THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rod@welchco.com
S U M M A R Y
DIARY: July 18, 2014 10:17 AM Friday;
Rod Welch
Kathy called on ordering tires and meeting doctor on diagnosis of osteoporosis.
1...Summary/Objective
2...Chair Recliner Rocker Recliner Received
3...Meeting VA Sacramento Request Clarification Medication and triamcinolone
..............
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CONTACTS
SUBJECTS
Chair Recliner Rocker Swivel Receive Vendor Bid New Tires 40000 Mile
0903 -
0903 - ..
0904 - Summary/Objective
0905 -
090501 - Follow up ref SDS 4 0000.
090502 -
090503 -
090504 -
090505 -
090507 - ..
0906 -
0907 -
0908 - Progress
0909 -
090901 - Chair Recliner Rocker Recliner Received
090902 -
090903 - Kathy has received her new chair for the living room. She likes it
090904 - alot, because the foot rest works, correcting the problem with the
090905 - old chair. The swivel feature is also helpful.
090906 -
150509 -
150510 -
150511 -
1506 -
SUBJECTS
Default Null Subject Account for Blank Record
1603 -
160401 - ..
160402 - Meeting VA Sacramento Request Clarification Medication and triamcinolone
160403 -
160404 - Follow up ref SDS 3 5N3O.
160405 -
160406 - Kath will visit Jamie Ward at the front desk of EDG Department for the
160407 - VA in Sacramento, where we visited with Doctor Lee on 140509 0900.
160408 - ref SDS 2 I167
160410 - ..
160411 - She will provide last four of ss for ID, and explain the customer
160412 - tried to refill Doctor Lee's prescription for Omeprazole, because
160413 - there were only 4 days supply taking 2 pills per day, prescribed by
160414 - Doctor Lee on 140509 0900. ref SDS 2 JG4K
160416 - ..
160417 - The VA online computer pharmacy system shows Doctor Lee's prescription
160418 - for Omeprazole is scheduled to be filled on 140725, and provides no
160419 - means for the customer to correct this refill date, reported on 140715
160420 - 1614. ref SDS 3 4Y6N
160422 - ..
160423 - The cusotmer can adjust dose down to just one pill a day. This will
160424 - extend supply to 140723.
160426 - ..
160427 - Since the VA has not submitted the Progress Notes we cannot verify the
160428 - prescription should be 2 pills per day.
160430 - ..
160431 - If Doctor Lee approves switching to 1 pill per day, it would be
160432 - helpful to get the prescription refilled OA 140718, in order to
160433 - maintain continuity of medication.
160435 - ..
160436 - If the customer should be taking 2 pills per day, then timely refill
160437 - is essential, and only the doctor can do this.
160439 - ..
160440 - Additionally, Doctor Lee seemed to report after the EGD procedure on
160441 - 140509, that he omitted the triamcinolone injection. ref SDS 2 I167
160442 - This has caused increased swallowing difficulties shown by rising
160443 - vomitting beginning OA 140712, in case study on 120101 0900.
160444 - ref SDS 1 4E4M
160445 -
160446 -
160447 -
160449 - ..
1605 -
1606 -
1607 - 1135
1608 -
160801 - Kathy called. She was able to speak with a nurse and explain issues.
160802 -
160803 - The nurse said Doctor Lee is in the office today. She will ask him
160804 - to call the customer before close of business.
160805 -
160806 -
160808 - ..
1609 -
1610 -
1611 - 1506
1612 -
161201 - Nurse Lapria.
161202 -
161203 - She related talking to Kathy earlier today, and understanding the
161204 - patient has been taking 1 pill a day, and wants to know if it should
161205 - be increased to 2 pills a day?
161207 - ..
161208 - Lapria was aware there is pending refill scheduled on 140725.
161210 - ..
161211 - Clarified that understood from the meeting on 140509, that the doctor
161212 - ordered 2 pills a day. Since refill is scheduled on 140725, there are
161213 - only enough pills to take 2 a day until 140723. If the doctor
161214 - actually ordered 2 pills per day, and feels that prescription should
161215 - be followed, then the refill should be updated to be issued today, in
161216 - order to arrive before pills run out.
161218 - ..
161219 - Also explained poor results following procedure on 140509, that
161220 - omitted injecting the steriod.
161222 - ..
161223 - There has been increased difficulty swallowing shown by vomitting,
161224 - beginning about 140712, as shown in case study on 120101 0900.
161225 - ref SDS 1 4E4M This occurred previously when triamcinolone steriod
161226 - injections were not performed, shown in case study on 140509 0900.
161227 - ref SDS 2 I167 If the doctor did not omit the steriod, then this is
161228 - occurring despite the injection, and if it was omitted, then it might
161229 - be remedied by reducing the time for the next procedure from 6 months
161230 - back to 4, i.e., next month in August.
161232 - ..
161233 - Lapria will ask the doctor to call back today, if he is in the
161234 - office.
161235 -
161236 - [On 140801 in case study on 120101, Omeprazole not
161237 - delivered, ref SDS 1 F53K; aligns with prior delays getting
161238 - Omeprazole refill issued by VA on 140725, reported on
161239 - 140715 1614, ref SDS 3 4O6H, and prescribed on 140509, to
161240 - take 2 pills a day for achalasia - relieve acid burn that
161241 - inflames LESV, ref SDS 2 JG4K, confirmed Progress Notes.
161242 - ref SDS 2 P43G Call to VA on 140718 to expedite delivery
161243 - asked if necessary to continue taking pills when supply
161244 - runs out. ref SDS 0 U76M
161246 - ..
161247 - [On 140802 1821 received Omeprazole refill from VA.
161248 - ref SDS 5 5N3O Resume taking 2 pills per day, shown in
161249 - case study on 120101. ref SDS 1 5F6M
161251 - ..
161252 - [On 140810 1839 letter to Doctor Lee requesting EGD
161253 - dilation with triamcinolone injection soonest, if
161254 - cancellation occurs; but, not an emergency, ref SDS 6 W83K,
161255 - based on history rising vomitting swallowing problems,
161256 - shown in patient history case study on 120101, beginning
161257 - 140712. ref SDS 1 4E4M
161259 - ..
161260 - [On 140814 2227 agenda meeting with Primary Care requesting
161261 - referral to advance EGD dilation for resolving increased
161262 - swallowing problems. ref SDS 7 K059
161264 - ..
161265 - [On 140819 0800 during meeting at VA Primary Care Clinic in
161266 - Martinez, Doctor Sandhu indicated Doctor Lee at VA Medical
161267 - Center in Sacramento will be notified about rising
161268 - achalasia symptoms for consideration to advance EGD
161269 - dilation procedure. ref SDS 8 EX78
161270 -
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1613 -