CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 6 0000. ref SDS 5 0000.
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Background on 160617 experienced stroke symptoms of left side vision
040902 - and motor control deficits after EGD dilation performed in GI Clinic
040903 - at VA Medical Center in Sacramento. ref SDS 3 5F6F On 161213
040904 - experienced severely contracted eye pupil after EGD dilation at GI
040905 - Clinic in Sacramento. ref SDS 4 R74J On 161215 Doctor Lee made
040906 - referral at Eye Department VA Clinic in Martinez. ref SDS 5 X15C
040908 - ..
040909 - On 161221 1104 received call from Anthony in Eye Clinic at VA Clinic
040910 - in Martinez; scheduled meeting with optimitrist ordered by Doctor
040911 - Marguiles, and on 170104 0900. ref SDS 6 M65I
040913 - ..
040914 - Today, met with Doctor Puckett.
040916 - ..
040917 - The doctor asked about objectives for the examination today?
040919 - ..
040920 - Related background, per above. ref SDS 0 M65I During meeting with
040921 - Doctor Lee in the GI Clinic on 161215, he seemed to say an eye
040922 - examination is needed to clear the patient for the next procedure,
040923 - because eye problems can impact conscious sedation. ref SDS 5 X23J
040925 - ..
040926 - Doctor Puckett asked when the next EGD procedure is scheduled?
040928 - ..
040929 - Advised there is a procedure scheduled on 170106, this Friday at
040930 - 1200.
040932 - ..
040933 - The doctor performed similar vision examination and tests done
040934 - previously by Doctor Margulies reported on 070221 0819. ref SDS 2 5D6G
040936 - ..
040937 - He found the patient qualifies for glasses to aid distance vision.
040938 - This was clarified in that patient vision could be improved with 2
040939 - sets of glasses - one for distance, and another for reading. The
040940 - decision to use glasses is personal, based performing normal daily
040941 - tasks. The doctor clarified that in this case glasses are not a
040942 - medical requirement, but a patient choice, because patient vision is
040943 - adequate for normal daily functionality.
040945 - ..
040946 - Doctor Puckett found "suspect" glaucoma due to indented optic nerve
040947 - from elevated pressure. He said this could be normal in this case,
040948 - and noted the same condition was observed during examination on
040949 - 060526, ref SDS 1 VU4W, and subsequently found by Doctor Margulies,
040950 - reported a year later on 070221 0819. ref SDS 2 Y24N The doctor said
040951 - that over the ensuing 11 years, there has been no progression. He
040952 - plans to continue monitoring this issue with annual checkups.
040954 - ..
040955 - Seem to have good peripheral vision and no clouding of vision, which
040956 - indicates no symptoms of cateracts nor glaucoma. He seemed to
040957 - advised these conditions can be compounded by steriods taken daily.
040959 - ..
040960 - Related taking Triamcinalone steriod injections 4 - 5 weeks in a row
040961 - prior to events on 161213, when the left pupil contracted with severe
040962 - pain from light. Doctor Puckett seemed to say reaction to steriods
040963 - would not cause contraction of the pupil and pain from sunlight.
040965 - ..
040966 - The doctor further advised examination by the Eye clinic cannot assess
040967 - vision symptoms in this case, which he feels are driven by
040968 - neurological factors.
040970 - ..
040971 - Asked Doctor Puckett to include this in the Progress Notes for
040972 - Doctor Lee to review prior to EGD on Friday, 170106 1200.
040974 - ..
040975 - In the afternoon, called Doctor Puckett to confirm these
040976 - understandings. He again advised that vision issues in this case
040977 - relate to neurology. He will flag his Progress Notes for Doctor Lee
040978 - to be a signatory, and that his computer system will flash notice for
040979 - him to read the Progress Notes in 10 minutes.
040981 - ..
040982 - The doctor applied several medications dropped into both eyes. Waited
040983 - for half an hour. Then another doctor took pictures of eyes.
040985 - ..
040986 - Scheduled return visit to complete eye examination on 170406 0900.
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0410 -