CONTACTS
SUBJECTS
Knee Pain Worse Complications Surgery 120322 Evidence MRI Radiology
1003 -
1003 - ..
1004 - Summary/Objective
1005 -
100501 - Follow up ref SDS 22 0000. ref SDS 21 0000.
100502 -
100503 -
100504 -
100505 -
100507 - ..
1006 -
1007 -
1008 - Progress
1009 -
100901 - Case Management Performed without Patient Assistance
100902 - Medical Records No Evidence Ordered from Lawler for 2nd Opinions
100903 -
100904 - Follow up ref SDS 22 MI5I, ref SDS 21 MI5I.
100905 -
100906 - Received letter from Robin saying...
100907 -
100908 - 1. Subject: Re: Driving Directions to SLDC
100909 - Date: Tue, 31 Jul 2012 20:01:48 -0700 (PDT)
100916 - ..
100917 - 2. Thank you again for your suggestions in confronting the doctors
100918 - about my knees. [...responding to the letter yesterday on
100919 - 120730 1420. ref SDS 22 UN4Y...]. My girlfriend, Carol picked
100920 - me up from work today and took me to my appt with Dr Lawler. I
100921 - was Dr Lawler' last patient, an advantage because I got to ask
100922 - him the "list" of questions I had prepared and he was very
100923 - patient and thorough in answering my questions.
100925 - ..
100926 - 3. Bottom line, I have arthritis in both my knees and wear & tear
100927 - of the soft tissue. Dr Lawler said that I didn't need surgery
100928 - on either knee.
100930 - ..
100931 - 4. There isn't a way of gauging from 1 to 10 what level or degree
100932 - my knees are in at present other than ALL people at some point
100933 - will get arthritis at varying degrees.
100935 - ..
100936 - Question for Doctor Lawler is "degree" of degenerative arthritis in
100937 - Robin's knees compared to other patients her age, presented in the
100938 - letter to Robin yesterday on 120730 1420. ref SDS 22 UN4Y
100940 - ..
100941 - Letter from Robin continues...
100942 -
100943 - 5. Dr Lawler said at some point in the distant future I may need
100944 - arthritis medication or arthroplasty.
100945 -
100946 - 6. He said that I MAY need knee replacement in the distant future
100947 - but not way to tell at this point nor do I need it now.
100949 - ..
100950 - What is "arthroplasty?
100952 - ..
100953 - Research on Internet says...
100954 -
100955 - http://en.wikipedia.org/wiki/Arthroplasty
100956 -
100957 - Arthroplasty (literally "surgical repair of joint") is an
100958 - operative procedure of orthopedic surgery performed, in
100959 - which the arthritic or dysfunctional joint surface is
100960 - replaced with something better or by remodeling or
100961 - realigning the joint by osteotomy or some other procedure.
100963 - ..
100964 - Arthroplasty seems to be another term for knee replacement.
100966 - ..
100967 - Letter from Robin continues...
100969 - ..
100970 - 7. He emphasized the importance of exercise to strengthen the
100971 - muscles around the knee, thigh muscles to support and take
100972 - stress off the knees. Of course no impact exercises.
100974 - ..
100975 - Robin does not mention discussion with Doctor Lawler about getting
100976 - more physical therapy planned in the letter to Robin yesterday and
100977 - including increased exercise to strengthen muscles that protect the
100978 - knee, reported on 120730 1420. ref SDS 22 UN6W
100980 - ..
100981 - Letter from Robin continues...
100982 -
100983 - 8. Dr Lawler is familiar with prolotherapy but doesn't believe it
100984 - works or would not endorse it, not recognized by the FDA, an
100985 - alternative treatment with no proof that it really works. Dr
100986 - Lawler said there are risks such as infection, solution side
100987 - effects and injecting in areas to where an adverse effect could
100988 - result.
100990 - ..
100991 - References issue in letter to Robin yesterday, and does not address
100992 - question of Doctor Lawler having treated patients who have received
100993 - prolotherapy, reported in the record on 120730 1420. ref SDS 22 UN5U
100995 - ..
100996 - Letter from Robin continues...
100997 -
100998 - 9. Dr Lawler did say that the burning I felt alongside the outside
100999 - of my knee very well could be the nerve that runs along that
101000 - area, sciatica nerve.
101002 - ..
101003 - Robin does not report that Doctor Lawler attributed continuing pain in
101004 - the right knee since surgery on 120322, due to neck and spine
101005 - disorders that cause pain in the leg and knee, called sciatica; nor
101006 - that Doctor Lawler made referral for care, planned for meeting with
101007 - Doctor Lawler in the letter to Robin on 120730 1420. ref SDS 22 UN7P
101009 - ..
101010 - Letter from Robin continues...
101011 -
101012 - 10. Also, told me that there are NOT new tears in my right knee,
101013 - that the post op MRI shows more clearly the edges of the soft
101014 - tissue and those are frayed edges NOT tears.
101016 - ..
101017 - This repeats prior reporting on Doctor Lawler disagreeing with
101018 - radiology interpretation of findings from MRI on 120717, as reported
101019 - by Robin on
101021 - ..
101022 - 11. Dr Lawler said the radiologist just READS and is not
101023 - experienced in the field of orthopedics, surgical procedures,
101024 - pre-op, post-op changes etc, shouldn't be giving his opinion
101025 - and scare the patient, being "me", yours truly.
101027 - ..
101028 - Letter to Robin recommended not mentioning discussions with Doctor
101029 - Vernacchia, the radiologist, reported on 120730 1420, ref SDS 22 UN6T;
101030 - so hopefully, Doctor Lawler is saying that radiology analysis reported
101031 - incorrectly finding 2 new "tears" in MRI test for the right knee on
101032 - 120717, as shown in the record on 120726 0753. ref SDS 18 PB3M
101033 -
101034 - [On 120802 1545 Doctor Schueckler, orthopedic surgeon,
101035 - 2nd opinion post-op examination finding bulging cyst on
101036 - patients right knee, ref SDS 23 MS38, and relates
101037 - causation from build up of fluid likely generated by the
101038 - body to protect against 2 tears in the right knee,
101039 - reported in follow up MRI on 120717. ref SDS 23 4T5N
101041 - ..
101042 - Letter from Robin continues...
101043 -
101044 - 12. Dr Lawler said too, that symptoms of arthritis, swelling etc
101045 - doesn't contribute to the tissue deteriorating, just a symptom.
101047 - ..
101048 - This representation seems conflicting with diagnosis of degenerative
101049 - arthritis.
101051 - ..
101052 - 13. Also, encouraged me to not worry that my knees are going to
101053 - burst, break but to strengthen the muscles.
101055 - ..
101056 - 14. In regard to taking gluclosimine he said no problem but there
101057 - isn't any proof that it makes a difference. He said to take it
101058 - for three months and go off of it and see if I feel a
101059 - difference.
101061 - ..
101062 - 15. Dr Lawler himself said he has arthritis in his knees and has
101063 - ceased being a runner, said it is the bodies sign of wear and
101064 - tear, aging.
101066 - ..
101067 - 16. I am relieved by all that Dr Lawler said, told me. I was very
101068 - worried that he was going to tell me that I would soon be a
101069 - candidate for knee replacement and he did my co-worker. I too
101070 - am very encouraged by your experience that you have overcome
101071 - the weakness in your knee with exercise and have avoided knee
101072 - replacement surgery, yay!!
101074 - ..
101075 - 17. I did get my MRI films from Lawler to take to the appointment
101076 - with Dr Schueckler this Thurs. Basically, I just want to go
101077 - to Dr Schueckler to get his opinion, what he says when he
101078 - looks at the MRI and reads my reports.
101080 - ..
101081 - 18. I'm not going to obtain progress notes, operative report etc
101082 - because if Dr Schueckler wants them he may obtain them after I
101083 - see him Thursday. There isn't time for him to review/look at
101084 - them before Thursday anyway.
101086 - ..
101087 - 19. I will appreciate your support in being there with me so I can
101088 - handle hearing, listening to what Dr Schueckler has to say.
101090 - ..
101091 - 20. I'm not expecting a completely opposite opinion but then I've
101092 - never met Dr Schueckler and depending on his take and how he
101093 - expresses what he thinks I may have difficulty hearing it more
101094 - so if I was alone.
101096 - ..
101097 - 21. I canceled my appointment with Dr Fow. After speaking with Dr
101098 - Vernacchia and a couple other people in the medical field, I
101099 - was advised that a second opinion is customary, not a 3rd, 4th
101100 - etc.. Too, my insurance only covers a 2nd opinion.
101102 - ..
101103 - 22. Dr Lawler is a highly esteemed orthopedic. Two people I work
101104 - with have had knee surgery by Dr Lawler and rave about him in
101105 - addition to others because of his reputation.
101107 - ..
101108 - 23. I'm uncertain about the prolotherapy, southern cal doctor so
101109 - will research further before I decide that I want to see Dr.
101110 - Darrow.
101112 - ..
101113 - 24. Oh, yes, there is parking where I work, ground level. San Luis
101114 - Diagnostic Center is on the corner of Monterey and Santa Rosa,
101115 - Shell gas station is across the street. I will come down, meet
101116 - you in the parking area 3ish ok:)
101118 - ..
101119 - 25. I hope you aren't disappointed in my lack of readiness for the
101120 - Schueckler appointment but I just want to get a second opinion
101121 - about what he sees on the MRI' and reports.
101123 - ..
101124 - 26. After the appointment, should Dr Schueckler decide to obtain
101125 - additional records, he may do so and I will follow up at a
101126 - later date. All of this is stressful and zaps my energy so
101127 - basically I just want to see how Dr Schueckler approaches my
101128 - condition.
101130 - ..
101131 - 27. I realize your time is valuable too and don't want you to feel
101132 - like you may be wasting a trip if I'm not prepared well. I do
101133 - appreciate your time and your sincere intentions in helping me
101134 - make the most of this appointment.
101136 - ..
101137 - 28. Yikes! its almost 8, gotta go to the gym, ride the bike!
101138 -
101154 -
101155 -
101156 -
101157 -
101158 -
101159 -
101160 -
101161 -
101162 -
101163 -
101164 -
101165 -
101166 -
101167 -
101168 -
101169 -
1012 -