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: September 12, 2017 01:30 PM Tuesday; Rod Welch

VA Doctor Stewart meeting automobile accident reports 3 ribs fractured ordered MRI for fractured neck.

1...Summary/Objective


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CONTACTS 

SUBJECTS
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0403 -    ..
0404 - Summary/Objective                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
0405 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040501 - Follow up ref SDS 13 0000. ref SDS 11 0000.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
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0406 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0407 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0408 - Progress                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
0409 -                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040901 - Met with Doctor Victoria Lyo, Chief Resident.  She is in her 7th year                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040902 - of residency.  Next year she will get fellowship.  Plans to work in                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040903 - Oregon in GI Department.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040908 -  ..
040909 - She will continue with Doctor Stewart for 2 more months.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
040911 -  ..
040912 - She cycled through Trauma Departement, so appreciates objectives of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040913 - meeting today, for comprehrensive review of automobile accident on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040914 - 170905. ref SDS 7 J69I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
040916 -  ..
040917 - Victoria suffered injuries from an autombile accident last February,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040918 - so she has personal experience with this line of care.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040920 -  ..
040921 - She had same experience of sneezing, coughing, and laughing causing                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040922 - severe pain in chest.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040924 -  ..
040925 - Victoria advised that radiology study actually reported 3 fractured                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040926 - ribs.  Two are in the left side chest, and the 3rd is in the back.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040928 -  ..
040929 - Meeting with Doctor Stewart explained pain turning head side to side.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040931 -  ..
040932 - Discussed concussion and loss of memory, reviewed in ER on 170906                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040933 - 1948. ref SDS 9 1X5I                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040935 -  ..
040936 - Doctor Stewart ordered MRI of neck to check for fractures from severe                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040937 - whiplash.  She feels further inquiry is prudent for collision at 65                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040938 - MPH striking the ground and tumbling several times, and based on pain                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040939 - turning head side-to-side now 2 weeks after the injury on 170905 2230,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040940 - ref SDS 7 J69I, further inquiry is prudent.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040942 -  ..
040943 - The doctor asked about injuries to the left leg and left arm.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040945 -  ..
040946 - Explained that yesterday, Lana in Wound Care changed the dressing and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040947 - inspected the big hematoma wound on the lower left leg.  At that time,                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040948 - Lana indicated the wound is healing normally.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     
040950 -  ..
040951 - Doctor Stewart asked Doctor Lyo to cut the dressing off, so they can                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040952 - make another examination.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040954 -  ..
040955 - Showed both doctor's pictures taken during treatment in Wound Care                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040956 - yesterday.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040958 -  ..
040959 - Doctor Stewart then said it is not necessary to remove and replace the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
040960 - dressing again today, since the pictures show clearly the scope of                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040961 - injury.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           
040963 -  ..
040964 - The doctor noted that the large hematoma wound on the lower left leg                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040965 - may require reconstructive surgery, similar to initial planning on                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                
040966 - 151006 1315, ref SDS 3 LJ8N, for prior hematoma wound on lower left                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
040967 - leg that occurred from falling during hike to Half Dome on 150916                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040968 - 0535. ref SDS 1 O87H                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        
040970 -  ..
040971 - As previously, Doctor Stewart wants another meeting in 2 weeks to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
040972 - assess progress recovering from this wound, toward considering                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
040973 - reconstructive surgery solution.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040975 -  ..
040976 - We discussed current schedule meeting Lana on Monday and Thursday to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              
040977 - change dressing.  We can change the meeting with Lana from Monday, to                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
040978 - Tuesday to fit Doctor Stewart's Clinic schedule, so Lana can remove                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               
040979 - the dressing.  They can make joint inspection, and then Lana can                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  
040980 - replace the dressing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
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