041310 - ..
041311 - Used medical scissors received from Lana, to remove existing gauze
041312 - bandage. The Enluxtra wound dressing, which Lana applied yesterday on
041313 - 150928 0900, ref SDS 3 XI5O, came loose easily. Set it on the work
041314 - table. It shows considerable absorbtion of flow from the wound, and
041315 - even from the perimeter mark Lana made around the wound to identify
041316 - excessive undermining of the wound...
041317 -
041318 - 
041320 - ..
041321 - There is no evidence the wound leaked through the Enluxtra bandage, as
041322 - occurred with the Meplix bandage placed on 150925 0336, ref SDS 2
041323 - IA6M, and which Lana removed yesterday on 150928, shown in the picture
041324 - of the same bandage the day before on 150927...
041325 -
041326 - 
041328 - ..
041329 - Wound today seems better today. Looks like less infection, dead skin,
041330 - and inflammation...
041331 -
041332 - 
041333 -
041334 - ...compared to the wound yesterday in Lana's office at the VA...
041335 -
041336 - 
041338 - ..
041339 - Was able to place the Enluxtra wound dressing in position while
041340 - wrapping with elastic gauze bandage, demonstrated by Lana yesterday.
041341 - Wrapped the bandage tight at the bottom, as instructed. Held it in
041342 - place with 2 strips of tape, and than wrapped a single strip of tape
041343 - all the way around the leg. Placed the elastic tubbing over the leg
041344 - to further secure the bandage, as explained in the record yesterday on
041345 - 150928 0900. ref SDS 3 M28H Took a picture to show final result of
041346 - wound dressing...
041348 - ..
041349 - 
041351 - ..
041352 - This all went well.
041353 -
041354 - [On 150930 0737 changed Enluxtra pad again covering
041355 - Hydrofera Blue Tunnel dressing, as instructed. ref SDS 4
041356 - VT6K
041357 -
041358 -
041359 -
041361 - ..
0414 -
0415 -
0416 - 1321
0417 -
041701 - Amelia called with VA discharge department, following up call on
041702 - 150925 0336. ref SDS 2 GX5M
041704 - ..
041705 - She asked if we still need home nurse support?
041707 - ..
041708 - Explained the new bandaging system Christy Burns applied, late Friday
041709 - afternoon, does not require home care, reported on 150925 0336.
041710 - ref SDS 2 LZ3M
041712 - ..
041713 - Reported meeting with Lana yesterday in the VA Wound Care clinic,
041714 - when Lana changed the wound dressing again.
041716 - ..
041717 - Amelia asked about home care to change the bandage today?
041719 - ..
041720 - Explained this was done earlier today with self-care, and went well,
041721 - because only the bandage needed to be changed, and not wound packing,
041722 - explained above. ref SDS 0 VT6K Advised that on Thursday, 151001,
041723 - Lana in VA Medical Center Wound Care Clinic Module 2 in San Francisco,
041724 - will change wound packing and bandaging. Lana will assess need for
041725 - referral back to Surgery Department, if healing is not progressing,
041726 - as explained in the letter to the medical team on
041728 - ..
041729 - Amillia was pleased that Home Care is not required.
041730 -
041731 -
041733 - ..
0418 -
0419 -
0420 - 1348
0421 -
042101 - Laura called. She is another of Doctor Rao's nurse aids, and is
042102 - following up the call from Cassandra yesterday on
042104 - ..
042105 - Laura confirmed that medications should have been provided for 7 days
042106 - of treatment at home. This aligns with understandings from Cassandra,
042107 - in Doctor Rao's office, when she called yesterday.
042109 - ..
042110 - Laura asked when the last time medications were taken?
042112 - ..
042113 - Reviewed the record on medications, diet, vitals and exercise, showing
042114 - last treatment was at 0130 this morning, reported in case study on
042115 - 140101 0600, ref SDS 1 YX3L Therefore, another treatment was
042116 - scheduled for 0730 this morning, and another at 1330, about 20 minutes
042117 - ago. These 2 treatments have been missed.
042119 - ..
042120 - Laura feels that filling the prescription for antibiotic is the most
042121 - critical to avoid rising infection from debridement surgery performed
042122 - last Wednesday on 150925.
042124 - ..
042125 - Laura will try to find source for getting medications to continue
042126 - treatment later today, until Thrusday.
042128 - ..
042129 - Discussed going to local VA Clinic in Martinez? Takes about 15
042130 - minutes to drive there. Laura asked if the VA Clinic has a pharmacy?
042132 - ..
042133 - Advised there is a Pharmacy at the VA Clinic in Martinez. Suggested
042134 - she call Pat or another of Doctor Sandhu's nurses in Primary Care to
042135 - expedite ordering medications at the Pharmacy. Doctor Sandhu has been
042136 - primary care doctor for 10 years. The doctor has had personal medical
042137 - issues in recent months, resulting in my transfer to Doctor Rao in San
042138 - Francisco for Primary Care, however, Doctor Sandhu and his team are
042139 - familiar with my care, and have always been prompt ordering
042140 - medications from the Pharmacy.
042142 - ..
042143 - Laura will invesigate and call back to advise where to get the
042144 - medication.
042146 - ..
042147 - Thanked Laura for timely response to notice yesterday that medications
042148 - provided on Friday, were less than required for the 7 day
042149 - prescription.
042150 -
042151 -
042153 - ..
0422 -
0423 -
0424 - 1417
0425 -
042501 - Laura called back. She said that arranging through the VA bureaucracy
042502 - to get prescription for medication today, from pharmacy at VA Clinic
042503 - in Martinez is too difficult. She will call in a prescription for the
042504 - medication to the CVS Pharmacy at the corner of Treat and Clayton
042505 - road, about a mile away.
042507 - ..
042508 - Laura suggested calling CVS before going there, so the prescription is
042509 - ready. She feels this will take about an hour.
042511 - ..
042512 - Laura will order refill of pain medication for delivery tomorrow or
042513 - Thursday, that will complete the doctor's prescription.
042515 - ..
042516 - Thanked Laura again for assistance.
042517 -
042519 - ..
0426 -
0427 -
0428 - 1600
0429 -
042901 - Called CVS Pharmacy...
042902 -
042903 - 925 676-4700
042905 - ..
042906 - Talked to someone in Pharmacy. Said the order is being prepared, and
042907 - will be ready when I arrive in 15 minutes or so.
042909 - ..
042910 - Drove to CVS Pharmacy down the road at Treat Boulevard and Clayton
042911 - Road.
042913 - ..
042914 - The pharmacist had the order ready.
042916 - ..
042917 - Received invoice...
042919 - ..
042920 - CVS Pharmacy
042921 - 4424 Treat Boulevard
042922 - Concord, CA 94521
042923 - 925 676 4700
042925 - ..
042926 - Date.......................... 150929 1646
042928 - ..
042929 - Reg #......................... 14
042930 - Transaction #................. 7105
042931 - Cashier #..................... 0973469
042932 - STR #......................... 9509
042933 - Some other number............. 2509 5095 2727 1051 46
042934 - Helped by..................... Kimia
042936 - ..
042937 - F 1 RX#....................... 430234
042939 - ..
042940 - Price......................... $40.25
042942 - ..
042943 - Post expense ledger...
042946 -
042947 -
042949 - ..
0430 -
0431 -
0432 - 1646
0433 -
043301 - Returned from CVS Pharmacy.
043303 - ..
043304 - These pills are configured differently from those received from the
043305 - VA on 150925 - they are 300 mg, so prescription is to take 1 every 6
043306 - hours instead of taking 2.
043307 -
043308 -
043310 - ..
0434 -
0435 -
0436 - 1740
0437 -
043701 - Took 1 pill Clindamycin 300 mg. It is a bigger pill, so harder to
043702 - swallow, but seemed to go down okay.
043703 -
043704 -
043705 -
043706 -
043707 -
043708 -
043709 -
043710 -
043711 -
043712 -
0438 -