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 24, 2012 01:06 AM Tuesday; Rod Welch

Robin letter 2n opinion Doctor Fow complications from knee surgery.

1...Summary/Objective
2...Glucosamine Chondroitin Resolved Knee Joint Pain Avoid Knee Replacement


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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 14 0000. ref SDS 13 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
100502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100506 -  ..
1006 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1007 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1008 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
1009 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100901 - Submitted letter to Robin saying...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100902 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100903 -    1.  Subject:  Knee Pain Relief Work Plan                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100904 -        Date:  Tue, 24 Jul 2012 01:54:00 -0700                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100911 -         ..
100912 -    2.  Good hearing you enjoyed the Bakersfield convention. [...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
100913 -        respoinding to Robin's letter on 120723 2305. ref SDS 14                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100914 -        MI5I...].  I was in Oregon on Saturday, to celebrate my mom's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100915 -        (Lillian) 90th birthday.  Saw some family for the first time in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100916 -        30 years.  Quite a jolt for all of us!!                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
100918 -         ..
100919 -    3.  Great getting the meeting moved up to 120719, seeing Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100920 -        Lawler on relieving knee pain [...reported in Robin's letter on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100921 -        120723 2305. ref SDS 14 978S...] from complications after                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100922 -        surgery he performed on 120322. ref SDS 5 699F  Wish you had                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100923 -        called me to support the meeting.  Your rights to get timely,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100924 -        effective care, including insurance coverage, depend on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
100925 -        presenting your case in a comprehensive, careful manner.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100927 -         ..
100928 -    4.  Wonderful you have a meeting scheduled with Fow on 120830. [...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100929 -        cited in Robin's letter received on 120723 2305. ref SDS 14                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
100930 -        U799...]                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100931 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100932 -            [On 120725 1208 at 2007 Robin schedule meeting with Doctor                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100933 -            Schueckler Thursday - either 120726 or 120802, to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
100934 -            complement 2nd opinion scheduled with Doctor Fow on 120830,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100935 -            and which will assist Doctor Lawler determining optimum                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100936 -            care for Robin to recover. ref SDS 15 N755                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100938 -             ..
100939 -            [On 120725 1208 at 2014 called and left message explaining                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100940 -            again that medical case management requires comprehensive                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100941 -            patient assistance to optimize care. ref SDS 15 EU5H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100943 -         ..
100944 -    5.  Doctor Fow needs scans of your knee before and after surgery on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100945 -        120322, ref SDS 5 699F, including most recently discussed on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100946 -        120718. ref SDS 13 UW7J  He needs the written reports                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100947 -        presumably issued by your office that interpret the scans,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
100948 -        including the report finding 2 new tears.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
100950 -         ..
100951 -    6.  Doctor Fow needs Doctor Lawler's medical chart, including all                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100952 -        progress notes before, during, and after surgery, including the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100953 -        most recent examination on 120719 (last Thursday) [...explained                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100954 -        in Robin's letter received yesterday on 120723 2305,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100955 -        ref SDS 14 978S...]                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
100956 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100957 -            [On 120725 1208 telephone message asks Robin about progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
100958 -            ordering medical records from Doctor Lawler's office for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
100959 -            submission to Doctor Fow to get 2nd opinion. ref SDS 15                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
100960 -            HI8F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100962 -             ..
100963 -            [On 120728 0027 Robin called and seemed to indicate she                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100964 -            will not obtain medical records on knee surgery for 2nd                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100965 -            opinions on recovering from knee pain due to complications                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100966 -            after surgery on 120322. ref SDS 16 PY7M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
100968 -         ..
100969 -    7.  Submit a written request for medical records to Doctor Lawler's                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100970 -        office, as shown in the draft letter sent to you on 120623.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100971 -        ref SDS 9 Q146                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
100973 -         ..
100974 -    8.  We will re-work the 1st para to reflect the recent meeting.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100975 -        Hand carry your medical records to Doctor Fow's office with                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
100976 -        letter explaining transmittal for the purpose of preparing 2nd                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100977 -        opinion.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100978 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100980 -  ..
100981 - Glucosamine Chondroitin Resolved Knee Joint Pain Avoid Knee Replacement                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
100982 - 
100983 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100984 -    9.  It may be small comfort to know that I was told 12 years ago on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100985 -        000124, that I would need knee replacement surgery in 5 years                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100986 -        (see line 221041. ref SDS 1 HU5O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
100988 -         ..
100989 -   10.  At that time, my doctor said he had similar knee pain from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
100990 -        tennis and running, and that he experienced relief using                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100991 -        Glucosamine Chondroitin.  I tried this, but could not swallow                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100992 -        the pills due to an esophageal issue.  About 4 years later on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100993 -        040529, Millie found liquid Glucosamine Chondroitin at Costco,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
100994 -        and this helped both of us (see line 110402. ref SDS 2 MN9P                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
100995 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
100996 -            [On 120725 1208 at 2007 Robin letter report diagnosis in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
100997 -            her 20s of having "weak knees" due to fatty ligaments; does                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
100998 -            this chronic condition, if true, prevent benefitting from                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
100999 -            Glucosamine Chondroitin to resolve knee pain Robin has been                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
101000 -            suffering for many years, and for 4 months post knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101001 -            surgery on 120322? follow up, ref SDS 15 U96N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
101003 -         ..
101004 -   11.  Currently, I have no knee pain, even with vigorous hiking. [...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
101005 -        repeating prior notice to Robin issued, 120222 1832,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
101006 -        ref SDS 4 LT4S...] on success relieving knee and other joint                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
101007 -        pain using Glucosamine Chondroitin.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
101009 -         ..
101010 -   12.  If Doctor Lawler is correct that you have only "frayed"                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
101011 -        cartilage, then your knee pain should be similarly relieved                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
101012 -        with Glucosamine Chondroitin [...recommended previously to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
101013 -        Robin in a letter on 120222 1832. ref SDS 4 LT4S; medication                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
101014 -        was ordered for Robin from Costco on 120516 1048. ref SDS 6                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
101015 -        E99F; Robin's letter on 120601, indicated she was taking                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101016 -        Glucosamine Chondroitin, ref SDS 7 HX9I...].  If the finding of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
101017 -        "tears" in the MRI report is correct, then affirmative medical                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
101018 -        care is required to recover from complications caused by knee                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
101019 -        surgery on 120322. ref SDS 5 699F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
101021 -         ..
101022 -   13.  Your case contrasts sharply with my knee problems.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
101024 -         ..
101025 -   14.  I suffered very serious knee injury in 1974 falling 40 feet to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
101026 -        a concrete surface.  Fortune smiled that day dodging death,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
101027 -        surviving with only a severely injured left knee.  After                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101028 -        surgery, and once adhesions were manually broken with a second                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
101029 -        medical procedure 6 weeks later, I had no further pain of any                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
101030 -        kind for nearly 15 years running and playing tennis.  Exercise                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
101031 -        finally caused problems addressed with a second surgery in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
101032 -        1988, and then again there was no further pain for over 10                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
101033 -        years.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
101035 -         ..
101036 -   15.  Your history of continuing pain 3 - 4 months after surgery on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
101037 -        120322, requires close scrutiny for diagnosis and resolution of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
101038 -        complications caused by surgery.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
101040 -         ..
101041 -   16.  Please send me a copy of the letter to Lawler's office                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
101042 -        requesting your medical chart.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
101043 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101050 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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101055 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101056 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101057 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
101058 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
1011 -