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: October 4, 2012 03:29 PM Thursday; Rod Welch

Fluconazole received from VA to treat esophagitis candidias infection.

1...Summary/Objective
2...Fluconazole Medication Prescription Recover Esophageal Infection Candidias


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CONTACTS 

SUBJECTS
VA Pharmacy Receive Fluconazole 200 mg RX # 24199285 Treat Esophagea                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2603 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2603 -    ..
2604 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2605 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
260501 - Follow up ref SDS 77 0000. ref SDS 76 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
260502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260505 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260506 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260508 -  ..
2606 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2607 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2608 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2609 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
260901 - EGD on 101210, seems to show progress recovering from esophagitis; the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
260902 - doctor dilated the LESV from 11 to 14 cm, reported on 101210 0930,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
260903 - ref SDS 49 XG6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260905 -  ..
260906 - Follow up EGD planned for February, ref SDS 49 L94L.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
260908 -  ..
260909 - Doctor Lee prescribed doubling dose of Omeprazole to increse recover                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260910 - from esophagitis, reported on 101210 0930. ref SDS 49 ZN4M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
260912 -  ..
260913 - On 101216 appears Doctor Lee ordered refill for omeprazole. ref SDS 51                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
260914 - 8785                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260916 -  ..
260917 - On 110320 0750 ordered refill Omeprazole to treat Achalasia,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
260918 - ref SDS 58 5N3O,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
260920 -  ..
260921 - On 110626 0721 ordered refill Omeprazole to treat Achalasia.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
260922 - ref SDS 62 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260924 -  ..
260925 - On 110913 2238 ordered refill Omeprazole to treat Achalasia,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
260926 - ref SDS 63 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260928 -  ..
260929 - On 120326 1549 ordered refill Omeprazole to treat Achalasia,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
260930 - ref SDS 68 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260932 -  ..
260933 - On 120330 1439 received refill Omeprazole to treat Achalasia.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
260934 - ref SDS 69 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260936 -  ..
260937 - On 120906 1100 Doctor Egan reduced dose Omeprazole 20 mg from 40 mg,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260938 - which increased effective treatments with current prescription.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260939 - ref SDS 72 W165                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260941 -  ..
260942 - On 120925 1300 Doctor Lee increased dose Omeprazole 40 mg from 20 mg,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260943 - which decreases effective treatments under current prescription.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
260944 - ref SDS 73 K37G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260946 -  ..
260947 - On 120927 1214 could not order refill prescription for Omeprazole.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
260948 - ref SDS 74 3Z4M                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260950 -  ..
260951 - On 121001 0820 VA ordered new prescription Omeprazole with 3 remaining                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
260952 - refills, ref SDS 76 5N3O, VA also ordered Fluconazole 200 mg, which is                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
260953 - not explained in the record, ref SDS 76 EO5H, and further which                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260954 - increases side effects for Rosuvastatin, ref SDS 76 0450, but on plus                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
260955 - side Fluconazole resolves electrolytes abnormalites, in this case                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
260956 - Total Bilirubin is nearly 100% over healthy range, causing peripheral                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260957 - neuropathy. ref SDS 76 ZH6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
260959 -  ..
260960 - On 121003 1438 received in the mail Omeprazole with incorrect dose                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
260961 - prescription. ref SDS 77 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
260962 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260963 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260964 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260965 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260967 -  ..
2610 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2611 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2612 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2613 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
261301 - Fluconazole Medication Prescription Recover Esophageal Infection Candidias                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
261302 - 
261303 - Follow up ref SDS 77 5N3O, ref SDS 76 5N3O.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
261304 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261305 - Received in the mail today prescription reported in the record                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
261306 - reviewing VA Pharmacy on 121001 0820. ref SDS 76 NI3L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
261307 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261308 -    1.  Sacramento VA Center 119                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261309 -        Mather, CA  96566                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
261310 -        866 600 8279                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
261311 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261312 -        ..12A4                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
261313 -        Provider........................Lee, Randle E                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
261315 -         ..
261316 -        RX # 24199285                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
261318 -         ..
261319 -        Date............................ SEP 29 2012                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
261321 -         ..
261322 -        Take 2 tablets by mouth once daily for 1 day, then take 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
261323 -        tablet once daily for 20 days for esophageous infection.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261325 -         ..
261326 -        9219/3110751                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
261328 -         ..
261329 -        Discard after................... 10/01/2013                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
261331 -         ..
261332 -        Quantity........................ 22                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
261334 -         ..
261335 -        Refill 3x....................... 09/29/2013                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
261337 -         ..
261338 -        Fill 1 of 1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
261340 -         ..
261341 -        Fluconazole 200 mg tablets                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
261343 -  ..
261344 - Began treatment today, as shown in case study on 101010 0744.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
261345 - ref SDS 46 1W9L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261346 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261347 -            [On 121016 1302 Fluconazole may be causing voice disorder                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
261348 -            reported in meeting at VA with CJ and Doctor Stewart,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
261349 -            ref SDS 78 AE7K, to review swallowing issue, planned to be                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
261350 -            resolved with Heller Myotomy surgery, reported originally                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
261351 -            on 091030. ref SDS 15 P69G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
261353 -             ..
261354 -            [On 121024 complete treatment with Fluconazole for Candida                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
261355 -            esophageal infection, shown in case study on 101010 0744                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
261356 -            follow up, ref SDS 46 QQ7K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
261357 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261358 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
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2614 -