CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up
040502 -
040503 -
040504 -
040505 -
040507 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Agenda...
040902 -
040903 - 1. Report favorable response to treatment on 170404 0800.
040904 - ref SDS 7 GX4F
040906 - ..
040907 - Significant metric - no vomiting.
040909 - ..
040910 - Taking Ensure after 1st Pantoprazole pill in morning, since
040911 - normally do not eat breakfast, re-ordered by Doctor Lee on
040912 - 170301 1200, ref SDS 5 AN5M, and orginally ordered on 161115
040913 - 0800. ref SDS 4 TG68
040915 - ..
040916 - Baking soda none for 2 months - a record.
040918 - ..
040919 - Diet continues mild with minimal meat, and care to cut things
040920 - into small pieces, chew well, and drink liquids generously with
040921 - each bite, see beginning on 170404 case study in, 160101 0700,
040922 - ref SDS 2 L56I
040924 - ..
040925 - Human interest - at VAMCSF on Monday. Met briefly with the
040926 - Chief of Diet and Nutriton Department. She was pleased hearing
040927 - Helen was instrumental prescribing Ensure for the patient to
040928 - have sufficient nutrition for heart surgery to heal, while
040929 - unable to swallow food until 3 months later, when Doctor
040930 - Stewart performed Heller Myotomy surgery.
040931 -
040932 -
040934 - ..
040935 - 2. Good news
040936 -
040937 - Orthopedics reported MRI last week shows right foot sustained
040938 - only mild right foot plantar plate tear, and so patient can
040939 - resume normal hiking with specialized Plantarflexion taping.
040940 - Made referral to Phyiscal Therapy to perform Plantarflexion
040941 - taping, scheduled to begin next week.
040943 - ..
040944 - Favorable Orthopedic findings and remedy are just in time to
040945 - recover from Cardiology findings that HDL 72 dropped to 54 over
040946 - just 2 months not hiking to recover plantar plate tear.
040947 -
040949 - ..
040950 - 3. Report on stroke symptoms following EGD on 160617?
040951 -
040952 - Doctor Lee advised during the meeting on 170404, the report for
040953 - EGD on 160617 has been completed. ref SDS 7 Y68M Need to
040954 - consider recommendations on drugs for conscious sedation.
040956 - ..
040957 - Why did procedure on 160617 take 30 minutes, when all the
040958 - procedures typically take 15 minutes? Was this a training
040959 - situation, where folks lost track of time?
040961 - ..
040962 - Versed - at heart of controversey in Supreme Court rulings on
040963 - issuing stays of executinon Arkansas in natonal new on 170418.
040964 - Evidently convicts are worried versed does not sedate prisoners
040965 - sufficiently to avoid "discomfort" when lethal drugs are
040966 - injected.
040968 - ..
040969 - What implications for trying Versed 4 ml, rather than 5 ml,
040970 - which is only 1 ml below 6 ml when stroke symptoms occurred.
040972 - ..
040973 - If procedure runs longer, can patient merely begin to wake
040974 - since there is no medical harm doing the procedure with the
040975 - patient awake, as done on 101210 0930. ref SDS 1 BE7K
040976 -
040977 -
040979 - ..
040980 - 4. PPI reduce dose to lower blood pressure and frequent
040981 - urination.
040983 - ..
040984 - Report Doctor Lee requested on 170301 showing correlation
040985 - between PPI and contraction of LESV. 170331 1400, ref SDS 6
040986 - X05J Study was completed on 170331 1400. ref SDS 6 MN7I
040987 -
040988 - F:\05\00003\SM\CC\CHMG\FNGC\CJGK\achalasia_meds_lesv.xlsx
040990 - ..
040991 - On 170411, Doctor Stewart made referral to Urology to evaluate
040992 - for prostrate issues, as Doctor Lee requested during the
040993 - meeting on 170411 1330. ref SDS 8 T44O
040995 - ..
040996 - On 170412 Doctor Simpson worried blood pressure rising too high
040997 - caused by high levels PPI. He proposed adding new pills to
040998 - solve problem taking PPI pills that raise blood pressure,
040999 - reported on 170412 1000. ref SDS 9 GG80
041001 - ..
041002 - Might PPI be reduced to reduce frequent urination and lower
041003 - blood pressure?
041004 -
041006 - ..
041007 - 5. Naproxen to support resume hiking. Right foot plantar plate
041008 - tear hurts. Doctor said patient can hike with plantarflexion
041009 - taping and this will not cause injury to get worse, but it
041010 - will continue to heal slowly. To re
041011 -
041012 -
041013 -
041015 - ..
041016 - 6. EGD dilation on 170516 - in 4 weeks can ulceration toward
041017 - increasing PPI again and ending Naproxen.
041019 - ..
041020 - Alternatively, maintain PPI until EGD on 170516, and assess
041021 - ulceration toward dose reduction.
041022 -
041023 -
041024 -
041026 - ..
041027 - 7. Fundoplication repair reduce reflux so less pills are needed.
041028 -
041029 - Doctor Stewart reported patients have very favorable results
041030 - following fundoplication with gastroscope, however only for
041031 - several months.
041033 - ..
041034 - Then fundoplication fails, as occurred in my case after 5
041035 - years, patients want Doctor Stewart to perform laproscopic
041036 - fundoplication, as she did in this case.
041038 - ..
041039 - Is there a difference between re-do fundoplication with
041040 - gastroscope, that might be more durable, than de novo
041041 - fundoplication with gastroscope that worries Doctor Stewart.
041043 - ..
041044 - What has Doctor Lee's research found on prospects for doing
041045 - fundoplicaton with gastroscope to reduce ulceration of LESV in
041046 - order to use less PPI to avoid side effects, discussed on
041047 - 160921 1130. ref SDS 3 I75J
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0411 -