -
101972 -
101973 -
1020 -

SUBJECTS
Dermatology - face blemish, 920810
Rosacia, 940624

1105 -
110501 -  ..
110502 - Rosacea Prescrption Medication Received at Pharmacy
110503 -
110504 - While waiting to get a physical exam, per above, ref SDS 0 0001, went
110505 - to the pharmacy across the street on Geary, and picked up medication
110506 - prescription, per the record on 940624. ref SDS 4 0001
110507 -
110508 -
110509 - Received following document
110510 -
110511 -
110512 -     SFO Pharmacy #2 - Dermatology
110513 -
110514 - Claim Check #: 94175 02033 A
110515 - Welch, Rod                                   Your Prescription
110516 - 28Jun94                                      Drug Benefit
110517 - Mr. #:  05519189                             Saved You:    $29.95
110518 -
110519 -
110520 -                        Retail Price             Your Price
110521 -                                    ----------
110522 - Rx#  313 55257             8.05                     3.00
110523 - Rx#  313 55258            23.90                     3.00
110524 -
110525 -
110526 -                   Total Rx Price:                   6.00
110527 -
110528 -
110529 -  ..
110530 - Medication Instructions
110531 -
110532 - Received ref OF 1 0001, titled "Tetracyclines," that gives general
110533 - instructions about taking the medication for the full prescription
110534 - period. ref OF 1 0896
110535 -
110536 -      Take with full glass of water and on empty stomach, ref OF 1 0896
110537 -      [this instruction is also on the medication label.]
110538 -
110539 -      Medication can be taken up to 4 times a day. ref OF 1 2074
110540 -      [instruction on the prescription label says to take 3 times a
110541 -      day.]
110542 -
110543 -        [On 000124 possible conflict with Glucosamine and Chrondroitin.
110544 -        ref SDS 11 2655]
110545 -
110546 -      Avoid "too much" sunlight, ref OF 1 9077. [this is also on
110547 -      medication label]
110548 -
110549 -      Avoid antacids, calcium supplements, iron supplements and magne-
110550 -      sium-containing preparations. Allow at an hour's time between
110551 -      your tetracycline dose and any of these other drugs, ref OF 1
110552 -      6745
110553 -
110554 -      Possible Side Effects
110555 -
110556 -      Mild diarrhea, nausea, cramps or burning of stomach may occur
110557 -      during treatment as body adjusts to the medicine. Tetracyclines
110558 -      may sometimes cause temporary darkening or discoloration of the
110559 -      tongue. Itching of the rectum or genital areas or soreness of the
110560 -      mouth or tongue can occur while taking Tetracyclines.
110561 -
110562 -      Contact the doctor if these effects are severe or persistent..
110563 -      ref OF 1 9563
110564 -
110565 -
110566 -  ..
1106 -
1107 -
1108 - Progress
1109 -
110901 - Per understandings with Kory on 940624, ref SDS 4 0001, I am deferring
110902 - rosacea medication treatment, per above, ref SDS 0 0877, to evaluate
110903 - change in condition from changing my diet. Since the meeting on
110904 - Friday, 940624, the severe blister on my nose has cleared, and most of
110905 - the blemishes on my forehead have disappeared.
110906 -
110907 - Therefore, I will continue to defer taking medicines until the
110908 - condition fails to continue to abate or if it begins to increase in
110909 - severity.  I do not have a good sense about cause and effect yet.  I
110910 - am eating less and have stopped having liquids with caffeine, but am
110911 - not convinced this accounts for the apparent improvement reported so
110912 - far.  It may be just a natural cycle, rather than a change in the
110913 - condition.  To test that, need to continue on present course, before
110914 - beginning to take prescribed medicine.
110915 -
110916 -     [On 940629 submitted letter on progress. ref SDS 5 6381]
110917 -
110918 -
1110 -
Distribution. . . . See "CONTACTS"