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: January 22, 2013 09:15 AM Tuesday; Rod Welch

VA SF Medical Center ENT meeting voice therapy.

1...Summary/Objective
2...Patient History Esophagus Surgery and EGD Dilations
3...Voice Disorder Medical History and Referral to ENT
4...Vocal Chords Weak Schedule Voice Therapy Correct Disorder


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CONTACTS 

SUBJECTS
Voice Problem Throat Examination No Infection No Virus Larynx No Med                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
2603 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2603 -    ..
2604 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
2605 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
260501 - Follow up ref SDS 23 0000. ref SDS 21 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
260502 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260503 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260504 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260506 -  ..
2606 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2607 - Background                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2608 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
260801 - Patient History Esophagus Surgery and EGD Dilations                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260802 - 
260803 - Follow up ref SDS 23 6E3M, ref SDS 21 0001.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
260804 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260805 - Patient history previously listed on 121016 1302. ref SDS 17 XS62                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
260806 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260807 -     1.  Heller Myotomy plan surgery............... 091030 0810, ref SDS 2 2N4G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260808 -         Resolve achalasia swallowing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260809 -         problem                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260811 -          ..
260812 -     2.  Heller Myotomy surgery.................... 091216 0600, ref SDS 3 KE9U                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260813 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260814 -         Progress notes surgery shown on........... 100928 0706, ref SDS 6 SO4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260815 -         and citing operation report shown in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
260816 -         VA records. ref DRP 1 YX6L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
260817 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260819 -  ..
260820 - Post surgery history...                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
260822 -          ..
260823 -     1.  EGD dilation acid burn on flap............ 100305 1000, ref SDS 4 PR6P                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260824 -         Omeprazole 20 mg prescribed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
260826 -          ..
260827 -     2.  EGD dilation no improvement............... 100827 0738, ref SDS 5 0466                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260828 -         Omeprazole 40 mg prescribed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
260830 -          ..
260831 -         Severe swallowing problems................ 101207 1000, ref SDS 8 WH4N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260833 -          ..
260834 -     3.  EGD dilation wrap appears healthy......... 101210 0930, ref SDS 9 XG6J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260835 -         Omeprazole 80 mg prescribed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
260837 -          ..
260838 -     4.  EGD dilation to size ring finger.......... 110429 1230, ref SDS 10 SS5R                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260839 -         Omeprazole 80 mg prescribed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
260841 -          ..
260842 -     5.  EGD dilation.............................. 110819 0830, ref SDS 11 SRM                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260843 -         Omeprazole 80 mg prescribed                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
260845 -          ..
260846 -         Omperazole 20 mg to lower blood                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
260847 -         pressure.......case study on 101010....... 111201 0744, ref SDS 7 734L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
260849 -          ..
260850 -     6.  EGD dilation 18 mm........................ 120322 1030, ref SDS 12 UH5F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260851 -         Omitted steriod                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
260852 -         Omeprazole 40 mg.......................... 120322 1030, ref SDS 12 B48L                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260854 -          ..
260855 -         Dizzy, peripheral neuropathy.............. 120906 1100, ref SDS 13 I05F                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260856 -         Omperazole 20 mg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
260858 -          ..
260859 -     7.  EGD dilation 9mm to 18 mm................. 120925 0900, ref SDS 14 TJ3N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260860 -         added steriod                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260861 -         Omperazole 40 mg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
260863 -          ..
260864 -     8.  EGD dilation 15 mm to 18 mm............... 130110 0900, ref SDS 25 K37G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260865 -         added steriod                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
260866 -         Omperazole 40 mg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
260867 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260868 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260869 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260870 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
260872 -  ..
2609 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2610 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2611 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
2612 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
261201 - Voice Disorder Medical History and Referral to ENT                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
261202 - 
261203 - Follow up ref SDS 23 3X6L.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
261204 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261205 -     1.  Biopsy EDG Dilation procedure                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261206 -         Doctor Lee VA Sacramento.................. 120925 0900, ref SDS 14 UN6K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261208 -          ..
261209 -     2.  Fluconazole begun to treat exophagus                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
261210 -         infection candida......................... 121004 1529, ref SDS 16 5N3O                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261212 -          ..
261213 -     3.  Meeting CJ and Doctor Stewart review                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
261214 -         surgery options accomplish objectives                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
261215 -         Heller Myotomy surgery to improve                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
261216 -         swallowing without further EGD                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
261217 -         Dilation procedures....................... 121016 1302, ref SDS 17 M68I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261219 -          ..
261220 -     4.  Voice disorder identified during                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
261221 -         examination by CJ......................... 121016 1302, ref SDS 17 AE7K                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261223 -          ..
261224 -     5.  ENT referral by Doctor Stewart............ 121113 1100, ref SDS 20 8K51                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261226 -          ..
261227 -     6.  ENT scheduled meeting 121221.............. 121115 1600, ref SDS 21 4X5H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
261228 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261229 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261230 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
261231 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
2613 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     

SUBJECTS
Voice Disorder Speech Therapy Schedule 130114 Correct Vocal Chords W                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
4303 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
430401 -  ..
430402 - Vocal Chords Weak Schedule Voice Therapy Correct Disorder                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
430403 - 
430404 - Follow up ref SDS 23 LS6W.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
430405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430406 - Meeting changed from 130114 to 130122 in call with Trish on 121226                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
430407 - 0742. ref SDS 24 0I4G                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       
430409 -  ..
430410 - Meeting changed again from 130122 0800 to 0915. 130114 1619,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
430411 - ref SDS 26 GJ52                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
430412 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430413 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430414 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430415 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430416 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430417 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430418 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430419 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430420 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430421 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
430422 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   
4305 -