CONTACTS
SUBJECTS
VA Notify Injury Hematoma Left Leg Symptoms Worsening Pain Need Crut
1403 -
1403 - ..
1404 - Summary/Objective
1405 -
140501 - Follow up ref SDS 28 0000. ref SDS 15 0000.
140502 -
140503 -
140504 -
140505 -
140507 - ..
1406 -
1407 -
1408 - Progress
1409 -
140901 - Meeting Primary Care VA Examin Injury Right Hip
140902 -
140903 - Follow up ref SDS 28 JN3J, ref SDS 15 499K.
140904 -
140905 - On, ref SDS 29 TS4N, 160504, met Lauren Rettberg, NP PA, in Primary
140906 - Care. Reported loss of balance that caused fall on 160501,
140907 - ref SDS 28 JN3J, shown in case study on 140101 0600. ref SDS 4 O85F
140908 - Lauren performed a neurological test, passed this including Romberg's
140909 - balance test. ref SDS 28 WZ50
140911 - ..
140912 - Lauren appoligized for delay placing the call today at 1200, rather
140913 - than scheduled time of 1100.
140915 - ..
140916 - Agenda....
140917 -
140918 - 1. Drinking more water.
140919 -
140920 - 2. Diet was going well until yesterday.
140922 - ..
140923 - 3. Referral Wound Clinic review acute lower leg wounds and
140924 - prescribe refills on...
140925 -
140926 - 1. Hydrofera Blue Bacteriostatic dressing
140927 - 2. Antiseptic spray
140928 - 3. Silvernitrate compound to advance healing
140929 - 4. Coban self-adhering tape
140930 - 5. Tape Micropore RX #610165 0 Refills
140932 - ..
140933 - Lauren tried to order above supplies. She said there is a
140934 - restriction.
140936 - ..
140937 - Problem to solve is developing dressing with effective supplies for
140938 - healing and preventing further injuries wearing Hoka Stinson 3 shoes,
140939 - which are needed to avoid recurrence of metatarsalgia. Hoka stopped
140940 - making the shoes that work, and new model requires special bandaging.
140941 - Doctor Simpson in Cardiology related similar problems, during the
140942 - meeting a week ago on 160504 1000. ref SDS 27 MO91
140944 - ..
140945 - Lauren will make referral to Wound Care Clinic.
140946 -
140948 - ..
140949 - 4. Referral Neurology for...
140950 -
140951 - 1. Order radiology study for calcium crystals (called
140952 - "otoconia") moving from vestibular chamber into one or more
140953 - semicircular canals causing loss of balance due to sway
140954 - that further causes falling, reviewed on 160505 0753,
140955 - ref SDS 29 S43G, and cited in a letter to the medical team
140956 - on 160505 1715. ref SDS 30 J080
140958 - ..
140959 - 2. Perform Sway study using software technology to rate
140960 - balance fitness for routine hiking, e.g., Half Dome.
140962 - ..
140963 - 3. Develop remedies to improve balance fitness, if warranted.
140965 - ..
140966 - Lauren will consult Neurology on making referral to evaluate balance
140967 - problem. If they concur, she will make the referral.
140969 - ..
140970 - If Neurology recommends interim evaluation, Lauren will make referral
140971 - to Gait and Balance PT clinic.
140973 - ..
140974 - She feels qualified to do the head turning maneuver that can sometimes
140975 - dislodge calcified crystals from semicircle canals that may restore
140976 - balance, and avoid further sway/falling problems. She will schedule
140977 - this within next week or so, at soonest opening on her calendar.
140978 -
140979 -
141122 -
141123 -
141124 -
141125 -
141126 -
141127 -