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: July 18, 2012 06:42 PM Wednesday; Rod Welch

Robin called on worsening condition knee, neck, back.

1...Summary/Objective


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CONTACTS 

SUBJECTS
Knee Pain Worse Complications Surgery 120322 Evidence MRI Radiology                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
1003 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1003 -    ..
1004 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
1005 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100501 - Follow up ref SDS 7 0000, ref SDS 6 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100506 -  ..
1006 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1007 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1008 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1009 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100901 - Robin called and was crying during some of this discussion because of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100902 - continuing knee pain, and now worries about needing another surgery                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100903 - for knee replacement.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100905 -  ..
100906 - Robin reported getting an MRI yesterday on her knee that was treated                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100907 - with arthroscopic surgery on 120322 0600. ref SDS 2 699F  This                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100908 - implements part of recommendations to get additional testing, in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100909 - letter to Robin on 120623 0238. ref SDS 4 Q23N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100911 -  ..
100912 - Robin works in a radiology firm in San Luis Obispo.  A colleage in the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100913 - office, who Robin understands is an MD, read the MRI scan and wrote                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100914 - the official medical analysis report.  He told Robin that the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100915 - radiology scan shows 2 new tears in her knee that were not present                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100916 - prior to surgery on 120322. ref SDS 2 699F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
100918 -  ..
100919 - Robin has suffered continuing pain in her knee since surgery on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100920 - 120322.  Most recently the letter to Robin presented a work plan on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100921 - obtaining 2nd opinions for recovering from complications caused by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100922 - surgery, shown on 120623 0238. ref SDS 4 Q45H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100924 -  ..
100925 - On 120601, Robin reported meeting with Doctor Lawler, who prescribed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100926 - cortisone injection to speed recovery from knee surgery on 120322, and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100927 - failed to order testing to diagnose complications from knee surgery                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100928 - causing continuing and severe pain. ref SDS 3 YQ8Y                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
100929 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100930 -            [On 120723 2305 Robin letter reports meeting with Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
100931 -            Lawler on 120719, who performed knee surgery on 120322,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100932 -            ref SDS 2 699F; Doctor Lawler advised that recent MRI scan                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100933 -            shows "frayed" and not "tears" in knee cartiledge,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100934 -            ref SDS 8 978S; Robin does not report Doctor Lawler                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100935 -            explaining severe pain Robin reported on 120718.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100936 -            ref SDS 0 UN6O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100938 -  ..
100939 - On 120701, Robin decided to try physical therapy recommended by a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
100940 - chiropractor, noted in letter to her at that time. 120701 1250,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100941 - ref SDS 5 KR9Y                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100943 -  ..
100944 - Robin is very concerned her knee may be innately fragile, resulting in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100945 - needing knee replacement surgery, like Bob had on 111031 0800.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
100946 - ref SDS 1 PQ5S                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100948 -  ..
100949 - Robin feels strongly she wants to avoid knee replacement treatment.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100950 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100951 -            [On 120723 2305 Robin letter reports meeting with Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
100952 -            Lawler on 120719, who performed knee surgery on 120322,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100953 -            ref SDS 2 699F; Doctor Lawler advised Robin may need knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
100954 -            replacement in the distant future, ref SDS 8 978S; Robin                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100955 -            indicated feeling relieved. ref SDS 8 U745                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100957 -  ..
100958 - Today, Robin indicated...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100959 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100960 -    1.  Doctor Lawler's office called and scheduled a meeting on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100961 -        120730, with Robin to review MIR scans and report.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100962 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100963 -        Tomorrow Robin will try to advance that meeting.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
100964 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100965 -            [On 120723 2305 Robin letter reports meeting with Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
100966 -            Lawler on 120719, who performed knee surgery on 120322,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100967 -            ref SDS 2 699F; Doctor Lawler advised that recent MRI scan                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100968 -            shows "frayed" and not "tears" in knee cartiledge,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100969 -            ref SDS 8 978S; Robin does not report Doctor Lawler                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100970 -            explaining cause nor offering treatment to relieve severe                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100971 -            pain Robin reported on 120718. ref SDS 0 UN6O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
100973 -         ..
100974 -    2.  Robin's car pool friend works for another orthopedic surgeon,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100975 -        and will ask about scheduling a meeting to see Robin for a 2nd                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100976 -        opinion on the best course to recover.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100977 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100978 -            [On 120723 2305 Robin letter does not report scheduling 2nd                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
100979 -            opinion with the car pool friend's doctor contact.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100980 -            ref SDS 8 978S                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100982 -         ..
100983 -    3.  Tomorrow, Robin will call Doctor Fow's office and request a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100984 -        meeting to get a 2nd opinion.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100985 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100986 -            [On 120723 2305 Robin letter reports scheduling 2nd opinion                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
100987 -            meeting with Doctor Fow on 120830. ref SDS 8 U799                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100989 -         ..
100990 -    4.  Robin understands that her insurance will pay for 2nd opinions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100991 -        to recover from complications after her knee surgery on 120322.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100993 -         ..
100994 -        Told Robin I will pay for Fow's 2nd opinion; Robin will get a                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100995 -        price when she calls tomorrow.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100997 -         ..
100998 -    5.  Robin wants to schedule going to Ensenada for treatment on her                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100999 -        neck, back, and her knee.  She feels this treatment may work                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
101000 -        better for her knee than conventional surgery, which she had on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
101001 -        120322, and for which she is now suffering complications; and,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
101002 -        better than knee replacement.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
101004 -         ..
101005 -        Today, we considered meeting with accredited medical doctors                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
101006 -        for opinion on recovering from complications caused by knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
101007 -        surgery on 120322.  Robin said she wants to ask her doctors                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
101008 -        about viability of alternative treatment by the doctor in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
101009 -        Ensenada.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
101010 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101011 -            [On 120723 2305 Robin's letter reports meeting with Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
101012 -            Lawler, who performed knee surgery on 120322, and she did                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
101013 -            not report asking Doctor Lawler aobut getting treatment by                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
101014 -            the doctor in Ensenada. ref SDS 8 978S                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
101015 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101016 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101017 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101018 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101019 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101020 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101021 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101022 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101023 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
1011 -