CONTACTS 

SUBJECTS
Default Null Subject Account for Blank Record

0403 -
0403 -    ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 40 0000. ref SDS 34 0000.
040502 -
040503 -
040504 -
040505 -
040507 -  ..
0406 -
0407 -
0408 - Background
0409 -
040901 - On 091103 Paula reported the VA has scheduled a meeting today with
040902 - Doctor Stewart for planning Heller Myotomy surgery to correct
040903 - achalasia problem. ref SDS 20 PS60  On 091104 0718 Medical Chart
040904 - discharge guidance lists meeting with Doctor Stewart 091117 1300,
040905 - which conflicts with patient history today. ref SDS 21 Q03J  On 091119
040906 - 1000 Erick confirmed visit with Doctor Stewart on 091208, and is
040907 - reviewing date of surgery scheduled for 091217. ref SDS 23 935H
040909 -  ..
040910 - On 091208 Doctor Stewart advanced the schedule for surgery one day to
040911 - 091216. ref SDS 25 6E41
040913 -  ..
040914 - On 091216 0600 meeting Doctor Stewart for Heller Myotomy surgery to
040915 - correct achalasia; check in at ASU. ref SDS 29 PP8W
040917 -  ..
040918 - On 091217 0600 meeting with Joe and Jon on recovring from Heller
040919 - Myotomy surgery; report of complication during surgery on 091216,
040920 - which was repaired, with plan for test to evaluate recovery. reported
040921 - on 091217 0600, ref SDS 30 0042  Doctor Stewart visited and expects
040922 - can start eating after favorable test. ref SDS 30 027A
040924 -  ..
040925 - On 091218 0600 xray with gastrogafin to evaluate repair for
040926 - complicaiton during Heller Myotomoy surgery Wednesday, ref SDS 31 PP8W,
040928 -  ..
040929 - On 091219 0600 doctor plans discharge tomorrow after evaluating
040930 - progress eating solid food today. ref SDS 32 PP5V  Since now eating
040931 - solid food, switched to oral pill medication to replace IV injections;
040932 - this relieved pain that has been increasing using IV catheters set on
040933 - Wednesday, ref SDS 32 PQPX, and also eliminated need to replace IV
040934 - catheters per TCU protocol. ref SDS 32 7Q55  Doctors prescribed hiking
040935 - to recover from Heller Myotomy surgery resolving achalasia.
040936 - ref SDS 32 7Q6P   Doctor Ratcliff and Neil visit and discussing doing a
040937 - small business trial to apply SDS technology for upgrading VA and UCSF
040938 - case management. ref SDS 32 0M6S  Nurse advises that patient approved
040939 - for moving to a ward for non-critical care, as a predicate to
040940 - discharge, but since there are no rooms available, patient will remain
040941 - in TCU untill a room is available. ref SDS 32 0M8S
040943 -  ..
040944 - On 091220 0527 discharge approved from hospital today. ref SDS 33 PP8W
040945 - Left the hospital about 1220. ref SDS 33 HB5O
040947 -  ..
040948 - On 091221 1532 Isagani called to schedule meeting with Doctor Stewart
040949 - at VA in San Francisco on 100105. ref SDS 34 PP8W
040951 -  ..
040952 - On 091222 1109 letter from Isagani says meeting with Doctor Stewart is
040953 - on 100112 1400, not Jan 5th; possibly there are 2 meetings scheduled.
040954 - ref SDS 35 J57K
040956 -  ..
040957 - On 091223 1452 VA letter says meeting with Doctor Stewart scheduled on
040958 - 100105 1400, ref SDS 36 PP8W
040960 -  ..
040961 - On 091228 1049 letter to VA asks Isagani to clarify date for meeting
040962 - with Doctor Stewart, and whether there are two (2) meetings?
040963 - ref SDS 37 PP8W
040965 -  ..
040966 - On 091228 1418 letter from Isagani says meeting with Doctor Stewart is
040967 - on 100105, and there is only 1 meeting scheduled, not 2. ref SDS 38
040968 - PP8W
040970 -  ..
040971 - On 100104 0930 met with Doctor Sandhu to begin care for heart surgery
040972 - and follow up on Heller Myotomy surgery to recover from achalasia.
040973 - ref SDS 39 PP8W
040975 -  ..
040976 - On 100105 1300 meeting with Jan and Doctor Stewart; examination finds
040977 - good progress recovering from Heller Myotomy surgery on 091216, and
040978 - procedure seems effective resolving achalasia problem, swallowing
040979 - improved. ref SDS 40 PP8W
040981 -  ..
040982 - On 100127 1210 submitted agenda in a letter to the medical team for
040983 - the meeting at the VA in Martinez scheduled for 100202; primary
040984 - objective to evaluate recovery from achalasia following Heller Myotomy
040985 - surgery at the VA in San Fancisco on 091216 0700. ref SDS 0 PP8W
040986 -
040987 -
040988 -
040990 -  ..
0410 -
0411 -
0412 - Progess
0413 -
041301 - Letter to medical team says...
041302 -
041303 -    1.  Subject: Agenda Meeting VA Feb 2, 2009
041304 -        Date: Wed, 27 Jan 2010 12:24:06 -0800
041315 -         ..
041316 -    2.  Meeting with Doctor Lee at VA in Martinez next week on 100202
041317 -        1400 will review progress recovering from achalasia following
041318 -        Heller Myotomy surgery by Doctor Stewart on 091216, and review
041319 -        by Doctor Stewart on 100105. ref SDS 40 VD4O
041320 -
041321 -            [On 100202 1400 met with Doctor Sandhu at VA in Martinez,
041322 -            ref SDS 41 PP8W, and scheduled endoscopy and colonoscopy
041323 -            for 100305. ref SDS 41 485W
041325 -         ..
041326 -    3.  Generally, there is significant improvement in swallowing and
041327 -        digestion.  Occasionally, there are days when considerable
041328 -        vomiting still occurs.  The circumstances are difficult to pin
041329 -        down.  My feeling is that surgery has achieved 90% of normal
041330 -        swallowing, since most days there is 100% of normal.
041332 -         ..
041333 -    4.  For the CT team...
041335 -         ..
041336 -    5.  Heart surgery on 090122 has yielded further improvement.
041338 -         ..
041339 -    6.  Prior to surgery, hiking 2 - 5 laps at Lafayette Reservoir
041340 -        would yield pulse 130 - 150 with a fast pace on flat terrain,
041341 -        and 180 - 210 hustling up hills.  Since surgery, the most I
041342 -        have done is 3 laps, about 8.25 miles.  Usually do 2 laps,  5.5
041343 -        miles.  Pulse on flat terrain is 115 - 125.  Going up hills it
041344 -        is very difficult to exceed pulse 150, usually, the pulse is
041345 -        only 140 or so.  This seems to suggest a much more efficient
041346 -        cardio va
041348 -         ..
041349 -    7.  A negative change seems to be resting pulse.  Prior to surgery,
041350 -        sitting and walking around, pulse would be 55 - 70.  Now it
041351 -        seems to be 70 - 100.  However, even when the pulse registers
041352 -        100+ at rest starting out hiking, there is a much lower
041353 -        differential rising to only 115 - 125 for much of the first
041354 -        lap.  Going up the first big hill, pulse only rises to 125.
041356 -         ..
041357 -    8.  Blood draw today or tomorrow will be reviewed with Doctor Lee
041358 -        on 100202.  Of primary interest is effect of simvistaten on
041359 -        cholesterol criteria.  On the last test at the VA in San
041360 -        Francisco, the nurse seemed to say most of the cholesterol
041361 -        diagnostics were within the target range.  The next lab will
041362 -        provide an update on treatment effectiveness.
041364 -         ..
041365 -    9.  Would like feedback from CT team on diagnostic targets for
041366 -        reducing or eliminating Simvastatin and Metoprolol, prescribed
041367 -        in the medical chart received from Paula on 091104. ref SDS 21
041368 -        UN6L
041370 -         ..
041371 -   10.  If cholesterol drops within targets for the lab tomorrow, then
041372 -        consideration should be made to experiment maintaining cardio
041373 -        vascular system with exercise, rather than medication??
041374 -
041381 -
041382 -
041383 -
041384 -
041385 -
041386 -
041387 -
041388 -
0414 -